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Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Why is blood pressure normal in the morning but increases at night?

Hello doctor, My mother's blood pressure is 130/80 in the morning, but by 10 pm before she eats her medicine in the night, her bp becomes 160/80. She is taking calcium channel blockers, which cause swelling in her legs resulting in difficulty in walking. She is currently under, Moxilong 0.3 mg tablet twice. Tazloc 40 twice. Ecosprin AV 75 in the night. Minipress XL 5 mg twice Prolomet XL 50 twice. Dytor 5 and Benidipine 8.

Hello. She is taking lots of medicines but still if BP is raised the possibilities may be, 1. Not reducing salt intake, not following a healthy lifestyle guidelines, and not exercising. 2. Medicines may not be taken appropriately, some over-the-counter medicines such as NSAIDs may raise blood pressure. 3. She is overweight, and as such if BP apparatus cuff bladder is less than 2/3rd of arm circumference, then BP may falsely appear high. 4. Some other disease such as hypothyroidism may be present, leading to secondary hypertension. Serum TSH (thyroid-stimulating hormone) test is advised for that. Please consider these issues while measuring BP.

Q. Kindly suggest the diet to improve my health.

Hello doctor,My height is 165 cm, and my body weight is 79 kg. I want to start doing exercise, and I want to become healthy. I want to know about what diet I must follow to improve my health. How many proteins, carbohydrates, vitamins, minerals, fats do I need to consume daily, and what diet I must take?

Hello. An average man needs 2500 calories to maintain, and 2000 to lose one pound of weight per week. At present, you are overweight BMI is 28.7. You have to reduce, but healthily. Choose whole foods instead of processed food, and avoid sugary drinks. Keep healthy food readily available. Fruits, vegetables, lean meats, fish, eggs, and nuts. Eat more fish than meat. Use whole grain flour in baking recipes and eat in smaller plates. Calculate 2000 calories. That means eating the equivalent of six ounces of grains each day, which includes 2.5 cups of veggies, two cups of fruit, three cups of dairy, and 5.5 ounces of protein-rich foods. Divide your food out over five meals like three slightly larger meals (breakfast, lunch and dinner) and two smaller snacks.

Q. Why does my brain become hot while studying even if I take proper rest?

Hello doctor, I feel that my brain becomes hot while studying. I studied the whole day and slept for two hours continuously for three days after that my left eye started paining, and my brain also started getting hot severely. Still, now it is continuing even if I take proper rest during exam time when I study less also.

Hello. Left eye pain and hot feeling in your head is due to severe mechanical stress to your body because of extreme mental exertion and lack of sleep for three days. As a neurologist, my first advice will be to take some rest and be relaxed and calm. To take rest and enough sleep at least five to six hours in a day is a part of exam preparation. Sleep is a must for better and powerful performance in an exam. It will refuel and restart our brain. Sleep will help to build up and potentiate our memory. So as first advice, please maintain sleep hygiene. And take five to six hours of sound sleep in a calm, cool, and dark room. Take food on time. At present, all your symptoms are due to the same. 1) Take cold water shower. 2) Go to bed and try to sleep. 3) If still, you have problems, you can take medicine to calm down your mind like tablet Etizola (Etizolam) 0.25 mg one tablet immediately. It will give you sleep and calmness. After six hours of sleep with that tablet, you will able to restart your reading, and then you can take if needed.

Q. Which medicine should I take when uric acid level is 8. 5?

Hello doctor, My mother has been diagnosed with 8.5 uric acid and recently underwent a hysterectomy. Which medicine should she take for uric acid?

Hello. High uric acid will require diet modification followed by medical treatment if not controlled by diet. You can start diet modification like, 1. Have adequate fluid intake. 2. Avoid dry fruits, cold drinks, and chocolate. 3. Avoid broccoli, spinach, beans, and non-vegetarian diet. I would highly recommend testing uric acid once again after one month to reassess the uric acid value. As a single high value should not be the basis for starting medical treatment. Because the treatment usually has to be continued for a long period. So begin the diet modification from today, and repeat uric acid after a month, and review again for further advice. As a patient with high uric acid has an increasing tendency to form renal calculi, I will also advise sonography of abdomen and pelvis, if already not done, before the surgery. Uric acid, RFT (renal function test), sonography of abdomen and pelvis. Review after one month with the above mentioned test.

Q. My swelling that has occurred after tooth removal has not subsided. Is it due to dry socket?

Hello doctor,I had my wisdom teeth removed before four days. Even after two days, my swelling has not gone down. I also have mild to moderate pain coming from the site of extraction, that also seems to affect my jaw. My jaw is stiff, and it hurts when I talk too much or move (look down, left, and right). I seem to have bad breath coming from my mouth, but I use salt water rinse every two hours which helps a little, but that odor is still there and seems to be stronger at night when I sleep. Have I formed a dry socket or an infection of some sort? If it helps, I also suffer from a preexisting condition regarding bleeding gums.

Hello. It is due to traumatic extraction and lack of proper precautions taken during tooth removal. It happens either due to wrong injection technique, lack of appropriate stabilization from the jaws, particularly lower jaw. Moreover, the probability of dry socket cannot be ruled. The bad odor is due to infection of the socket. Can you please send further information like a photograph of the tooth or socket or any radiograph? Do you feel numbness in lip or tongue? Are you able to open your mouth correctly? Your inputs will help to address it properly.

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. My eye swelling has not reduced even after using eye drops. Why is it so?

Hello doctor,Before three days, I had a feeling in my eye that there was something in it, probably my eyelash. I tried to get it out with water, but the sensation did not go. After two days, I met a pharmacist who prescribed me an anti-allergy eye drop (containing Antazoline). I have been using it every three hours. However, the first time I used it, and then I woke up with a swollen red eye. Today is the sixth day of use, the redness has reduced, but the swelling is still there. The vision in the affected eye is now blurry along the side with a burning sensation on exposure to sunlight.

Hello. Antazoline is not a drug to be used every three hours, and we as ophthalmologists do not use it much. I would advise you to consult an ophthalmologist because the blurriness that you are now experiencing is more worrying than the swelling of the eyelids and redness of the eye. Please take some high-quality photos of your eye and send them. I will try and help you in the best way possible. Also, provide me with your body temperature.

Q. Why do I have pain in the center part of the stomach below the kidney?

Hello doctor,I have regular pain in the upper center part of the stomach just below the kidney. Please tell me the reason and medicine. Pain arises, especially in the early morning.

Hello. The reason can be gastritis, which is inflammation of the stomach. Please do the mentioned test and use the medicine below until you get the test result. H.Pylori in stools. Gastritis H. Pylori infection. Ranitidine 150 mg one capsule two times per day before food. Avoid chilli food, caffeine, mint, soda drinks, chocolates, and heavy fried food. Until I see the lab results. Give two hours gap before sleep and after eating. Follow-up when you get the lab result and mention whether you are getting improvement on the prescribed medication.

Q. Does polycythemia occur due to smoking?

Hello doctor,I was recently diagnosed with polycythemia due to increased red cell count of 5.28x10^12/L, HCT 0.466, and hemoglobin of 161 g/l. I stopped smoking two weeks ago. Six months ago, when I started to smoke, I smoke only four cigarettes per day. Would the high red cell count be a case of secondary polycythemia, or would it be due to smoking? If so, would my red cell count decrease after a month after I have smoked? Also, in this situation, would I need to take a low dose aspirin before a long haul flight (12 hours)?

Hello, Welcome to the icliniq.com. You have polycythemia. It can be primary or secondary polycythemia. The primary polycythemia is the cancer of bone marrow, which means myeloproliferative neoplasm. However your total WBC count and platelet count within range. So the chance of primary polycythemia less. You have an excess smoking history. Thus smoking can lead to secondary polycythemia, which is a pure benign condition. Smoking can decrease oxygen level in blood and so compensatorily more red blood cells produced. You have to stop smoking to cure your secondary polycythemia. If you stop smoking than gradually your CBC (complete blood count) will be normal. Drink lots of water like two to three liters per day to help in your polycythemia. You may need not to use aspirin as per my opinion. I hope I have answered your question. Let me know if I can assist you further.

Q. Is surgery mandatory for breast cancer after chemotherapy?

Hello doctor, I need a second opinion on getting a surgery done for breast cancer after chemotherapy.

Hello, Welcome to ilciniq.com. There is are multifilament lesion (attachment removed to protect patient identity). I suggest total mastectomy, which is complete removal of the breast. The chances of recurrence will be low in this approach.

Q. Please explain the time taken by a fertilized egg to implant.

Hello doctor, I have a few questions regarding ectopic pregnancy. 1) How long does a fertilized egg stuck and implant itself in a tube? 2) I ovulated on day 15 and felt a sharp pain in the right side (for a moment) on day 24 (8 days post ovulation), is it an ectopic symptom?

Hello. It depends on your period length and regularity that when and how the system will work. If you have regular periods then 14 days before menses you have ovulation, and if fertilization occurs on the ninth day, then you can have implantation at right or wrong place. If one-sided lower abdominal pain occurs after unprotected sex at the end of third or fourth weeks post period with or without bleeding, then it should be reported that you need urgent beta hCG. If positive, then should repeat beta hCG after 48 hours to check its progression to finalize the diagnosis if the pain is not severe. If after a positive pregnancy test for the pain have a transvaginal scan by expertise hands, immediate intervention. Have complete treatment of any health issue you have. Practice daily walk, yoga, and exercise. Have recreational activities and quit recreational drugs. You need to consult for detailed evaluation. Beta hCG twice and transvaginal ultrasound. Mediate detailed evaluation in case of one-sided lower abdominal pain along with positive pregnancy test.

Q. I can see a tar kind of thing when I cough in the morning. Why?

Hello doctor,I am a smoker for the past 10 years. Now reduced from last two to three months. During morning cough I can see tar kind of things after brushing. Why is it so?

Hello. You have been a smoker for 10 years, and I am not sure how many sticks or packs you consume in a day, that may help in quantifying your pack year. Now this cough is productive of dark tar stained mucus. Going by your symptoms and body weight, it seems you have really lost so much weight. I want to know for how long your cough has lasted whether it is more than three weeks or three months. I want to know if you have drenching night sweat, and anorexia that is loss of appetite. Is there any change in your voice like hoarseness, do you have pains in your chest when you cough, any halitosis (smell mouth) difficulty with breathing or any pains with breathing. Do you get breathless on mild or moderate exertion, any dwellings of your feet? Is your fever continuous and not relieved by Paracetamol or Ibuprofen? From all these, based on the history of long years of smoking, and the obvious wasting (weight loss) it is suggestive of a possible COPD (chronic obstructive pulmonary disorder), to rule out malignancy also possible ptb (pulmonary TB). Try and do a sputum microscopy culture and sensitivity, do a chest X-ray, but if you can afford a chest CT scan that will give a better image of your lungs. Do sputum AFB for TB get the results of the test for further review. Chronic bronchitis, pulmonary cancer, TB (tuberculosis), congestive cardiac failure, and bronchiectasis.

Q. What does my FNAC report of breast indicate?

Hello doctor, I am waiting to be booked for what my doctor calls a core-biopsy and it is taking too long. As I wait I would like to research and gain more information. I would like an interpretation of this report please. These are the results of a fine needle aspiration on left breast: The smears are highly cellular. Cohesive branching monolayers of mildly pleomorphic ductal epithelial cells are present in a background containing frequent bare bipolar nuclei, occasional macrophages and some myxoid stroma. Within the epithelial cell aggregates, nuclear streaming and an admixed myoepithelial cell population is revealed. No dissociated malignant cell population or true papillary epithelial cell aggregates with fibrovascular cores are identified.

Hi. This is a picture suggestive of a fibroadenoma. It is not a malignant bump. But, FNAC identifies only the part that has been included in that needle. So to confirm, we do a trucut biopsy which tests the entire lump and is conclusive. 99 % this is a non-cancerous lump.

Q. Is it advisable to undergo super Lasik surgery in a 37-year-old person?

Hello doctor, I am planning to undergo vision correction surgery. I am 37 years old, female, single. My ophthalmologist informed me that I have astigmatism. I am short sighted. My doctor suggested of a super Lasik surgery. Can you please advise if I should go ahead with this surgery? Secondly, what would be the side effects? And the recovering period. The doctor did mention I have a thick cornea and I will recover the same day. But I am not very confident and require your second opinion.

Hello. It is hard to advise you fully not knowing the full refractive status of your eyes and seeing the keratotopgraphy report that you underwent already and must have a report of it, you could upload it here for better evaluation. However, you have to understand that a human eye starts changing its refraction after the age of 40 and will continue to change every five years after that. So you will enjoy the result of this operation for a maximum of five years and then you will start wearing spectacles for near so keep that in mind. The second issue that you might face a new condition, that is if you are not suffering from it before the operation, and that is dry eye for which you still need to use a lubricant at least four times daily for the rest of your life. In summary, the choice is upto you of course but at such an age, I would not advise. If you would like a more decisive advice, please upload the reports.

Q. Pregnancy kit shows positive result but ultrasound shows no pregnancy. Please help.

Hello doctor, My period got delayed by 10 days and after checking with a pregnancy kit, I found out that I am pregnant. But, when underwent sonography, there was no pregnancy. I have not got my periods yet and have vomiting and giddiness. Please help.

Hello. I would suggest you to repeat pregnancy test immediately and if again positive then repeat ultrasound as well to see what is happening and you can start taking Folic acid meanwhile. In the early pregnancies, sometimes sac is not seen and it becomes visible as pregnancy progresses. So, if pregnancy test is still positive then sac must become visible and if pregnancy test becomes negative that means that the previous one could be a false positive one.

Q. I take Olanzapine. Why am I having headache, cramps, nausea, and bad morning sickness?

Hello doctor, I have headache, cramps, nausea, bad morning sickness, back pain, hunger, feel light headed. I am taking Olanzapine and Zyprexa.

Hi. The symptoms that you mentioned are common side-effects of Olanzapine (Zyprexa). Please, do your best to tolerate the side-effects especially in the beginning of therapy (if you just started taking the medicines) as in some situations the side effects decrease in intensity by time. I strongly advise you not to stop this medicine or skip doses as it is extremely important to stick to its dosage and continue to follow up with your doctor.

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. Why am I having extreme bloating, abdominal pain, and fatigue with scaly marks?

Hello doctor, I have been having increased issues with extreme bloating, abdominal pain, fatigue, vomiting a lot of the time, excessive diarrhea, weird tiny patches of scaly marks on my shins, arms, and face. I literally dread eating anything. I am not starving by any means, I have more than enough meat on my bones but eating is worse than feeling pains of hunger. This has been increasing year by year and has been present for about five years now. My PCP is related to stress but I know there is something much more dire going on. I recently did an at home test for food sensitivities and I had reactions to 93 out of 96 foods tested. Does not seem quite right to me and I understand that IgG does not test for allergies. I am highly reactive to citrus as well as baker's yeast. Previously I thought I was having an allergy to the protein found in wheat and I went on and off of a gluten-free diet. I have gone so far as acupuncture to assist with proper digestion because I frequently find myself vomiting up undigested foods at least 7 to 9 hours after consuming them. I am 35 years old, a mother of five and a business owner of three. I do not consume sweets only because I have never taken a liking to them, I do not drink sodas, teas nor do I consume coffee. I also do not consume red meats and I am not a huge fan of vegetables. I have recently regurgitated a pile of blood and every time I eat anything, I am extremely bloated almost immediately. I am getting worried. Please suggest underlying potential issues that I should have tested with my local GP and specialists.

Hi. To help you better, I need to have a look on your blood reports. Please attach them.

Q. Does the CBC report of elevated WBC and platelets mean leukemia?

Hello doctor, About a month ago, I did a CBC for a regular check up. It came back as elevated WBC and platelets. It was 16.3. Neutrophils absolute 11.8, lymph’s absolute 3.5, platelets 402. Everything else was in normal range. I have had it done twice and it stayed about the same. I recently did an abdominal CT scan and it was normal. My doctor is going to do another CBC and if it is still elevated, she is going to send me to a specialist. I am extremely upset and worried. I have no symptoms. Does this mean I more than likely to have leukemia? I am a single mother and I am terrified. Could I please get a response?

Hello. Your platelet count is within normal limit. So do not worry about that. Your total count and neutrophils count is high. But your total count is not high enough to be labelled as leukemia. Usually such high count up to 20000 can be due to infection or any inflammation. So in such case, antibiotic course can be prescribed and repeated CBC after 10 days. However, if you can attach your reports then further comment can be given. Do not directly think about leukemia.In leukemia, total count is very high up to 1 lakh.

Q. I experience on and off acid reflux as well as mild dysphagia. Does it indicate esophageal cancer?

Hello doctor,I am a 26-year-old male. I have been experiencing on and off acid reflux for a few weeks as well as mild dysphagia (strangely only at breakfast). I am afraid of esophageal cancer. I do not smoke and drink. I exercise regularly, and I am not overweight. I have no family history of any cancer. I do suffer from anxiety issues, though, and I have pollen allergies.

Hello. First, I would like to reassure you that dysphagia and reflux symptoms are very common and more common than esophageal cancer. I want to reassure you that this is very unlikely to be esophageal cancer. Esophageal cancer is more common in older patients who have a history of smoking and or alcohol abuse. In patients with reflux symptoms, those symptoms are usually longstanding, and progress to Barrett's esophagus before any cancer develops. I think that you have gastroesophageal reflux and I think your symptoms can be easily managed. 1. Start an over-the-counter reflux medication. I recommend Ranitidine 150 mg every 12 hours. It takes about 30 minutes to start working, and you can take this as soon as you get up in the morning. 2. Make sure to not eat for two to three hours before going to bed. 3. Avoid spicy or acidic foods, especially for breakfast when you complain you have the most symptoms. This would include avoiding ketchup, citric fruit juices, coffee, and tea. Try to eat a very bland diet for the next two to four weeks and see if that improves. Eggs and toast, for example, caffeine can cause acid, and so I recommend avoiding coffee and tea. If you must have it (as I can understand), try to wait until later in the morning and make sure that you have any coffee or tea with food (even just a dry piece of toast). If your symptoms have not improved in one month, you may need to see a gastroenterologist to be evaluated for esophagitis or an ulcer.

Q. I have a short penis and nightfall problem too. Is it normal?

Hello, I am a 25 year old person. I have a short penis. It is only 2-2.5 inches long in flaccid state, but the length and diameter is 4 inches in erect state. I want to increase the size of my penis. Apart from this, I also have nightfall problem which lasts for less than 2 minutes. It will occur 4 to 5 times in a month. I had masturbated a lot during my early ages. I am an unmarried person, going to get married soon. So, will the penis size affect my marriage life? If so, I need a permanent solution for this. Kindly suggest me medications with no side effects to solve this problem.

Hello. I hope, this will help you. Kindly follow up with a sexologist online -->

Q. Does premature ejaculation occur due to masturbation habit?

Hello doctor, I have a premature ejaculation problem. When I am doing foreplay with my girlfriend, it automatically gets ejaculated after four to five minutes. Is it due to my masturbation habit?

Hello. I can understand your concern. I have worked through your attached query in detail. Masturbation is not responsible for your symptoms. Masturbation has no evil effects on your sex life. Premature ejaculation will gradually subside in due course of time. In case if symptoms persist, few medications like Dapoxetine will help. Practicing sex regularly will help to overcome premature ejaculation. Anxiety. Performance anxiety. Premature ejaculation. Tablet Dapoxetine. Increasing foreplay.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. Why am I unable to protest verbally though I can?

Hi doctor, My writing skill is very strong but verbally I cannot protest at all against difficult people. My verbal communication skill is proper and organized if and only if I am focused and conscious at that moment. Otherwise, I tend to be unprofessional and non-intelligent in speaking. Even when a friend illogically shouts over me, I cry over phone and still keep talking in gentle manner. My logic remains in my mind, but I just cannot speak out, which in turn disturbs me later. Sometimes, I get angry by thinking I could not stand verbally for myself at the right time. In the past I was taking Trinicalm plus. What is the problem? I have a feeling that either I am too gentle, less courageous, lack confidence or definitely soft natured and lack mental strength. Please help me.

Hi. Sometimes, it happens because of low self-esteem. Hence, you need to work on it. You need aversion therapy. You do not have to interfere in other's rights but, other side you have to stand for your rights. Do not be very cruel or too innocent, and then people will start teasing you. Remain in between. For some people who are having predicted behavior, you can prepare answer beforehand. So, you will get some self-confidence. Also, do not think too much about others. Forget everybody. Focus on yourself. Remain happy and tension free.

Q. What is the cause for toothache after eating?

Hi doctor, I am a 23 year old female. Few weeks earlier, I had tooth pain after eating. Yesterday, I had acute pain in the tooth. I have attached the OPG scan for your reference. I would like to know, from the OPG, what is your opinion about the extent of decay? And also I would like to know about the possible diagnosis. Thank you.

Hi. Before I answer, I would like to point out a few issues here. You have not mentioned the location of your tooth pain, whether it is on the right or left side. The right and left indicator on the orthopantomograph (OPG) are not visible on the scanned image. So, I am going to describe the findings as I see it. To my right and left, I can see there is decay in two upper molar teeth. Upper third tooth from my right and the upper third tooth from my left.The decay in the upper right first molar appears to be deep. Depending on the symptoms, if you have acute pain that is unchanged, persistent and disturbs your sleep, then the tooth will require root canal treatment (RCT). This is because the nerve of the tooth (pulp) has been involved by the decay. If the RCT is started right away, the tooth can be saved. The decay in the upper left molar tooth is moderately deep and can be filled, if you get it done right away. If delayed, then the decay is likely to progress and involve the nerve of the tooth (pulp), then root canal treatment would be the only option to save the tooth.

Q. My left hip is completely fused. Can we have a healthy baby?

Hi doctor, I have severe ankylosing spondylitis since 19 years. I am a 28 year old male, married and would like to have a baby now. I am taking Indomethacin 75 mg and Omeprazole twice a day. My left hip is completely fused, but I have no pain. There is pain in right hip and lower back. Please let me know, can I have a healthy baby. What should we do to get healthy, fit and fine baby? I do not want baby to be defective. Kindly give me suggestions to improve my health. My wife is completely fine and healthy. I have attached my Hb, CRP and ESR reports. Please guide me.

Hi. Do not worry about your condition and your future baby. You are fine and your baby will also be fine, as genetic transmission is rare in this case. Again you should change the painkiller if you are not responding to it. You can start tablet Rofecoxib 50 mg daily for five days and let me know the condition of your pain. Apply Dolopar gel (Diclofenac) topically. Go for active physiotherapy exercises. Take a capsule Nutrolin B plus (multivitamin) daily for 15 days.

Q. Which tests should I do to check adrenal gland functions?

Hi doctor, I am a 27 year old man and a student of ecological solution. I do a little bit of sport. I eat a balanced diet. I have fatigue and headache when I do anaerobic exercise, and when I read a book. According to my doctor, my average blood pressure is 12.8 or 12.7. All my family members are in good health. My mother's sister has osteoporosis. Reading a book or something else gives me headache and fatigue, so I need to rest after reading something. When I need to read something I must drink a lot of water to be less tired, because if I do not drink a lot of water before reading I need to rest five times more than the usual. Because of this reason, I have stopped my schooling. I got my standard blood test, TSH and lipid test done, I used to do running of one hour by weekend. I want to do home body building like push-up, but I cannot do it like I used to do before. I do not know why my anaerobic capacity has decreased a lot in the last three years. When I do some push-ups or another anaerobic exercise like 100 m speed running, I have really bad results; I take too much time to do this kind of exercise. I am abnormally getting breathless and my heart beats fast. I was not like that before six years, but my physical appearance has not changed. I must drink 1 liter of water 35 minutes before running, if I do not then I cannot even stand for ten minutes. If I drink a lot of water like 1 liter, 40 minutes before, I can do 70 push-ups at the first series, but If I drink only one or two glasses of water 10 minutes before, I cannot do 45 push-ups and my heart begin to beat hard and I am completely breathless and tired. After a running session of 40 minutes to one hour, immediately when I begin to do my legs muscles stretching even if I am completely relaxed and feel good, without any breathlessness also. When I do my stretching my heart begins to beat very fast and hard and I begin to be breathless. Then I must wait and drink water and do my stretching very slowly. I have never felt this before, and I used to work at school with pleasure, read some books and do sport more easily. My wear has a strange smell after sport. It smells something like a rotten wood plank. It is a smooth bad odor not too much aggressive but really unusual. The few doctors I have seen do not know what the source of the problem is, but we found that I do not have a good thermoregulation because I am cold and need a lot of clothes. It seems like I feel better when I am in vasodilation period like under the sun or in a hot place. So, I tried a supplement called Citrulline six months ago, to have more arginine in the body to have a better vasodilation. Indeed, I feel really less tired since I take the Citrulline. I feel like my muscle cells and other tissue are more supplied in something that I need in these cells. Citrulline helped a bit, but it did not resolve the problem. Hope you could help me. Thank you.

Hi. All your clinical problems appear to be related to anaerobic respiration. Based on your query, my opinion is as follows: For respiration, oxygen is most important - Anaerobic respiration mainly occurs because of reduced oxygen. You might require a lung function tests to evaluate for adequate oxygenation. If you are a smoker or exposed to pollution, dust or industrial exposure, it can get affected. Anemia requires evaluation. Hope your hemoglobin level is within normal limits. Get a hemogram done. Anaerobic respiration leads on to lactic acid production. This lactic acid accumulation causes muscle pain and tiredness. Do get your lactic acid accumulation level in blood evaluated before and after the exercise. Lactic acid level requires correlation with possible muscle storage disorders or dystrophies compared to exercise; there may be increased lactic acid production. Hydration would be washing of this lactic acid, which is possibly making you feel better. Meet a biochemist to get yourself tested for lactic acid increase and possible causes. Sweat glands can produce abnormal smell depending on diet. Look into your diet closely. Citrulline produces nitric oxide leading on to vasodilatation. It could be removing some amount of lactic acid or increasing oxygenation, but overall the main cause from lungs to blood and blood to muscle requires identification. Get the tests for hemoglobin level, lung function tests along with oxygen saturation and serum lactic acid. If all are normal, then muscle glycogen storage disorders or muscle biopsy for any pathology maybe necessary.

Q. I am having itching in the penis area. What should I do?

Hello doctor, I have itching in the penis area. Kindly advice.

Hello. Please wash the area with lukewarm water regularly. Use a mild soap. Do not use the same towel in pubic area that which you use elsewhere on the body. Observe clearly if there is any change in color, foul smell, lesions over the penis. Maintain good hygiene down there. Remove pubic hair and keep the area dry. If you are the type who sweats a lot, then use mild antiperspirant talc over the groin area. If the climate where you live is very sultry, and you may need to bath many times daily. Use a different set of clothes every day. Do not use the same clothes again.

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. Why do I get bleeding from the nose frequently?

Hello doctor, I frequently get bleeding from the nose, but it does not create pain. But some times it flows from my nose automatically. What could it be?

Hello. Do you have any medical problems that we should know about? How old are you? Are you exposed to any environmental stimulants (irritating chemicals, etc.)? Most often, a bloody nose is not concerning, but it should be evaluated if it is happening regularly. How much blood is coming out? A teaspoon? Is it always one nostril? You can certainly start using a saline nasal spray three to four times a day in each nostril. You can also put some Vaseline in each nose before you go to sleep at night. However, if there are any other medical problems or anything concerning in your history, as I mentioned above, then you should be evaluated in person. You may need to see an ear, nose, and throat (E.N.T) doctor who can take a look in your nose and see if any blood vessels are prominent and can be treated with cautery. Or you may need to see your general medical doctor and have some blood work done, including a full blood count and platelet levels. Please let me know your answers to my questions, and hopefully, I can direct you further.

Q. I am worried and emotional most of the time. Kindly advice.

Hello doctor, I am constantly worrying about little things and I am emotional most of the time. I feel tired all day. Please advice.

Hello. Generalized anxiety, social anxiety, and related low mood symptoms are quite common in adolescents. It is positive that you are insightful about your symptoms and seeking help. Have an open talk with your parents and trusted family members about your worries and difficulties. It is important not to isolate yourself as it will worsen things. You can practice some self-help interventions to manage your anxiety like, 1) Try progressive muscle relaxation exercises. 2) Deep breathing techniques. 3) Exercise regularly for at least 15-20 minutes daily. 4) Eat healthily and sleep regularly for at least eight hours. 5) Develop some relaxing hobbies like listening to music and watching exciting programs on TV can help to provide a useful distraction. If anxiety is persistent, you can consult a doctor locally and have some counseling or talking therapy to manage your anxious thoughts and develop positive coping strategies.

Q. What is the treatment when TSH is normal but T3 and T4 level are high?

Hello doctor, According to the lab report which was taken a week before TSH level is normal but T3 and T4 level is mildly increased. Please suggest will I be cured with medicine or without medicine. Currently, I am under medication for a chocolate cyst (Dienogest 2 mg).

Hello. I have just read your query, and from what you have mentioned, it appears that you have a normal thyroid function test results. The slightly high T3 and T4 are not a thing to worry because they can be caused by other hormonal medicine that you are taking for your chocolate cyst.You can keep checking your thyroid function test every three months. I hope you find my advice beneficial.

Q. I have Braxton Hicks at 27 weeks. Could I be in preterm?

Hello doctor, I am 27 weeks pregnant and have had Braxton Hicks steady for two days with my back cramping and pressure in my bum and vagina. Could I be in preterm?

Hello. You have not mentioned your gynecological, obstetrics, menstrual and drug history. Have you previously had a normal delivery? If no, then the body prepares itself for normal vaginal delivery in the third trimester. In the first time mother, this process is long as it is happening for the first time. So, it takes more time than mothers who already had labor and normal delivery. Everyone's threshold for pain and body's reaction to late perineal changes in the third trimester and labor are different. Only mild cramps without severe contractions episodic going towards lower pelvis from the back are Braxton Hicks and it does not show labor changes in the cervix. Pressure symptoms, bladder heaviness, and recurrent urine are usual symptoms in the third trimester as the baby is mostly in cephalic presentation and growing size creates pressure in neighboring organs naturally. But precautions are necessary. It is better to differentiate between just Braxton Hicks and labor pains with cervical changes. Preterm delivery having lots of factors like infection, fetal, and maternal anomalies and diseases, rupture membranes, etc. Pain threshold relation to cervical changes is different for everyone. I cannot rule out that back cramping, the pressure in bum and vagina cannot lead to preterm delivery but there are factors behind that also that need to sort out. Otherwise, backache, pressure symptoms, mild labor like pains are normal symptoms in most of the women in late pregnancy. I hope you get my point. If there is a pain in the third trimester, we need to check with baby monitoring and mother's cervical changes with the strength of contractions. I hope u get my point. In case of labor-like frequent contractions, rupture of membranes and reduced fetal movements, you need to report to the hospital for monitoring and examination. For more information consult an obstetrician and gynaecologist online -->

Q. Why does my vaginal opening feel lumpy and a bit swollen?

Hi doctor, I am an 18 year old female. I have noticed that my vaginal opening feels lumpy and possibly a bit swollen, and I am panicking. It does not hurt, and it is not raw or itchy either. Please help me put my mind at ease.

Hi. How are you doing? At this young age of 18 years, I do not see any reason for you to get tensed. Hope I have clarified your query, do write back. All the best. For more information consult an obstetrician and gynaecologist online -->

Q. I have a 4th nerve palsy issue and it scares me. Please help.

Hello doctor, I am a 58-year-old cyclist. I recently started having a strange problem with my vision that started almost a month ago. It was also around the same time I was getting new glasses, but my optometrist said that he does not think the two are related. He referred me to see a neuro-ophthalmologist, and it looks like I have a 4th nerve palsy issue. After reading about it, it is familiar to my recent experiences. No accidents, history of diabetes or other issues. It seems to be my right eye. Looking straight, left and up is fine. The problem comes when looking down (bifocals) or looking right. I also read that blood flow could be an issue. I have been using my inversion table lately more often. I do feel obvious pressure in my eyes using this. Is that an issue? It scares me now, so I put it in the garage. I read this can be idiopathic and can even go away in a few months. Is it true?

Hello. The symptoms you are experiencing can all be in 4th nerve or superior oblique muscle palsy. This muscle acts to stabilize the eye when looking down and is the primary muscle acting while looking down and outwards. Since you mentioned that you do not have diabetes or other systemic illnesses, the cause could be idiopathic. Such idiopathic nerve palsies do have a good chance of improving on their own. The best sign to look for improvement is to see the double images moving closer to each other, and eventually disappear, on the complete resolution. In case you have any further questions or want any additional information, please let me know.

Q. What should I do to treat the constipation in a 2 year old child?

Hello doctor, My baby is 2 years old. For the past four months, she gets constipated. She has to move her bowels daily because if she does not have it more than 24 hours, she will get constipated. We tried changing her milk, but it only made her stools harder. She is currently on similac go and grow. We add water on her milk because she hates drinking water and she is a very picky eater. I use pedia lax to help move her bowels. What should I do?

Hello. Instead of using 30 ml water with each scoop, please add 45 ml water to each scoop for making the formula. Also, reduce the consumption of milk and simultaneously increase the consumption of fruits, vegetables, chicken, etc., whatever the child likes. As of now, you can use laxatives as and when required. However, as soon as a week or two after the above diet changes are made, the need for a laxative should be much lesser than what it is now.

Q. I had frenuloplasty a few days back and my erections are painful. When will it be rectified?

Hello doctor,I am 28 years and 6'1" tall with weight 85 kg. I had frenuloplasty a few days back and feeling normal about it. Sometimes I get erections, and it hurts a lot as the stitches may be the reason. I want to admit that I had a premature ejaculation issue as well before the surgery. Was it because of this short frenulum, and will it be better now? Also, I was unable to penetrate the vagina easily. Will it be rectified? If no what else should I do?Please suggest.

Hello. I can understand your concern about your symptoms. Yes, for a few weeks you will be having pain. The premature ejaculation could be because of the short frenulum, now after the procedure we will know it for sure. If your premature ejaculation persists, we can think of the other causes. Yes, you will be better after surgery with proper foreplay and appropriate lubrication you can easily penetrate since you just had the procedure. We need to wait for the recovery to to think about other cause of your issue and work on it. I hope I have answered your query. If you have further doubts, I would be happy to help you.

Q. I am suffering from stomach cramps and diarrhea. What should I do?

Hello doctor, I am having bad stomach cramps that I can feel through my throat and diarrhea for the past one week. Kindly advice.

Hello, Welcome to ilciniq.com. Please follow the following prescription. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. IBS (irritable bowel syndrome), abdominal flatulence, and diarrhea. Buscopan (Hyoscine ButylBromide) one tablet three times a day. Eucarbon (Charcoal) two tablets three times a day after meals.

Q. Can I have Estrogen tablets for not being lustful and not getting lubricated easily?

Hello doctor,I am 26 years old. I am not being lustful lately and not getting lubricated easily. So I want to ask that is it fine to have Estrogen tablets. Are there any adverse side effects of it?

Hello. I can understand your concern about your symptoms. No, you should not use estrogen tablets without an endocrinologist or a gynecologist review. Decreased lust or libido can be due to, 1. Infections. 2. Diabetes and hypertension. 3. Hormonal disturbances like low testosterone, low levels of thyroid, and high levels of prolactin. 4. Obesity, high cholesterol 5. Chronic disease. 6. Drugs and anxiety. You have to do vaginal examination by a gynecologist to rule out local infection. USG (ultrasound) pelvis to rule out pelvis infection and ovaries and uterus abnormalities. Thyroid check-up Free T3, T4, TSH (thyroid stimulating hormone), and lipid profile to know the cholesterol level. Also check blood pressure, and RBS (random blood sugar). Kindly share more details regarding above reason so that we can work on cause and treatment.

Q. I think the CT abdomen shows some liver problem. Kindly suggest solution.

Hello doctor, I may have a liver problem and would like to get advice. I had done some medical tests recently and the liver turned out to be a bit problematic for me. Hence, thought of consulting a specialist. I am currently blood pressure, blood thinner, cholesterol-reducing drugs, and medicine for thyroid.

Hello. I have gone through your query. Your BP and cholesterol levels seem to be fairly well under control of treatment. Kindly share all your available reports, liver function tests, and details of the symptoms and problem that you are facing at present. Kindly get back with the above details and any other questions if you have further discussion and management.

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. What is the treatment for dandruff, and hairfall associated with tiny itchy balls on my scalp?

Hello doctor,I have dandruff, hair fall, and lately, I saw tiny white balls on my scalp after which my scalp became very itchy. Please tell me how to treat this condition.

Hello. You have seborrheic dermatitis probably. Use the following medications. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Zydip-C lotion (Clotrimazole, Beclomethasone) apply once at night on the scalp. 2. Protar K shampoo (Ketoconazole, Coal tar) three days per week. 3 Tablet Desloratadine 5 mg once at night. Do this for 20 days and avoid hair oil.

Q. My face is swollen. Shall I visit ER or a doctor?

Hello doctor,In the left side of my face right in front of the ear and around the lower back of my ear is swollen. I had a sore throat a few days before, and I have been coughing hard with lots of mucus. I had also swollen a teary, red, and slightly painful left eye, which started, a week before. What is this? Shall I go to the ER or doctor for my swollen face? I already consulted a doctor two days before the swelling and under antibiotics.

Hello. There are multiple reasons for what you suffer from, and your case could be one of them. First, that could be part of the illness, which is acute upper respiratory tract Infection (viral or bacterial, usually viral comes with such symptoms). The swelling could be as part of the disease as well which is swollen lymph nodes located around the ear and nothing to worry about as it is part of the infection that can be confirmed by neck ultrasound scan in all circumstances. I suggest you move to the emergency room for further evaluation and clinical examination. Acute URTI (urinary tract infection), reactionary lymphadenitis. Consult the emergency room for further evaluation.

Q. What should I do for facial warts?

Hi doctor, I am getting facial warts again and again at the same place. I go for swimming every day. Is it because of that? I have undergone laser treatment twice and it went away with it. Now, again I have the same problem. What should I do? Is there anything that I can apply as I do not want to get laser treatment again and again? I have enclosed my picture. Please help me.

Hi. Facial warts occur due to HPV (human papilloma virus) and some people are more susceptible to it due to some complex immunological parameters. They are too notorious to recur and avoid shaving for some time. Also, the probable treatment is electrocautery. Going to the swimming pool will not affect their behavior as you are already infected. But, you should use separate towels to prevent other susceptible person getting infected. For further information consult a dermatologist online -->

Q. What can I do when my penis discharge some fluid when my partner touch or hug me?

Hello doctor,I am 21 years old with weight 58 kg, and height 5'7". My penis size is 6 cm in normal, in erect it is 12 cm. Is this normal? What are the normal sex and ejaculation time? I feel very uncomfortable when I meet my girlfriend or talk with her in the phone about some hot topic because my penis becomes erect when she touch or hug me, and there is a seminal fluid is a discharge. What can I do for these problems?

Hello. I can understand your concern about your symptoms. Many research says the average length of a flaccid penis is 3.61 inches, while the average length of an erect penis is 5.16 inches. Few studies recommended flaccid penis length of less than 1.6 inches or an erect penis of less than three inches should be considered for treatment. Pre-ejaculatory fluid when you are with your partner is normal. Considering your age, you will be fine in a few days. Normal sex time can be from 3 to 20 minutes, depending on the experience and stamina.

Q. Why is there pain in heart in a hypotensive patient?

Hi doctor, I have low blood pressure and am suffering with low pain in the heart for the past two days.

Hi. We define low blood pressure if the reading is lower than 90 mm Hg systolic or 60 mm Hg diastolic or if the patient has symptoms which are lightheadedness, dizziness, fainting, blurred vision or lack of concentration. These symptoms are most prominent when individuals go from the lying or sitting position to the standing position. The causes of low blood pressure could be endocrine problems, dehydration, blood loss, severe infection (septicemia), severe allergic reaction (anaphylaxis), or lack of nutrients in your diet. My advice to you is to eat a diet higher in salt, drink a lot of fluid especially in hot weather and while sick with a viral illness. And for your case, try to measure your blood pressure before and after taking normal saline. If there is no change, you can talk to an endocrine specialist. For more information consult an endocrinologist online -->

Q. I have itchy rashes at the bottom of the ears with negative HIV tests. Do I need another HIV test?

Hello doctor, I had protected sex with a woman. After a few days, I had an itch at the bottom of one of my ears. After 12 days, I done an HIV RNA PCR test and it was negative. After a few days, I had a wart-like bump in the shaft of my penis and body itching. Then after 60 days, I have done HIV duo combo test and it was negative. In these days, I had intense itching with rash similiar at the bottom of both of my ears. After 90 days, I have done the ELISA test, test for hepatitis A and B, herpes, syphilis, chlamydia, and they were negatives. After a few days, I had small itchy red bumps in the body. After 225 days, I done HIV tridot test and it was negative. But the itching in the body with bumps continues. Now I am 314th day after sex. What should I do? Should I go for another HIV test or other STD tests?

Hi, Welcome to icliniq.com. I have gone through the case. In my opinion, if you have no contact history for almost a year then there is no need to repeat all the tests. But first, you need detailed physical examination because there are different types of itchy red bumps and some of these are linked to sex and some are not. So do not go for all tests at once.

Q. Why do I feel weak with low BP and inability to stand properly?

Hello doctor, I am a 27-year-old man. Sometimes, I feel very weak. My BP goes down and I am unable to stand properly. Also, there is a pain in my foot. Please tell me the treatment to cover this type of problem.

Hello. You have two main concerns. The weakness is not due to low blood pressure. The low blood pressure can lead to dizziness and inability to stand as described by you. For that try to maintain hydration with lots of water and whenever you feel dizziness take salted food and fruit juices. You can check your blood sugar level as well. For tiredness, I suggest you investigate with serum potassium, serum sodium estimation, serum TSH (thyroid stimulating hormone) estimation, CBC (complete blood count), liver profile, and kidney profile. You can revert back with reports. For pain in the foot, avoid prolonged standing or walking. It is advisable to investigate with X-ray foot for further work up. You should get checked your serum calcium and vitamin D level as well.

Q. Sometimes, I get palpitations, low BP and low sugar blackouts. Please advise.

Dear doctor, Sometimes I get low BP, low sugar blackouts and palpitations. Please advise.

Hi. Low blood pressure may be due to genetic factors. Do you have a family history of low blood pressure? Hydration and correction of electrolytes might help you. Mix one teaspoon of Electral powder (essential electrolytes) in a glass of water and drink thrice a day for a month. Low blood sugar and blackouts can occur if you do not eat your meals on time. Make sure you eat more frequent smaller meals, once in two hours. Alternatively, you can carry Hypotab tablets that contain a fixed dose of glucose. Pop it in when you feel a blackout coming. Palpitation can occur if your hemoglobin level is low. Include green leafy vegetables in your diet. If your blood counts are not good, you might need a supplement. Get a complete blood count done and get back with the results to a general medicine physician online -->

Q. Can long term usage of Ismo trigger low blood pressure and vertigo?

Hello doctor, I am a 75-year-old male. I had IHD 40 years back. 23 years back, my doctor asked me to add Ismo 10 mg twice a day. Since then, I am taking it twice a day uninterruptedly. Then I was 54 years old. My BP has always been normal in all these years. Maybe 150/80 or 140/90 till a few years back. Now it is in normal level say 120/80, 120/73, 115/70, etc. Since a year, I am experiencing low blood pressure at times, giving me vertigo-like dizziness for 1 hour or 2 only in the early mornings and when I take Vertin, it subsides after 1 or 2 hours. Recently, I went to a well-known cardiologist in my area. He checked me and said that I have systemic hypertension and I need not take Ismo any longer as I do not need it. The BP at that time was 130/70. Before my going to the above cardiologist also I have experienced these levels like 120/70, 110/69, 125/75 likewise. He further said after stoppage of Ismo, the BP levels come to normal levels and I will not experience dizziness anymore. But, I am afraid of stopping the Ismo abruptly for fear of getting an anginal attack, which I have never experienced. I am afraid whether to ask my doctor about this. So, I have stopped taking one dose of Ismo 10 mg during the night. Slowly I shall stop the other doses also in due course. Kindly give me your valuable advice about Ismo, about stopping Ismo and dizziness. Is there any harm if I stop one dose? Does long usage of Ismo trigger low blood pressure and vertigo? Please enlighten me on this subject.

Hello. Firstly, Ismo (Isosorbide Mononitrate) is given for angina or chest pain. If one is not having it without Ismo then it may be stopped. So it is not an absolutely necessary medicine in absence of angina. Next thing, it can cause low BP, and low bp can cause dizziness. But, you mentioned, the lowest BP recorded was 110 systolic, and it is not too low to cause dizziness usually. Have you checked your BP while you being dizzy? So this BP can cause dizziness but not usually. Next thing, you said the response to Vertin (Betahistine), which is not likely in Ismo or hypotension induced dizziness. Vertin is for vertigo induced from the internal ear which is a very common problem. Also, importantly. dizziness induced by hypotension or Ismo will occur on standing or walking, but not while lying down or resting. So if it occurs on lying down as well or on neck movements then it is likely from the internal ear. Next, you should get one echo done to rule out the decrease in heart function as BP is remaining on the lower side. So overall, just go through the above description, and try to decide whether it is Ismo induced or from the internal ear, and you may stop Ismo as advised by the local cardiologist. Also, echo is necessary.

Q. I have low blood pressure. Kindly advise.

Hello doctor, Is low blood pressure of 102/72 anything to worry about?

Hello. No, low blood pressure is not to be worried much but you should take little high protein diet and sodium diet. Keep an active lifestyle and eat lots of fruits and vegetables to maintain good blood pressure and keep away the weakness. Keep getting your blood parameters checked as it is beneficial for one to stay updated with your vital parameters.

Q. My mother has a lump in her breast. Kindly guide.

Hello doctor, My mother found a lump in her breast, which is movable and mildly painful. Then she was suggested for a mammogram, and it resulted as a mass lesion with an irregular margin of 8*10 cm birads v category. We are waiting for the biopsy result. She does not have any symptoms other than a lump, and she is very worried about the issue. Please help.

Hello. Mass of 8*10 cm will most likely be cancerous. If I were your treating doctor, I would first evaluate in detail the extent of the disease, with the help of examination, chest X-ray, ultrasound of the abdomen. Once confirmed that the condition is limited to the breast, her treatment options will involve surgery, chemotherapy, and radiation. These days with advanced techniques, we have high cure rates for breast cancer with minimum side effects.

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. Will foreign bodies cause redness in eyes?

Hello doctor, My eye has become red and is watering, I think a foreign object has entered but I am not able to find it. What should I do? It happened yesterday and icing did not help. Currently, I am under medication for high blood pressure.

Hi. First this to rule out is a foreign body in the eye. For that ask someone to examine your eye with a torchlight and also check the upper lid by everting it because that is the common site for foreign body. Sometimes a very small foreign body cannot be seen with the naked eye and need an eye exam by a doctor. Wash your eye with clean water. If there is no foreign body seen then it is most probably conjunctivitis (that presents with the same symptoms) usually viral conjunctivitis. It usually takes 7-10 days to complete recovery but during this period protect your other eye and other family members because it spreads from one person to another through contact. For symptomatic relief, keep washing your eyes with cold water and do icepacks. That helps to relieve discomfort. Start antibiotic (Moxifloxacin 0.5%) eye drops four times a day to avoid secondary infection. If pain and discomfort are severe consult your nearby eye doctor for a complete eye exam.

Q. What can be done for tender and itchy red spots on hands?

Hello doctor, I have red spots on my hands that started about 10 days ago. I also have a couple of spots on my foot. They are mildly tender and itchy. They have gotten worse but not more that 8 to 10. I have no medical history and do not take any medications daily. I had a cut on my finger from opening a metal box a few days before onset.

Hi. I saw your pictures (attachment removed to protect patient identity). There are multiple erythematous (red) plaques and papules (bumps) on palms, sole, and wrist. Few lesions do look like target lesions. With these features, I can list a few possibilities as follows: May I know your age? Is there any similar rash inside the mouth? Did you have a fever before this rash or in the past one month? Have you used any topical cream? Is it the first episode? Did you take any painkillers, Ibuprofen, Diclofenac in the recent past? Do you have any history of eczema? For more information consult a dermatologist online -->

Q. Kindly tell me the reason for child's skin rashes.

Hello doctor, My son is 5 years old and has developed rashes on face and few on his hands. He has no fever and is fresh playing around. He went out to farm with family and zoo last week, and since yesterday he started developing few rashes. He was having very low fever a couple days back but recovered without medication. My concern is these rashes could be due to any viral or the possibility of allergy? Please suggest any test or treatment.

Hi. Probably may be a viral infection like hand foot and mouth disease. Do not worry. Please give syrup Crocin (250 mg/5 ml), 3 ml SOS, if the temperature is above 100 F. As for the rash, please apply Calamine lotion. It should be better in a few days time.

Q. What causes palpitations and episodes of passing out for a few years?

Hello doctor, I had palpitations and episodes of passing out on and off for a few years. I had blood, ultrasound, and ECG (electrocardiogram) tests done, and so far, I have no answers as what is causing it. Is there anything they can do to help the symptoms at this point or do I have to put up with it and hope they find a cause and treat.

Hello. The probable cause in you is a cardiac arrhythmia. Firstly, were these episodes witnessed by others? And I guess there are tonic clonic movements as seen in seizures. Also, any precipitating events like stress, urination or passing stool, etc., this is to rule out the possibility of vasovagal syncopes. So, considering the likely possibility of cardiac arrhythmia and recurrent syncopes, there is an option of electrophysiological studies which can answer the cause. Otherwise, we will have to wait and watch until the episode of arrhythmia recurs and captured on ILR (implantable loop recorder). But, if you are having symptoms at present and there is nothing on ILR, then it cannot be a cardiac arrhythmia. So, if you are symptoms at present, then ILR should be interrogated, and if asymptomatic, then electrophysiological studies is an option. Otherwise, wait and watch. I hope this helps you and get back if you have any doubts.

Q. Why am I having small red bumps on both sides of the bottom corners of my mouth?

Hello doctor, I have small red bumps on both sides of the bottom corners of my mouth. They look like small pimples, but they are not very bumpy. It seems like it is more just redness in little pimple areas rather than actual bumps like pimples would be. I was given Metronidazole and I used it twice a day for 30 days and it seemed to get a little better at the start, but the problem still persists. I have had this problem for six months and I have scheduled a visit with a dermatologist, but it will not be for a few months. I am not sure if this is relevant, but I work with pig guts, so, maybe I got something from them, but I am not sure since I have been working for almost five months before I got these symptoms. One thing I have noticed is that in the morning it looks like it has improved, but then by the end of the day it looks like it is back to normal. I am not sure what the problem is and am not sure if it can be treated without a prescription, but I am willing to try various things.

Hello. I understand your concern. It seems superficial folliculitis (attachment removed to protect patient identity). In this condition you get small red lesions with yellowish pustules. Use the following medications: Cream T-Bact (Mupirocin). Apply twice a day on the affected areas as well as the nasal vestibules which harbor the bacteria responsible for the recurrence. Do this for 10 days. Take care.

Q. Followed by PMS, my period lasted for only two days. Is it worrisome?

Hi doctor, I am sexually active. But always use protection and double check after to see if the condom broke or not in case we need to take a pill. My period is fairly regular and lasts for 7 days. This time I did experience mild PMS symptoms and stomach cramps prior to onset. My period was five days earlier. And this time, period lasted for only two days but the flow was proper as always. Is there something I need to worry about?

Hello. Firstly, a single episode of early menstruation with normal flow does not qualify for being labeled as a case of polymenorrhea. Secondly, as you have been protected during intercourse, an implantation lasting for two complete days is also unlikely. So, you are pregnancy safe. Thirdly, the early withdrawal is likely to be stress induced hormonal imbalance especially progesterone level during this cycle which caused PMS (premenstrual syndrome) and menstrual cramps in this cycle. So, there is no actual need to be worried. Just maintain a menstrual calendar for next three months to understand the pattern of bleed. If the pattern continues then a hormonal profile and an ultrasound pelvis shall be required. But as of now, no intervention or investigation advised. Just increase your water intake and if not then try yoga and meditation which are great stress busters.

Q. Would vagina close due to psychological reason?

Hi doctor, I noticed that for the past three months, I have had vaginal infection. But, all the tests were negative including vaginal swab and urine, which was done last month. I would like to know whether the vagina closes due to psychological reason. For example, when one do not want to have sex with someone. Please explain.

Hello. It is called as vaginismus. It is muscle spasm causing contraction of vagina. It happens due to various psychological issues. It could be due to guilt of sexual activity and some unconscious unresolved issues. It could also be due to dislike of partner. It needs counseling and medicines.

Q. I have lower back pain. What does my MRI indicate?

Hi doctor, I have lower back pain and right buttock pain. I have consulted a doctor for this, but I am not satisfied with the explanations. I have undergone MRI as per advice and here is the result. Posterior disc bulge with annular tear, moderate to severe stenosis of both neural foramina and mild stenosis of both lateral recesses at L3-L4. Disc desiccation and posterior disc bulge with moderate to severe stenosis of both neural foramina at L4-L5. Posterior disc bulge with mild to moderate stenosis of the left neural foramen, moderate stenosis of the right neural foramen and mild stenosis of the right lateral recess at L5-S1. Straightening of the lumbar lordosis most likely due to muscle spasm. Apparent posterior convexities are noted at C3-C4, C4-C5, C5-C6 and C6-C7. Disc desiccation is seen at C4-C5, C5-C6, and C6-C7. Please guide.

Hello. You have mentioned that you have pain in lower back region with radiation of pain to right buttock region. Along with this, you have also mentioned about your MRI reports (attachments removed to protect patient identity) which show degenerative disc disease at multiple levels. Actually, I need your clinical details after which it can be correlated with MRI images and then I can advise you accordingly. Please tell me in detail the intensity of your back pain on a scale of 1-10. I would like to see your detailed neurological examination if possible that includes assessment of motor power, sensory examination and evaluation of deep tendon reflexes. This can be done either by a qualified physical therapist or an orthopedic or spine surgeon. That will give me an insight on whether there is any compression of nerves, etc. I also want to see your MRI scan and dynamic x-ray anteroposterior and lateral - flexion and extension views of the involved region of spine. This can tell us, whether there is any dynamic instability at the involved region or not. Kindly also enclose any recent blood tests if you have done, your past significant medical history, etc. Once I have this information, I can clinically correlate and let you know the treatment plan. 1. Clinical examination findings. 2. MRI image. 3. Dynamic x-ray.

Q. What can cause weakness in postmenopausal period?

Hi doctor, I have been in menopause for 6 years now. Over three months I have been having bouts of weakness in shoulders, arms and sides of stomach. I feel very weak and strange. I do not feel dizzy. Sometimes it starts with a hot flash. Or else I will stay awake with this terrible feeling and will have hot flash at the end of it. I had CBC. As my symptoms become worse I went to an urgent care and the doctor took 6 vials of blood. He checked many things including EKG, which is normal. My fasting finger prick was 74 and HbA1c 5.6. I have attached the rest of the blood reports.

Hi. I have gone through the details provided by you. All investigations are normal (attachment removed to protect patient identity) such as hemoglobin levels, non-diabetic, with normal resting EKG. So, these are not issue in your case. However, the following are the possibilities. Post menopausal hormone imbalances - You might have increased spurts of estrogen production which are causing the hot flashes. This is common in such menopausal age and requires only mild treatment if there is evidence of the increase. For this, get the following tests done - FSH (follicle stimulating hormone), LH (luteinizing hormone), estradiol and progesterone levels in blood. Hypertension - Get your BP monitored on daily basis at different times of the day and see if there is increase in levels at any point of time. This is again a reason for hot flashes, anger and weakness. It can be cured with mild medicine if found to be present. Check for your thyroid levels. Since you are overweight, there might be a possibility that you are suffering from hypothyroidism. Vitamin D3 levels - this is another reason for general weakness. Now if we go to further serious reasons, then one probability can be TIA (transient ischemic attack), there can be slight loss of blood supply to the brain which might be causing weakness in limbs. I am not sure if this would fit into you as coming to a conclusion requires medical examination which we cannot do online. I would suggest that you send us all reports as mentioned above and also go to a doctor to get full examination done. Only then we can comment on what is the right treatment in your case.

Q. Does the CBC test results of 2 years and 6 months old indicate something serious?

Hello doctor, 2 years and 6 months old with abnormal CBC test results (two tests seven weeks apart). First tested because of enlarged lymph node (only one side) in neck. Node has reduced in size to what appears normal. Low MCHC (just barely outside range of 32.0 to 36.0) 31.3. Low NE % of 26.1 Auto diff with range 43.0 to 65.0, high LY % 62.7 with range 20.5 to 45.5, high EO % 3.9 with range .9 to 2.9. Highly # 6.2 with range of 1.0 to 5.5. What does this indicate? I have read all the horrible possibilities. Is it possible these are indicative of something not serious?

Hello. Your CBC report is suggestive of lymphocytosis (attachment removed to protect patient identity). The common cause for lymphocytosis is viral infection. The enlarged lymph node could be due to that. Now, your enlarged node return to normal size as per history, so suggestive of infective etiology. You might be feared about leukemia like condition. But in blood cancer, total count is very much high like more than 50000. So, it is not suggestive of blood cancer. However, if you have persistent lymphocytosis, then it is advisable to investigate with peripheral smear examination report for further work up. It will be able to help in identifying any abnormal cells, if present like atypical lymphocytes, blast, etc. You can consult your pediatrician for detailed physical examination.

Q. Can ALS cause muscle twitching?

Hello doctor, My bicep muscle has been twitching and my leg and arms muscles twitch occasionally. I am super anxious about ALS. I am 36 and postpartum six weeks but I cannot stop obsessing about ALS. Please help.

Hello. I understand your concern and would explain that there are a lot of other benign causes that may lead to fasciculations like anxiety and insomnia, benign fasciculation syndrome, vitamin D and vitamin B12 deficiency, an electrolyte imbalance or thyroid gland dysfunction. For this reason, I would recommend performing some tests: Complete blood count, blood electrolytes, thyroid hormone levels, vitamin D and vitamin B12 plasma levels. Nerve conduction studies would help to definitely exclude ALS and put your mind to peace. You should discuss with your doctor on the above tests.

Q. I have diabetes with vertigo, RBBB, and constipation. Please help.

Hello doctor, Taking CTD-L 6.25/25 for hypertension and Amaryl MV-1 for diabetes for more than five years. My fasting sugar level is always above 200 on average. Besides this, I have vertigo syndrome, RBBB, severe constipation, and for the last three years itching in lower legs (right leg in winter and left leg in summer). Most of the time I am sitting for my job. My height is 181 cm and weight 110 kg (no change for the last five years).

Hello. After going through short the medical history I want to address some points for you. First important aspect of management of diabetes is diet. That will remain the primary objective for the management of type 2 diabetes across the globe. Please elaborate a little about your basic diet pattern. Second important aspect of management of diabetes is exercise. As you have mentioned your are an accountant and that will make you a less active person during a major time of the day. While on the job and presently in lockdown at home, take small 5-10 minutes of time and walk across the corridor. Start with little things. Then on the third part comes the medicines. You have not mentioned how many times a day you are taking Amaryl MV 1. Please do mention that. Your weight is also more compared to your height, Amaryl can cause a little weight gain also. You should opt for tablets that will not gain weight. There are certain medicines available now which controls blood sugars and also help in weight loss. Apart from this, I would like to know about your family history of diabetes and the stress levels you are facing on the scale of 1-10. Are you getting enough sleep? How many times you have to go for urine at night? Any pain, or burning sensation in legs? Obesity. Uncontrolled sugar levels. FBS (fasting blood sugar). PPBS (post prandial blood sugar). HbA1c (glycated hemoglobin). Lipid profile. Serum creatinine. Type 2 DM. Continue the same medicines until we work on detailed diabetic history. Take six to seven small frequent meals a day. More leafy vegetables, fruits, pulses. Take less grains, maida, and processed food. Once detailed history available and reports done.

Q. What does abutment of the nerve root mean?

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Q. Will Nano-Leo give permanent solution for erection problem?

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Hi. For further doubts consult a sexologist online -->

Q. Every time I eat spicy food, I poop blood. Why?

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Hi. For further doubts consult a sexologist online -->

Q. What causes upper stomach pain, nausea, loose stools, fatigue, and gas with vomiting?

Hello doctor, I am having upper stomach pain, nausea, loose stools, fatigue, gas. I had one episode of vomiting (regurgitation) about five days ago, and the symptoms all went downhill from there. I am taking Aspirin, Zoloft, Prednisolone, Cellcept, Hydroxychloroquine, Amlodipine and Clonidine. I have lupus (SLE), anxiety, and GERD. I am also 18 years old and 200+ lbs.

Hi. The symptoms that you mentioned are consistent with acute gastroenteritis. Please follow the following diet, take the following medicines and do the following investigation. Diet: BRAT diet which is short for banana, white rice, apple sauce and white toast (bread). Stop eating all vegetables and fruits except bananas and potatoes. Drink ample fluid. Avoid dairy products, caffeine drinks, spicy food, food from outside, fried food, sweets. You can eat poultry or meat but cooked blandly. When you start to get better, introduce normal diet bit by bit. Feco-oral. Stool analysis, stool C and S. Acute gastroenteritis. 1. ORS one sachet in 1/2 cup water every four hours for four days. 2. Metoclopramide (Primperan) tablets one tablet two times a day for three days. 3. Eucarbon (Carbon) tablet two tablets three times a day after food for five days.

Q. My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. What does it indicate?

Hello doctor, My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. Presence of diverticulum and ulcer near the pyloric ring. I have constant nausea, bloating, and throat tightness.

Hello. Gastritis is an inflammation of stomach mucosa. It happens due to Helicobacter pylori a bacterial infection, smoking, alcohol and also certain medicines like Aspirin. Presence of diverticulum also causes gastritis. You are taking good medicines to your concern, continue them. You can add Panchsakar Churna 3 gm twice a day with warm water after meals and Arogyavardhini Vati 1tab twice a day after meals. Avoid spicy and fried junk foods, quit smoking and drinking if you have these habits. There may be need of surgical removal of diverticulum.

Q. I am suffering from mood swings. Kindly advice is this due to bipolar disorder.

Hello doctor,I want to get some information regarding bipolar disorder because I think I have it. I had horrible mood swings, one moment I am overly happy, and the next moment I feel depressed. My sleeping schedule is also different than usual.

Hello. Let me answer your questions via some bullets some points to make things easier to understand. 1. You are only 14 years old, and it is very unusual for a significant mood disorder like bipolar mood disorder to manifest at such a young age. However, this does not mean it is impossible but just far less likely. 2. As a young woman at 14 years of age, it can be considered completely to have mood swings and sleep disruption due to premenstrual hormonal changes. Puberty, overall, is a time of huge biological and psychological change and is not uncommon for a person to experience broad mood changes within one day. 3. I feel your mood swings and general well being should have a keen eye kept on them. If you have a severe mental health disorder, it will become clear fairly soon. 4. From your point of view, as long as you are still able to function normally at school and keep up with your academics as well as maintain relatively good social interactions you are very likely not suffering from a severe mental illness like bipolar. Also, consider the extent of your inner sense of personal distress. Sometimes things can seem like the end of the world in puberty but are much less severe when viewed from a different perspective. 5. I think it would be wise if your parents could allow you to see a psychotherapist or counselor regularly going forward for you to unload your feelings in a safe and confidential environment. Also, such a person could keep an experienced eye on you, and if any severe psychiatric symptoms appear, they can be recognized and acted on it correctly. 6. So my final suggestion is to ask your parents if they are willing to help you find a suitably qualified psychologist and counselor that you can see regularly and feel you can trust them with your feelings. Remember if you are unsure about how you feel and if it is reasonable and not something to worry about, it is always better to speak up about how you think, just as you have done here. Should see a clinical psychologist or counsellor regularly.

Q. I am having swollen lymph node in my neck. Will it be painful after adjusting my neck?

Hello doctor, I went to the chiropractor and got my neck adjusted. I had sore on my neck more in the back left corner then the pain passed down to my left arm. After checking, they said it was a flare-up and to ice it. The next day I had it adjusted again, and he pointed out that I had a swollen lymph node on the left side. I still had sore in the same spot and was worried about my artery and my lymph node. Could my lymph node be painful because they adjusted my neck or because my muscle was sore and irritated?

Hello. I do not think that because of chiropractor there will be any trouble to the lymph node. If the pain is radiating in nature, then it can be related to intervertebral disc injury which can be a past injury and due to which you had a sore neck. As the intervertebral discs are located in between the two vertebral bodies and the muscles are the supporting structures any trouble to the disc can first make the muscle sore and change the normal curvature of the cervical spine. The radiating symptoms can arise due to nerve root entrapment by the muscle as well as the intervertebral disc. Having an MRI scan of the cervical spine will be useful to avoid further injuries. Also, doing hot water fermentation will help to reduce the muscle spasm of the cervical spine region and the trapezius muscle by which the normal alignment of the cervical spine is achieved. Using cervical soft collar will help to reduce the mobility of the cervical spine leading to stabilization of the joints and less nerve root entrapment. Exercises like static neck exercises, shoulder stabilization exercises, interscapular muscle strengthening exercises will help to regain the muscle strength and correct the cervical spine alignment. If you have any more questions, you can ask me anytime.

Q. How good is Albenza for a raccoon roundworm exposure?

Hello doctor,I am concerned about a possible raccoon roundworm exposure. I have read that I can take a prophylactic 10-day course of Albenza to keep any eggs from entering my CNS. I might have type 2 diabetes for a while and have put off bloodwork to find out. I am a glaucoma suspect based on the last eye exam. How hard is Albenza on the body? Is it generally well tolerated for many days? Do immediate side effects get better after a few days?

Hello. Albendazole 400 mg single star dose is enough for prophylactic deworming. 10 days course is not required. Usually, it is very safe and is well tolerated. A rare side effect is a seizure, that can happen if the worm is already lying dormant in your CNS. I generally prefer a three-day course of Mebendazole 100 mg twice daily as it does not enter CNS and so there are no changes of seizures. I hope it helps. If you have any further queries, please ask me.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.