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[ { "from": "human", "value": "Hi doctor, My son is 15 years. He got his DTaP vaccine two weeks ago and had CBC 20 days later. All came well except neutrophil count, which came back as 800 and total WBC 2500. We are going to repeat the test tomorrow. Can the vaccine be the cause for the neutropenia? And if so, how long will it take to recover?" }, { "from": "assistant", "value": "Hi. Based on your query, my opinion is as follows: If the count continues to be low compared to previous report before vaccination then bone marrow aspiration or biopsy needs to be done. Revert back after the investigations to a hematologist online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I have symptoms related to the mind and body. I have no clarity in thinking. I cannot make any decisions. Even if I do, the moment I make the decision, I get negative thoughts and a sudden jerk in my mind with a sensation of fear. Also, I have on and off memory issues. It appears fine some days and on others, I have a difficulty with memory retention. I am very prone to irritation, interruption of thoughts, cannot think clearly, confusion in mind, low mental stamina, unable to focus, no concentration, loss of conscious mind, on and off slurred speech, mild depression andsevere headache. This ache covers my mind so that I cannot think anything and it stresses me out.I am a spiritual person. But, these problems are not allowing me to experience any spiritual knowledge. The knowledge I experience now will not stay with me after a few days. On some days, I will not have any of these issues and feel all fine, but then again after some time, it recurs.I had experienced these problems last year when I had a B12 deficiency and got cured when the levels were treated. But, this time after taking so many B12 supplements still the problems are not resolving. I have digestion issues as well. From around five months, I am experiencing this issue. Still, the issue persists and it takes lot of time to digest food and other problems. My gastro confirmed that there are no structural issues with my GI tract, and gave medicines for indigestion, but there is not much of an improvement till date. I have a fissure in the center of the tongue. Earlier, it was small and now it has become big. I also have back pain, body pains, and nerve pains, small sores in the side walls of mouth, small dots on the tip of the tongue, anal itching, burning sensation in the anus after passing stools, a yellowish coating on the tongue, low sexual interest, and premature ejaculation. I am unable to gain weight as well. All these problems started last year. I have consulted several doctors but did not obtain a proper cure till date. One doctor here asked me to consult a psychiatrist. So, you are my hope." }, { "from": "assistant", "value": "Hello.I read your query with keen interest and understand your concerns. Regarding the attached reports (attachment removed to protect patient identity), I like to comment on the following things. I hope this helps you. Feel free to write back to me if you have more questions. For more information consult an andrologist online -->" } ]

[ { "from": "human", "value": "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?" }, { "from": "assistant", "value": "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 -->" } ]

[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had a cracked temporary crown in the tooth. I had some decay in the same tooth. I do not have pain in the tooth. But I had a sensitivity. My dentist examined the tooth and told that the decay has extended to the nerve area. My dentist did a root canal in the tooth. Now, I am fine with a temporary crown placed. Can I get a permanent crown now? Please advice." }, { "from": "assistant", "value": "Hi. Crown failures often indicate a caries progression below the tooth. The supporting tooth substance which is infected by caries can no longer resist the forces of mastication, and they tend to crack, break and fail. The tooth decay must be removed entirely to protect the tooth. You had tooth sensitivity due to the affected nerve present in the infected tooth. In the root canal treatment, the infected nerve is removed, and it is placed with gutta-percha. After that, a filling is placed to protect the tooth. Now you can go for a permanent crown. As long as the root canal treatment is fine and the tooth substance is adequate, you can proceed with a permanent crown. Please send the X-ray of the root canal treated tooth to guide you further. I would like to see whether the root canal treated tooth is fine and to see whether the remaining tooth substance is sufficient to support a permanent crown. Brush your teeth twice daily and take good care of your crowns and bridges by using interdental brushes." } ]

[ { "from": "human", "value": "Hello doctor, My mother has been having throat pain while swallowing and fever since last evening. She has been advised Clavam 625 twice for five days. Her fever has not gone below 100 and after about four hours of taking Dolo 650, it goes up to 102.5. So far, she has taken three doses of Clavam. Is it normal to have such a high fever in throat infection? Could it be dengue?" }, { "from": "assistant", "value": "Hello. Yes, it is certainly possible to have such a fever and it is likely she has an upper respiratory tract infection. I think whatever she is receiving is fine. Antibiotics will take at least 48 hours to act and initially, the infection is viral. So, antibiotics may not work for the initial two to three days. I think she should continue the same treatment. Hope this helps you. Get back if you have any doubts. For more information consult a general medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am having an abscess on my balls. It is reddish and painful, but not much. I have jock itch right now. I saw terrific images on the internet, but it is not like that. Please help." }, { "from": "assistant", "value": "Hi. Please put up two to three clear photos of the affected area for proper evaluation and guidance. Revert back with the photos to a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 26 year old female. I have some backbone problem. I feel slight pain in my backbone from two to three years when I was in a desk job. I used to sit most of the time on a chair." }, { "from": "assistant", "value": "Hi. From the complaints you had described, mostly it could be related to poor posture at your workplace. Lack of exercise could also be one of the causes. I would suggest you consult an orthopaedician online for further follow up -->" } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "assistant", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am taking tablet Primolut N 5 mg three times a day for bleeding. I am using it for a short-term period. Once my bleeding stops, I will stop using it. Can I take Primolut N 5 mg along with my regular oral contraceptive pill?" }, { "from": "assistant", "value": "Hi. Primolut N 5 mg (Norethisterone) is a hormonal medication used to delay periods and after stopping it, it can cause withdrawal bleeding within one to two weeks and can cause unscheduled bleeding or irregular periods or spotting. When you are taking oral contraceptives pills along with it, it can affect your menstrual cycles. Both the medications will interact with each other. Oral contraceptive pills are cyclic combined hormonal contraceptives pills that not only provide contraception but, also gives you cyclic bleeding. You can use both medications separately or one medication at a time. Take Primolut N 5 mg twice daily from the day 4 to 24th day or use only combined oral contraceptives cyclically. It would be better if you send your detailed history. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I need a multivitamin supplement and digestive enzymes to regain bone, ligaments, and tendons weakened by digestive issues. Malabsorption of essential nutrients due to digestive conditions like chronic atopic gastritis resulted in bone loss, osteoporosis, low stomach acid, and joint weakness like ligaments of knee, etc. I need supplements that do not depend on stomach acid." }, { "from": "assistant", "value": "Hello. After going through your query and detailed report I suggest to calm your gut first which in turn helps to increase absorption of vitamin and calcium and start with L- glutamine supplement 5g capsule daily preferably before going to bed or at least an hour before meals. Later you can opt for multivitamin supplements with good food intake. Along with that follow these tips. 1. Increase high protein diet, including almonds, vegetables, fish, chicken, and eggs. 2. Do muscle strength exercises if allowed by ortho. 3. Increase fluid intake. 4. Do rest for 8-9 hours of sleep. 5. Manage stress with meditation. 6. Do breathing exercises. 7. Manage to follow small frequent meals. 8. Do take 2500 kcal diet. If required you need to add supplement (whey protein) L-Glutamine." } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have a question regarding the Schwarz appliance. I have been wearing it for a couple of weeks now, and I have noticed that, on expanding the upper palate, the palate has come down and it became less shallow. Why is it so? Is it a good thing to have the palate coming down? How should be the palate usually, when you are not wearing the retainer? Shallow or more flat? Please suggest." }, { "from": "assistant", "value": "Hi. As a part of our body, palate comes in many shapes and sizes. It may be deeper, more shallow, flatter and it may include a torus palatinus. This appliance, which, you are using now, modifies your palate and it helps to erase some orthodontic problems. As long as the age is concerned, when the body growth ends, the palate gains a standard size, and this application can make it flatter than it is used to be. You can consult your orthodontist and check it whether everything is fine." } ]

[ { "from": "human", "value": "Hello doctor, I went to the ER a week ago for abdominal pain. A pregnancy test was performed and it was negative. An ultrasound scan was performed and they found two heterogeneous ovarian cysts, one on the right is 1.5 cm and the other on the left is 1.4 cm. There were multiple simple cysts. My endometrial lining was 6 mm. They said everything else looked good. I have a history of ovarian cysts. Do heterogeneous cysts happen before or after ovulation? Do they impact menstruation? Also, what is the difference between heterogeneous and homogeneous ovarian cysts?" }, { "from": "assistant", "value": "Hi. First of all, 1.5 cm and 1.4 cm are a very small size for a cyst. Because, in every cycle around ovulation one of your ovary makes around 3 cm follicle (cyst). In a sonography, if it looks clear without any shadow in the cyst, then it is homogeneous and when something is found floating in the cyst as echoes (shadow), then it is called heterogeneous. Homogeneous have clear fluid. In heterogeneous cyst, the shadow may be due to blood, pus cells, epithelial cells, other debris, hormones, enzymes or turbid fluid. In 1.5 cm and 1.4 cm sized small cysts, it is not so much important that whether it is heterogeneous or homogeneous because it is mostly going to disappear around your period. Before ovulation, mostly follicles are with clear fluid. After ovulation, it may be homogeneous or heterogeneous with decreased size. Actually, it looks like disappearing follicle and not a cyst. A cyst can disturb your cycle only if it is of a bigger size and remains even after menstruation. Mostly it begins from unruptured follicle during ovulation and the size can be from 4 cm to 11 cm or even bigger in some case. This type of cyst requires treatment. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,My husband has not removed his contact lens from his eyes in over 10 years he says. He cannot remove them. Please let me know what he should do." }, { "from": "assistant", "value": "Hello, Welcome to iclinq.com. If contact lens has been there for the last 10 years, then it would cause a lot of problems like redness, watering, itching, pain, blurring of vision. I do not think the contact lens is still there. You should still consult an Ophthalmologist for an eye exam to ascertain it, and get it removed if still present. Please follow up with what the doctor advises and any other query." } ]

[ { "from": "human", "value": "Hello doctor, I have crooked teeth, four up and four down. I want to know what should be done to them to fix. I had recently started facing the problem of gum bleeding and bad smell from mouth. Some yellow decay are there inside my lower four teeth." }, { "from": "assistant", "value": "Hi. I can understand the problem. It is called lower jaw insufficiency and it is an orthodontic problem with crowding in lower front teeth. The yellow layer is called dental calculus and it is a calcified dirt. I would suggest you undergo orthodontic treatment. The dentist may extract one or two teeth as a part of treatment after a thorough examination. He shall align the teeth properly in a year duration. Also, undergo scaling and polishing of your teeth at the earliest." } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have enlarged prostate. Also, my blood urea and creatinine have increased. Will it improve with the treatment of alpha-blockers (Tamdura)?" }, { "from": "assistant", "value": "Hi. USG KUB, DRE and PSA. 1. BPH (benign prostatic hyperplasia). 2. Hydroureter (dilation of ureter) or hydronephrosis. BPH. Urological intervention. Revert back with the answers to the above questions to an internal medicine physician online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I am looking forward to have advice about the outcome or prognosis of nerve regeneration and repair for my son. Before 13 days, my 10 years old son fell with a bottle in his right-hand palm and had his palm triangle open. As we were in another place, the local surgeon cleaned the injury, and I took him to another place where he undertook a surgery before 10 days of nerve repair of the proper ulnar digital nerve of the median nerve. I do not know if it is the exact term, but the nerve cut was the one at the root of the index, and that goes on the inner side (facing the 3rd). Would you please advice me about the outcome of this surgery? Is this nerve responsible for some functional disabilities of the Index? Is it only sensitive? Can he flex his index and use it usually afterward? No other tissues were cut, like tendon." }, { "from": "assistant", "value": "Hello. I have read your concern. Can you give me more of the details of the surgery if you can still remember? How was it repaired as what you have told by your doctor? How is the finger at this moment (can he flex? can he feel anything at the tip of the finger?) I am hoping for your reply." } ]

[ { "from": "human", "value": "Hello doctor, I have bruxism and TMJ, and I just started using a mouth guard that I got from my dentist. I am concerned because when I wake up in the morning, I feel that my bite is different. My back teeth do not touch. However, after 1 or 2 hours my bite goes back to normal. Is this normal?" }, { "from": "assistant", "value": "Hi. Do you wear your nightguard properly at night? If yes, then it is normal that you feel the gap between teeth. As it is the prime function of giving you nightguard that it does not let your teeth overlap firmly and deeply. This tray does not allow teeth of both arches to meet another and creates a gap of about 0.5 mm to 1 mm while you are wearing it. When you keep wearing it for a long time like 4 or 6 months it eventually creates this 0.5 mm gap in your TMJ that is the real achievement, now even when you do not wear the tray your teeth will not overlap deeply and will maintain some space in between. That is a good sign. Stay happy and blessed. Take care." } ]

[ { "from": "human", "value": "Hello doctor, I am suffering from erectile dysfunction. Early morning sex power is also very low. There is a quick immature erection. The genital part does not stand properly. Right now, I am taking 1000 mg L-Arginine once daily. Can you please solve my problem?" }, { "from": "assistant", "value": "Hello, Welcome to the icliniq.com. For your erectile dysfunction problem, you have to rule out organic cause like thickening of an artery supplying penis due to fat deposition. It is called atherosclerosis thickening of the artery. For that color Doppler ultrasound, penile angiography can be done. USG (ultrasound) testes and serum testosterone estimation also need to be done. I suggest you avoid stress if you are having anxiety or stressful event history (psychological cause like stress is also associated with erectile dysfunction). You have to check your blood pressure and serum cholesterol values as well. Obesity also can be responsible for erectile dysfunction. So lose your weight. Take more fruit juices, especially pomegranates juice once daily at night. Regular exercise, yoga, meditation can be beneficial. If there is no improvement in one to two months, then we will discuss further. I hope I have answered your question. Let me know if I can assist you further." } ]

[ { "from": "human", "value": "Hello doctor, Six weeks ago, I had tooth #2 pulled. The healing process has been normal as described by my dentist. I am now experiencing temperature sensitivity on tooth #4, which was previously asymptomatic. Even room-temperature liquid hurts. About eight weeks ago, I had the crown on tooth #4 replaced for cosmetic purposes. There was no pain with this and it did not hurt until this past week. Is there a chance my roots or nerves might be shifting due to the healing process of the extraction and causing the sensitivity? As a side note, tooth #3 in between the extraction and the one that hurts has had a root canal therapy years ago, which (I assume) is why I am not feeling pain in that one." }, { "from": "assistant", "value": "Hi. Yes, your tooth might be sensitive due to the extraction process that happened in the surrounding area. Keep doing saline water mouth rinses. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses 3 to 4 times a day for a week. If sensitivity goes away, well and good. If symptoms remain same, and sensitivity to air and liquid increases, it means your root is now sensitive and you might need removal of the crown, get a root canal done of this tooth and get back the same crown on it. Give me followup after a week. Stay happy and blessed." } ]

[ { "from": "human", "value": "How to increase my height? I am 23 years old." }, { "from": "assistant", "value": "Hello. Consult a nutritionist online for further follow up --->" } ]

[ { "from": "human", "value": "Hello doctor, Can you please have a look at my reports. Is my BUN to creatinine ratio normal? I am diabetic and I have been taking Glykind-M, half a tablet every day." }, { "from": "assistant", "value": "Hello. Hope this helps you. For more information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 30 year old woman. I found blood in my stool this morning, for the first time in life. I am sure that is not period. Is it a sign of bowel cancer?" }, { "from": "assistant", "value": "Hello. I assure you not to worry a lot as things can be settled with proper care and follow up. There are some reasons for fresh blood in stools, with stools, before or after stools other than menstrual blood.First of all, it may be hemorrhoids. You may have felt some dilated small lesions on the anal opening before or after passing stools ( if this was bleeding hemorrhoid). It is due to a disease named portal hypertension and you need to follow it up and it will settle down with treatment. Your general surgeon is the person to decide the stage of hemorrhoids and treatment goes accordingly. He may do proctoscopy, colonoscopy or digital rectal examination. The other cause is anal fissure bleed. When stools get hard due to constipation and when patient forcibly defecates, it causes a breach in the mucosal lining of the rectum and anus and it bleeds in the form of fresh blood. Lactulose syrup, whole grain foods, dietary fiber supplements, plenty of fluids and a good physical activity will help improve this condition. But it may also need treatment with antibiotics to avoid severe infection. General surgeon consultation for a physical examination is my suggestion. Last but not least is the cancerous growth. It is serious but less likely in your case. But if you have a family history of colon cancer, have a change in bowel habits, lost weight, loss in appetite, constipation or diarrhea, You may be having cancer. A general surgeon will diagnose with colonoscopy and barium tests through radiologic studies. Final suggestion - avoid constipation, keep a good physical activity, avoid fast foods, processed meats, low fiber diet, and soft drinks. Go to a general surgeon in person for proper evaluation and treatment." } ]

[ { "from": "human", "value": "Hello Doctor, I am suffering from anxiety and depression. My doctor prescribed 15mg of Mirap at night and 0.50mg of Clonazepam twice daily. And Clonazepam has to be halved after every 10 days. Is it fine? Need a second opinion." }, { "from": "assistant", "value": "Hi. Mirap is a Mirtazapine which is indicated for depression. In my professional experience, it is not as efficacious as the SSRIs such as Fluoxetine or Paroxetine or Citalopram. Mirap at the dosage of 15mg does help the patient to sleep better but it is also known for significant weight gain upto 10lbs in 2 weeks. Clonazepam is indeed an useful adjunct and helps with the anxiety component. But I only prefer to use it as an \"as needed adjunct\" and no standing doses. I can help you better, if you are fine with booking a session for an online therapy for a detailed evaluation." } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "Hi doctor, My weight is 80 kilograms. As per my height, my weight should be around 60 to 65 kilograms. Please suggest some tips to lose my weight." }, { "from": "assistant", "value": "Hi. Start your day with a half liter of warm water followed by eight to ten soaked almonds and raisins. Never start your day with tea or coffee. Then try to do simple exercises like walking or light aerobics. You have to do simple exercise for at least 45 minutes for five days a week. Eat all your meals at a set time. Eat a healthy snack in between your major meals. Choose any one among the following such as a handful of peanuts or any other raw nuts or dry fruits, a bowl of sprouts, or any fruit. Drink at least three liters of water daily. Sleep and wake up at the same time every day. Reduce taking oily foods and sweets. Avoid drinking sugary drinks. Finish your last meal at least two hours before you go to bed. Follow these tips, and you will see a change within a month." } ]

[ { "from": "human", "value": "Hi doctor, I have noticed two problems in me. I have these problems for three months. I have disturbed sleep on several days and erectile issues (sustaining erection during intercourse). I am a hypothyroid patient for two years (I take thyroxine Sodium 100 mcg). I have high myopia (-10 power in both eyes) and severe dry eyes (Schirmer score of 2 mm in each eye). I take Restasis, Systane ultra and Eyemist eye gel for the dryness. I have tight schedules throughout the day. I consulted a psychiatrist last month. The doctor told me that the issues are due to anxiety and she advised me to take Vilano 20 mg in the afternoon, and Clomipramine 10 mg at night time. I have attached the prescription. After five days of taking medicines, I felt my mood to be better. But I faced several side effects with dry mouth, chest spasms, total erectile dysfunction, and a sore throat. I consulted an ENT specialist for a sore throat, and he advised me to stop the anxiety medicines as throat issues can also occur due to the medication. I quitted it, and I faced several withdrawal symptoms on the next day. I was getting brain zaps while going to sleep (electric currents running through my brain) and I was unable to sleep for two days. Hence, I consulted a neurologist. He suggested me Lonazep 0.5 mg, Sove 5 mg and advised me to do a psychological assessment. Based on the evaluation, he informed me to continue taking Lonazep 0.5 mg, Sove 5 mg for 60 days and also advised me to do cognitive therapy, relaxation therapy, and yoga. I have the following questions. Am I following the right direction? I think taking Lonazep 0.5 mg and Sove 5 mg will not be an easy one to stop. Can I have withdrawal symptoms after taking it? Is it right to take anxiety medicines? I still have brain zaps, and I always take alcohol for once a week. Will I have any impact due to the medication? If yes, please suggest." }, { "from": "assistant", "value": "Hi. You are not following the right direction regarding medicines. There are two types of treatment such as primary medicine like SSRI (e.g., Vilazodone) and supportive medicines like Sove and Benzodiazepines like Lonazep. We can take an example. If you have malaria or dengue, you will have a fever and Paracetamol is taken. But it will not cover the whole illness to cure it, and so we will take specific medicine for malaria such as Quinine. Yes, Benzodiazepines have withdrawal symptoms when quitted suddenly. It is better to take proper medication. The side effects such as dryness of mouth and dryness of eyes, you had were due to Clonil. Vilazodone does not show such side effects so you can start retaking it. There are other options also, but we can try taking Vilazodone first. The worsening of anxiety does not occur due to medicines. It is a natural course of illness which got unmasked when you quit the medication. Taking alcohol occasionally is fine. But in anxiety and depression, usually, people perceive that alcohol can cure the problem, and they can make them relax. But there is a need to understand that it may lead to alcohol addiction, worsening of anxiety and depression. Gradually taper off and stop taking Lonazep (Clonazepam) and Sove (Zolpidem) and build the dose of Vilano in future." } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "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?" }, { "from": "assistant", "value": "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 -->" } ]

[ { "from": "human", "value": "Hello doctor, During rainy and winter season get frequent fevers. Most of the times I get it diagnosed, and every time doctors tell it is only viral fever. Fevers generally come twice a month. I take Paracetamol and Cefixime usually (on the advice of doctors). Generally, the illnesses go in 10 days. This has been happening from the last three years. Can you suggest any cure for it? I am a small time businessman, and this is affecting my financials. Regarding my medical history, I am a premature baby of seven months. As told by my mom and relatives, I remained alive on medicines with great difficulty. And also from childhood, I used to get skin diseases frequently, and for that, I think I was regularly administered antibiotics." }, { "from": "assistant", "value": "Hello. I need to know a few things, 1. Do you feel feverish, or does the thermometer record a temperature? 2. What other symptoms do you get? Runny or blocked nose, sore throat, throat pain with swallowing, headaches, body pains, etc. 3. Does anyone else around you (family members, co-workers, etc.) develop similar symptoms before or after you do? 4. Do you get any tests done like blood tests or X-rays during those episodes? From your description, it appears that you are getting frequent viral upper respiratory tract infections. These are acquired from other patients through the air (coughing, sneezing, etc.). They are usually short-lived and last no more than five to seven days. Since more than 300 different viruses can cause similar symptoms, you can get infected multiple times each time with a different virus. The same virus cannot affect you again. Unfortunately, antibiotics do not work against viruses. They are meant for bacterial infections only. However, doctors continue to prescribe antibiotics unnecessarily, and this has led to the emergence of widespread bacterial resistance. Other than symptomatic treatment, no medicine can cure or prevent these infections. They are self-limited, and you will get better even if you do not take any medication. The older you get, the less frequently you will get these infections as your body will be building up defenses with every disease. No household tips or vitamin supplements have been proven to work. Premature birth can lead to increased frequency of infections, but unless the infections are bacterial, not much can be done about them. Please get back to me with answers to the above questions and also attach any test reports you may have." } ]

[ { "from": "human", "value": "Hello doctor, I accidentally swallowed Harpic (toilet cleaner) but immediately puked it. It did not go in my stomach. But my teeth are feeling rough even after brushing.What should I do? Will this roughness last for a long time? How should I treat it?" }, { "from": "assistant", "value": "Hi. I have read through your query and the relevant details. The Harpic cleaner contains various chemicals which are acidic and these when exposed to tooth surfaces would cause enamel roughness. That is the reason you have such a feeling in spite of brushing. I cannot guarantee that this roughness will fade away. But, the best home remedy is to do oil pulling twice daily with coconut or gingelly oil and avoiding any acidic food such as lemon or any citrus fruits or fizzy drinks. Apart from these, you could also visit your nearby dentist to get a professional polishing done. It is a special white powder used to polish teeth with a machine called pumice polishing. For more information consult a dentist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 30 year old male. I got rashes on my glans penis after sex with my wife. I have consulted a doctor and he suggested to use Zovirax 200 mg four times a day for one week, thinking that it is herpes. But, I think it is not. I have used it but no improvement at all. The rashes getting disappeared within a week when there is a gap of intercourse. After sex, I am developing rashes again and as there is a gap of one week, the rashes getting disappeared. This has started only one month back. No pain, no itching, the rashes look red. I think it may be fungal or bacterial infection. What medicine shall I use? When I used Candid dusting powder, the rashes are getting cured. Kindly suggest." }, { "from": "assistant", "value": "Hi. Revert back with clear pictures to a dermatologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 22 year old female. I had started my treatment with braces in the age of 14 and it continued for around three years. Then, I used retainers for some time. I was told by my doctor that I have a small jaw and extracted four of my teeth. After getting the whole treatment done when I look into the mirror I see my jaw inclined due to which my face looks weird and not proportionate. The jawline and my teeth are still not aligned straight. I could not get the beautiful smile which I always admired. I do not want to go through the pain of braces again. Is there anything else I can do? And how long the procedure will be?" }, { "from": "assistant", "value": "Hi. By looking at your pictures (attachment removed to protect patient identity), it seems that your orthodontic treatment was not successful. Now it seems that you have more problems in your lower jaw. So, it is better to correct lower teeth only. You should either try to put crowns (cap) over the lower central four teeth, or there is a method called veneering where we put a half cap over the front teeth on both upper and lower to give a good look to your smile. Ask a specialist that is an endodontist to give veneers to the front six teeth on both upper and lower jaw. The procedure veneering is a little bit costly but gives a very good aesthetic smile makeover. Your weight is also very low which means your overall bone growth is not up to the mark." } ]

[ { "from": "human", "value": "Hello doctor, I had a CT scan done yesterday for something else (nothing serious). They did say there was a 0.3 cm superior right lower lobe pulmonary nodule. Minimal bibasilar atelectasis. No focal consolidative opacities and no acute abnormality in the lungs. The doctor said since I am not at high risk due to size. I have never been a smoker, and because of the tiny size he did not think I need a follow-up, just with PCP. I wanted a second opinion on this." }, { "from": "assistant", "value": "Hello. Any past history of pnuemonia, bronchitis, or any history of tuberculosis? Connect me with details for full evaluation and management." } ]

[ { "from": "human", "value": "Hello doctor, I had unprotected sex on the sixth day of my period in which bleeding has already stopped. What should I do to avoid pregnancy?" }, { "from": "assistant", "value": "Hello. Please send me some more details. If you have regular cycles with 28 days or more, then day six of periods is not the fertile period of your cycle. But having short irregular periods results in the risk of having the issue of conception. So check on your cycles. If regular and if 28 days or more in duration then no need of I-pill or emergency contraceptive. Otherwise, in case of the irregular or short period better to have emergency contraceptives pill. Have complete treatment of any health issue you have. Have a balanced diet, weight, and BMI. Practice daily walk and yoga. You can have regular contraceptives to avoid conception. Hormonal. Depends on cycles regularity. As per need." } ]

[ { "from": "human", "value": "Hi doctor, A dog bit me hard in my leg. I had a lot of blood flowing from my wound. I cleaned the wound with disinfectant for 20 minutes. Now the blood flow has stopped. I have done preexposure prophylaxis before three months for safety. Do I have to go to the hospital immediately?" }, { "from": "assistant", "value": "Hi. You should go to the hospital soon and begin post-exposure prophylaxis as early as possible. It is better to have rabies immunoglobulin injection soon. You should clean the wound with soap and water. Get a dressing from the doctor with a Betadine solution (Povidone-Iodine) followed by application of Mupirocin ointment. You have to do dressing daily. You should have anti-rabies vaccination on day 0, 3, 7, 14 and 28. Also, rabies immunoglobulin should be taken intramuscularly. Tetanus vaccination is also required. You can take capsule Augmentin duo 1 gm (Amoxicillin with Clavulanic acid) two times a day. You can take tablet Pantoprazole 40 mg before breakfast once a day for five days to prevent wound infection." } ]

[ { "from": "human", "value": "Hello doctor, My 6 year old daughter was born with tyrosinemia type 1. She had diarrhea and bloody stools for 10 days, a month back. She was tested for many things, and everything came back normal, except her calprotectin level was 1250 while she had loose and bloody stools. She was admitted and had a cleanse and got an endoscopy done, and it showed lots of inflammation. She was put on a high dosage of steroids and Sulfasalazine for five weeks. The bleeding has stopped, and we weaned off the steroids. The biopsy results said it was IBD. Two weeks ago, she had her calprotectin level checked again, and it was in the 200. This week, we checked it again, and it was 39. I will include pictures of the biopsy results and pictures of the endoscopy. Her doctor said that the reports are not 100 % fine, and it is either UC or Crohn's. The doctor said that further down the line, we would be able to know which one she has. I would love to get a second opinion on what it could be." }, { "from": "assistant", "value": "Hi. I have seen all the attached reports (attachment removed to protect patient identity). Have a nice day. Revert with more information to paediatrician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have cracked nipples that have failed to heal for the past five weeks. I am a nursing mother, and I am not able to feed." }, { "from": "assistant", "value": "Hello. Please apply Purelan 100 (Lanolin) to the cracked nipples and express the milk to prevent engorgement and feed the baby that milk (store in hygienic conditions) along with some top feeds if required. Reduce the latching of the baby to enhance healing. Till you have healed completely feed the baby expressed milk and top feeds. I hope this should help." } ]

[ { "from": "human", "value": "Hi doctor, Yesterday I was doing my thing (masturbating) and I noticed a little soreness under the head of penis. I have been going at it probably twice a day lately. I am just a little concerned that it may be herpes. But I have not been sexually active for a very long time. Also, I have had two negative herpes blood test 28 weeks post exposure and again 70 weeks post exposure from my last sexual encounter and both negative. I did test positive for HSV1 though. I usually get between one to three outbreaks annually on my top and bottom lip. Anyway, I have noticed irritation in that area in the past when I masturbate so I am not sure if it is just a minor chaffing or friction burn or possibly herpes. I am currently being treated for genital warts that my last girlfriend left me with almost 17 months ago. So I am very conscious of any changes below the belt. I did not happen to notice any blistering but the area looks shiny and a little wet. I am not experiencing any pain either." }, { "from": "assistant", "value": "Hi. I have been through your case in detail. Well in short as you know there are two possibilities: 1. Friction erosion. 2. It could be herpes infection. Herpes 2 usually on genitalia and herpes 1 on lips. As now there is no limitation in having herpes 1 on genitalia due to common oral sex. So in my opinion, you may have it as blistering is not the only presentation, superficial erosions also represent herpes. So it is always better to keep pathology of herpes in mind rather rely only on the frictional blister. For management, do the following: All treatment for seven days. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have weird uncontrollable eye movements similar to nystagmus. I feel bad when I walk behind the people. My eyes have a flickering problem. It makes people feel uncomfortable around me. I have a peripheral vision starring problem too. I am attaching my picture." }, { "from": "assistant", "value": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Your eyes look fairly stable. You have a normal involuntary pursuit movement of the eyes in which your eyes can track anything which moves in front of you. There is no need to worry. If the people around you feel uncomfortable, try to look momentarily towards them, and then shift your gaze to someone or something else. People feel uncomfortable when they have a feeling that someone is staring at them. Still, I recommend you consult a neuro-ophthalmologist soon." } ]

[ { "from": "human", "value": "Hi doctor, My age is 23 years and on the seventh day of my period. I had intercourse for the first time at 11 AM. Then, I had a sudden bleeding spot starting and I took I-pill at 6 PM. I have started nausea, feeling like vomiting, and next morning chills with fever, and weakness. So., I am worried about pregnancy. Any chance there is pregnancy?" }, { "from": "assistant", "value": "Hello. As you said it is your first time having intercourse, you observed bleeding and then after an emergency pill, you had vomiting and then fever and chill. After the first time of penetrative vaginal sex, there Is hymen rupture that causes bleeding after sex. That could be a bit different in amount from person to person. After first sex, you may have some symptoms. Those can be exaggerated by hormonal emergency pills and differ from person to person. As you have taken I-pill already if it is taken in the right dosage, then least chances of pregnancy actually. Pregnancy is expected more likely in the fertileperiod with unprotected sex than in the rest of the cycle. And after I-pill, it is least likely. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I want to buy some equipment or medial device to prevent snoring during sleep. It should be safe and be able to buy online, preferably FDA approved." }, { "from": "assistant", "value": "Hello. Snoring while sleeping is usually associated with sleep apnea syndrome. Sleep apnea is a sleep disorder in which pauses occur in breathing during sleep. Symptoms usually occur due to obstruction of the airway.For the treatment of snoring, we have to treat the sleep apnea first. Few such devices which I would suggest are: Before purchasing them, do consult a sleep medicine specialist in person for clinical examination." } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a programmer, and I use the computer for 12 hours every day. My eyes start hurting after 30 minutes of staring at the computer. I do not have any vision issues, apart from the pain that I feel." }, { "from": "assistant", "value": "Hello. I hope this will help you. For more information consult an eye care ophthalmologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had indigestion problems last month and I was given a Pan 40 injection in a 24/7 hospital in my locality. The moment I was given the injection, my body developed rashes, redness, and itching. My doctor immediately gave Avil injection after which rashes and redness subsided. Two days back, I again had got indigestion problems after a week of having junk food outside. This time I had Pan D tablet, but this time after an hour I developed rashes, itching, and the whole body turned red. I again went to the 24/7 hospital and the doctor again injected Avil after which the redness and itching subsided. The doctor also told me never to take Pantoprazole tablets as I am allergic and reacting very badly. Now, I have been given Rantac and I have no problems now. So, here are my questions: As my doctor told PAN tablets will be regularly prescribed for other illness too to avoid acidity and other stomach ailments, do I have to tell that I have Pantoprazole allergy whenever I visit a doctor? Is Pantoprazole allergy something I need to be concerned about? Should I have to do anything?" }, { "from": "assistant", "value": "Hello. I have gone through your question and I understand your concerns but yes Pantoprazole allergy is a permanent condition that you will need to report to any doctor you visit before prescribing medications. Also, this allergy is nothing to worry about as long as you avoid taking Pantoprazole but can get very serious and even fatal if you take it again. I hope you find this helpful. For more information consult a general medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have tried Lexapro, Wellbutrin, Effexor, and Prozac for anxiety and panic disorder. But I suffer from the side effects of these medications. My biggest complaints were increased anxiety, and panic attacks, along with weight gain (50 pounds), and tachycardia that kept me up at night and freaked me out. So my family doctor sent me to a psychiatrist, and he prescribed Imipramine. I had never heard of this, so I searched, and it seems like weight gain and tachycardia (my two most significant concerns with medications) are common side effects for this medication. I am not sure why he prescribed this one to me, but I wanted to get a second opinion to see if this is a good idea since I already have tachycardia and do not wish to gain more weight. I am scared even to try this medicine because I do not want to go into some weird heart rhythm." }, { "from": "assistant", "value": "Hello. I can understand your problem. Imipramine is a tricyclic antidepressant drug, and yes the drug is known to result in side effects like weight gain. But this depends upon the dose, the duration of treatment, patient factors, etc. Lexapro (Escitalopram), Wellbutrin (Bupropion), Effexor (Venlafaxine), Prozac (Fluoxetine), etc., are serotonergic drugs and it is common with these drugs to see increased anxiety for first few days of starting the drugs. In most cases, this rebound increase in anxiety goes by own. So my advice is to continue the drugs even if you see worsening of symptoms. In most cases, after a week of starting the drugs symptoms remit. Imipramine is also the right choice, and the drug causes sedation so you should take medicine in the evening after dinner and should start with low doses. When the drug is started in low doses, then you will not face any rebound increase in anxiety. Kindly get ECG done before starting the medication." } ]

[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, My CRL is 5.18 cm. How old is my baby now? How can I get my gestational age accurately?" }, { "from": "assistant", "value": "Hi. The CRL of 5.18 cm corresponds to 11 to 12 weeks of gestation. A difference of two to three days is possible depending on the position of the baby and the measurement of the caliper placement. Ideally, we recommend a first scan to know the exact dating and to calculate the expected due date (EDD). As you have not mentioned your last menstrual period (LMP), I am unable to estimate the gestational age by LMP. Please provide them. I can say the result whether there is a delay in growth or there is a delayed conception." } ]

[ { "from": "human", "value": "Hi doctor, I have pain in the second tooth from my wisdom tooth. I have the pain for a month. I want to pull it or remove it. But I am scared. I gave birth to my child before six months through C-section. Is there any other option available to remove the tooth? Does it cause any effect on breastfeeding?" }, { "from": "assistant", "value": "Hi. I have gone through your question, (attachment removed to protect patient identity) and I can understand your concern. You have a grossly decayed infectious tooth which needs removal. Visit a dentist soon and remove it promptly. It does not affect your breastfeeding. You can avoid taking too much of painkillers and medications prescribed by the doctor. Dental extraction is a simple procedure, and there is no issue to be afraid of it. In case, if you do not want to get it removed, then you can take Amoxicillin 500 mg for five days, and it will treat your infection. I suggest you get it removed if it is so grossly decayed, or root canaled." } ]

[ { "from": "human", "value": "Hello doctor, I would like your opinion regarding the attached CT scan of my head. I specifically want to know if you see any indication of a meningioma in the left posterior parietal lobe. I would also like your opinion regarding whether or not a CT without contrast would show this particular anomaly. Will a 1 cm meningioma grow so rapidly? It was not there when I took a CT scan three years ago. I am waiting for your evaluation of this CT. Thank you in advance." }, { "from": "assistant", "value": "Hello. I have seen the MRI (attachment removed to protect patient identity). For more information consult a neuro surgeon online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 32-year-old, male, 105 kg, 6 feet in height. Recently, I have been diagnosed with diabetes. I am not on any medication. I am strictly controlling food and doing regular aerobic exercises. My one hour postprandial BG is always around 200." }, { "from": "assistant", "value": "Hi. Please update your FBS (fasting blood sugar) and HbA1c (glycosylated hemoglobin). Anyway, your sugar values are high. So, you have to take the necessary precautions to prevent the progression of the disease. First is adequate exercise. Daily do aerobic exercise for at least 30 minutes, then comes diet control. Small frequent low carbohydrate meals. Avoid oily food. Increase amount of leafy vegetables. Reduce salt intake. It is better to add drugs like Metformin or SGLT2 inhibitors to reduce your sugar values. These drugs will help you to reduce your weight too. Check your lipid profile and thyroid status." } ]

[ { "from": "human", "value": "Hello doctor, I often eat deep fried potatoes with chilly powder. Some say that it will turn into bad materials after they reach the belly. I do not believe it. Is that true? Why is it so?" }, { "from": "assistant", "value": "Hi. Any food that is deep fried in oil or that contains oil in considerable amounts is not good for your body. Excessive intake of oil might lead to cholesterol deposition in your blood vessels, which in turn can reduce blood supply to the heart. This poses a future risk of heart disease. Moreover, excessive intake of oily food is also a risk factor for obesity. If you indulge in regular physical exercise and control your intake of oily food on a daily basis, you can take a small serving of maybe a small cup of your favorite fried potatoes once a week. This again depends on your age, physical activity, and medical history. Just to stay on the safer side, I advise you to undergo a laboratory test called lipid profile. The blood sample will be taken on an empty stomach. This test will give you an insight into your blood levels of cholesterol and triglycerides." } ]

[ { "from": "human", "value": "Hello doctor, I am feeling empty and emotionally drained. I do not feel like living anymore. I am tired of everyone blaming me every now and then for everything for no big reason. Sometimes I do not understand my fault. I feel suicidal many times." }, { "from": "assistant", "value": "Hi. Such feelings at this stage of life when we enter our teens is quite common and there are multiple reasons for it, few being changes in our body especially hormonal changes associated with puberty. You are not alone with such feelings of loneliness and suicidal tendencies. But the good thing is most of it is illusional and not true. Contrary to what we believe at this point in life, our parents love us a lot and are very much concerned about us. Talking to them and to teachers, guides, mentors will help you in understanding and overcoming the differences. A visit to a school counselor or a psychologist will definitely be of help. This life is very precious and there are a lot of people who love us. We do not realize how blessed we are. Best wishes for your future." } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 55 year old male. I am diabetic for the past 15 years and I also have high BP. Before 20 to 25 days, while walking I felt like dizziness and I could not climb the staircase. Before my BP was 240/140 mmHg, but now it is 160/100 mmHg. Later on the creatinine and blood urea was also more. Now, my BP is 160/100 mmHg. As the day proceeds by evening I feel unstable and feel uneasy then BP increases to 190/110 mmHg or more. Yesterday night, I felt like a paralytic stroke of my left leg while sleeping, but any how suddenly got up and I was safe. My current medication is tablet Telma 40 mg, tablet Telma 20 mg and tablet Amlong in the morning and at night respectively. For diabetes, my current medication is tablet Glycomet GP2 both in the morning and night. Presently, I am not taking any Insulin due to controlled sugar. I am attaching my blood test report. Please advise some medications if any keeping in view of the above reports." }, { "from": "assistant", "value": "Hi. High uncontrolled BP and sugar. Get an NCCT, RFT, HbA1c, fasting and postprandial sugar test, complete urine examination and USG test done. Lifestyle modification as follows: 1. Reduce salt, sugar and fatty food. 2. Do mediation and some breathing exercises. Revert back with the test reports and answers to the above questions to an internal medicine physician online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 18 years old and I have been having big problems with making friends since I was 7. I go to school and I do not talk at all (only if someone or teacher asks me something). I just cannot find any topics to talk to people and the worst is that I do not know what should I say back when I somehow succeed in starting the conversation. Besides all my life I feel like I am the one that jumps around people and tries to talk to them and they just do not care so I quickly give up and end up alone. And my house is so stressful too, it is so loud because my parents scream so much and I spend most of the time locked in my room because when I hear them screaming it feels so stressful (all this stress is like sitting on my back and I cannot make it stop). Is it even possible for me to make friends? It has been half a year since school started and everyone is occupied by their friends. How can I stop blushing when I am given too much attention? Is it possible that I have some kind of mental illness or maybe autism?" }, { "from": "assistant", "value": "Hello. First of all, this is not a serious mental issue. Just remain relaxed. You have social anxiety most likely and this anxiety is resulting in symptoms like blushing when you are getting attention, difficulty in making friends, etc. This is social anxiety and a lot of individuals of your age develop. So do not think that you have any abnormality. Just continue to make your efforts to make friends and you will gain confidence with time. No need to get worried." } ]

[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hello Doctor, Two days ago I used an epilator on my upper lip, it became red and hurts a bit. Then I applied a cream to moisturize it. Today, after shower, I peeled it off. But the redness is still present. What do I do?" }, { "from": "assistant", "value": "Hello. If it does not heal, consult a dermatologist online with a detailed history -->" } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am suffering from sinus problem since birth. Currently, I am suffering from a cold, headache and unable to breathe properly due to nose blockage intermittently. Kindly advise which medicines I should take. I am 44 years old and currently working in a call center where I have to sit in AC for at least eight hours." }, { "from": "assistant", "value": "Hello. It seems this is your chronic problem as you have been suffering for the two years. For the best result, I would advise you to seek consultation from a good homeopathy doctor who can prescribe the correct remedy based on the detailed case history. For the meantime, based on the above short description, I would advise you to take Kali Bichromicum 30c four pills twice a day for five days. Do not eat or drink 30 minutes before or after taking this remedy. Avoid taking a lemon, strong coffee, raw onion, and raw garlic until you take this remedy. Kindly report back in 10 days." } ]

[ { "from": "human", "value": "Hi doctor, I have been diagnosed with PCOS for more than 3 years. Recently I have been doing yoga and doing intermittent fasting for the past 2 months. Now I got my period twice in April and for may month it is spotting for the last 2 days. Please help me." }, { "from": "assistant", "value": "Hi. Treatment of women with PCOS should begin with lifestyle measures. For those who are obese, a combination of weight loss and exercise may stimulate ovulation. Intermittent fasting is wonderful lifestyle. What is your mode of intermittent fasting. Are you doing 16/8 or fast and feast? Have you tried 36 hours fasting? Please let me know. Also, low carbohydrates diet with no sugary juices and no added sugar is very beneficial. If the woman is not overweight or weight loss is ineffective then: taking into account potential adverse effects, ease and mode of use, the woman's BMI, and monitoring needed, Clomifene citrate or Metformin or a combination of the above. For women who are taking Clomifene citrate, I offer ultrasound monitoring during at least the first cycle of treatment to ensure that they are taking a dose that minimises the risk of multiple pregnancy. Women prescribed Metformin may know side effects such as nausea, vomiting and other gastrointestinal disturbances. If woman known to be resistant to Clomifene citrate, we can go for laparoscopic ovarian drilling or combined treatment with Clomifene citrate and Metformin if not already offered as first-line treatment or Gonadotrophins. So, there are plenty of options available and you are not alone we can together make a plan for management. Please give me more details if you have done investigations ultrasound and Harmone tests." } ]

[ { "from": "human", "value": "Hello doctor, I had an exposure with a call girl with protection. However, during intercourse, the condom broke. I am worried about HIV. Could you please guide me regarding what kind of tests I should undertake. Also, I would like to understand how many days later I should go for the test. As on today, it has been 24 hours since exposure." }, { "from": "assistant", "value": "Hello. For more information consult an HIV AIDS specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have a high white blood cell count. It is more than usual. I got my blood tested. And the result is I have 12000 white blood count. In the report, it is written that normal count is up to 11000. Do I have to worry about anything? Please help." }, { "from": "assistant", "value": "Hello. I have gone through your query. White blood cells are a type of blood cells which are majorly involved in fighting infection in the body and are usually increased in amounts when the body is fighting against an infection and occasionally in certain other conditions. Though 12,000 count is a definitely increased number, it need not be considered very high if there are no associated symptoms or any other medical history. But before that, we need to look into the differential count of white blood cells which means the percentage of various different kinds of white blood cells which are elevated in different kinds of infections and other values in your blood picture report. I need you to answer me questions regarding certain symptoms. Though white blood cells are increased in certain types of blood cancers, the numbers are usually higher than your value. Please get back to me with the detailed differential count of white blood cells, hemoglobin, platelets and peripheral smear reports and also details regarding the above mentioned symptoms. This way we can exclude all the possible causes of your elevated white blood cells. For more information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, My daughter has started to stammer. What should I do?" }, { "from": "assistant", "value": "Hello. Stammering or stuttering is not very uncommon in this age group. Most children do stammer at this age, and with time over a few months, it gets resolved usually. I believe that the delivery of this child was smooth, and she had no history of admissions for any illness. Also, her milestones are normal and not delayed. Now here, the family has to play an important role. Your child has started developing speech, and this is quite normal to happen. So, first of all, you stop worrying. And even if you worry because I know it can be alarming for parents, please do not pass on your anxiety to your kid. Just do not let her feel that it is abnormal. Whenever she speaks, to listen to her and never try to correct her or scold her for this. Pay attention to what she is saying and look at her, and eye contact should be there. When you talk to her, talk slowly so that she can grasp every word. Kids always try to imitate us. She will also start speaking slowly, which will help her say words correctly and with ease. Never criticize or scold, also tell everyone at your home and even school teachers. Encourage her to speak. Do not pass your anxiety to your kid is most important because if a child gets anxious, it will get more pronounced. Slowly and gradually, you will see that your kid has outgrown this. If still, you feel that there is no improvement after one to two months, speech therapy may be done. Speech therapy should be started before four to five years. I hope this advice would be helpful to you. I would be there for any help." } ]

[ { "from": "human", "value": "Hello doctor, I am 30 years old. I am so hearted psychologically because of the bad difficult odor which comes from my foot. When I wear shoes, my feet immediately feel warm and release a bad odor in just a few minutes. The worst thing is that it also has a smell without shoe whether I washed or not. This made me stay far from my friends, co-workers, family, and from my society almost. I tried some medication from nearby health centers such as Flucanozole, Decozol, Aquax and so on still using but no change. I lived with a problem for more than 10 years. Please, could you suggest me something? Why my foot smells badly with no shoes and even affect my neighbors?" }, { "from": "assistant", "value": "Hello. Yes, this condition is called bromhidrosis, the abnormal odor is due to local bacterias. Follow this prescription. Maintain hygiene of area and wash it with mild soap and water. Use Silver Zeolite powder on your feet after drying of feet. Try to avoid closed shoes or condition of humidity. Use local antiseptic solution like Povidone Iodine at one time daily to kill the bacteria (it can make your skin dry, so use Vaseline (Petroleum jelly) if it gets dry. Avoid garlic from your diet." } ]

[ { "from": "human", "value": "Hello doctor, I am suffering from lung congestion at dawn. The condition is relieved during the day, persisting for a month. Kindly suggest the remedy." }, { "from": "assistant", "value": "Hi. Possibly, you might be having some mild infection in the lung that is causing the congestion towards early morning. When patients come with these complaints, I evaluate them and see if they have any infection or allergy. Symptoms suggesting infection are a cough, thick mucus, chest pain, mucus production while coughing, fever, a headache. Symptoms suggesting allergy or asthma are running nose, wheeze, a dry cough, sneezing. If you have any of the above kindly let me know details regarding each complaint. Like the time for which it is present, the aggravating or relieving factors. Also, general precautions that you can follow to relieve some of the issues are: 1. Steam inhalation with Carpol plus capsules put in the water, take steam through open mouth twice a day, once before sleep and then in the morning. 2. Avoidance of direct cold winds, AC blower, dust, smoke. 3. Avoidance of smoking and drinking. 4. Adequate nutritious food comprising all nutrients. Kindly revert back to me regarding your other complaints and we can make a decisive diagnosis and institute the right treatment." } ]

[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "assistant", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,My daughter is 3 years old. When she was 2, we shifted to a new place and from there she started having allergy problem like bronchitis. Every time she catches a cold and it developed into allergic bronchitis. In X-ray report, it says she has hyperreactive airway disease. Now finally, I changed place again. How long will it take to improve as she still sneezes a lot?" }, { "from": "assistant", "value": "Hello. As per the history and the doctor's notes, I understand your daughter has allergic rhinitis and lower airway hyperreactivity. There is no easy solution for allergy. Allergy is due to some component in the air that she breathes. We must identify what she is allergic to. Some of the following you may need to do. 1. After using the Duonase spray for 15 days as given by your doctor, change it to Mometasone and use it once daily. Two puffs in each nostril for 30 days and thereafter one puff each nostril. There is a particular way to use spray. If you do not know that then revert back. 2. Continue the Montair LC syrup for a couple of weeks and keep using it on an SOS basis whenever she gets allergy. When you start, continue it for a day. A single daily dosage is sufficient usually. 3. Inhalers like Asthalin and Seroflo are to be used as per the chest physician advice. Keep both handy and may need to be used whenever there are flare-ups. 4. Maintain a diary and write down whenever she gets allergic symptoms, when she goes to some new place, when she opens any old book, garden, pollen, any relation to the food she eats, linens, beddings, etc. 5. Keep house and surroundings extremely clean and tidy. 6. Stop exposure to smoke, pollution dust, and direct cold air. Do revert back to me for further support and help. It is important the kid has a healthy childhood for appropriate development physically and mentally." } ]

[ { "from": "human", "value": "Hi doctor, I am 33 years old. Before 10 months, I came to know that I am a diabetic. My fasting sugar was 155 and PP was 215. My doctor prescribed Geminor M1. My HBA1C is 5.5 and ABG is 111 now. The issue is that I am more skinny now. I was 62 kg when I was diagnosed and now I am 58 kg. Please tell me what to do." }, { "from": "assistant", "value": "Hi. For further information consult a diabetologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am meant to be having a root canal filling in one of my teeth. I have had it temporarily filled twice and now it has fallen out but it feels like there is only one side of my tooth almost like it has broken in half. Will they still do the root canal filling?" }, { "from": "assistant", "value": "Hi. I have gone through your question. I can understand your concern. Yes, if the root stem is strong and not resorbed, root canal treatment can be performed, after that, if the crown tissue is grossly damaged they will do another procedure called post and core treatment. So, you need not worry." } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "assistant", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 21-year-old female. My partner and I were intimate and he came on my hands. We were sitting side by side and there was no genital contact. There was also no fingering or intercourse. I then proceeded to wash my hands with running water and some bodywash gel. I then washed down there using a jet spray and one hand only on the outsides and did not do fingering while washing either. Is there a risk of pregnancy? I also took an Ipill within three hours after that. Please do help." }, { "from": "assistant", "value": "Hello. There is no risk of pregnancy as intercourse was not resorted to. Also before touching your genitals, you washed with soap which would have killed the sperms right away. There was no requirement of taking an Ipill, but now that you have taken it, it is just double protection and you should wait for your withdrawal bleed in the next few days. Once the bleed starts it would mean endometrial shed and indicate that you are pregnancy safe. There are possibilities that you may face some side effects due to high dose Progesterones like a headache, nausea, bloating before the bleed, but that is normal and can be countered by increasing your water intake till the bleeding starts." } ]

[ { "from": "human", "value": "Hello doctor, I am a 28 year old male, having terrible acne issues since my teenage. Now I am married and a father of a child, and I still have pimples all the time. I have been treated for acne for many years. Some of the doctors suggested me to take Doxycycline 20 mg daily for 3 months. It delayed the appearance of pimples but did not stop them. Then, I moved on and got help from another skin specialist. He treated me and gave me soap and face wash. He also gave me another antibiotic called Azithromycin 500 mg for 3 days in a week for about 2 months. He also gave me topical creams (Deriva-CMS, Adapalene microspheres, Clindamycin phosphate gel). But the same thing happened again. The acne eruption stopped only for a few months when I was taking medicines, and after that, it started coming back.These pimples are also seen in my back. But now, only very few pimples are left in my back. I guess due to all these medications it has reduced but not permanently gone. I heard about Isotretinoin medication which is also an option for acne, but I have not tried it. I am really suffering from acne issues for quite a long time. Please help me get rid of this." }, { "from": "assistant", "value": "Hello. I have reviewed the images (attachment removed to protect patient identity) Moderately severe to severe grade of acne and persisting since years such as in your case is an automatic choice for treatment with Oral Retinoids i.e Isotretinoin. You may continue with other topical medications like Adapalene, Clindamycin, and Benzoyl peroxide gel and oral antibiotics such as Azithromycin." } ]

[ { "from": "human", "value": "Hi doctor, I have placed caps in my two teeth. Now, I got swelling around the teeth. X-ray has been taken. The doctor told me that there is some infection in the teeth, so it needs a root canal to be done. I do not have any pain in the teeth. I have only swelling in the teeth. Please suggest what to do?" }, { "from": "assistant", "value": "Hi. Pain will come back after a few days if the root canal treatment is not done for the infected teeth. It is better to do a root canal treatment in the teeth as soon as possible as the pain can become unbearable. Such swelling come due to nerves that get rotten inside the teeth due to various reasons like putting a cap over it. You will need antibiotics and painkillers. For more information consult a dentist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I have a family friend that recently was admitted to hospital for shortness of breath. She was advised that after several examinations that she has a form of cancer. The information that we were provided with was that they were unable to ascertain where or how severe the cancer was. Some confusion over whether it was thyroid or lung cancer and also its placement. The advice given was for her to undertake a bronchoscopy in order to do a biopsy of the lung. She had complications as a result of the bronchoscopy and was put in ICU for observation. That was last week, we have now been told that she will not recover and is too weak to breathe for herself and fight cancer. They have given her 48 hours. I really would like a second opinion because I feel we have not been told the full story. Would you recommend this procedure despite knowing that a patient was under stress with her breathing? Was there another way they could have gone about retrieving what they needed through a different procedure? I just want to quiet the nagging thoughts I have because I feel like this should have been a simple day proceedure." }, { "from": "assistant", "value": "Hi. Confirmation of any form of cancer is by biopsy only when the malignant cells are visualized under a microscope and reported to be positive. Rest of the radiological test like HRCT and MRI are highly sensitive but not specific. I am assuming that the cancer was either diagnosed by cytology or radiology in her case and they did a bronchoscopy to get the tissue they suspected of being malignant. Usually, broncoscopy is done under anesthesia and does not cause any complication. Probably the cancer had been more advanced in this case or the patient's physical condition was poor but anyhow there is no other way than broncocopic tissue examination to confirm the diagnosis." } ]

[ { "from": "human", "value": "Hi doctor, I have been getting spots on my penis. I do not remember that I had them as a kid. I know it has been getting more over time, but really slow that I do not realize it. I remember that the doctor messed up my circumcision and my parents were going to sue the doctor for that thus the skin around it looks like that. What are the dark spots? Is there a way to get rid of them and the excess skin on the side of my penis? Please help." }, { "from": "assistant", "value": "Hello. I have gone through all your photos (attachment removed to protect patient identity). Basically you have two queries. First the extra skin which you want to remove. That can be possible by surgery but if you do not have any problem with that then you avoid surgical procedure now. Second are the patches. Well, let me tell you that your skin is totally normal but you have white patches. I mean to say your penis skin is little dark and that extra white patch is the main problem. This is type of penile vitiligo. In vitiligo the skin loses its normal dark pigmentation. It is not a dangerous problem and it is not going to impair penile function in future. This problem could be triggered by circumcision or maybe not. Use Tacroze 0.03% cream (Tacrolimus) once at night over white patches. I again want to emphasize it that the white patches are the problem not the dark one. As I have seen many cases, I am able to identify it. Continue this cream for 20 days and let me know the effect. Revert back after 20 days to a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "assistant", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]

[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "assistant", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "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." }, { "from": "assistant", "value": "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 -->" } ]

[ { "from": "human", "value": "Hi doctor,My wife is 42 years old. She is feeling pain in the right wrist while moving the palm laterally outward. The movement gets somewhat obstructed slightly and it is not smooth. This has been started after an occasion when she tried to pull or carry one heavy bag a week ago. X-ray has been done on her right wrist which is enclosed herewith. Please comment on the severity of the wound and its medication. Thank you." }, { "from": "assistant", "value": "Hello. Revert back with the photos to an orthopaedician and traumatologist online -->" } ]

[ { "from": "human", "value": "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." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,I have been struggling with acne for a while now and have been postponing going to my general physician. I have been very hesitant on what to use and do not ever apply anything apart from a light cleanser on my face. I am not even sure what the term would be for it except the loose term rosacea. I am looking for advice on what prescription or non-prescription medication would be safe and effective for my acne with concerns of my nose getting worse. I also have very pale skin." }, { "from": "assistant", "value": "Hello. Your concern is acne rosacea and sensitive, acne-prone skin. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had an injury to my eyes seven months back. I got metal shavings in both and had to remove and left scars on my retina. Since then everything is blurry and went to the eye doctor last month. My prescription has not changed. They say I have dry eye and starting of cataracts. Can the injury be a result of those things? I did not have a problem before." }, { "from": "assistant", "value": "Hi. Blurred vision may be due to a corneal problem, cataract or retinal scars. After trauma, all these complications can occur. Dry eyes will improve with artificial tears and cornea will get normal. But any corneal scar or opacity will remain and can hinder in vision. Cataract may be age-related or due to trauma. So if it is visually significant it is treated by surgical removal and intraocular lens implantation and your doctor will guide you when it needs to remove. The retinal scar can cause decrease vision significantly if they involve a central part of the retina called macula responsible for sharpest vision. But we can do much to treat retinal scars. So things to do are treat dry eyes and cataract (if surgery needed). I would suggest you visit your eye doctor and he will guide you accordingly." } ]

[ { "from": "human", "value": "Hello doctor, I am a 44-year-old woman. I am taking treatment for a cyst in the ovary and irregular cycle for the last four months. I am given Cabergoline tablets to be taken once in a week. My weight, in the beginning, was 71 kg. Today I checked weight to be 66 kg. I did nothing for weight loss except used two staircases of 10 steps each at the workplace. Being a teacher I am bound to use staircase more. Having done nothing I am confused about the reason for weight loss." }, { "from": "assistant", "value": "Hi. Everything is fine. Just because your cyst has disappeared as your hormonal level becomes normal and you keep exercising, so not to worry. Your weight was high just because of hormonal imbalance. Since you have taken treatment for that, your weight reduces. It is a good sign. Not to worry. Just have protein rich and fibre rich diet. Avoid fats." } ]

[ { "from": "human", "value": "Hello doctor, My 17 months old daughter booked in for grommets and adenoidectomy due to fluid in middle ear and recurrent ear infections. We are flying two weeks after the procedure. We will be visiting a place with bad air pollution. Will she be more at risk of respiratory infection with no adenoids?" }, { "from": "assistant", "value": "Hello. At a place with bad air pollution, one's respiratory mucosa tends to get excoriated and irritated due to the harmful contents in the air. This can make the area supple and raw and more prone to bacteria and viruses in the surroundings. Having removed adenoids does not make your kid very susceptible to respiratory infections although theoretically adenoids are supposed to help contain infection by acting as a portal of immunity for harmful organisms entering through nose and throat. But at two weeks post surgery, the area will still be slightly raw and healing would not be complete. Hence, that can cause more susceptibility to environmental pathogens. I suggest you take a good course of antibiotics post surgery and during the hospital stay. Take a course of antibiotics for the baby with you and start when you feel she is developing an infection during your trip. Take decongestant nasal drops sprays and Tylenol for fever relief. Avoid areas of frank dust and pollution. Stay away from direct cold winds and Aircon air. If feasible put a face mask for the baby. The mother also should stay healthy as much as possible and follow all precautions to not develop an infection or allergy." } ]

[ { "from": "human", "value": "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." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]