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sajilperfects

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llama_medical_dataset_7k_qa

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[ { "from": "human", "value": "Hello doctor, My mother is 57 years old and she is a cardiac patient. She is having skin infection around his face, neck, and ear area. For the past two days she is taking the following medicines for this infection: 1. Surfaz- SN ointment (Clotrimazole, Beclomethasone Dipropionate, and Neomycin sulfate cream). 2. Zenflox- OZ (Ofloxacin and Ornidazole). 3. Allegra 120 mg. Please suggest." }, { "from": "assistant", "value": "Hello. I have seen the picture. (attachment removed to protect patient identity). This is herpes zoster. The following medicines are required for this condition. Tablet Valcivir 1 g thrice daily for seven days, Fusidic acid cream twice daily, and tablet Dolo 650 mg (as required for pain). Is there any hearing loss or ringing voices inside that side of ear? Any face palsy? (for this you can send front facing a picture of your face with both eyes wide open)." } ]

[ { "from": "human", "value": "Hello doctor, My daughter is 18 months of age. She was born at 38 weeks due to placenta failure and oxygen issues. She was 5 lbs 10 ounces at birth and was healthy (did not have to stay in the NICU). She hit all of her milestones in terms of rolling over, crawling and walking (walked at 14.5 months), but is a toe walker. Her left leg (to us) is weaker than her right and her left leg does not bend as much as her right leg. She began to speak around 10 months of age then her speech left. We came to find out she had chronic fluid and a month back she had tubes placed. I am hearing more vowel and consonants now but no true words yet. She makes fine eye contact. Her non-verbal communication is good. She responds to her name but not always. She is beginning to learn more of what we are saying, she plays with some toys, is not terribly social. We are thinking that she may be on the autism spectrum and we have an evaluation soon to determine that. But my question is, could this be cerebral palsy?" }, { "from": "assistant", "value": "Hi. I understand the situation you are facing with your child. As there is no history of perinatal insult and NICU stay at birth, cerebral palsy could be less likely at this early age to diagnose. The description you made is more of a like to be an autistic spectrum disorder. But this could be just a small delay in catching up all milestones. Some kids learn early and some little late. So, observe over a period and if no improvement is seen, then consult a pediatric neurologist and developmental specialist for further evaluation and management." } ]

[ { "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": "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, My mother-in-law is having difficulty in walking, climbing stairs and sitting. She is having pain in her waist for the last one month. She feels tired and helpless. She always wants to sleep. On some occasions, she becomes unconscious without any reason. When we checked her blood pressure, it was normal. We consulted many doctors and I have attached her reports here for your reference. She is currently on Myotop, Gudbie DSR, Nurokind More, Parnacal OS and Myolaxin." }, { "from": "assistant", "value": "Hello. Revert back with the answers to the above questions to an orthopaedician and traumatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I want to ask that is there any method with which we can have periods earlier than due date? Also, if we can use any tablet to delay monthly periods?" }, { "from": "assistant", "value": "Hi. There are medicines to delay periods but to bring it early might be dicey, as spotting may stay, finally botching the occasion. Please start taking tablet Norethisterone 5 mg twice a day two days prior to the expected date of periods and continue till the day you want to. Periods usually commence within 3 to 7 days of stopping the medicine." } ]

[ { "from": "human", "value": "Hello doctor, How long does it take for Acidophilus to get out of your system? Since stopping I have experienced indigestion. I am wondering how long it will take for the probiotic to be out of my system. Last week I started having some digestive issues. Mainly just pain and pressure in my upper abdomen. I did not experience any diarrhea. I thought I was slightly constipated and did take Miralax one night and eventually, the stool did return to normal. However last week I woke up with awful indigestion. Next day, I had lower stomach cramping the entire day. Later that night the pain was on my lower left side, I decided to go to the ER. There they did urine tests, and did press around my belly and back, and took vitals, everything was normal. I was given Maalox and felt better. The pain eventually went away. However, again last night I woke up with awful indigestion. I recently stopped taking Acidophilus because they were not helping. I am wondering if stopping is contributing to my issues." }, { "from": "assistant", "value": "Hi. I do not think your indigestion is because of Acidophilus. Also, these probiotics do not get into the system. It just stays in the GI tract. They do not get absorbed. They can stay for a longer period of time and are beneficial. I think all this indigestion-like feeling is dyspepsia, may be non-specific. Just avoid overeating, spicy, and oily food. You can use Nexum 40 mg tablets over the counter for 1 to 2 weeks, every day in the morning 20 minutes before breakfast. You will get better." } ]

[ { "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 cholesterol is 170, triglycerides are 293, HDL 24 and LDL 107, non-HDL cholesterol 143. What measures should I take and when should I repeat my test?" }, { "from": "assistant", "value": "Hello. I have gone through your report, and especially your triglycerides and HDL are deranged. These are not immediately life-threatening but may be harmful in long term. Firstly, I guess this was a fasting sample even without tea in the morning, if not then you should get it repeated with absolute fasting of at least eight hours as it can falsely elevate triglycerides. Next thing, you should have a period of 2 to 3 months with a healthy lifestyle before starting medicines as medicine may reduce triglycerides but it will again rise after you stop medicines. So maintenance is important with lifestyle changes. So, you should have a healthy lifestyle like avoiding fatty oily and a high-calorie diet. Avoid free sugar, cola drink, and other beverages. Plenty of green leafy vegetables. Reduce alcohol consumption and smoking, non-vegetarian especially meat and chicken, if any. Most important are the exercise to burn your lipids, so should have at least 30 minutes a day and at least five days a week of exercise like brisk walking or running according to your capacity. After 2 to 3 months of a healthy lifestyle, repeat lipid profile and see for the changes. If there is no response then you may take medicines like Fenofibrate." } ]

[ { "from": "human", "value": "Hello doctor,My nose is always blocked and have mucus, from past four months. To open up my nostrils, I have to use Otrivin, else my nose stays blocked." }, { "from": "assistant", "value": "Hello. In your condition, we must rule out certain etiologies as follows: This would require you telling us in more details your problems. Let me ask you certain questions and please provide answers to those as objective as possible. Please let us know about all these. If you have done any test or scanning or investigation for this purpose please upload the films and reports in your follow-up query to me. For more information consult an allergy specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have an uneven skin tone with dark forehead and dry skin. I want to brighten my complexion. Also, I have small bumps and ingrown hair after waxing. I have attached pictures of the same. Please suggest a treatment." }, { "from": "assistant", "value": "Hello. I have read your query and examined your picture (attachment removed to protect patient identity). Consult your specialist doctor, discuss with him/her and take the medicines after their consent. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,I am 21 years old. About a month ago, I realized I had tiny smooth painless bumps on the inside of my butt cheek. They do not have pus, itch, or hurt. I have had unprotected sex, so I went to a clinic. That doctor said it was not herpes and she did not think it was warts because there were too many of them and they were too smooth. She recommended I see a dermatologist. I do not shave my bottom so I knows it is not razor bumps. I do not remember ever seeing them before and they do seem to be spreading although some have disappeared. Any ideas what it could be?" }, { "from": "assistant", "value": "Hi. I saw your clinical pictures (attachment removed to protect patient identity). I am very sorry the pictures are bit blurry, but it looks like molluscum. You will have to meet dermatologist because you are saying that they are spreading. Molluscum is also sexually transmitted viral infection. Molluscum is a highly contagious viral infection, presents with pearly white papules (bumps) with a central pit. It can be confirmed by dermoscopic examination. Another possibility is folliculitis in that area, they are usually painful pustules. 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 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 having a burning sensation in my leg. I am wondering if that is a blood clot and if I should go to the emergency room. I had a massive pulmonary embolism and have been coded for 45 minutes. I am on a blood thinner called Eliquis. I am very freaked out right now as I have not had this burning sensation in years." }, { "from": "assistant", "value": "Hello. DVT (deep venous thrombosis) that is a blood clot in the legs does not cause burning sensation but causes swelling of the affected leg and you are already on blood thinners. I hope you INR (international normalized ratio) is within therapeutic range unless you are taking new oral anticoagulants. I think you should do blood sugar and preferably HbA1c (glycated hemoglobin) and relax as it cannot be DVT. For more information consult a cardiothoracic surgeon online -->" } ]

[ { "from": "human", "value": "Hi doctor, I need some advice on behalf of my mother who is 67 years old. For the past 12 days my mother has been experiencing pain in the throat area, feels like something is stuck, vomiting mucous, weakness, body aches, white tongue, difficulty swallowing, and vomiting feeling while talking and eating. She vomits about twice a day. She consulted an ENT and internal medicine doctor. ENT dismissed her after nothing found in throat using a camera but the internal medicine doctor did some investigations. Results showed UTI (epithelial cells 20-25/HPF and pus cells 30-35) and TSH (13.5) raised as well as Candida Albicans growth from a throat swab. She has had this issue every few months and normally clears up on its own, but this time it is very severe and not going away. Current medication: Cefotil (Cefuroxime 500 mg and Clavulanic acid 125 mg), Gelora gel for oral thrush (Miconazole BP 2%), Motigut for vomiting 10mg), Thyroxine (50 mcg currently but internal medicine doctor asked to increase the dose to 1.5 tablets due to high TSH). Urine culture was done and it was normal. My query is, whether this is a bad infection, not bacterial but growth of esophageal candidiasis can be treated by antifungal therapy Fluconazole? No improvements are seen with many antibiotics. Oral thrush candida was found on initial appointments and also candida in throat swab. Is there any harm in trying a course of Fluconazole? She had a history of fungal infections in the throat which normally clear up on its own. This time it seems much more serious. If it is fine, what dosage would you recommend and for what period?" }, { "from": "assistant", "value": "Hello. Yes, your mother is suffering from 1. Hypothyroidism. 2. Oral candidiasis. 3. UTI (urinary tract infection). 4. Dysphagia. Oral candidiasis or oral thrush if not improved within five days after starting local antifungals then you may start oral antifungal medication. You may use tablet AF (Fluconazole) 150 mg once a day for one week. But in case of old age, people may feel nausea or vomiting for this drug then you can give iv Fluconazole (Forcan 100 ml) once a day for five days. In old age, vitamin B12 deficiency is also common, so it may present like glossitis with pharyngitis. Take vitamin B12 injection weekly once. You can give Neurobion injection also. Use Candid B mouth paint for local application. Use tablet Levosulfuride 25 mg twice a day for nausea and vomiting. At the same time check for serum electrolytes levels which may be altered in old age lead to vomiting. You may give probiotics like capsule Gut ok or Sporulac sachets to increase the immunity levels and also prevent gut growth of fungus. Remaining medications you continue the same. Response to the treatment may take four to five days. Diabetic patients are more prone to oral candidiasis so check for blood sugar." } ]

[ { "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,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 have two dark red circular spots under the tongue, on the duct area that has not gone away in months. Kindly help." }, { "from": "assistant", "value": "Hello. It seems to be a small blood clot which may have occurred at the soft tissue at the salivary duct area. The reason may be due to suction pressure which might have created a negative pressure inside mouth causing such minor blood clots. It is not a severe condition to get worried. Due to the soft tissue area, it takes too much time to go away. It will resolve on its own, and no action is needed, and definitely, nothing to be worried. Send a clear picture if possible." } ]

[ { "from": "human", "value": "Hello doctor, I have been experiencing what my mother says is a panic attack, but I am not sure because I only get racing thoughts, my heart races or beats really hard, and I feel shaky like I might cry (no other symptoms). I read that panic attacks peak at 10 minutes, but I feel this way for hours and it keeps me up at night. I have no previous problems with mental health, and I think it is only a fear of the dark keeping me up. What should I do?" }, { "from": "assistant", "value": "Hello. Your mother is probably right. You are describing anxiety and panic symptoms. Staying at a noisy Air BNB has probably accentuated your fears. How long have you been having these symptoms? If you are not having any problems during the day and no problems during other situations, then it possibly is just a fearful psychological reaction to an unfamiliar situation. If it is persistent and pervasive, it will be helpful to see your doctor for an assessment. Try these simple measures to manage your fear: 1. Breathing techniques. 2. Progressive muscle relaxation exercises. 3. Keep a light switched on in your room during sleep. Perhaps having some music at low volume can help. 4. Speak to your mother, friend regularly, if possible, you can share your room with a friend to make it less fearful. Remember that these fearful thoughts get better gradually with support. Take care." } ]

[ { "from": "human", "value": "Hi doctor, I got tested for Chlamydia trachomatis and got my report. It gives out the value as 2.2411 and the safety zone is 0.08. I would like you to suggest me the treatment. Thank you." }, { "from": "assistant", "value": "Hi. Please upload your test results for my reference. Thank you. Revert back with the reports to a sexologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had eye checkup nine months back as I had light pain in right eye. The doctor advised me to get OCT and CCT. With the test reports he said that I have glaucoma. He advised me to take an eye drop named Lumigan one drop daily at night in both eyes. I am not satisfied with his opinion and so went to another doctor. He said no glaucoma and advised to take vitamin tablet daily. After a week consulted another doctor and he said that the OCT report is normal and no need to take any eye drop. After a week I went to a famous eye hospital and consulted there. Again took an OCT and reported to have glaucoma and advised to take Brimosun 0.15% drops twice daily with a gap of 12 hours. A month later went to another hospital and the doctor said he is in confused state and asked me to check my eye regularly and take OCT for every six months. Then two months later I visited a glaucoma expert and he examined my eye deeply and done another OCT. After all tests he said I am a glaucoma suspect patient and advised to take eye drop Timolast 0.5% or Timolet od every morning one drop in both eyes. My eye pressure is always between 20 and 24 in both eyes. My first and second time CCT reports are 502-503 and 533-534 respectively. My OCT reports showed 10% area in red figure and balance in green figure in the left eye and 10% area in yellow and balance in green in the right eye. Is it necessary to take glaucoma drop? If yes, which one to take from the above? Is Timolet a highly concentrated one in comparison of Brimosun 0.15%? My mother suffered with glaucoma. I am taking Thyronorm 75 daily. Please advise me in detail. Thank you." }, { "from": "assistant", "value": "Hi. First of all please relax. There is nothing to worry. All the doctors are correct. Now let me explain you. Glaucoma is a very slowly progressive disease. You are glaucoma suspect means you are at risk of glaucoma or have many predisposing factors for glaucoma, but there is no conclusive evidence to diagnose glaucoma. Predisposing factors present in you are as follows: All these factors make you susceptible for glaucoma, but it is not conclusive. You should not worry about glaucoma or loss of eye sight. Having said that you can use Timolast eye drop (Timolol) or Timolet eye drop twice a day, there is no harm in using this eye drop. Some doctors give Lumigan (Bimatoprost) and some give Brimosun (Brimonidine). There is no harm in using any of these eye drops, but please use only one of these. For further information consult an eye care ophthalmologist 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": "Hello doctor, My mother is 65 years old. She is having a fever for the last seven days. She also suffers from stomach problems. For the first five days she did not have any stools, then she passes stools four times the day before yesterday, and few times yesterday. Probably she has severe amoebiasis. But her fever is not receding. What to do? She is currently on Omez D once, Ofloxacin 200 mg bd, Azithral 500 mg OD, Vizilac one tab TDS, Metronidazole taken for five days and now stopped, ORS in ample amount." }, { "from": "assistant", "value": "Hello. I reviewed your mother's history and investigation. (attachment removed to protect patient identity). The history and low TLC (total leukocyte count) and low platelets on CBC (complete blood count) are suggestive of enteric fever. Kindly do the following things. It does not look like to be amoebiasis. US (ultrasound) abdomen. Enteric fever. Continue Azithromycin in the same dose and complete five days. Injection. Ceftriaxone 2 gram IV in 100 ml NS daily for seven days. Tablet Paracetamol three times daily. ORS (oral rehydration solution). Use a soft diet. Get back to me with the US report." } ]

[ { "from": "human", "value": "Hi doctor, I have a skin infection in my inner thighs. It burns and itches a lot. Even, the slightest touch triggers the itching. I have been applying Clotrimazole for the past two days. On using it, the itching stops. But again, I have itching after a few hours. I have the infection in my inner thighs near the scrotum. I have attached an image. Please suggest." }, { "from": "assistant", "value": "Hi. I have gone through the attachment (attachment removed to protect patient identity). You have a candida infection in the groin area, called tinea cruris. Use Clotrimazole ointment twice daily for ten days. Take Itraconazole 100 mg orally once daily for ten days. Keep the area dry." } ]

[ { "from": "human", "value": "Hello doctor, I have tingling left arm. Thumb and index finger are somewhat numb. Skin lesions infect arm. I was told that they are not shingles. Bone at base where skull and spine meet is stiff and sore. On no medication. Taking Ibuprofen for pain." }, { "from": "assistant", "value": "Hi. Tingling sensation in the left arm can be due to nerve compression in the neck or in the arm. You will need a thorough physical exam followed by electroneuromyography study of the arms and legs and if possible, MRI of the cervical spine. Meanwhile, do not lift heavy weight and bend forward." } ]

[ { "from": "human", "value": "Hello doctor, I have moles under the nails of each of my big toes. They appeared over the last months, but I do not remember exactly when. The one on my left toe is a round dot in addition to a diagonal line next to it and that goes to the right edge of my nail, while the one on my right toe is just a round dot. The nails themselves are also somewhat cracked and do not look good. I am wondering if there could be cause for concern. I am sending a photo of my toe. Please help me." }, { "from": "assistant", "value": "Hi. Revert back with answers to the above questions to a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well." }, { "from": "assistant", "value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help." } ]

[ { "from": "human", "value": "Hi doctor, Around three months back, I started to hear a strange noise at night. We live in a village. Apart from the odd barking dog and passing car, it is silent, especially at night. However, I started to hear what sounded like a distant engine, but it never got any closer. It is almost like a droning sound, not a hum as such as seemed to almost vibrating through me. It did not particularly stop me sleeping, but was annoying. It was there for a couple of nights and I would go outside and could not hear it. I could hear it in other rooms of the house, although maybe not as loud as the bedroom. I could find no real explanation for it. Electric cables are going to the house but have been the same for years, and nothing has changed. Then a couple of weeks later, the noise was back and was really loud when I went to bed. I fell asleep but woke in the middle of the night, and it kept me awake. The next day I could still hear it everywhere in the house, also in the next door house, but not so much outside. It is like a constant distant aircraft noise or car engine that goes in and out, louder, quieter, louder, quieter and at times I almost feel it than hear it. It left me tired with a slight headache, and it was just pulsating through my body all the time. That was the worst day. Since then we moved to another house in an entirely different area, although still a quiet village location. There is a very little passing traffic as we are at the end of a lane. At first the noise seemed to have gone; however, I have begun to notice it again. I can hear it all the time, but in the day there are other noises and distractions. It is at night when it is very quiet I can hear a constant drone. It now seems mainly in my left ear, or I can hear it especially in that ear. If I put my finger in that ear, it stops. Also if I hold my nose and blow and keep the pressure up the noise cannot be heard. If I put my finger in my right ear, I can still hear it, although maybe not as loudly. For example, it was very distant this morning. If I put my left ear on the pillow and lie on my side, I can hear it just the same. It does not keep me awake and or cause me any real problems. I am just getting concerned it could be due to something nasty, like a brain tumour or something. I went to the pharmacist and got some cleaning spray. I have also had a consultation with an ENT specialist. I did not explain to him about the droning sound as it is difficult in another language, but he gave me a checkup and did not find anything out of the ordinary by looking in my ears, nose, throat, etc. I have recently been diagnosed with hypothyroidism although I can get no connection. If it is tinnitus, then I can live with it quickly enough at the moment. But, I am concerned that it could be the symptom of any serious underlying problem. I have had recent blood tests done, and they were all fine apart from my TSH levels for hypothyroidism, and my blood pressure is fine." }, { "from": "assistant", "value": "Hi. Revert with the reports to an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, Can I get pregnant without having sperm released inside my vagina during the intercourse? How can I confirm if I maybe pregnant? If I am pregnant what should I do for abortion without surgical means?" }, { "from": "assistant", "value": "Hi. Until there is ejaculation in the vagina or precum, there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt then take an emergency contraceptive pill within 72 hours of intercourse. There is no chance of pregnancy. However, if you have crossed 72 hours of intercourse then please do not take any medication without expert advice. If you happen to miss your period then get a urine pregnancy test done with an early morning urine sample to ensure that you are not pregnant. However, if you have a doubt then get back to me." } ]

[ { "from": "human", "value": "Hi doctor, My mother is 78 years old now. Before 12 days back, she had a cough and high fever. She had a wheezing problem along with a cough. She was given Azithromycin and Cratex expectorant. Her temperature got subsided after five days. But the coughing problem has not stopped. Her X-Ray finding suggested COPD. Her hemoglobin level is 9.2 ng/dL. She has WBC of 1980 WBC per microliter of blood. She has neutrophils of 28 % and lymphocytes of 69 %. She has ESR of 60 mm/hr. Currently, she is taking Domperidone, Etizolam, and Olmesartan." }, { "from": "assistant", "value": "Hi. She has a chronic obstructive pulmonary disease. Her lymphocytes are elevated. She seems to have viral bronchitis. Her total WBC count is decreased. It can occur due to bone marrow suppression by a viral infection. For wheezing, she can take Ipratropium bromide inhalation through a nebulizer for three to five days. Please mention whether it is a dry cough or a wet cough. According to the characteristics of a cough, further treatment can be guided. She needs to consult a pulmonologist for chest examination." } ]

[ { "from": "human", "value": "Hello doctor, I am a 19-year-old girl. In my first year in school, I feel helpless and depressed because I cannot make friends, more specifically they do not like spending time with me because I am serious most of the time. And my way of thinking is different also I cannot focus on studies. I do give my best to succeed in the exams but still, I m feeling like it is not me, or it is not what I want to do. But I am not sure those are just thoughts that makes me all the time unfocused on what is necessary at the moment , I also suffer from a lack of confidence in myself and cannot say that my situation is the worse but all these 19 years I only learned to hate and hurt myself more than anyone can else do to me. I am scared of taking any wrong decision because I cannot afford it either mentally or financially. Please, can you help me? Going to a psychiatrist in my place is expensive and suspicious. I was a great person until nine years, everything has changed. I struggled alone till 16 which made me talk to some friends and my brother and my secret fiance. Still, I think it is too late because I became a person who is afraid of being happy for more than half a day." }, { "from": "assistant", "value": "Hello. First of all, you should stop hating yourself and stop blaming yourself for anything. The symptoms like helplessness, worthlessness (hating self), difficulty in making friends, weak confidence, lack of focus, indecisiveness, etc., are occurring most likely due to some mood disorder. This could be depression. Depression results in impairment in functioning. To come out of these thoughts, there are two treatment options. Medicines especially antidepressants are the first choice for these symptoms. But since you cannot afford to visit a psychiatrist so this option at this point is not possible. Another option is cognitive behavior therapy (CBT). This is a session based therapy. A therapist is needed, and this helps a lot in coming out of depression. Over the years since childhood, a person learns wrong things, but these thoughts become cognitive distortions like for example if you did not perform well in a group of friends, then you will imply this to your whole life that you are worthless because you fail to perform well in friends. Maximizing negative things, minimizing the positive things, disqualifying positives, generalizing things, etc. are examples of cognitive distortions. In CBT the cognitive distortions are identified, and an individual is made aware of these distortions. Then therapist and individual work together to eliminate these distortions and to work how an individual can live happily. Thanks" } ]

[ { "from": "human", "value": "Hello doctor, My 7-month-old baby does not want to feed on the bottle. I am currently breastfeeding and I want to feed her Enfamil. What can I do about it? She is not gaining weight. Her weight is consistent at 7.5 kg since she was 4 months old. But she is good. No illness. But my main complaint is that she does not want to drink from her bottle and I do not want to breastfeed anymore." }, { "from": "assistant", "value": "Hi. I understand your concern. Bottle feeding is not recommended to any child for long term. You can try spoon feeding. Yes, it will not be easy to shift from breastfeeding to top feed. Should try gradually. As per WHO, the baby should be continued on breastfeeding for a minimum of 1 year of age. It is good for overall long-term growth of the baby." } ]

[ { "from": "human", "value": "Hello doctor, I am 18 years old. I had a symtoms of piles. I think there must be a little growth of substance. Is it very serious? What can I do for it? And tell me some practices to control it." }, { "from": "assistant", "value": "Hello. First of all, do not worry too much. It does not seem you have complicated piles since this presents with sudden and intense local pain (in which case you should go to a surgeon). It seems you have a mild disease. There are various recommendations for this problem. You should poop without difficulty. I recommend Psyllium Plantago (oral powder) one spoon in a glass of water every morning. Sitz bath with warm (not too warm) water two times a day (for 20 to 30 minutes). Diltiazem ointment, place a small amount in the affected área two times a day (after you do sitz bath). Continue this for at least six weeks and you should get very good results." } ]

[ { "from": "human", "value": "Hello doctor,The patient is 65 years old. Doctors have concluded liver fibrosis stage 2. In fibro scan, the lymphocytes are 95 %, amylase is 20 U/L, monocytes and macrophages is 5 %. The fluid is hazy in appearance. Can liver fibrosis be reversed?" }, { "from": "assistant", "value": "Hello. Interpretation of reports. With this advanced fibrosis, it could not be reversed back." } ]

[ { "from": "human", "value": "Hello doctor, For the last two weeks, my two wisdom teeth on the right side of my face have been coming in. The pain has been incredibly severe and is almost unbearable at this point. I have been experiencing headaches and tenderness pain in my neck, jaw, and gums. I have trouble moving my jaw and speaking at times due to the pain. My teeth have become extremely sensitive to hot or cold items, my teeth are so sore that I struggle to chew food since my molars cannot touch without resulting in an incredible amount of pain. I do not have any swelling in my jaw or neck aside from my gums. I have been taking as much Advil as is safe in a day and some CBD oil as well. However, nothing seems to be helping. I am really worried that I have an infection and how long I should wait before going to an emergency room." }, { "from": "assistant", "value": "Hi. I can understand this pain. It is like erupting pressure pain caused at every 2 to 3 months interval. Since you are done with Advil (Ibuprofen) and it is not going away. Please start taking the following antibiotic regime as soon as possible. Tablet Augmentin (Amoxicillin) 625 mg twice a day, tablet Metronidazole 400 mg twice a day, tablet Brufen 400 mg three times a day. Do a course of all these medicines for 5 to 7 days. An infection will subside through it and hopefully, you will be at peace for a month. You can repeat this course every two months if condition recurs. If the pain does not subside through this course then sure go to an emergency room. Moreover, do salt water mouth rinses. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses three times a day. Take mustard oil put a pinch of salt in it, make a paste and apply on swollen areas inside the mouth, at gum line before sleeping. This also helps in reducing swelling. Give me a followup after three days. Stay happy and blessed. Indeed, there comes ease after every difficulty or pain. Take care." } ]

[ { "from": "human", "value": "Hello doctor,My partner's periods date is 23. Last periods was on the 23rd two months ago. My partner and I were intimate on 10th last month. It was unprotected. So, she took an I-pill on the 12th. She bled on 22nd. Again we had sex on 9th this month. It was protected but the condom slipped. So, for protection, I gave her Unwanted-72 on the 10th. Till now, she did not bleed and her period date is also due. Please help." }, { "from": "assistant", "value": "Hello. Although you have rightly taken the emergency contraceptive pill both the time well within 72 hours after intimacy, so considering that she had her first bleed on time, it is likely that her next menses would anyhow be delayed by few days as a side effect known with I-pill. Now that you have taken an I-pill again, the bleeding should be expected by seven to 10 days ideally, but you can wait another week for withdrawal bleed to start naturally. If no bleed in next seven days then get a urine pregnancy test done to rule out pregnancy, possibly due to I-pill failure and if the test is negative then you can opt for a progesterone-induced withdrawal. Please follow up with further clarifications and discussion.Regards. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I found a very small dark spot on my thigh today. To the best of my recollection, I have never seen it before. Now, of course, I am thinking the worse and believe I have melanoma. I am olive-skinned. I have never had an issue with moles or dark spots before. My mom had a pre-cancerous growth removed from her face years ago and she is fine. She goes to her check-ups and applies sunscreen all the time. When I was a kid, I never saw my mom applying sunscreen. It was the 70's and it was just something we did not do. She just turned 76. I attached a photo. I am sure you will think it is something that should be looked at and so do I. I am going to make an appointment with a dermatologist. But I also suffer from health anxiety, depression and OCD so I am convinced it is melanoma and I am feeling very depressed right now." }, { "from": "assistant", "value": "Hello. I have seen the pictures (attachment removed to protect patient identity). No, it is not melanoma. It is a normal nevus (benign). For your confirmation, you can go for an excisional biopsy of the lesion. Histopathology reports will confirm that the lesion is benign or malignant. Do not worry it is normal nevus due to melanosis (increase in melanin pigment)." } ]

[ { "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 have been sick with side effects from Doxycycline for two weeks. I had a UTI which has cleared. I have been to the doctor twice, they checked my urine, and there is no infection. I feel tired, have chills, I feel cold, have a back and joint pain. I do not have a fever. I have read that, sometimes it can last up to three weeks. Is it possible to last this long? My blood tests are also normal." }, { "from": "assistant", "value": "Hello. Revert with more information to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had been suffering from this problem from last one week, as I retract my penis outer wall, it is paining and slightly swollen, also the tip of the penis has red small colour dots on it and it is scratchy and painful. So please recommend for necessary action." }, { "from": "assistant", "value": "Hi. It is looking like candidal balanitis. Please take the following medications and revert back to me in seven days. Tablet Intawin 200 mg daily for 10 days, Canestan lotion, apply twice daily, tablet Teczin M once daily." } ]

[ { "from": "human", "value": "Hello doctor, I am 36 years old. I am taking Sysron NCR 10 mg for heavy bleeding. I had unprotected sex on the 12th day of my periods. How to prevent my pregnancy?" }, { "from": "assistant", "value": "Hello. 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": "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": "Hi doctor, I twisted my leg and got an x-ray done. The report showed fracture at the base of the 5th metatarsal bone. How to proceed with the treatment? Thank you in advance." }, { "from": "assistant", "value": "Hi. Sorry to hear about your injury. I had looked at the x-rays (attachment removed to protect patient identity) you seem to be having a pseudo-Jones fracture. Mostly, this fracture can heal without any surgical intervention. You will have to use either a walking cast or an orthopedic boot. If it is painless, then weight bearing by the cast or boot will be fine. This part does not bear any pressure. Few fractures though healed, may be associated with some amount of pain. In your case, the fracture line is entering into the cuboid-metatarsal joint. Hence, some pain may be present. I would like to have a look at the lateral view x-rays of your foot as well your knee to check for any injury associated with other tarsometatarsal joints. Pseudo-Jones fracture. 1. Walking with below knee cast or splint. 2. Walking with orthopedic boot for six weeks with weight as bearable." } ]

[ { "from": "human", "value": "Hello doctor, Can you please tell me how to treat high alkaline phosphatase in blood?" }, { "from": "assistant", "value": "Hello. Alkaline phosphatase levels are measured to detect any kind of liver or bone disorder in the body. ALP raises with blockage of bile ducts which owing to conditions called cirrhosis, inflammation of the gallbladder, the presence of stones in the gallbladder or maybe due to hepatitis. Bone diseases presenting with high ALP include vitamin D or calcium deficiency. I need answers of a few questions before I can suggest treatment. What is your age? Are you on any medications or have you used any medicine in the past six months? Do you have a history of liver or bone disease? Do you have any symptoms of pain? Other than these, I want you to share your ALP report. Liver disease, drug intake. Complete LFTs, vitamin D levels, USG abdomen. Hepatitis, liver cirrhosis, vitamin D deficiency. Avoid food rich in zinc such as spinach and meat, increase fluid and dairy intake." } ]

[ { "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 am 27 years old, male, pursuing PG. This is the dissertation writing time for me. For that, I have to rely on a laptop most of the time. It makes my eyes uncomfortable (red and dry). So, would be glad to have suggestions. Any glasses that I could use while working on a laptop?" }, { "from": "assistant", "value": "Hi. People who spend much time in front of digital screens like a laptop, mobiles, etc., are at higher risk of developing dry eyes also called computer eye syndrome. Usually, we blink 8 to 12 times per minute but while using digital devices blink rate is decreased 2 to 3 times per minute. That is why tear film is disturbed and eyes get dry. So keep using Refresh Tears and try to modify the habits like blinking every 10 to 15 seconds during laptop use and try to avoid any humid environment. I hope these simple things will help you a lot." } ]

[ { "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 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 grandmother is 98 years old. Of late, she is complaining of head reeling often. She does not have high blood pressure or diabetes and her haemoglobin is normal. She has roti in the morning, rice and dal for lunch and roti for dinner. Her bowel movements are normal. What may be the possible reason and line of treatment?" }, { "from": "assistant", "value": "Hello. It is good to see your concern about your grandmother. But one thing you have to keep in mind always is that she belongs to a very fragile age group. Just like the young ones, old people also need special care. A most common condition in this age group is malnutrition, which occurs due to poor diet. This adds to every other risk factor which can develop in this age group. As per the reports (attachment removed to protect patient identity), there are no abnormalities yet, which is good. However, there can always be some underlying protein deficiency in this age group. Also, I would suggest you get her serum electrolytes, liver function profile, ECG and cardiac profile done. Increase the protein content in the diet, you can give egg white as well. Try to divide meals into 5 parts rather than the usual 3 meals a day. For her headache, I would say, in this age, there could be many reasons for headache such as reduced vision, refractory errors, glaucoma, anemia, respiratory conditions, etc. Hence you have to get a detailed assessment done to rule out every cause. For symptomatic improvement, you can give her NSAIDS such as Naproxen, Paracetamol when needed, but avoid repeated usage. Maintain her hydration, nutrition with high protein content. Once the assessment has been done, it is better to start with some medications, as in this age one should always be cautious." } ]

[ { "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 am 45 years and suffering from severe premature ejaculation (cannot sustain for a minute or two) and mild to moderate erectile dysfunction (less hardness and short length after erection, difficult penetrating other than the missionary position, long delay in repeat erection) since the beginning of my sexual life. For last few years, I am taking Dapoxetine 30 mg (Duralast 30) before sex. It gives me a bit control but as I find 30 mg not much effective so I started taking two pills of 30 mg sometimes together and sometimes after a gap of 3 to 6 hours. Occasionally, I also add 25 mg Sildenafil or Tadalafil 20 mg (Tazzle) for improving erection. My problems are as under:I find Dapoxetine 30 mg not effective but when I take two tablets, can control the ejaculation in a better way but has nausea feeling and low libido. I also feel too hungry after 1 to 2 hours of taking tablets. Besides even two tablets has effect for 2 to 3 hours and does not remain effective if sex is delayed. Now I started giving a gap of 2 to 3 hours between two doses of 30 mg which reduced the side effects. Is this pattern of dose fine?Is there a probability of any longterm effect of taking 60 mg daily dose of Dapoxetine?As most of the time one cannot fix the time of sex in advance as it depend upon the mood of the partner too. So Dapoxetinecannot be used as a curative medicine to improve the condition permanently or it is only SOS?How can I reduce the side effect especially of low libido and nausea?Effect of sildenafil remain a bit longer and help in erection even for two days of taking the tablet. What is your recommendation of doses? How to enhance the length of the penis as my penis face difficulty in reaching partner’s G spot and it reaches to full length only just before erection. Please advise a remedy." }, { "from": "assistant", "value": "Hello. I will answer as per order of your queries: For more information consult a sexologist 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, How does guava help boost weight loss? Can guava extract help in prostate cancer prevention? How does guava work as a remedy for cold? Why is guava recommended for better brain health? What can guava's high vitamin A content do for our eyesight? What are the other benefits of consuming guava (if any)?" }, { "from": "assistant", "value": "Hi. Guava helps in weight loss as it contains roughage or fibers. Fibers include both soluble and insoluble fiber. Fibers are the part of plant foods. Not all fibers are completely digested by the human body, hence they will not add to your calories, but they add bulk to the food. After consuming it fills our stomach and makes us reduce the quantity intake of other caloric foods like rice, bread, etc. Guava contains vitamin C, hence it acts as a remedy for cold. Guava contains vitamin E and C which are very much needed for good memory. Hence, it is helpful for good brain health. Guava is rich in vitamin C, A, antioxidants and lycopene which help in the prevention of prostate and other types of cancers. Other benefits of guava are: Rather than consuming an extract, it is always advisable to eat the complete fruit to get the complete benefits." } ]

[ { "from": "human", "value": "Hello, I am a 50 year old female who would like to have a breast reduction. However, I am high risk for vomiting from the anesthesia. I have a phobia of vomiting. I am a non smoker. I've had general anesthesia once before and I vomited several times. I am so scared that I have rescefuled the surger 3 times. Is there anything else that can be used instead of general anesthesia? What can be done to prevent the vomiting? Thank you" }, { "from": "assistant", "value": "Hi, General anaesthesia has known post aesthesia effects of nausea ,retching, vomiting etc. Also these may be due to direct effect of surgery and pain. You seem to be very sensitive and anxious to it. But usually it is seen that with each subsequent episode of administration of general anaesthesia these effects tend to decrease in severity. So if last time you had vomiting postanaesthesia this time it will be less severe in terms of no. Of episodes etc. This will reduce your discomfort. Also if you may have prexisting GERD or gastroduodenal ulcer , gastritis. These may also cause nausea vomiting postoperative. So I would advice discuss issues with your anaesthesiologist and surgeon. Nausea, vomiting can be taken care of by medicines like proton pump inhibitors, H2antihistaminics, antiemetics which will be give by your physician in recommended doses. Some pre-op anxiolytic medicines on night before surgery will help you reduce anxiety. Take a light non oily meal on day before surgery so that stomach stays relatively acid free." } ]

[ { "from": "human", "value": "Hi doctor,I am a 23 year old female. I am 45 days pregnant, and my HbA1c is 8.9. Will it cause any problem to the baby? I am taking medicine, and my sugar is under control now." }, { "from": "assistant", "value": "Hello. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am suffering from chest pain in the left side from 4 to 5 days, but my lipid profile and 2D echocardiography both reports are normal. What to do? What is the reason of chest pain?" }, { "from": "assistant", "value": "Hi. Chronic reflux of stomach acids into your esophagus can irritate your esophagus. In severe cases, it can cause dysphagia. Scar tissue can develop in your esophagus. The scar tissue can narrow your esophagus. This is known as an esophageal stricture. In some cases, dysphagia can be a direct result of esophageal damage. The lining of the esophagus can alter to resemble the tissue that lines your intestines. This is a condition called Barrett’s esophagus." } ]

[ { "from": "human", "value": "Hi doctor, I have had the headache issue for more than 12 years now and seems to be getting worse. The onset of this headache starts with like a pressure getting built up in my head, like stress for no reason and all of a sudden and then the headache starts at the back of the head and within minutes it gets severe. If I have to describe the location, it is above the base of the skull and below the top of the skull. The pain is so severe that I have to take a pain killer else it will not subside. There are no other symptoms like vomiting, dizziness, nausea, speech imbalance nothing. The pain is pulsating or throbbing and it increases with any movement or applying pressure. This headache also comes on while having alcohol and on a very rare occasion at the time of ejaculation while having sex with my partner (once in a blue moon scenario). I got my cervical spine CT scan done and the reports were normal. The onset of headache has to do something with the time as well, for example, if today it has started in the evening then for the next few days it will happen around the same time. If I think a lot or involved in any discussion (intense or involves me getting anxious or excited) it triggers. It also gets triggered sometimes, if I am washing dishes or cooking food which requires a bit of focus. I do not know what the pattern is but all I know is it is ruining my quality of life. The frequency of these headaches are very frequent and consuming pain killers has started to affect my digestive system. I want to get rid of this problem. Please suggest." }, { "from": "assistant", "value": "Hi. Your headache most likely is migraine since it has been going on for the last 12 years. Another less likely possibility is occipital neuralgia. One thing that is not clear from your description is whether the pain is localized to one side or occurs on either side. Nevertheless, I would recommend the following: 1. MRI of the brain to rule out structural abnormalities that could be causing the headache. 2. Start on tablet Topiramate 25 mg twice a day and build up to 50 mg twice a day. 3. Maintain a headache diary- note the time, duration and character of pain in a diary each time you have pain. 4. Consider tablet Pregabalin 75 mg twice a day if Topiramate is not effective. Migraine or occipital neuralgia. Migraine or occipital neuralgia." } ]

[ { "from": "human", "value": "Hello doctor, My 2-year-old put my mascara wand in his mouth. His teeth and all around his mouth were black. I used a toothbrush and water to get all the black out. What else should I do? I am not sure how much he swallowed. Can it harm him?" }, { "from": "assistant", "value": "Hello. Mascara contains iron oxide, carbon black along with a base of paraffin or mineral oil. As your child had taken it in his mouth and you already have cleaned it. Now there is nothing to worry, you may ask him to gargle with Chlorhexidine mouthwash which will improve the oral hygeine. If a very small amount was swallowed, there is nothing to worry, it may not cause any harm." } ]

[ { "from": "human", "value": "Hello doctor, There is abdomen pain since three days. Pain is not continous but really painful. Little loose motion, light headache when gets out of bed, little fever on day 1 and 2." }, { "from": "assistant", "value": "Hi. Such pain in abdomen with stool discomfort can happen as a result of stomach infection. Important here is clinical examination to know the site of the pain. So it is advisable to see your doctor. If he would feel suspicious, he would send you for an ultrasound abdomen. If all normal, you would be treated with antibiotics like Ofloxacin. Till you get medical help, you may take a combination of Pantoprazole and Domperidone that would reduce your acidity and pain. Take light food and drink plenty of fluids. Stomach infection. Ultrasound abdomen. Colic. Stomach infection. Light food. Review with ultrasound." } ]

[ { "from": "human", "value": "Hello doctor, My cum is not coming out by force or thrust. The cum is just flowing out of my penis. Three years earlier the cum was coming out by force or thrust. I am having erectile dysfunction may be since last two years or two and half years, and I was not having erectile disfunction earlier. I am taking Megalis 20 and Tentex Forte prescribed by a doctor and through these medicines, I am having a proper erection. I am having only one testicle, my another testicle was removed when I was of 13 years due to its under development. I want to have my cum come out by thrust or force from my penis to have a baby as I am married. I am 37 years of age, and my height is 5 feet 8 inches." }, { "from": "assistant", "value": "Hi. I have gone through your query. I would like to know whether the amount of semen ejaculated had been the same over the last three years or has it decreased? Firstly, the speed with which the ejaculate came out does not unduly affect your fertility. I would suggest you have a semen examination if not done before to check for the sperm count which is more important. Secondly coming to your complaint, I would ideally like to do a full physical examination given your previous history. It could either be some blockage in the path of semen or the semen could be going back into the bladder. I would suggest you to visit your local urologist for a detailed clinical examination, an ultrasound to check if there is any blockage and a semen test to check for the volume and sperm count. Another possibility is incoordination of the muscles that normally gives the speed to the ejaculate, which cannot be tested to identify. As I said before, if your primary concern is to have a child, then I would suggest you to get a semen analysis first. If it is normal then you do not have anything to worry about." } ]

[ { "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": "Dear Doctor, I am suffering from anxiety and panic attacks for the last 3 years. I went to a neurologist 2 years back and he advised me to take REXIPRA 10 for 3 months, SOLTUS 50 for 6 months, HEMIDAP PLUS for 9 months & ZEPAM .5 for 12 months. Upon following these medications, I was improving but was not absolutely fine. And after 1 year I visited the same doctor again and he advised me to take ZEPAM .5, REXIPRA 5 & AMIXIDE. Now I am absolutely feeling restless, sleep deprived and very anxious. When I leave these medicine, I feel addicted and I am in immediate need of it. Absolute anxiety and nervousness, high pulse rate and high BP. I am not able to understand whether I am suffering from a neurological or a psychological problem. Should I consult a neurologist or a psychiatrist? 25 years/ male, height 6 feet, weight 70 kg. Please help." }, { "from": "assistant", "value": "Hi. I read your query and understood your concern. As per your diagnosis of anxiety and panic attacks, there should be no doubt whether you need neurologist or psychiatrist. Both these conditions come under the domain of psychiatrist and they are more able to treat these conditions. Other than anxiety and panic attacks you have got addiction problem because of the wrong use of medicines. In my view there is no role of SOLTUS in case of anxiety and panic attacks. If you feel fine with an online psychiatry consultation session (via phone or video chat), then I will be happy to help you. You con contact me by either putting a detailed query or booking an online consultation." } ]

[ { "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, 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, 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 am a 24 year old male. Before a month, I visited a hospital in my hometown for pain on the penis. They conducted VDRL and TPHA test and said that the test came back as weak positive. So, it is the first stage of syphilis. They prescribed me an injection and some tablets for five days. After 10 days, I moved to my place and got both VDRL and TPHA tests in a reputed diagnostic center and the tests came back negative. But, I have taken the medicines prescribed to me. Now, I am getting some neck pain and headache. Can that be a side effect of those medications?" }, { "from": "assistant", "value": "Hello. Revert with the prescription details to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I and my fiancee had sex with condoms on the third of this month. When we ran out of condoms, I inserted my clean penis into her vagina for hardly 5 to 10 seconds. But as soon as I felt I am going to ejaculate, I withdraw it and I ejaculated on her stomach immediately after taking my penis out. She took Plan B pill after 16 hours just to be sure. We had sex again the next day but it was all with condoms. She noticed white vaginal discharge along with foul smell and pain inside the vagina near the cervical area and burning sensation in the vagina on 5th evening. She is having an urge to pee frequently but little is coming out and it hurts while peeing. What could be the cause? Please help." }, { "from": "assistant", "value": "Hi. I think she is having a urinary infection plus a vaginal infection. We might need to change antibiotic after culture report. Urine routine and culture. UTI with vaginitis. Plenty of fluids. Start tablet Niftran 100 mg bd for three days till awaiting culture report, support analyzer 2 teaspoons in one cup of water 2 to 3 times a day, tablet Clingen Forte vaginal pessary one tablet to be inserted in the vagina at night for seven days, tablet for Forcan 150 mg just one tablet two hours after meal. Pass urine before and after intercourse." } ]

[ { "from": "human", "value": "Hi doctor, I have a girlfriend. I have bought condoms to have sex. We are ready to have sex. We are planning to avoid pregnancy. We are planning to have intercourse once a year. Can condoms prevent the condition of pregnancy? What is the best method used to prevent pregnancy successfully? Please suggest." }, { "from": "assistant", "value": "Hi. Condoms should be used properly. It can prevent the condition of pregnancy. There should not be any breakage or leakage through the condom. If there is any doubt, your partner can take Unwanted 72 (Levonorgestrel) within 72 hours of intercourse. If you have the sex once a year, then using a condom is suitable for you. But if it is decided at least one to two months before, then she can start oral pills at least two months before and continue taking it till the full month of intercourse. If it is a regular activity, then she can take oral pills as contraception. It is 100 percent effective. Condoms have a failure rate of 20 %." } ]

[ { "from": "human", "value": "Hello doctor, I am an 18-year-old male. I have a lump on the inside of my groin. It is about the size of a 5 cent Australian piece, and I can feel it under my skin almost as if the skin moves over the top of it. So, I do not think it is a dermatological thing. I have little spots around my pubic area but I think that is because of the hairs. This feels like something different. It does not look inflamed from the outside, and it is not sore to touch (just a bit tender). It feels like it rolls underneath my skin but stays in the same spot obviously." }, { "from": "assistant", "value": "Hi. If I am not wrong 5 cents Australian piece is around 2 cm in size. As you have described, it is a lymph node in your inguinal region. The human body has about 600 lymph nodes. Their role is to clean antigens from the extracellular fluid. It helps in fighting inflammation and infection. Lymphadenopathy (LAP) is the term to describe the conditions in which lymph nodes become abnormal in size, consistency, and number. A normal-sized lymph node is usually less than 1 cm in diameter. An inguinal lymph node size up to 1.5 cm should be considered normal. Lymphadenopathy can be called generalized when it affects two or more parts of the body. Enlarged lymph nodes associated with significant fever, night sweats, and unexplained weight loss (more than 10% in less than six months) are considered as red flags. It required an urgent evaluation for lymphoma. Those are not present in your case. Pain and tenderness on a lymph node is a non-specific finding. It is typically due to minor infection. Other causes of the inguinal lymph node are benign reactive lymphadenopathy, sexually transmitted disease, cellulitis or local infection, etc. Benign reactive inguinal lymphadenopathy is seen in patients who walk barefooted outdoors. If it is tender you can take Paracetamol. Keep watch. Avoid walking barefoot. Keep hygiene of your private parts. If it persists and associated pain or fever or other site engaged lymph nodes, you will need an evaluation. I hope this helps. Regards." } ]

[ { "from": "human", "value": "Hi doctor, I am a 27 year old male. From last six months, I am suffering from poor quality of sleep. I am not able to wake up early in the morning whether I go to bed early or late. My body feels heavy and lazy. I also have muscle aches, especially the muscle of palm and feet. Low energy, fatigue, daytime sleepiness and laziness are the symptoms that are present every day. I am here to understand this and get treated for the same. Please help." }, { "from": "assistant", "value": "Hi. For further information consult an ayurveda specialist online -->" } ]

[ { "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": "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 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 couple of canker sores and two are on my lip and has pus in them and two on the bottom. Can you tell me what to do with them?" }, { "from": "assistant", "value": "Hello. I have been through your query and I can understand your concern. Canker sores are a characteristic feature of syphilis. This syphilis is a sexually transmitted disease. Purulent pustules are generally seen which burst to form canker sores. You should get yourself tested for the syphilis infection as soon as possible because syphilis should be treated immediately. Otherwise, it can lead to some of the serious complications to the brain, heart, nervous system, etc. However, you do not need to worry as once detected it can be completely eradicated from the body. I would advise you to have a visit to your nearest dentist and also make an appointment with the general physician for eliminating any other cause for the same. If you were my patient, after detailed drug history, I would have prescribed you antibiotics like Penicillin and topical analgesics (if the pain is in the sores) for the infection elimination. I would also advise you to adhere to not having sex during this period as it can spread through having sex. I would also advise you to have good oral hygiene and brush your teeth twice daily and floss regularly." } ]

[ { "from": "human", "value": "Hello doctor,I am 40 years old. I have major adult acne breakouts mainly on my cheeks, neck, and under my ear. I am dark complexioned, so when it does clear, it leaves scarring and dark spots. The last dermatologist I consulted suggested birth control. Could please give some suggestions?" }, { "from": "assistant", "value": "Hello. I saw your pictures (attachment removed to protect patient identity). I can see pus-filled acne along with post acne pigmentation. Start using Azithromycin 500mg of any brand for six consecutive days after breakfast. Apply Epiduo gel once daily bedtime for a short contact period of 30 minutes then rinses off with cool water. Start biluma cream once daily in the morning on the spots. Avoid all sorts of dairy products bedtime and prefer carrots and spinach along with few soaked almonds. Have reviews about salicylic acid peeling and plan for three sessions accordingly. I hope this will help you." } ]

[ { "from": "human", "value": "Hello doctor, I am a diabetic taking Glimepiride and Metformin. I have developed a kidney stone measuring 1.6 mm and the doctor has advised for a surgery. Is there any non-surgical management?" }, { "from": "assistant", "value": "Hello. I have seen your report (attachment removed to protect patient identity). It is unlikely that 1.6 mm Kidney stone will come out on its own. You require surgery. There are many options like URSL and PCNL. Which option does your doctor prefer? For more information consult a urologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a female, 18 years old, suffering from weakness, headache, body pains, back pain, stomach pain, and leg pains. Sometimes, not able to bear pain. I am suffering since last two months." }, { "from": "assistant", "value": "Hi. You have severe anemia (attachment removed to protect patient identity) which needs to be corrected urgently. Some of your symptoms can be attributed to the anemia itself. However, it is very important to identify the cause of such severe anemia. Please give me more details about your symptoms and get the following investigations done. 1. Peripheral blood film. 2. Hb electrophoresis. 3. USG of the whole abdomen. 4. Serum electrolytes. 5. Liver enzymes. As soon as possible get the tests done so that we can correct the anemia and identify the cause. You may need blood transfusion if symptoms are severe or if there is breathing difficulty." } ]

[ { "from": "human", "value": "Hello doctor, My baby is 7 weeks old and she is on exclusive breastfeeding. She prefers the right breast than the left and cries to latch on the left. So I started to pump and bottle feed from left and direct feed from the right. I pump three to four times a day and make around 100 ml from the left. My breasts are lopsided and the right side is full most of the time while the left side feels very soft. This week all of a sudden my little one prefers bottle than my breasts so I wanted to wean of bottle feeding the pumped milk. She now sucks like around 30 minutes a day from the left and rest from the right. I do not want to pump or express again from the left to increase the supply. My question is, how can I balance feeding from both breasts without pumping? My little one does not like spoon feeding the expressed breast milk. Please help." }, { "from": "assistant", "value": "Hello. It is normal for a baby that he or she chooses any one side of the breast on its own. But if you feel that your breast lopsided then you need to take some tricks. Start to feed your baby from the small one. Let him suck more and more from the small one. After some days, it will become large and engorge. But do not avoid to breastfed from the larger one too. When the large one fills please feed your baby from this side or express milk by using hand. You can use a breast pump to express milk from the larger breast. But if you do not want to use pump, use your hands. You do not need to feed him with this expressed milk. Do continue breastfeeding a few days from small one more and more. After some days both will become balanced. One thing do not practice your baby bottle feeding. Then he won't breastfeed again." } ]

[ { "from": "human", "value": "Hello doctor, I am 65 years old, 173 cm height, 84 kg suffering CAD, HTN and DM type 2. Having three stents and still PLV 90 % blockage. On tablet Atorvas 20, Starpress XL 50, Nitrofix SR 30, Telma 40, Dianorm-M and injection Lantus 24 u. But due to angina or short breathing, tablet Flavedon MR also started for three weeks. Now I am feeling well. Whether all three tablets are necessary for angina? Please guide." }, { "from": "assistant", "value": "Hello. Yes, you will need all tablets, as they have an additive effect. Other two antianginal like Starpress (Metoprolol), has many beneficial effects other than this, and decrease mortality. So it needs to be continued. Also, Nitrofix (Isosorbide mononitrate) is also important and needs to be continued, otherwise angina will recur. You should have a healthy lifestyle like avoiding fatty, oily and high-calorie diet. Have low salt diet and monitor blood pressure regularly and BP should not be persistently more than 140/90 mmHg. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol, if any." } ]

[ { "from": "human", "value": "Hi doctor, Please list a few things that are toxic to humans. Please explain." }, { "from": "assistant", "value": "Hi. Detergents contain hazardous chemicals. It can irritate our skin and cause eczema. Some people may even get contact dermatitis. When they are ingested, it damages our mucosal lining of the gastrointestinal tract. Perfumes and body sprays contain chemicals. When they are inhaled, they irritate the mucosal surface of the respiratory tract leading to asthma and allergic rhinitis. Processed food like sausages are harmful to the digestive system and may predispose to colon cancer if ingested regularly over a long time. Canned food also contain chemicals that are carcinogenic. Air fresheners contain chemicals that are harmful to the kidneys and lungs. Some may affect reproductive functions also." } ]

[ { "from": "human", "value": "Hi doctor, I am a pregnant woman. I am very much worried about HIV. Because my tongue skin is getting peeled off and my armpit lumps are painful. I did not test for HIV yet. If it is positive, then should I have to abort my baby or can I safely deliver a baby? I am in a big depression now." }, { "from": "assistant", "value": "Hi. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 27 years old. I have got allergies on my inner thighs. I used all the medicines. But there is no relief. Recently, I went for sonography and found with multiple cysts in the ovary. Due to allergy, the skin of inner thighs got darker, and I have reddish marks with itching on my face. Please help me." }, { "from": "assistant", "value": "Hi. With your descriptions, it seems that you have developed tinea cruris. It requires a minimum of two to three months to have a complete cure. I would suggest you take tablet Itraconazole 100 mg once daily and use 2 % Miconazole gel local application twice daily for one month and use Kz 2 % soap (Ketoconazole) for bathing after consulting your GP or nearby dermatologist. Revert me after a month." } ]

[ { "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": "Hi doctor, My voice is very low. I am not able to scold or intimidate anyone. When my friends abuse me, I am not able to reply them. They take advantage of me. They never heed my words. Sometimes, I feel much worried about it. I also hesitate and vibrate while talking. People keep me down with their voice. I am not able to cope with them. My friends suggest me to increase my pitch. Sometimes, I am not audible to my friends also. I have this problem since my childhood. I am having some fear to speak to people and even my friends. Give me some tips to improve my speech and articulation skills." }, { "from": "assistant", "value": "Hello. For further doubts consult a speech therapist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I went to the dentist. I have dark brown stains on my teeth. He said it is from drinking fizzy drink and the only way to fix it is veneers. Is this true?" }, { "from": "assistant", "value": "Hi. Yes, these are now internal stains that cannot be simply removed through scaling. One of the causes for these kinds of stains is fizzy drinks, others may include taking Iron supplements for long, or may be due to the use of extra fluoride in water during childhood like the use of salty water in some part of your age, use of alcohol, smoking or tobacco. All these may lead to these internal stains. Treatment options for these are composite veneers like economical or veneers of zirconia which are expensive but very good in aesthetics. No need for capping is there as staining is just around gums area (attachment removed to protect patient identity). Feel free to ask if you have any further questions regarding it. Stay happy and blessed. Take care." } ]

[ { "from": "human", "value": "Hi doctor, I have hemorrhoids and a lot of gas build up that triggers it painfully, constantly. I have no relief with the constant gas no matter what I do. I tried liquid Kombucha for a few months and found relief but when a hurricane struck us, I had to go without it and went back to square one. In an effort to not be so reliant on it, I am trying probiotics with no luck. Would you recommend any topical treatment as well as probiotics to help treat the gas and hemorrhoids?" }, { "from": "assistant", "value": "Hello. First of all, stop all spicy, junk and fermented food. Consume fruits like banana, papaya, pomogrenate, grapes. Avoid green chilli completely. Take one cup of water, add 1/2 teaspoon of jeera and boil it, do not filter and add 1/2 teaspoon of ghee. Drink warm daily once for 10 days. Have buttermilk daily before lunch. Apply Pilex or Pilorid ointment twice a day on anal region. If still problem does not get solved, consult any ayurvedic doctor face to face. Sometimes patients are telling hemorrhoids but it may be fissure or fistula." } ]

[ { "from": "human", "value": "Hi doctor, I am a 26 year old female. I had my period on 21st and had unprotected sex 12 days later. The next day I took an I-pill. Then, I have had unprotected sex three to four times in the last four days. What are the chances of me getting pregnant? What can I do to prevent pregnancy now? Should I take another I-pill or some other I-pill? I understand that I should be more careful about this from now on." }, { "from": "assistant", "value": "Hi. If you have regular monthly menses, then mostly you will not have any problem. The second thing is that after four days you cannot do much more. If you have intercourse three to four times in the last four days, then you should have taken precautions or tablets before and not after four days. Now, you have to wait for your period to come. One positive thing is that, if you have regular monthly period, then your expected period is around the next two days. The last 10 days before menses are coming in safe period and you do not have chance of pregnancy if you have unprotected sex during this time. You can go to the doctor and ask for copper-T as emergency contraception today only. It can be placed up to five days after sex. It inhibits implantation of pregnancy. Also, there is no study if you take I-pill for two times in one cycle will be effective or not. So, it is not that easy and also, it can disturb your cycle for at least one or two cycles. Either go for the copper-T or wait for your period for more than four to five days. If you did not get period, then do a urine pregnancy test. If that is negative, then wait for sometime. If that is positive, then you will need early termination. Have protected sex and stay safe. I-pill is emergency contraception and it is not like you can take whenever you like. 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, 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, My 4 month old baby was born preterm and detected with high 17-OHP levels. The details are as follows: Baseline level on screening 196 ng/mL. Two other tests showed 20 ng/mL and 10 ng/mL. The recent test showed 5 ng/mL. As per consultation with my doctor, high 17-OHP is due to preterm. Also, note that my baby is on formula milk. Please advise." }, { "from": "assistant", "value": "Hi. Revert back with the reports to an endocrinologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am suffering from rheumatoid arthritis for past 15 years, which has now affected my whole body. Since one and a half year, I am getting shortness of breath and cough. Last year, when I was admitted in the hospital to get this treated, my doctor advised me to use external oxygen for long term. Since then, I am using oxygen concentrator. Over a month, my shortness of breath and cough has increased and I am finding difficulty even in speaking. Please help." }, { "from": "assistant", "value": "Hi. For further information consult a pulmonologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 45 years old and working as a senior level finance professional in a multi-partner practice owned by all of us. After going through the high levels of anxiety for several years, I consulted a psychologist who is my friend. After few months of showing little improvement, he put me on Escitalopram 10 mg. For about 2 years I took this medicine and was generally fine. When my friend moved out of the country, I shifted to a new doctor and he is a more senior person. He changed the drug to Paroxetine 25 mg which I have been on for the last nine months. I would probably say I am doing better now than before. The issue is regarding further counseling. While my friend did not feel that there is a need to continue counseling once he put me on the medicine. But, the new one seems to feel that I should resume counseling. Based on his advise, I went back to the counselor I originally saw, but somehow she seems to feel that I do not need any structured counseling. I am generally a religious person and try to follow certain regular spiritual practices like visiting a temple almost every day, reading at least a little from any scripture and do some chanting. At the same time, I still have the little odd feelings of discomfort too at times, though it does not trouble me so much like earlier. Specific cause of worry now is mostly the side effect of the long-term medication I take for anxiety, BP (Telmesartan) and for GERD (Esomeprazole). The primary concern now is that on most days I have a general feeling of boredom as though there is not anything much to do. Generally, I try to avoid associating with any new demanding assignments because I do not feel comfortable about doing things unless I am fully sure about the work. On the other side, it is also my dream to be a successful writer of fiction novels. I have finished one book, but that has not found any worthy publisher so far, which is disappointing. So, even though I have been working on my second book, I do not have too much confidence that my writing will reach anywhere. I am not a social type person and like to spend time at home. I will also confess that by nature I am known as a negative thinker, both at work and in the house. But my relationship with people are generally very cordial, because I try to lighten issues and also try my best to avoid any sort of conflict. All this leaves me with a general sense of dissatisfaction, although I am very clear that I do not want to stick my neck any further out either. Though at times, I fantasize about career and location change. I do not dare to think anything seriously, because I am sure that I will not get such a comfortable position again. But, to conclude the issue which is confusing me right now is, do I need counseling again? I am far from clear, what can I hope to achieve from therapy which I cannot get from my religious and spiritual practices? I note that online therapy is also an option on this site. Is that as effective as direct counseling?" }, { "from": "assistant", "value": "Hi. From your detailed information, I feel that you have responded to medication. All SSRI (selective serotonin reuptake inhibitor) medications tend to over time make the person who takes them more relaxed. This could be attributed to the main task of reducing anxiety. Thus maybe a lower dose for a few months may benefit. Importantly, the absence of anxiety or motivation is more troublesome. Also, I do not think that any counseling will help you. As you are already aware and attend to the problem of not pursuing tasks to completion CBT (cognitive behavioral therapy) or NLP (neuro-linguistic programming) or coach may help." } ]

[ { "from": "human", "value": "Hello doctor, I am 18 years old, weight is 55 kg, height is 5'11\". I have a problem in gaining weight. The checkup shows that all things are normal. I am eating regularly. Kindly explain the problem in detail and tell whether taking protein powder has any side effect or not." }, { "from": "assistant", "value": "Hello. I just read your query. See gaining weight depends on metabolism, genes, and activity, etc. Metabolism of every person varies depending on thyroid gland functioning. Genes mean that if your parents are skinny then there are chances that you will be lean. Physical activity also determines weight gain. Without any indication, protein powder intake is not good. It may lead to health issues. Bodybuilders take it but they take it under the supervision and it is required in them. So I advise you to visit a nearby physician and ask for the supplies according to your requirement." } ]

[ { "from": "human", "value": "Hi doctor, I have been diagnosed with GERD as confirmed by an ENT specialist, I took medicine for over a month but I did not get totally well. I changed my diet plans, cut off fatty foods, fried foods, citrus foods, etc., started excersice. I elevate my head while sleeping. But nowadays I wake up in the middle of night with very dry mouth and extreme sore throat, sometimes coughing. When I drink water even warm water my throat is itching, it does not get much itchy while swallowing. I am feeling comparatively at day time." }, { "from": "assistant", "value": "Hello. Do not worry, you will get well soon. Yes, you have problem of GERD, due to acid reflux you have this problem. I will suggest you some investigation and treatment for this. Follow same diet plan. Try to walk for sometime after every meal. Get done upper GI endoscopy done from some good institute if not done previously. Send me blood investigation and other investigation report if available so I will see them and advice you accordingly. Here I am prescribing some medicine which will surely help you. Tablet Normaxin 1 tab BD for 7 days, tablet Rablet L 1 tab OD before breakfast, syrup Gelusil 2 tsp TDS, syrup Sucral 1 Tsp TDS. Total duration 7 days." } ]

[ { "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, 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, 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.--->" } ]