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sajilperfects

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[ { "from": "human", "value": "Hello doctor, I am suffering from mouth problem. My mouth does not open fully. I used to chew tobacco before. So how can I get rid of the disease?" }, { "from": "assistant", "value": "Hi. As per your query and presentation of symptoms of reduced mouth opening can be due to most common reason that is oral submucous fibrosis in which there is a formation of thick fibrous bands below the mucosa of cheeks and lips leading to stiffening and difficulty in mouth opening. It is a precancerous condition (although not cancer) and should be taken care of. It is commonly seen in individuals with tobacco and areca nut chewing habit. You need to consult an oral physician or a dentist and get evaluated and he can advise applying a steroid ointment in combination with Hyaluronidase containing ointment to break fibers. Intralesional injections of Steroid and Hyaluronidase can be advised to be injected after every three to four days. Anti-oxidant like Lycopene is also advised. Physiotherapy, like blowing cheeks, trying to open the mouth under pressure etc., can be demonstrated and advised to be done daily. Complete cessation of the habit of tobacco if you have chewing is a must." } ]

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

[ { "from": "human", "value": "Hi doctor, I am 40 years old, and my weight is 97 kilograms. I am a diabetic patient, and my A1C test showed a result of 9 %. I am taking Sitaglu Met 500 mg. It has not helped me. When I take it, within five minutes, my sugar level gets increased to 250 mg/dL and comes down again to 180 mg/dL or 190 mg/dL. Sometimes, it does not get reduced. My fasting blood sugar level is 180 mg/dL. I am thinking to change my medicines. Please suggest." }, { "from": "assistant", "value": "Hi. Please verify the dose of Sitaglu Met. It is a combination medication. It has two medicines Sitagliptin and Metformin. Please mention whether you take 50 mg/500 mg or 50 mg/1000 mg dose. Please send a picture of it. Medication alone cannot control diabetes. Determining the type of diabetes is essential. There is a possibility that you may have type 1, so appropriate testing is required. You are overweight for your age, and the blood sugar is high. If your diabetic level is not controlled at this stage, it can lead to kidney problem and vision problem in two to three years. Both are irreversible once they get developed. Have control in your diet. If you are surely diagnosed with type 2, I can suggest you take Glucophage 1000 mg (Metformin) daily and Linagliptin injection. It is not insulin. It controls the blood sugar, and it helps to lose weight." } ]

[ { "from": "human", "value": "Hi doctor, I got a minor surgery for liver abscess and a drain was installed. Pus in the color of chocolate and little thick is coming out. Is it normal? How much time it will take to recover? For how many days the drain has to be installed?" }, { "from": "assistant", "value": "Hello. I had gone through all the data you have posted. We need to know some more details about your problem. Liver abscess is mainly of two types: Bacterial and amebic. From your description as chocolate like pus, it goes more in favor of amebic etiology. So, we need to keep you on tissue agents like Metronidazole, luminal agents like Diloxanide furoate and Paromomycin for elimination of ameba from the intestine. If pus culture grows bacteria or if abscesses are multiple, then we need to provide specific coverage against the organism. Depending upon the amount of pus inside, it is normal for draining of pus like that. Time to recovery depends upon the cause of amebic versus bacterial, size of the abscess and white blood cell count. Drain needs to be continued until full drainage of the collection is done. Repeat ultrasound scan has to be performed to look for residual collection. Manipulation of the position of the drain may be needed for drainage of residual collection. Once the collection becomes dry, then the drain can be removed. Revert back with the answers to the above questions to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 62-year-old male. I went for a routine X-ray, and the radiologist found some streakiness in the lower left lung. He said it appeared small and not significant, but it was adviced that I should come back in six months for a comparative X-ray and that it could just be a scar from an earlier infection. I have read that a small scar area is probably non-progressive but I have also read about IPF, and that fills me with fear. Spirometry test was normal as it was a physical exam. I am so scared that it might be a progressive disease, but I hope that it is just an old scar as it is really small. Otherwise mostly healthy with no cough or difficulty breathing at all. Are all lung scars progressive?" }, { "from": "assistant", "value": "Hello. Does not look worrisome (attachment removed to protect patient identity). Small streaks or fibrosis is usually due to old infection or collapses etc., The usual cause for such fibrosis is typically an infection and commonly found at such age groups. The probability of IPF (idiopathic pulmonary fibrosis) is extremely low as the fibrosis is not diffuse or bilateral, no symptoms and spirometry are normal. So, I think it is not worrisome at present and should follow up as advised to be sure. Should consult your doctor earlier if developed any symptoms. Majority of the scar is non-progressive and extremely common to find such scars on routine X-ray and the majority are benign. I hope this helps you and get back if you have any doubts." } ]

[ { "from": "human", "value": "Hi doctor, I do not used to sleep a lot from early age. Daily to the maximum I will sleep for 6-7 hours. Now, these days I find scary researches about how sleep deprivation can damage brain permanently. I want to know whether my condition too is also related to sleep deprivation. Will it cause any permanent subtle changes to my brain? Please help me." }, { "from": "assistant", "value": "Hi. Yes, the research has gained a lot of attention and we do consider the facts. But, what has been done cannot be reversed. However, if we go with clinical experience, usually people who modify back there lifestyle do not get any ill effects in life. In fact, I would advice in such case that you should stop thinking that what is reversible and what is not. Start living your life normally and take help with a psychiatrist if there is great difficulty in sleeping. One can be treated easily with hypnotic drugs which help in controlling these issues." } ]

[ { "from": "human", "value": "Hi doctor, Last Wednesday night, I got palpitations. I took Rivotril 5 mg and slept. Next day I rushed to my physician. He prescribed me Ciplar 10 mg tablet and advised me to take one tablet daily after breakfast. Palpitations did not happen from past three months. My doctor advised me to continue the tablet and said nothing to worry. But I am worried as what could be the reason for my palpitations. I am disturbed by thinking that will I get heart attack? I am sleepless now. Please help." }, { "from": "assistant", "value": "Hi. Palpitations in the absence of loss of consciousness/blackout/sudden fall are not considered as malignant. Occasional non-recurrent palpitations may not be significant at all. Hence you need to see if you have any of these alarming symptoms or these palpitations are recurrent or not. On the background of structurally normal heart - your normal ECG and ECHO study (attachment removed to protect patient identity) with no other cardiac symptoms, absence of alarming symptoms and absence of recurrence, speak of a non-cardiac cause. These may be related to stress, thyroid disorder and certain medications. I would suggest you to upload your recent ECG if possible. Revert back with your report and answers to a cardiologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had two episodes of UTI that led to kidney infection which had been treated with strong antibiotic injections this year and last. I am currently taking Niftran, Silodosin 8 mg along with Ayurvedic medicines like Bangshil, Chandraprabha Vati, Punarnavasa, Sukumaram Kashayam along with Brihatyadi Kashayam and Gokharu Kadha as well as Sudarshan Prostate Plus. I am also taking phytonutrients like Quercetin, Saw Palmetto, Cranberry extract, D-Mannose, Prostaquil, Swedish Pollen Flower Extract, etc. I have also done acupuncture without success. My urologist did an X-ray of the urethra and says that there is a mild bladder neck obstruction and a mildly enlarged prostate because of which I am not able to pass urine fully. My urine flow is also weak (peak flow of 17 ml) and it takes some time for urination to begin. I have a history of chronic testicular pain in the left testis for the last ten years and burning sensation at the tip of the penis (since five years). It was suspected as TB of epididymitis and I was given anti-TB drugs for nine months. But, there was only a mild improvement in pain. I consulted two other urologists and they told me that I do not have TB but chronic non-bacterial prostatitis for which there is no effective treatment in allopathy. I am taking painkillers like Tapentadol along with Duzela for the last five years from a pain specialist. There is an improvement in pain on taking these medicines. I have Grade 2 varicocele in left testicle and the pain is confined to the epididymis and spermatic cord. The pain gets worse after exertion. I also take Daflon on and off. My urologist says a permanent solution is bladder neck incision along with varicocelectomy and spermatic cord denervation. I would like to look at Ayurveda for a few more years because the narrowing of the urethra/bladder neck is mild and the prostate enlargement has been reduced after taking ayurvedic medicines. My biggest concern is that I do not want to get UTI again which may lead to kidney infection. I am able to empty my bladder although the urine flow is weak at times. My libido is low and testosterone level is borderline. I am taking Mildfil 5 mg along with Silodosin. My right testis had atrophied after a hernia surgery about thirty-five years back. My LFT and kidney function tests are all normal. I have slight cholesterol. I do not have any other major complaints apart from GERD. I seek your advice on improving my health condition. Please let me know if you need any other information or details." }, { "from": "assistant", "value": "Hi. You are loaded with many medicines. From my view, I suggest you can take the following medicines. Since you are taking medicines for a long time, you may do a KFT (kidney function test) and report it soon. If you are satisfied with your sexual power then it is fine. Take Salam panja 100 g plus Ashwagandha powder 100 g - mix together in a mixer and consume 5 g before breakfast and before bed with warm milk and little sugar. Do not use hot water on the scrotum. Pour cold water while bathing. Continue all for three months and revert back later. For more information consult an ayurveda specialist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I was diagnosed with PCOS in January so my gynecologist prescribed me Ginette 35 for six months and Bonemac D3 for one month. But from March my periods are regular without taking medicines but there is sometimes slight pain in my lower abdomen and side abdomen. Should I continue medicines despite having normal and regular periods?" }, { "from": "assistant", "value": "Hello. If you are having regular periods in terms of flow, duration and regularities and if you have already stopped taking Ginette since March, there is no need to resume its intake immediately unless you need contraception also at the same time or not wanting a pregnancy now. In that case, you need to use an alternative mode of contraception to avoid your pregnancy. Please attach your previous prescriptions blood test and ultrasound scan reports based upon which PCOS was diagnosed. Also, inform your height weight and whether there is excessive hair in the chin, upper lip, chest, and abdomen Follow up with reports again. Also, follow the lifestyle modifications described below. Blood for serum fasting insulin levels. Blood for serum vitamin D3 levels. USG (ultrasound) TVS (transvaginal scan) if not done in the past three months. Continue vitamin D. Avoid junk food spicy and dip fried foods. Low carbohydrates, fat restricted, gluten-free diet is recommended. Regular brisk cardio excercise like walking jogging cycling swimming for at least 30 minutes a day is a must. Take frequent small meals." } ]

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

[ { "from": "human", "value": "Hi doctor, I am 21 years old and my menstrual cycle is generally of 30 days. Last month I had sex with my boyfriend on just after 2 days of my periods. Though we used condoms but I felt as if it was leaking so to be double sure I took one Unwanted 72 in 23 hours. Now, I am 13 days late for my periods. I am getting muscle cramps and whenever I rush to the washroom to see I just find white liquid discharge. I have no other specific symptoms. I took two home pregnancy tests and both are negative. I am afraid. Can I be pregnant? If yes then how can I abort? And if no then why am I not getting my periods? Please help." }, { "from": "assistant", "value": "Hello. As you had taken one Unwanted 72 within 24 hours after the intercourse, you must have received a withdrawal bleed after 5-7 days. If yes, then the date of the withdrawal bleed would form your fresh LMP (last menstrual period) and you should be starting your count for next menses from that date. As the pregnancy tests are negative, you are not pregnant from that sexual encounter. Hence, considering the possible withdrawal bleed your next menses should start only by now. As you have started experiencing mild cramping and vaginal mucoid discharge which are part of PMS (premenstrual syndrome), it is indicative that you will start your menses soon. Hence, please be patient for another one week and you will get your menses. For further information consult an obstetrician and gynaecologist 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, I have about 4 inches of patches of ringworms on both of my buttocks and a 3-inch patch on my vaginal area. I am using Covate GM cream for the treatment but it is not showing any results. Please help." }, { "from": "assistant", "value": "Hi. If you have ringworm infection, kindly use oral and topical antifungal agents. If it is very red, mild steroid combined with an antifungal agent is to be used. You will get better after treatment. Scraping for fungus. Tinea cruris. Tinea cruris. Tablet Terbinafine 250 mg OD. Apply topical Terbinafine ointment BD. Apply a combination of Hydrocortisone plus Clotrimazole (like Hydrozole) at night. Take antihistamine OD. Maintain hygiene of the area. Wash with soap and water. Avoid using Dettol and other irritants." } ]

[ { "from": "human", "value": "Hello doctor, I was just wondering for a second opinion on some results which I have received being 8+4 weeks pregnant. My FBC was normal but my hemoglobin A2 Level is 4.3 and it says the normal range is 1.5 to 3.6. But I just wanted to know if this definitely means I am a carrier of beta-thalassemia." }, { "from": "assistant", "value": "Hi. Your attached CBC report shows normal hemoglobin and MCV with RBC count is also within range (attachment removed to protect patient identity). I have calculated Mentzer index as well which is also not in favor of thalassemia minor. Moreover, in the report, also it has been mentioned that referral to higher laboratory needed for confirmation. So, your chance of having thalassemia minor is less. I suggest you investigate with Hb electrophoresis by HPLC method to exclusively rule out thalassemia minor in a different laboratory." } ]

[ { "from": "human", "value": "Hello doctor, When I was 11 years old, I was knocked off my bike and cracked my front tooth in half horizontally, shortly after the dentist fixed it. Since then I have had no problems with it and had multiple x-rays to check on it. When it happened, the color of the tooth changed very slightly, to a very slightly more yellow shade than the rest of my teeth. I am curious to know what happened when the trauma occurred. Did my tooth die? What are they checking for when they x-ray the tooth?" }, { "from": "assistant", "value": "Hello. I have been through your query and can understand your concern. Any trauma to the tooth generally has long-term consequences like tooth discoloration, etc. As you said that your tooth was fractured, it might have led to a slight injury to the pulp or even if not so, the fracture line would have been close to the pulp. In both cases, the pulp over time starts to become non-vital sometimes due to injury and sometimes due to the restorative material lying in close proximity to the pulp. This over time results in the discoloration of the tooth. The characteristic feature of this discoloration will be that only the involved tooth will be discolored and other teeth will be normal or not discolored. If that is the case, it generally means that the tooth is in the process of becoming non-vital till the tooth becomes slight brownish black which means the tooth is entirely non-vital. It is generally not associated with any kind of pain as the process is chronic and takes time to set in. I would advise you to have a visit to your nearest dentist. He would prescribe a vitality test of the tooth and also would get an x-ray for the tooth. By that way, he would come to know if the tooth is dead or still vital and accordingly will propose treatment. If the tooth is vital, he will put some medication over the pulp to let it heal and then fill with the pulp friendly restoration. However, if the tooth is dead, I would suggest you to go for the root canal treatment (after evaluating the condition of the tooth and soft tissue). Meanwhile, keep your oral hygiene good, brush twice daily and floss regularly. Use mouth rinses to clean the mouth after meals." } ]

[ { "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, A fly bit on my neck around 2-3 days back. It has lead to red spot on that area and further the spots increased with time. I am not sure whether some of the spots have come as I shaved my beard at that time as well. But, such spots have never appeared due to shaving in the past. I have attached pictures of the same. Kindly guide me." }, { "from": "assistant", "value": "Hi. I have gone through your complaints and seen the attached photographs (attachment removed to protect patient identity). According to me, the small spots are due to pseudofolliculitis which is because of inflammation caused by shaved hair. I would recommend you to apply steroid antibiotic combination like Mometasone and Fusidic acid combination on the affected area twice daily for 7-10 days. Also apply the same cream on the insect bite area. If these spots are itchy take tablet Levocetirizine 5 mg one tablet daily at bedtime. Inflammation due to shaved hair. Pseudofolliculitis. Avoid shaving for few days." } ]

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

[ { "from": "human", "value": "Hi doctor, I had protected sex using condoms six days before my expected periods, but that was not safe. My periods has now lapsed. What should I do now?" }, { "from": "assistant", "value": "Hi. For further doubts consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I was in the recovery room after undergoing total knee replacement (TKR), and my heart rate dropped to 38. I felt weak and tired, so the nurse added something to my IV, and I felt fine, and all vitals returned to normal. They took me to my room, and I ate and was resting. My heart rate dropped to 32, and I was nauseated, cold, sweating, and very pale. The emergency team was called, and after 20 minutes, they got all my vital signs back to normal. They wired me with a portable heart monitor to see what was going on. The next day, I was doing knee exercises with the nurse, we walked down the hall and returned to my room, and I was put in a chair to finish my exercises when I passed out. According to my heart monitor, my heart stopped for 30 seconds. I had no idea of what happened. After 30 minutes, the emergency team had all my vitals back to normal. I was taken to ICU. My heart chambers, valves, and arteries were normal. I am 61 years old with a history of stage IIIC colon cancer with six months of chemotherapy. I have no history of blackouts, heart issues, or family history of such. Next day they put in a pacemaker only as a precautionary measure, they cannot explain how or why it happened. Three weeks after, I do not have any problems. Do you think the TKR could have caused this to happen?" }, { "from": "assistant", "value": "Hi. I have gone through all your explanations in detail. For more information consult a cardiologist 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 have got my urine pregnancy test positive five days before. My last period was in the mid of last month. I have taken unwanted 72 after 11 days of my periods, but there may be some contraceptive failure. I consulted my medical friend, and she suggested me about medical abortion and prescribed Clear kit. So yesterday morning I have taken Mifepristone and today in the morning I have taken one tablet of Misoprostol as guided by her. But it is around four hours after taking medicine, but still, there is no bleeding. Now even three tablets are remaining. Please help me." }, { "from": "assistant", "value": "Hello. Let me start by giving the right schedule for MTP kit. Mifepristone 200 mg orally single dose, will dislodge an embryo from the uterine lining. This will have some gastric problems but no bleeding. After 48 hours of this oral pill, place all four tabs of Misoprostol 200 mcg each at a time vaginal, after wetting it properly in water. Or you can have all four tablets orally at a time. This will soften the cervix and also make uterus to contract. Now you will have pain and bleeding. Complete expulsion will occur within four to five days of Misoprostol. Now you can keep those remaining three tablets vaginal after two days in the morning time. Do not worry, and it will not fail. I hope I have clarified your query, do write back for your question and feedback." } ]

[ { "from": "human", "value": "Hello doctor, I have recently had the bar inserted in my arm and have had side effects weeks after. I was wondering if these side effects are normal or are something to look into going to the doctors for. For two weeks, my period has not stopped, with the past week my flow has been fairly light and although I have had cramps, it is not as bad as when my period was originally due." }, { "from": "assistant", "value": "Hi. You are having a continuous bleeding problem. For that, you need to find any underlying specific cause, if present. It is advisable to investigate with USG pelvis and pelvic examination for primary work up. If all comes normal then investigate further with serum FSH, LH and DHEA estimation. If no cause identified then dysfunctional uterine bleeding is the possibility. You can be prescribed Tranexamic acid tablet and a Hormonal pill for bleeding. USG pelvis. DUB or other organic cause. Tranexamic acid just now and if needed Progesterone containing pill." } ]

[ { "from": "human", "value": "I have a small pimple or swelling in anal area where stools are passing from last one week which is not painful and there is no problem with bowel movement. Its having an itching sometimes.. it is piles or any related disease. It just had a small itching sensation and had small pain while washing after bowel movement and no pain while passing stool." }, { "from": "assistant", "value": "Hello Dear. I welcome you to icliniq. This seem to be a perianal boil. The boil is a pus containing hair follicle. Hair are the stalk and follicles are the trunk of the hair. The follicle can get infected and cause enlarged painful swelling called as boil. It is not communicating to your bowel thats why you dont have problem with your bowel. The best thing you can do is to keep this bottom are clean and hygienic. Wash it thoroughly with each bath and remove hairs timely.. You can apply fusidic cream three times daily over it. It shall heal in few days of application of this cream. I hope you will be fine. Good day. perianal boil/folliculitis none fusidin cream for local application follow up if symptom persist" } ]

[ { "from": "human", "value": "Hello doctor, I am 26 years old and I have missed my period this month. Last period was on 19th of last month. Few days ago, I vomited two times, so I have checked urine test a few days back. There was a faint line. Again I checked it in the evening on the same day, the result was faint line. But when ultrasound and T.V.S. test were done then result was negative. The doctor has suggested me to keep in touch and again check up after a week. Please suggest me what to do." }, { "from": "assistant", "value": "Hi. I can understand your concern. Urine pregnancy test may give faint line during early pregnancy. And also in ultrasound it may take around six weeks for visualization of gestational sac. So, you better go for blood test for pregnancy which will give accurate result compared to the urine pregnancy test. Beta hCG levels above 25 indicates positive result for pregnancy. Take care." } ]

[ { "from": "human", "value": "Hi doctor, I had unprotected intercourse on the 11th. My menses date was on 26th of the same month, but I missed my menses. I had a pregnancy test after eight days and it was positive. I took the first set of abortion pills on the same day at 6:30 PM. At 10:30 PM, I started to have bleeding and the cramps and pain continued till morning 6 AM. It bled and five to six blood clots were there. I took my second set of pills at 10 AM. After that bleeding was very less, but the cramps were there. Till now I have some bleeding and small spots with an interval. Is everything working well? I want to assure that the abortion is complete. Please suggest me." }, { "from": "assistant", "value": "Hello. Firstly, you have not mentioned the name of the pills or the pack that you have taken for medical abortion. From the set of pills, I understand that you have taken two pills at 6.30 PM and then a second set of Misoprostol pills at 10 AM after 16 hours. This is a wrong protocol to use just Misoprostol pills alone and also at such a gap of 16 hours. The bleeding experienced may just be an endometrial shed and the gestational sac may not have been aborted out at all, because cytotrophoblastic invasion has not been stopped by the first pill called Mifepristone. As the bleeding has stopped it is suggested that you should get a transvaginal ultrasound done tomorrow or today to see if the sac has been aborted or not as you saw fewer blood clots and no tissue like glistening lump. I feel that you have not aborted yet as the pills have been wrongly consumed. I want you to mention the name of the pack that you have used or the name of the pills that you have consumed. There are multiple packs available and the only concern in such early pregnancy of less than seven weeks is that Mifepristone is required 36 hours prior to Misoprostol intake and then completion success rates are higher. Nevertheless, get a transvaginal ultrasound done to check for completion and review with the report." } ]

[ { "from": "human", "value": "Hi doctor, I am a 50 year old male. My weight is 84 kg and 5 feet 10 inches tall. I am experiencing pain while urinating in the outlet of the organ. This is the first time I am getting such a pain. Please help me." }, { "from": "assistant", "value": "Hi. I have gone through your case and can well understand your genuine health concern. 1. Urinary tract infection. 2. Calculus in bladder or urethra. 3. Any local pathology in urethra. 1. Complete blood count. 2. Urine routine examination. 3. Ultrasound of abdomen and pelvis. Revert back for follow up along with the investigation reports to an internal medicine physician online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I am 32 weeks pregnant. This is my second pregnancy and I delivered my first child through C-section. I have low Hb content. As per my blood report done before a month, my Hb was 5.2 g/dL. After a couple of days, I was given two bottles of blood through an IV and started to have iron enriched foods and vitamin C added fruits. A week later, I had my blood test done. My Hb was 7.4 g/dL and electrophoresis was normal. Now, after a month, my Hb level is increased to 8.7 g/dL. Should I receive another bottle of blood to increase my hemoglobin further?" }, { "from": "assistant", "value": "Hi. Hemoglobin (Hb) less than 10 g/dL during pregnancy is unfavorable. Blood transfusion should be done when Hb levels are less than 7 g/dL, so you do not need a blood transfusion now. You have to check your Hb till it reaches at least 10. The rate of increase in Hb is same either iron orally taken or through blood transfusion if provided iron gets absorbed from gut properly. Your rate of increase in Hb level is also good. I suggest you investigate the cause of anemia. You must get a serum vitamin B12 level done along with the stool examination for ova cyst as these may also be causing anemia along with iron deficiency. I advise you to have a high protein diet, iron enriched food and oral Iron supplements. 1. Iron deficiency anemia. 2. Macrocytic anemia. 3. Worm infestation. Hb levels every two weeks, serum B12 levels and stool examination for ova cyst and iron studies. Gestational anemia. Oral Iron and vitamin C supplementation. Mebendazole and vitamin B12 supplementation if required. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Revert back with reports after 15 days to an obstetrician and gynaecologist online.--->" } ]

[ { "from": "human", "value": "Hello doctor,I am suddenly feeling faint, weak, shaking, confused, and as if moving in slow motion. It has been going on for nearly 24 hours. Is this low blood sugar or stroke?" }, { "from": "assistant", "value": "Hello. For more information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, My niece aged 14 years weighs 60 kg. Recently her monthly cycles are not proper and she is having heavy pain at times in a day in her lower area. Recently we consulted a gynecologist and recommended to go for ultrasound scan of whole abdomen. In the scan report under ovaries section it was mentioned as RO 16 x 12 cm and LO 4.3 x 1.4 cm. Both ovaries show multiple cysts measuring 6 x 6 cm noted 10 to 15 in number in periphery with echogenic stroma. Cystic lesion noted in RO measuring 16 x 11 cm. No septa, solid or nodules detected. Please suggest me how to come out of this problem. Is there any medicine or exercise required which help us more and bring happiness in her life?" }, { "from": "assistant", "value": "Hi. I went through your query. I am really sorry to know your niece is suffering from stomach and irregular cycles. I understand it can be a very annoying problem. By the ultrasound report that you have given here, it seems your niece has PCOS (polycystic ovarian syndrome). It usually presents with irregular cycles and excessive weight problems. Other problems which also may be seen are acne, pimples, dark pigmentation on certain areas like neck and in between fingers, excessive hair on face, chin and other body parts, etc. To confirm her diagnosis you get a serum LH (luteinizing hormone) or FSH (follicle stimulating hormone) done. If ratio is of nearly 2:1 or greater it confirms that she has PCOS. PCOS is a very common but complex hormonal problem. She would really need to work hard to lose weight. As weight loss itself would help her achieve normal regular menstruation. Also I suggest you get a thyroid function test done because PCOS is also many times associated with thyroid problems. For the issue of painful and irregular cycles, it would be a good idea to put her on regular low dose hormone pills for three months and watch her response. It should help her out. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I delivered my first child two months ago, with C-section. I got my first period after delivery, yesterday. My child is only on breastfeeding. I want to know when can I start exercising, light as well as proper gym in order to get back to shape. I want to know till when do we need to be on sexual abstinence. Also, when can I plan my next child?" }, { "from": "assistant", "value": "Hello. As it has been more than 9 weeks post delivery already, you can start your light abdominal toning exercises if your pain has completely subsided. Generally, we tell the mother to avoid exercising for 6 weeks till strength is achieved over the c-section scar. Do not lift weights for at least 6 months. As your menses have resumed, even though you have been breastfeeding, you may get pregnant as ovulation may start if sexual activity is resumed now. You can safely resume sexual activity now if there has been no pain over the scar. Next child should ideally be planned after an interval of 3 years. So it is suggested that you should be practicing contraception, be it barrier or hormonal to avoid unwanted conception hence. Wishing you good health." } ]

[ { "from": "human", "value": "Hi doctor, I am a 54 year old male. My weight is 84 kg, and weight is 175 cm. I have done a CT scan before three months, and it showed mild thickening of the sigmoid colon suggestive colitis. I do not have any symptoms of colitis, diarrhea or blood in the stool. I have done stool occult blood tests several times since the report, and all came negative. Also, my CBC test fine. My complaint is a very mild abdominal pain for around two to three times a year. It would last for a week or so along with the feeling that I need to have a bowel movement. Besides the CT report, I have no sense of colitis. Would you explain my symptoms?" }, { "from": "assistant", "value": "Hi. For further information consult a medical gastroenterologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 20-year-old female. About a week ago, I noticed an ingrown hair in my pubic area. I left it for a couple of days and then put a hot compression on the area, exfoliated, and tried to free the hair. I used a pin to pull the end out of the skin so I could tweeze the hair out, but I ended up popping the pump and pus just started oozing out. It was sore the next morning and I let it go until tonight, I tried to free the hair again and just ended up squeezing the lump, this time it was a bit larger, again blood and pus came out, but I pulled a hair out with the tweezers and I believe that it was the ingrown hair. I just noticed that my right lymph node in my neck and my groin area are swollen. I would rather not go to see my doctor. Any advice? And the tweezers and pin were both sterilized both times." }, { "from": "assistant", "value": "Hi. After going through your history, I suppose you are having folliculitis. The lesion is filled with pus, then the best way to get rid of it completely is to incise and drain the pus completely. After draining the pus, you may have to apply antibacterial ointments like Mupirocin. This will take not more than three days to completely cure the infection there. Since you have enlarged lymph nodes, you may have to take a course of antibiotics like Azithromycin, Clarithromycin or Zifi 200 minimum for a week after consultation with a physician." } ]

[ { "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,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 a 35-year-old female. I am suffering from a vaginal infection. I want to get pregnant. Is it safe and possible for me after treatment?" }, { "from": "assistant", "value": "Hello. There are different kinds of vaginal infections. The most common are yeast infections and bacterial vaginosis. They are easy to treat most of the time and should not alter your ability to get pregnant. These types of infections can also occur during pregnancy and can safely be treated at that time as well. It is difficult to give more detailed information without knowing the type of infections and the treatment provided." } ]

[ { "from": "human", "value": "Hello doctor, I am 45 years old, female, having an irregular menstrual gap of 10 days and having pain in the left side of the body in hand and legs." }, { "from": "assistant", "value": "Hello. At this stage, two things are possible. First irregular menses due to the premenopausal syndrome. In this condition due to hormonal dysbalance, patient menses are irregular. It will solve automatically. Second is PCOD. In this case, the patient has increased weight gain and irregular menses. For this, you have to start tablet Metformin 250 mg BD, tablet Progesterone (Meperoate) 10 mg from the 21st day of cycle to 25th day. (Last week of the cycle)." } ]

[ { "from": "human", "value": "Hi doctor, My father is suffering from some brain problem. I do not know the type of problem. He forgotten everything including our family members. He previously had taken treatment for depression for the last three years." }, { "from": "assistant", "value": "Hi. I have seen all the attachments you sent (attachment removed to protect patient identity). Revert back with the reports to a neurologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 23 year old female. Yesterday morning, when I was in the classroom, I picked up my phone from my left hand and my hand started shaking really badly. Then, I kept my hand on the lap and it stopped. When I picked up my phone again, it happened. I moved my hand a little in case any nerve was pinched and eventually within some minutes it got fine. I am really freaked out if it is something like a brain tumor. Sometime, I get a little tremor when I hold something or turn pages in the left hand only. Also, my shoulder and hand are paining a little. I am a medical intern, so I did the heel to shin test and finger to nose test. They were normal. I also made my friend check my power and that was also normal. Please help me." }, { "from": "assistant", "value": "Hi. Due to wrong positioning. 1. Anxiety. 2. Thyroid dysfunction. 3. Epilepsy. For further information consult a neurologist 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 tooth has a hole in it, the gums are now inflated and it blocks the hole now. What procedure would the dentist do in my tooth? Also, the placement of the tooth is in the upper middle part." }, { "from": "assistant", "value": "Hello. I have gone through your query and understand your concern. For more information consult a dentist online -->" } ]

[ { "from": "human", "value": "Hello doctors,These days I get depressed a lot. I fear I am not worthy of anything. I want to study astrophysics and be a researcher but due to academic pressure, I get stressed. I am a good student and topper in my class but due to my parents' constant fights and arguments, I get disturbed mentally. I am totally down. I am not me. I can feel it and cannot do anything about it. I hate everyone. I do not want anyone. I feel like shouting from my lungs. I want to scream but I cannot. Sometimes, I get suicidal thoughts. I do not know what to do." }, { "from": "assistant", "value": "Hi. I can understand your difficult position due to stress in the family. Remember it is not your fault and it is common for young people to feel stressed and low in the mood when facing problems at home or outside. First, try to discuss your problems with either of your parents when they are in a calmer mood. You can also discuss with a trusted uncle, aunt or grandparent. Do not suffer alone at such a young age. When you are experiencing negative and suicidal thoughts, do not be alone. Discuss with a trusted member of the family who can understand and support you. Try to change things under your control and do not worry too much which you cannot control. Try to relax. You can try progressive muscle relaxation exercises, deep breathing exercises. Eat and sleep regularly. Do regular physical activities like walking, watch TV, listen to songs at least for 20 to 30 minutes daily. Do not get bogged down by studies alone. If your mood does not improve in 1 to 2 weeks, it will benefit to see your family doctor to rule out clinical depression. If depressed, you will need talking therapy or counseling, sometimes antidepressant medication will also be prescribed to make you feel better. Remember these difficulties are temporary. You will get better and I wish you are able to pursue a research career in astrophysics. Discuss with your parents. You can even show them this response. Family stress, academic pressure." } ]

[ { "from": "human", "value": "Hi doctor, I went for a trip. There I had naked body to body massage along with blow job using condom and even touched the private parts. But, we did not involve in intercourse. Later, I kissed and had intercourse using condom, but with a different girl. Yesterday, my doctor forcefully pushed my penis skin back and found a small red rash inside the foreskin. He advised me to get few tests done and prescribed tablet Doxycycline 500 mg and tablet Valvir 500 mg. What are my chances of getting STD? I felt very uncomfortable, when the doctor pushed my penis skin back. He prescribed a lotion and asked me to regularly push the penis skin back and to clean it with water and apply the lotion. I got back home and tried to do the same, but could not do so. I saw something on my penis tip that was very sensitive to touch. Is this natural? Did the doctor teared my skin tissue by pushing my penis skin back? I am having weird pain in my penis. Please help. Thank you in advance." }, { "from": "assistant", "value": "Hello. I can understand your concern. The doctor pulled the skin back forcefully which means you has phimosis. Phimosis is a normal condition, where an individual failed to pull his penis foreskin back. If the skin was pulled back during childhood itself, it could have resulted in good retraction. Try to remove the skin or keep retracting the skin repeatedly. If you are not able to remove and retract the skin back, then I would suggest you to get a circumcision done. This will help to clean the penis with ease. As you did not have unprotected intercourse, the chance for STD (sexually transmitted diseases) is very less. The rash on penis can occur in case of urinary tract infection too. Take the antibiotics advised by your doctor." } ]

[ { "from": "human", "value": "Hello doctor, I am a 19-year-old boy since the last six months. I am feeling physical symptoms like a tight band wrapped around my head anytime, tightness and pain in the neck, ringing ears, stuffy nose, sneezing, upset stomach, bloating, gas, back pain, eye strain, red eyes, mild headaches above eyebrows, tense muscles, sudden chills, shivering, sometimes sweating, dry mouth, nausea, weakness, constant feeling of having a big disease like a brain tumor, cancer. I had done MRI brain a few months back and the report was normal. But after I again start worrying that I have got a brain tumor after MRI. I cannot concentrate on my studies. I am anytime worrying. Please convey me that how much time is needed for a brain tumor to grow. Does it grow in a few months? I have spent a lot of money on the scan reports. Everything is normal. Please convey me." }, { "from": "assistant", "value": "Hello. Your brain MRI is perfectly normal, so we can completely exclude any possible brain tumor. In my opinion, your symptoms are compatible with a tension-type headache, which is a benign type of headache related to psychological stress. I recommend performing yoga and regular physical activity." } ]

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

[ { "from": "human", "value": "Hi doctor, I am suffering from psoriasis for the past 24 years. I have tried a lot of ointments already. I heard one of the reasons is lack of vitamin D. Is it true? I am 54 years old now." }, { "from": "assistant", "value": "Hi. Psoriasis is a T-cell mediated autoimmune disorder. What you have heard about lack of Vitamin D as its cause is a myth among patients because nowadays there is a new class of topical drugs available which are analogues of Vitamin D. These reduce the excessive cell proliferation and differentiation seen in the skin cells of a psoriasis patient. A few of these drugs are Calcipotriol, Calcitriol, and Tacalcitol. Their pros are that they do not cause skin atrophy, but they are useful only for stable and moderate psoriasis. To help you better, I need photographs plus a detailed history with a previous medication you had taken." } ]

[ { "from": "human", "value": "Hello doctor, I have a right ovarian cyst of 4 cm and left adnexal heterogeneous shadow of 6 cm. What is to be done? Is there anything to worry about? Does it require an operation on an urgent basis? I am unmarried but not virgin and have a regular conjugal life with a single partner. Do I need to stop being intimate? And my weight is 62 kg and height is 5’4’’." }, { "from": "assistant", "value": "Hi. It is not an emergency as the right ovarian cyst is not more than 5 cm. You do a regular ultrasound to measure the cyst size. If it goes more than 5 cm that we have to operate it. There is no relationship of it with your relationship or virginity." } ]

[ { "from": "human", "value": "Hello doctor, I have one side nose block due to my allergy. The doctor gave me these medicines. I want to know what he has mentioned in this prescription." }, { "from": "assistant", "value": "Hi. He has given you a nasal spray Fluticasone. It has to be used twice daily two puffs in each nostril after holding your breath. The next he has given you Odimont LC which is an antihistaminic with Leukotriene inhibitor. Additionally, he has given you a cough syrup Ascoril C (Codeine and Chlorpheniramine) and a painkiller Doser D. The painkiller has some anti-inflammatory action also. Do you have any other queries regarding these? The former two to be taken for 15 days and latter two for three days. He has asked to review on the date mentioned." } ]

[ { "from": "human", "value": "Hello doctor, I have an anal fissure. I am taking homeopathy for the past 25 days. It worked for the first 20 days, but for the past five days, my pain has increased significantly. Is it homeopathy aggravation or something else?" }, { "from": "assistant", "value": "Hello Can you please mention the name of the homeopathic remedy taken? The increased pain after an immense relief can be due to two reasons. The first, the given remedy acted superficially hence you noticed immediate relief. However, since the action of remedy is not completed it stopped working at a certain point where you started getting pain again. The second reason is the aggravation of homeopathic remedy which occurs if the remedy is taken too often in large doses. It is important to know how many doses and in which potency the remedy was taken. If this is an aggravation of remedy, stop the remedy, the pain will subside slowly over the time. If the pain does not subside completely, you can take Nux Vomica 200C one dose (four pills or two drops in a spoon of water) once a day for three days. This remedy will help to reduce the aggravation. Also, it is important to know if the fissure has started to heal in the last 20 days or has it got worse. This can be determined by the physician who will perform the physical examination. Hence, I would advise you to consult a physician and get it checked." } ]

[ { "from": "human", "value": "Hi doctor, I am 15 weeks pregnant. Is it right to go swimming in a pool now?" }, { "from": "assistant", "value": "Hi. If you know swimming before pregnancy, then you can do it in pregnancy also. Have few precautionary steps. If you do not have a risk of threatened miscarriage, low lying placenta or other complications, then there is a need to avoid overexertion in pregnancy when you go swimming. Try to warm up and cool down yourself gradually. Do not do overexertion. If you feel tired, come out of the pool immediately. If you are not feeling well, then it is better to avoid swimming. Do not swim in deep waters. Try to have someone with you while going swimming. Try to avoid swimming in late pregnancy and if you have any abnormal symptoms like breathlessness, abdominal pain, nausea, and vomiting." } ]

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

[ { "from": "human", "value": "Hi doctor, I am a 36 year old female. I smoke but I have no medical history. I do take medicines for depression. About 2 months ago, I started to lose my voice. Otherwise, I felt fine. I do not have a history of losing my voice, so I assumed I must have picked up a virus. My voice slowly continued to become audibly worse, but still no cold or sore throat. Then about 3 weeks ago, my voice became so hoarse that I had to take a leave of absence from my job because no one was able to understand me anymore; I was audible, but so hoarse and able to speak only at quiet volumes. Now, at this time I started having a hard time in eating. It feels like food is getting stuck in my esophagus and for some reason I cannot breathe. I am drinking water to move the food down. I stopped eating solid food last week due to these choking episodes. If I try to speak now, I get ever so slightly short of breath. I also was developing these noises when I breath in deeply. I thought it as asthma, but I do not have wheezing. And when I got into a situation yesterday, I felt like I was having an attack of some sort that loud sounded and felt like croup. I could barely breath when I inhale and I made a really strange and loud croup noise. It settled out eventually. I think it is probably time to see an ENT to know what is going on. I do not really want to go to the ER because I am not aware if they have an ENT there who they could consult to see what is wrong. Plus, I really do not know what all this could be? And maybe it is not serious and it is just a bad virus too. I am trying to decide if my problem can wait for an ENT visit with a doctor when one becomes available in about two weeks. Should I go to an urgent care or ER? Thank you for your time." }, { "from": "assistant", "value": "Hello. For further queries consult an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am suffering for the past two months supposedly some fungal infection on the wrist of my right hand. It is circular and expands in a ring red in color. I have been using Candid B cream but as it goes away it comes back again and increase in size. When it expands, white pus-like small things form and on applying the cream for 2 to 3 days goes away but again surrounding area gets these small pus-like things and so the ring expands. It has left a white patch in the center and red ring at sides. It burns in hot but feels good in cold air. Is there a medicine which I can take?" }, { "from": "assistant", "value": "Hi. Your history is strongly in favor of tinea corporis. Tinea Corporis is a fungal infection, usually a consequence of excessive sweating, occlusion, and friction. If not treated correctly, it tends to keep recurring. Candid B is a combination of an antifungal with steroid and such combinations have recently been banned too. The steroid in the composition tends to only suppress but not cure the infection. In addition, it adds to the resistance, hence further delaying the response when treated correctly. Kindly upload appropriate images to confirm the diagnosis, stop Candid B immediately, let us know all the sites which are affected (groins, axilla, etc.) and mention if you are a diabetic. Tablet Levocet 5 mg once daily at nite for two weeks for itching. Stop Candid B." } ]

[ { "from": "human", "value": "Hi, I am 24 years. I did urine pregnancy test and got tested as positive. After 10 days, I visited doctor and I got it confirmed. After 17 days I got 3 drops of bleeding. Doctor scanned and told negative. Again in urine test another light line found. Doctor saw that strip and she gave some tablets to use. And she told embryo is not visible in scan and she told me to come after 1 month to scan again. Am I pregnant or not?" }, { "from": "assistant", "value": "Hello. Please do not hesitate to send in further queries to an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?" }, { "from": "assistant", "value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had thrush a few weeks ago due to antibiotics. It subsided on taking cream and a pessary after which I stopped the cream in three to four days. After a few days, the thrush again appeared on my vagina (labia). Nurse in a walk said still there is thrush and advised to take Fluconazole and cream. So took one pill of Fluconazole and took cream for a week. However, the painful cuts are still there and itchy. I have got some pictures attached. Wiping hurts a lot because it is sensitive to the touch. I also have some similar cut near my butt hole." }, { "from": "assistant", "value": "Hello. These are definitely (attachment removed to protect patient identity) old thrush lesions which have become inflamed and red, due to possible frequent scratching following itching over the region. The scratching has possibly led to abrasions or knife-like cuts. They are likely to be painful and oozing increases if scratching continues. Instead of using Plan Canesten cream, use cream Canesten-s (which contains Clotrimazole 1 % with Beclomethasone 0.025 % w/v) and apply it overall knife cut lesions thrice a day for the next three days. Beclomethasone is a steroid which blocks the production of certain chemical messengers (prostaglandins) that make the skin red, swollen and itchy (often following scratching- vicious cycle). Clotrimazole is an antifungal which stops the growth of fungi on the surface by preventing them from forming their protective covering. Keep the local area as dry as possible throughout the day, especially post micturition, use soft cotton towels to dry (clean sheets regularly and use a fresh one each time as tissues can cause further abrasions. So do not wipe, just pat and dry). After that, you may apply an antifungal dusting powder (Canesten dusting powder) after application of the cream, over both vulval and peri-anal region which shall help local moisture in check and allow lesions to heal. Please wear loose cotton undergarments to avoid any further frictional injury." } ]

[ { "from": "human", "value": "Hello doctor, I had depression symptoms. When I checked thyroid, it was normal. but when I checked my thyroid antibody the result shows thyroglobulin antibody (ATG), serum: 32.77 IU/mL." }, { "from": "assistant", "value": "Hello. I just read your query and from what you have mentioned, it appears that you have antithyroglobulin antibodies. The presence of antibodies only suggests that you may develop thyroid dysfunction in the future but as of now your thyroid gland is functioning well. I would suggest repeating thyroid function test every three to six months. Hope you find my advice beneficial. Good luck. For more information consult an endocrinologist 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": "Hello doctor, I have redness in the foreskin and glans which becomes bright red when subjected to friction and becomes normal or very light red. This redness comes and goes often. It has been there for a year and above. I took all viral tests and it is negative for all. I used Candid B ointment with no results. It is still the same light red in glans as seen in the picture. Sometimes, foreskin becomes red then and there and disappears without any clue. 1.5 years before I had oral sex and got sharp teeth scratch in glans for which I doubted and took tests but it is negative for all the parameters and sugar is also normal. Kindly advise in this regard and what should be done for the redness to disappear." }, { "from": "assistant", "value": "Hi. There are no active lesions in the photos. There will be some amount of redness with friction. Do not worry about it much. It appears there are no symptoms like itching. Avoid friction or irritation. Do not do forceful masturbation. Avoid using harsh soap or cleanser. Do not wash too frequently. Wash the area twice daily with warm water. You can apply the Candid (Clotrimazole) cream twice daily if too itchy or redness." } ]

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

[ { "from": "human", "value": "Hello doctor, I had sex with my partner before two days and that was my ovulation day. I started taking Krimson 35 from the next day. Am I safe?" }, { "from": "assistant", "value": "Hello. Actually Krimson 35 is not an emergency contraceptive pill. Hence, there a chances of pregnancy. I would suggest to do serum beta hCG (human chroionic gonadotropin) after 10 days of sex." } ]

[ { "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, 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 facing low back pain from the last one month. I have attached my MRI report." }, { "from": "assistant", "value": "Hello. Your MRI report (attachment removed to protect patient identity) indicates a disc herniation in the lower vertebral column. This could be the cause of your back pain. Coming to this point, I recommend taking Ibuprofen 400 mg three times daily and a muscle relaxant (Flexeril or Tiocolchiside) for 1 to 2 weeks. It is also important having some rest and avoid prolonged standing up or sitting position or weight lifting. A lumbar brace can help. If your situation does not improve or even worsens, consulting with a spinal surgeon may be needed. Rest, painkillers, muscle relaxants. Lumbar brace, avoid weight lifting." } ]

[ { "from": "human", "value": "Hi doctor, My mother is around 60 years but she looks older than her age. The skin of her face and body is shrinking very fast. And, she feels sleepy whenever she sits up for a long period of ten minutes or more. Please help." }, { "from": "assistant", "value": "Hi. At her age, cellular aging can speed up depending on her overall health. If she has any underlying chronic disease or if she has a deficiency of essential minerals and micronutrients, all these can speed up the aging process. However at her age, fatigue or excessive tiredness judging from the fact that she falls asleep frequently, must be evaluated thoroughly. Please provide more details as to whether she has any disease or chronic conditions. Also, let me know if she can sleep at night or if there is any recent history of weight loss, etc. If yes then thorough investigation is needed to rule out any underlying pathology. Please give me more details and get the following investigations done primarily. Revert with more information to a family physician online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 23-year-old female. I have severe chills that I needed to wear thick sweaters and jackets at home without AC or fan. I do not feel the heat. And just cold water or slight cold breeze in the morning makes my head frozen or close to shutting down and it is getting worse. It always starts with the nose and then my head. Sometimes, I have to sleep to make the symptoms less severe. I am not under any medications nor do I have any medical condition." }, { "from": "assistant", "value": "Hello. I can understand your concern. According to your statement, you have been suffering from severe chills that you needed to wear thick warm clothes at home without AC or fan in summer now. Chills are the sensation of feeling cold. Chills are caused by rapid muscle contraction and relaxation. They are the body's way of producing heat when it feels cold. They often occur alongside a fever which is when the person's temperature is higher than normal. However, a person can also experience chills without a fever like you and there can be many different reasons for this. Possible causes include hypothyroidism is when a person's thyroid gland does not produce enough hormone that regulates their metabolism. Some people like you are more sensitive to the cold and may feel chills more frequently. Any type of viral or bacterial infection sometimes produces chills before a person gets a fever. Chill is a classic symptom of Malaria. It can have three stages. 1. Cold stage where a person experience chills. 2. Hot stage where they have a high temperature. 3. Sweating stage. Anemia may develop due to poor diet, age, chronic illness, medications, gynecological diseases, etc. Most common symptoms include waking up tired, looking pale, and always feeling cold with chills. Hypothermia can be resulted from dropping body temperature below the normal range due to any causes. Hypothermia can be dangerous especially when your body temperature falls further. If the temperature falls below 96 degrees you should seek medical care immediately. So you should monitor the body temperature with a thermometer during chills. You can do some investigations like CBC (complete blood count) with PBF (peripheral blood film), thyroid function test (T3, T4, TSH), RBS (random blood sugar), etc. Treatment depends on causes. So we should find out the exact causes of your suffering and then treat them accordingly. I want to add that dehydration, anxiety, panic attacks may cause chills too. When your body does not have enough fluids it is hard to maintain regular body temperature and this can lead to hyperthermia and fever like symptoms including chills. Again anxiety is more often associated with feeling sweaty than feeling cold but sometimes it can cause a chilly feel as well. And if you have panic attacks you might experience full body chills according to the National Institute of Mental Health (NIMH). In order to cope up with your chills, you can do the following • Drink lots of fluids including oral rehydration saline and plenty of rest. • Sponge with lukewarm water. • Don't bundle up in blankets or use AC or high speed fans. • Enjoy a warm soup and drink warm beverages. • Use a humidifier. Please inform the results after undergoing the investigations." } ]

[ { "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, Over the last two days, I have had a bad sore throat. It also accompanies with a slight cough, trouble in sleeping, occasional uncommon sweating, body soreness or fatigue, slight vomiting and voice loss. It is not really getting better. It originally appeared to be just a bad cold, but today there is blood in my sputum. It started about 15 minutes ago and it is only when I spit it out every few minutes. Should I be concerned? My mom thinks that it may be due to a laryngoscope I got at the ENT yesterday. But, no bleeding occurred until now. Thank you." }, { "from": "assistant", "value": "Hi. For further information consult an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I got stung by a bee yesterday morning on my toe. When I woke up this morning, I started feeling itches here and there in my body. I also got two blisters on the top of my toe where the bee had stung." }, { "from": "assistant", "value": "Hello. With the conversation we had, I understand that you were bitten by a bee yesterday (insect bite) on your toe and today you have blisters, itching, and swelling. Based on the information you gave, I have suggested some measures as well as some medications. Please wash the toe with lukewarm water and see carefully if any part of the sting (sharp organ of the bee) is left in the toe where it stung. If so you must contact your local doctor who can do the needful steps to remove the sting. If not, then apply some antibacterial cream (like Mupirocin ointment or Betadine ointment) over the blisters. Apply the cream twice daily and wash off with lukewarm water before the next application. Wear comfortable footwear that does not rub over the affected part. Next, to get relief from itching, take an antihistaminic tablet. Antihistaminics that you may take are Levocetirizine 5 mg once a day (if effects wean off, then take twice a day) or Cetirizine 10 mg once a day. If there is pain take a painkiller (Paracetamol 650 mg) if needed. If there is severe swelling and that is increasing with days you need to consult with your doctor to see if it has caused an infection. Increasing pain, pus from the blisters, change of color of surrounding normal skin, fever are some other symptoms showing worsening of the condition or infection. If you are a diabetic with poor sugar control, you run an increased risk of developing an infection. In such a case depending on the severity of infection, anti-bacterial agents have to be instituted. Take rest and do not move the affected toe a lot. Eat plenty of nutritious food and take 4 liters of water per day (this should be the case normally). Especially so now because when you take medicines, the body needs abundant water to take care of metabolism." } ]

[ { "from": "human", "value": "Hi doctor, I had unprotected sex with my wife on the fourth day of her menses and she took I-pill within 24 hours. The next day also we had unprotected sex and she again took an I-pill. After eight days, she bled and eight days later again she bled. She should get her menses by now, but still she did not get. We checked home pregnancy kit and it was negative. What could be the reason for delayed menses?" }, { "from": "assistant", "value": "Hi. She has already bled twice this month and that means to say that she has already done with her periods, though before actual date. So, now she will not have her periods. Moreover, you said that the urine pregnancy test is negative and so there is nothing to worry about. Just wait for the next month periods. Do not hurry and take any further medications. She will be alright. One more thing I would like to suggest you. If you have intercourse within 10 days of periods, then you need not take emergency pills as it is the safe period where there are no chances of pregnancy. 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, My 2 year old child has knock knees. Is there any treatment for this condition without surgery?" }, { "from": "assistant", "value": "Hello, Welcome to iIcliniq.com. So, I would advise the following: Once you get these tests done, I can correlate them and let you know what will be the correct management for your child.Revert back with the reports to an orthopaedician and traumatologist 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 female with a Jones fracture. I broke it for the first time last year and again this year. At this stage, it is showing a nonunion, but I can easily bear weight and there is no pain or swelling. I have no plans to play sports or go running in the future. I was wondering if I can live without getting pinned. As of now, I cannot take leave from work. Also, what will happen if a nonunion is is left untreated?" }, { "from": "assistant", "value": "Hello. I have gone through your question, and it seems that your fracture is not healing well. There are a few points which I want you to know: The first and the fifth metatarsal are actually the weight-bearing bones in the foot. So, proper union of any fracture involving these two bones is important. Jones fracture involves the fifth metatarsal of the foot and that too in an area with a slightly peculiar blood supply. So, if not managed well, can lead to nonunion. You are very young, and at this stage, it is not advisable to leave any fracture unsupervised in terms of treatment. If your concerned orthopedic doctor is telling to get it pinned or open reduction and internal fixation with a screw, then it makes quite a lot of sense to actually undergo that treatment. I can actually advise you in a better manner if I can see your fresh x-ray and also your clinical picture showing the involved foot. Also, you have not mentioned the total duration since the second injury, and what form of management is being done right now. If it goes into permanent nonunion, you will keep on having foot problems from time to time in the form of pain, swelling, and difficulty in ambulation." } ]

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

[ { "from": "human", "value": "Hi doctor, I have few questions which I would like to ask a professional. As I am not able to find the answers by myself, I would love to hear from a practicing professional. How is the best Insulin treatment (syringe, pen, pump and pod) selected for a type 1 diabetes patient? Generally, how long the patients need to learn the injecting technique? Why does injecting Insulin into the same location cause a hard bump in that area? Is this reaction the reason ports are not used to deliver Insulin? How common is the use of the new inhaled Insulin? Does it have to be supplemented by another method of injection? When would an islet cell transplant be recommended? When would a patient be given an entire pancreas transplant operation rather than an islet cell transplant? In both situations, what keeps the beta cells from being tagged by autoantibodies and destroyed again?" }, { "from": "assistant", "value": "Hi. Rather than the best way, we consider more convenient and economical ways for the patient. The best is always an Insulin pump, but it is costly and requires continued patient education. Injecting Insulin into the same site will cause damage to the fat tissue which results in necrosis (cell death). Because of the fat damage, hard bump forms. New inhalation Insulin is not yet come into usage in full fledges. Also, I have not put any of my patients yet on inhaled Insulin, so cannot comment. But yes, initially it has to be supplemented with subcutaneous Insulin as dosing and efficacy is not completely established for Inhaled Insulin. Islet cell transplant is recommended for patients of type 1 diabetes who are difficult to control on Insulin (by any method). If the transplant is considered for only diabetes purpose then only islet cell transplant is sufficient. The pancreas has other functions like digestion. If the digestion system gets impaired in a patient who is requiring islet cell transplant, in such a patient'sentire pancreas transplant would be helpful. Well, if no immunosuppressant is used post-transplant, these autoantibodies can destroy the newly transplanted pancreas also." } ]

[ { "from": "human", "value": "Hello doctor, I am a 23-year-old female who is currently struggling with the unknown of what is happening to my body. Since I first started menstruating, I have always been heavy and longer than average. My normal periods last for 8-10 days, and I use typically 1.5 complete boxes of tampons during a cycle. I am in a long term relationship and have only had this singular sexual partner since 2017. I am not on birth control of any means and in some cases, I have had to use emergency contraceptives post intercourse. In the past two months, I have used contraceptives twice, once in the end of March, and most recently about two weeks ago. Since then, and this is the first time experiencing this, I have had dark brown, clumpy discharge, the closest comparison would be like damp coffee grounds. Within the past week, I had also gotten a thing flesh-toned or white clot with blood on it, about 2.5 inches in length. I am started to feel concerned as the discharge has not stopped and I believe that is occurring rather than a menstrual cycle, at the time I am writing this I should have had my period cycle now, but instead, I have this dark brown discharge. At this time, I fear the idea of going to a doctor’s office for the safety of myself during this pandemic but also do not want to prolong any critical issues I may be facing. I have taken photographed images of all of this in worry that the typed description does not come across correctly. Please help." }, { "from": "assistant", "value": "Hi. Do not be stressed, I am here to help. According to your history, you have not got periods this month and you are having some abnormal discharge. I saw the picture. (attachment removed to protect patient identity). My first suggestion would be to do get a urine pregnancy test. I understand that you have used emergency contraceptive but sometimes it fails. We need to know whether you have a pregnancy in which cases sometime the discharge is of nature as you described. You may be in the process of a miscarriage. If this is negative, then the next step would be to get a pelvic ultrasound done because the discharge seems unusual. But let me assure you that there are more chances of you having a miscarriage due to the failure of emergency contraceptives. In case your urine pregnancy test is positive you need to take proper treatment like pregnancy termination kits or Misoprostol tablets depending on the condition of the conceptus (baby) at this time. In case your pregnancy test is negative you need a pap smear, ultrasound, and sos biopsy of the tissue you are discharging. Whatever it is, it can be managed properly if it is addressed on time. There is no need for panic. Please follow up with your pregnancy test results. I hope this helps. Failure of emergency contraception. Pregnancy test. Endometrial hyperplasia. According to the test results." } ]

[ { "from": "human", "value": "Hi doctor, My baby has undergone hospitalization many times since birth. She has been placed with tracheostomy and gastrostomy tube due to which mobility of the baby is not possible. We are consulting with renowned ENT surgeons and pediatric doctors and we had been told that ''the aspiration can be due to poor co-ordination and tracheostomy tube placement for long period. Once decannulation is tolerated by baby, then the aspiration problem will not persist''. Now they have told us to wait and concentrate on the baby's weight gain. But we want to take a second opinion from you. So, please suggest proper steps to be taken from our end." }, { "from": "assistant", "value": "Hi. The aspiration of feeds is due to the presence of bulbar palsy and palate pharyngeal muscle incoordination. As per the doctor's advise, try to improve the nutrition of the child and weight. Once the child gains a proper weight, then decannulation (removing tracheostomy tube) can be planned depending on the child's fitness. Be in follow-up with the doctor. The child will be fine. For further queries consult a paediatrician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 30 year old male. I had a BMG urethroplasty a week ago. Currently urinating with catheter due to pan-anterior urethral stricture. Are there any complications and risks associated with it?" }, { "from": "assistant", "value": "Hello. I welcome you and want to assure you need not 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. The panurethral stricture is rather a less common but serious challenging surgical issue the urologists have to face. 2. This surgery is usually challenging as there is scanty tissue to cover the whole length of the urethra. Also as we know the reason for panurethral strictures is usually inflammatory disease, so the results of surgical repair may be less than expected on the scale of satisfaction. It is due to the spongiofibrosis of the repaired tissue. 3. During the post-operative period, infections and breakdown of the repaired tissue is commonly seen as a complication. But with all these risks, still this surgery is going on very successfully throughout the globe. If there is urinary tract infection your physician may prescribe you with Nitrofurantoin (Macrodantin). Take cranberry juice to avoid infection." } ]

[ { "from": "human", "value": "Hello doctor, I am a 26 year old female. I went to my GP last year for a swollen lymph node, on the right side of the jaw. But, my GP was not concerned. Recently, I have noticed this lymph node is still there. It is movable, hard, sausage shaped and attached from under the ear. It is moveable next to the throat. I have also noticed that my tonsil on that side is very visible but the left side looks sunken and I am unable to see it at all. I do not really have any symptoms of illness. I have a headache now and again behind the eyes and temples. I have also got a single red dot on the roof of the mouth that I never had before." }, { "from": "assistant", "value": "Hello. You have a unilateral enlargement of the tonsil, namely the right one. Do revert back if you need any further support. For more information consult an ENT otolaryngologist 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, Behind my bottom right molar, there is an open sore, and it feels like something is tearing out. It is swollen over my molar too. There is a white discoloration around the sore, and back of my throat hurts on the same side. It hurts badly. I have difficulty in swallowing and in eating foods. Please help." }, { "from": "assistant", "value": "Hi. You have not mentioned the duration of your problem. It can be due to third molar impaction. When a wisdom tooth comes out from the oral cavity, sometimes it makes a problem. But if you have a difficulty with swallowing, then you should go to a local medical emergency. You can have a localized infection. A dental X-ray can help you. It can be a pericoronitis or due to a third molar impaction. You can take antibiotics. You can remove the impacted tooth after seeing the X-ray. The affected area should be clean. Follow proper oral hygiene and do not touch the affected area. Take a soft diet and do not take hot food. Do not apply force or pressure on the affected area." } ]

[ { "from": "human", "value": "Hello doctor, I am a 49 year old fairly healthy male. My height is 6 feet and weight is 260. I am overweight and also have low testosterone. I have had a noticeable shrinkage in my testicles in recent years. I have embarrassing erectile issues, including premature ejaculation and often I am unable to maintain an erection. I am not on any regular medication. I do not drink alcohol or smoke. I have attached my photos for your reference. My skin is discolored with red circles on my inner side of the legs up to each side of the scrotum. It frequently itches especially after much walking. The red circles are also present just above my penis, but are obscured by my pubic hair. I am also concerned about a patch of darker skin on my scrotum. There is also a pimple or a tag of skin on my inner right leg; two smaller ones on the inner left leg and one at the top of my right leg where my pubic hair stops. They all sometimes hurt, especially when my innerwear rub against them. I have had these for years. I was in the hope that they would go away on their own, but now I have noticed a few small ones begins to develop in the same area. There is also a mole or pimple like growth between the base of my scrotum and anus. This hurts or itches when I sit or walk too long. I have not sought treatment to care of these issues before because of embarrassment. What treatment or medication might help? What do you suggest?" }, { "from": "assistant", "value": "Hello. At the onset I would like to tell you that though I understand your concern and situation, but there is nothing to be ashamed or apprehensive of yourself. It is a medical problem and can only be tackled by proper medical treatment and advice, and not by hiding your problem from doctors. It is great that you do not smoke as it may increase your problem. According to your weight and height your BMI is 35, which falls in borderline to moderately to severely obese. I advise you to visit or ask an endocrinologist regarding the shrinking of the testicles and erectile issues as these may be related to hormonal balance or even obesity. Red circles on the inner thighs (attachment removed to protect patient identity) are indicative of fungal infection known as tinea cruris. For this, a course of antifungals is advised. I would suggest the following treatment. Consult your specialist doctor, discuss with him or her and take the medicine with consent. The outgrowths of skin are skin tags and they are usually related to hyperlipidemia. They are not harmful and only have cosmetic concerns. They are best dealt with by simple office based surgery with cautery machine requiring only local anesthesia, which is a 5 minute superficial procedure. But, they will not go on their own. You may get your fasting serum lipid profile done, which will measure the levels of cholesterol, LDL (low-density lipoprotein), VLDL (very low density lipoprotein) and HDL (high-density lipoprotein). If any of these are abnormal suitable, then medicine can be started. Medicine is important as abnormal lipid profile increases one's risk of cardiac events in the future. One important thing on which I cannot emphasize enough would be decreasing your weight. If you can gradually decrease your weight even by a few pounds, you would see a lot of these medical problems would get better by themselves. You may follow up after two to three weeks. Revert back after three weeks to a dermatologist 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, My son is 7 years old. Diagnosed with mild autism when he was 3. Currently, showing hyperactivity, unable to sit still without supervision. Seems restless all the time. He has delayed speech development. He is not on any medication but under behavioral therapy." }, { "from": "assistant", "value": "Hi. Autism, unfortunately, is sometimes associated with an array of other behavioral co-morbidities like intellectual disability and ADHD (attention deficit hyperactivity disorder). The symptoms you described are almost suggestive of ADHD. Along with behavior therapy, medicines like Methylphenidate, Amphetamines, and Atomoxetine are very helpful in controlling hyperactivity and attentional problems. These medicines are FDA approved for such problems." } ]

[ { "from": "human", "value": "Hello ! Can you please review my blood test? My concern are low level of ferritin, high level of B12 and Urine WBC is very high." }, { "from": "assistant", "value": "Hi, Welcome to the icliniq Following is my opinion for your asked question. The low ferritn , Low Mcv could be suggestive of early iron deficiency anemia. The common cause for high B12 include supplement intake , Liver disease or Kidney disease. Your liver & kidney profile reports are normal.So don't worry about that. If you have any history of supplement intake than mention it.B12 excreted by urine , so might need not to worry about that.High Non Veg food also sometime can cause elevated B12. For low ferritin no need of any treatment.Repeat your serum ferritin & serum iron after few days. The WBC in urine could be due to urinary tract infection.For that investigate further with urine culture report.Meanwhile take more water & cranberry juice extract tablet.Attach the urine culture report once done. Hope this will help you Regards" } ]

[ { "from": "human", "value": "Hi doctor, My baby boy, who is 8 months 14 days old. His weight is 7.6 kg and height is 27 inches. He is taking Arbivit-3 and Zincovit drops daily according to the doctor's advice. Are his weight and height fine? From few days, there are some reddish spots developed on his head and in some parts of the body. It is gradually increasing and there is no secretion from this spot. What are these spots? Are these harmful? What is the treatment? Please explain me." }, { "from": "assistant", "value": "Hi. For further information consult a paediatrician online -->" } ]

[ { "from": "human", "value": "Hi doctor, Following is the growth hormone test report of my son aged 11 years and 7 months and his height is about 129 cm and weight is 32 kg. I am very concerned about his growth. Please comment in detail about the possible treatment and their side effects, if any?" }, { "from": "assistant", "value": "Hello. I just read your report about your son and I am sorry to say that he has a growth hormone deficiency (attachment removed to protect patient identity). He needs to take growth hormone injections for it. These are to be taken on a proper prescription from a pediatric endocrinologist in your place. These are to be taken daily. The side effects are listed here like peripheral edema, edema, arthralgia, paresthesia, skeletal pain, flu-like symptoms, rhinitis, pain, hypertension, gastrointestinal side effects." } ]

[ { "from": "human", "value": "Hello doctor, My jaw pops and cracks and it has been happening for like two years. It used to be worse but it comes and goes. Also, when I move my wrists, there is a cracking or popping noise. Sometimes, my wrist locks and I have to roll it to fix it. Is this bad? I am a female." }, { "from": "assistant", "value": "Hello. Fingers popping is common and not considered to be a cause for worry. It, however, must be remembered that you should avoid popping them. Jaw cracking is another condition that as long it is not painful it can be observed, but if you have pain in the areas just in front of the ears when you clench your teeth or you feel a click, or you are unable to either open your jaw fully or if the jaw dislocates then you should see a doctor. Wrist clicking and locking need to be seen by a doctor to confirm that this is from a generalized laxity of the ligaments and not from an injury." } ]

[ { "from": "human", "value": "Hello doctor, I am a 53 year old army veteran, served for 33 years, who was diagnosed while serving in the army with chronic granulomatous disease and sleep apnea. When I filed a Veterans Administration (VA) claim, the VA rated me for compensation but combined the ratings into one rating. This means that the VA is saying that granulomatous disease caused the sleep apnea. All of my research indicates these two medical diagnoses are completely independent of each other and have no impacts on each other. I am looking for a medical opinion to support my research so that I may submit it to the VA so I am rated separately for each diagnosis." }, { "from": "assistant", "value": "Hello. Chronic granulomatous disease (CGD) is an immunodeficiency condition where the white blood cells cannot fight the pathogens effectively which cause different types of infections. As for sleep apnea, it is caused by narrowing of the air passages mostly in the nasopharynx area which cause interrupted night sleep, usually the cause is obesity in short-necked persons or hypertrophied uvula. There is no relation between both except in very rare conditions (Kimura's disease) where CGD causes hypertrophy of the larynx. Please provide me with some photos of your neck and inside your mouth to see if there is hypertrophied uvula. Sleep apnea is usually associated with hypertension and severe headaches. Do you have any of them? Revert with more information to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, What does it mean if a swab test (just the Q tip inserted into the vagina) is very painful? More details about the presenting complaint: I have been bleeding nonstop for months, even while on Progesterone. And have heavy discharge with a bad smell. I went to the doctor to test for infection. Current medications include Progesterone and the past medications of the same issue include birth controls." }, { "from": "assistant", "value": "Hello. You are likely to have mixed vaginosis infection both bacterial and fungal which can easily cause cervicitis and is the likely reason you are bleeding since then. More so the infection causes vaginal walls to inflame and hence the pain on insertion. You shall require a course or oral antibiotics along with antifungal vaginal pessaries for complete treatment. Please discuss with your gynecologist and take an informed decision." } ]

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

[ { "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.--->" } ]