conversations
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[
{
"from": "human",
"value": "Hi doctor, My bilirubin levels are high. I just took an opinion from my general physician and he asked me to contact a gastroenterologist to know the exact reason for high bilirubin. Can you suggest any other tests or medication for this? I have also attached my laboratory reports for your reference."
},
{
"from": "assistant",
"value": "Hi. For further information consult a medical gastroenterologist 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 would like to get help reading knee MRI. Based on physical examination: Acute medial meniscus tear. Pain, clicking sound and cannot do activities."
},
{
"from": "assistant",
"value": "Hi. Please note the images are sub-optimal for giving a professional report as we need to see the images in detail at the workstation computer (attachment removed to protect patient identity). However, my observations after viewing the images sent by you are the following: Your MRI knee is showing a mild knee joint effusion and is the likely cause of your pain an discomfort. The medial meniscus shows a suspicious area of signal abnormality in in the anterior horn root area and is not a serious concern. The rest of the meniscus is looking normal. The anterior cruciate ligament is intact, however there can changes from a mild strain of the ligament."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I had a brief interaction with a woman who is very likely to have STD, specifically herpes, and I have a few questions about herpes testing. The full story is that about three weeks ago, after a bad breakup, I went to a massage parlor. The parlor was the type that is sort of seedy and known for extras and the masseuse assumed I wanted sex and was immediately ready to go. I sort of talked her down to a handjob and the masseuse took off her clothes, straddled my legs, and did her thing while I lay on my back. For about 10 seconds during the hand-job, her genital area was pressed against my scrotal area, and she also kissed the shaft of my penis twice. There was no intercourse, and I did not see any herpes lesions on her, but I also was not able to look inside her or get more than a few brief looks between her legs before she was on top of me.After the experience, I was very worried about having contracted herpes from the genital contact, so I got some tests done. An IgM plus a full STD screen at three days after the incident, and an IgG and a second IgM at 10 days after the incident. Everything was negative. I have had no symptoms other than a bump on the inside of my thigh, and I have had bumps before in the same spot due to thigh chafing when I walk. I actually had one on the other thigh before the incident. Currently, it is about 22 days after the incident, and I am planning on getting a third IgM done to be extra sure there has been no change. What worries me is that I have read online that the IgM test is unreliable and that 50 % give false negative results. So basically, my questions are, with no symptoms, three negative IgM for HSV 1 and 2, and a negative IgG, is it safe to assume I do not have herpes? Is the IgM completely unreliable or are three negatives taken at different times conclusive? And is it fine to continue with dating and sexual activity given my current circumstances? Or should I abstain from sex completely for another nine weeks and wait till I can take a more accurate IgG? I started a new relationship a couple weeks after the incident, and I do not want to risk infecting her, but I also do not want to ruin the relationship if I do not need to. I also suffer from generalized anxiety disorder. So, any concrete information you have would be helpful. Lately, I have been having especially bad panic attacks and hot flashes. Currently, I am taking Effexor 75 mg."
},
{
"from": "assistant",
"value": "Hi. I have gone through your case in detail. And after detailed analysis of your contact, it is concluded that you basically are not sure whether the woman actually had any herpes or not. Moreover, all your test results till now are negative. So, in absence of any symptoms of herpes and negative tests both for IgM and IgG, it means you are not having any herpes. So just stay relax. A false negative is said when you have a clinical lesion of herpes and clinician is quite sure of that but your tests turn out to be negative.In addition to this, if herpes had to appear it would have been evident within 10 to 14 days of your contact. As long as you are herpes free, both clinically and pathologically, you are free to go ahead. For more information consult a dermatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My daughter is 1 month and 26 days old. Her birth weight was 3.05 kg. Her current weight is 4.4 kg. She spits the milk after burping also. She has been diagnosed with laryngomalacia. I wanted to know whether it a matter of concern or not."
},
{
"from": "assistant",
"value": "Hi. The current weight of the child is absolutely normal according to the birth weight of the child. There is no need to worry about this. Babies often spit very little amount of milk after feeding even after burping, this is a normal thing. If it is problematic, then the weight of the child does not increase. Since the weight of the child is normal according to age, I think this is normal and we should not worry about this. Also working should be done for around 10 minutes for effective results. Laryngomalacia is a condition in which the muscles of the larynx are weak and as a result, there is stridor sound during breathing. This is not a serious issue. Laryngomalacia usually gets corrected around eight months of age. Sometimes calcium levels are low which can result in stridor like sound, so calcium level should be done in the child. If low, then calcium needs to be started."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 35-year-old female. My weight is 91, and I have three children. I am not having my menstrual period for the past four years. After running some tests, doctors confirmed it is high prolactin, and gave me drugs, but it did not help. I want to find out if there going to be any damages to my health because of this? What can I do?"
},
{
"from": "assistant",
"value": "Hello. It points out that you had early menopause, which occurs in 5 to 10 percent of women at age less than 40 years of age. And yes it has adverse effects same just like menopause in another woman at the usual age. So you must consult your local doctor and get a prescription for HRT (hormonal replacement therapy) which will result in monthly cycles as well as protect you from developing early osteoporosis. You have to continue taking it until the natural age of menopause. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have minor beta thalassemia which I got from my mother, but unlike her (asymptomatic), I have anemia symptoms like paleness, shortness of breath after the least effort, feeling tired all the time, broken nails and I want to know if it could be due to lack of iron? Could people with minor beta thalassemia also get iron deficiency anemia? Knowing that I get heavy cycles and my diet is very poor."
},
{
"from": "assistant",
"value": "Hi. I have reviewed your query and here is my advise. Yes, your symptoms point towards iron deficiency anemia. In beta thalassemia minor patient usually feels more fatigue on exertion as compared to normal people without thalassemia. However do not worry regarding thalassemia minor, they can live a normal life. Thalassemia people can develop iron deficiency anemia secondarily. So rule it out by CBC profile with blood indices as well. You can revert back with reports so that I can guide you further."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a brown discoloration of the skin around my fingertips. What is the reason?"
},
{
"from": "assistant",
"value": "Hi. Revert with more information to a cosmetologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am 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 want to get some information regarding bipolar disorder because I think I have it. I had horrible mood swings, one moment I am overly happy, and the next moment I feel depressed. My sleeping schedule is also different than usual."
},
{
"from": "assistant",
"value": "Hello. Let me answer your questions via some bullets some points to make things easier to understand. 1. You are only 14 years old, and it is very unusual for a significant mood disorder like bipolar mood disorder to manifest at such a young age. However, this does not mean it is impossible but just far less likely. 2. As a young woman at 14 years of age, it can be considered completely to have mood swings and sleep disruption due to premenstrual hormonal changes. Puberty, overall, is a time of huge biological and psychological change and is not uncommon for a person to experience broad mood changes within one day. 3. I feel your mood swings and general well being should have a keen eye kept on them. If you have a severe mental health disorder, it will become clear fairly soon. 4. From your point of view, as long as you are still able to function normally at school and keep up with your academics as well as maintain relatively good social interactions you are very likely not suffering from a severe mental illness like bipolar. Also, consider the extent of your inner sense of personal distress. Sometimes things can seem like the end of the world in puberty but are much less severe when viewed from a different perspective. 5. I think it would be wise if your parents could allow you to see a psychotherapist or counselor regularly going forward for you to unload your feelings in a safe and confidential environment. Also, such a person could keep an experienced eye on you, and if any severe psychiatric symptoms appear, they can be recognized and acted on it correctly. 6. So my final suggestion is to ask your parents if they are willing to help you find a suitably qualified psychologist and counselor that you can see regularly and feel you can trust them with your feelings. Remember if you are unsure about how you feel and if it is reasonable and not something to worry about, it is always better to speak up about how you think, just as you have done here. Should see a clinical psychologist or counsellor regularly."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 20 years old. My weight is 52 kg. I want to gain my weight. Can I use Nutrigain? Will it help in the build up my muscles?"
},
{
"from": "assistant",
"value": "Hi. The first thing you have to focus on your daily diet and not only supplements. So make a high-calorie food. Eat more cereals 300 gm mainly plain rice, brown rice or bread, oatmeals, maize, Nutrela, and all whole grains. Add all good quality proteins like organic, dairy proteins, fish, milk, eggs, plant-based sources like pulses and soy products. Add two tablespoons of ghee on rice and butter on chapatis. Add dry fruits, nuts, almonds, etc. Add plenty of vegetables, fruits mainly banana and sleep minimum 8 hours. Take good foods with proper digestions and need to consume all out to make the body fit and gain muscles."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had protected sex with my wife. But, there was little semen outside the condom. To eliminate any chances of pregnancy, she took an I-pill after 36 hours of intercourse. Are there any chances of pregnancy and if not, are there any chances of her periods getting delayed?"
},
{
"from": "assistant",
"value": "Hello. You have done the right thing. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect."
},
{
"from": "assistant",
"value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well."
},
{
"from": "assistant",
"value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My partner is 48 years old, and her weight is 65 kilograms. She has RBC of 5.6 mcL, Hb of 15.3 g/dL, and creatinine of 0.9 mg/dL. The urine report shows white cells of 60 to 80 WBCs per high power field. There are traces of proteins, leucocytes, and epithelial cells also."
},
{
"from": "assistant",
"value": "Hi. Your partner has urinary tract infection. She needs to do a urine culture and sensitivity. Meanwhile, get examined by a gynecologist to know the local source of infection. If she is symptomatic, with fever or burning micturition, then she needs to take a course of antibiotics."
}
] |
[
{
"from": "human",
"value": "Respected doctor, My 63 year old mother was diagnosed with tuberculosis meningitis (TBM) 10 months ago when she complained of a severe headache. She has undergone CSF study and the report of the study is attached. She has been taking ATT medicines since then. The list of all the medicines she is taking is also attached. The medicines had come down to only one tablet (R-Cinex) in the last 10 months. But, now for the last two months, she started having back pain in the spine area and is now suspected to have a TB infection in the spine. She has a history of L3-L4 collapse four years ago, but that was due to osteoporosis. Her BMD score was -3.2. The spine has been severely infected from L1 to L5. The MRI revealed an abscess with a pus collection in it (report attached). The doctor says it could be Pott's spine and may be because of a drug resistance (MDR), and they wanted to perform a USG aspiration for Xpert plus SRL, culture and sensitivity of pus. But, the test did not happen because the location of the pus was very deep in the muscle and could not be extracted. So, they extracted some tissues near by the infection area and sent for a small biopsy. The report of the histopathology (small biopsy) is also attached. It says mild nonspecific chronic inflammation. Since no strong evidence of drug resistance could be found in the small biopsy, the doctor has restarted the medicine of AKT-4 plus STM 0.75, and they want to see whether this reduces the problem or not. They said we cannot start DR/MDR treatment without any strong evidence of drug resistance. The current OPD card is also attached in which the medicine has been restarted. Now please guide us about what should be the treatment plan of the disease based on the information submitted. Can anything can be done to get a strong evidence of drug resistance since the ATT medicine is very heavy and the doctor has restarted this medicine only on the basis of his opinion? How can we assess the recovery from the disease apart from relying only on the reduction of pain? Does she require any further MRI or any test after some time?"
},
{
"from": "assistant",
"value": "Hello. I went through your post which has nicely described the events. Also, I reviewed her reports (attachment removed to protect patient identity). For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am six weeks pregnant and there is a stone of 3 to 4 mm in gallbladder. Can I get operated for the same?"
},
{
"from": "assistant",
"value": "Hello. I understand that you are worried about gallstones and it can be stressful whilst undergoing pregnancy. However, let me assure you that most gallstones do not cause any symptoms. Seeing as they are small in size, they can be easily left alone until after the mother has delivered the baby. The risk of miscarriage is always present whenever a pregnant women undergoes any procedure. Are there any symptoms that are bothering the mother? Like jaundice, uncontrollable pain, etc.? I would also request you to share the investigation reports as it will help us make a better decision. LFT, Ultrasonography Pain medication - Tablet Paracetamol 500mg SOS if having pain Avoid spicy and oily food"
}
] |
[
{
"from": "human",
"value": "Hello doctor, We are trying to conceive a baby. But the semen analysis report says that I have low sperm count (6 million counts) with very low motility. Please help me."
},
{
"from": "assistant",
"value": "Hi. Firstly, we have to diagnose the cause of your problem. The most common cause of this is a condition called varicocele. For the detection of varicocele, I suggest you do the following:"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "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 have severe stomach and back pain at the same time. Suggest some quick remedy."
},
{
"from": "assistant",
"value": "Hi. I have read through your query in detail. Please find my observations below. Severe pain in abdomen radiating to the back might be due to many conditions which require evaluation. Problems that might cause the stomach and back pain, all the possible reasons, For spasmodic pain you can take antispasmodic medicine like Spasmonil plus (Dicyclomine hydrochloride and Mefenamic acid). This has to be taken twice daily for pain that might be a spasm. This should reduce any spasmodic pain that you are having. Once pain is stable then please consult your doctor and get examined clinically. If required the doctor might ask for an ultrasound scan abdomen to be done to know the cause. Above mentioned causes are the commonest and there are many other conditions which might cause a similar pain. Clinical examination and investigations are important."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My wife is having swelling over the collarbone and back. Our doctor diagnosed rheumatism after blood test. Now, she has pain in ribs when she carries our 2 year old son or any weight. Our doctor had prescribed Bon-DK, Bon-K2, etc. How long will it take to recover? Is this a serious problem? Will this get cured? Please explain."
},
{
"from": "assistant",
"value": "Hi. Anti-CCP, ANA and serum uric acid. 1. Rheumatoid arthritis. 2. Soft tissue rheumatism. 3. Seronegative arthritis. For further information consult an orthopaedician and traumatologist 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 28 years of age and 24 weeks pregnant with my first baby. I have had two miscarriages in the past. I am experiencing severe anxiety from the past three months. I developed this problem four years back, and I was put on a few medications which are in the attachment. I took them for around two months and felt better. But now it has returned, and I am feeling completely helpless. I stay in a remote place with my husband. I am scared of everything. I feel detached from the environment. I am restless with intrusive thoughts. Now I am not attached to my baby too. I do not have any future plans. I love my husband, but I am scared to live with him. I am not on any medication as I am pregnant. I will sit on the internet to find some solution but reading horror stories about anxiety making me crazy. Please help me"
},
{
"from": "assistant",
"value": "Hi. We understand your problem. The symptoms that you have told fit into generalized anxiety disorder with depressive symptoms. You had treatment in the past, and you were better with that. This time because of your pregnancy, things are not that straightforward. Still in my opinion, after evaluating risk and benefit, you should have both medications and psychotherapy. Initially, you can try tablet Clonazepam (Clonotril 0.25 mg twice daily). It is low dose only and safer after 3 months of pregnancy. Also, you should have your thyroid function and CBC test done. You can take an appointment for sessions, in which we can have detailed evaluation and management. Just remember you became better last time and this time also you will be better soon."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 28 years old male. I tested my blood triglyceride and cholesterol. I have a triglyceride of 3.07 mmol/L and cholesterol of 4.33 mmol/L. I am worried about my high triglyceride level. Currently, I am taking Atenolol 25 mg in the morning. Please help."
},
{
"from": "assistant",
"value": "Hi. I understand your concern. Your triglyceride level is at a higher level than the upper normal value. Several causes increase the blood triglyceride levels. Foods rich in fats such as dairy products, and meat can increase triglyceride. Other exogenous substances may also affect the level. Beta blockers such as Atenolol can also raise the blood lipid profile (triglycerides). An increase in blood triglyceride level is approached appropriately by modifying the diet profile by reducing fatty-rich components and increasing the intake of plenty of fibers, such as vegetables, and fruits. Having a physically active lifestyle every day and avoiding risk factors like close smoking contacts and excessive alcohol consumption are very helpful. If there is no improvement, then medications can help. Take Ciprofibrate 100 mg in capsules, one capsule daily. You should consult your doctor soon."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am hepatitis C positive with IgM + IgG of 14.2. This test was conducted five years ago. What is the significance of this? I have full medical test including LFT from two months back including sonography where things were normal. Do I need to worry about this? Does it require a treatment or the count is within limits?"
},
{
"from": "assistant",
"value": "Hello. You need to get the hepatitis C quantitative assay (RNA level) done and need to get treatment depending upon that. There is no need to worry. Your other labs are fine (attachment removed to protect patient identity). But please be under the strict follow-up of a nearby gastro/ hepatologist. Regards. For more information consult a medical gastroenterologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am gurgling when breathing in and out, especially when laying down. In the beginning, I had a fever with strong cough and wheezing sound when breathing in and out, after a few days, I am back to normal, but this wheezing turned into gurgle till now."
},
{
"from": "assistant",
"value": "Hello. Take syrup Bromhexine two tablespoon thrice daily for a week. It will produce a cough. Please excrete it out. Also, do steam inhalation thrice a day for a week."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I missed my period last month and after the first late day I took a pregnancy test and it said not pregnant. So I waited for a few more days to go by to take another and it said positive so from that day I scheduled a follow-up appointment and when I went to get an ultrasound they told me that there was nothing there. So she predicted that I may be early, so she used the camera and she still did not see anything. She told me to undergo a urine test and it came out negative meaning I am not pregnant. I left there and took another test at home and it said negative. It has been a whole month and I still do not have my period. What could be wrong with my body?"
},
{
"from": "assistant",
"value": "Hi. Have you done the blood pregnancy test (hCG)? It could have been a chemical pregnancy meaning non-viable early pregnancy. You can take medicines for withdrawal bleeding like Norethisterone 5 mg twice a day for five days. You will get periods after you stop the medicine. The bleeding might start by 4 to 14 days. Did the radiologist mention the endometrial thickness?"
}
] |
[
{
"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, Due to weather change, I caught a cold and dry cough is there since last four days. Please suggest some medicine to expel a cough from the body."
},
{
"from": "assistant",
"value": "Hello. A dry cough is very common with a change of weather and is often prolonged. It often causes a lot of discomforts especially in the throat. It can also be associated with seasonal allergies. You will be needing an expectorant along with a drug from the bronchodilator group for dilation of the bronchioles and easy expectoration of mucus. I suggest syrup Mexair which contains Terbutaline (bronchodilator) and Guaifenesin (expectorant). Other than that I would suggest you do steam inhalation twice day. Syrup Mexair twice a day."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My 3 year old son was diagnosed with sepsis with SIRS, three days back. But, now his WBC and C-reactive protein are within limits. Will he have sepsis again? He frequently gets wheezing and allergic cough. He is currently taking Amclav."
},
{
"from": "assistant",
"value": "Hello. Regards. For more information consult a paediatrician online -->"
}
] |
[
{
"from": "human",
"value": "Dear Doctor, My eye power is -9 on left and -3 on right. I feel very uncomfortable wearing eyeglasses. When I see, objects double and get dizzy. How to improve? Age - 17 years/ female."
},
{
"from": "assistant",
"value": "Hi. Consult an eye care ophthalmologist online for follow up -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 33 year old male. I have been suffering from social anxiety for the past one year. Although I was extremely shy as a child and up to about 25 years of age. After that, I overcame my social anxiety and became confident. I managed somehow not to care about other peoples opinion about me. I could convince with almost anybody because I ignored what the people think or say. But, for the past one year I have lost my ability to ignore what other people think or say and I have started to value their opinions about me rather than my own opinion about me. I have become self conscious, shy and quiet. I am not feeling depressed or sad, but this feeling has made me extremely unproductive and I just think what others think about me. My past medication is Olanex for the social anxiety. Please recommend some other medications as this condition has been disturbing my social as well as professional life and my colleagues have started to make fun of me."
},
{
"from": "assistant",
"value": "Hi. I have read your query and understand your concern. Social anxiety disorder is really a disturbing condition, but can be controlled with proper medicines and behavior therapy. Anxiety disorders occur in episodes and sometimes follow waxing and waning course. You had anxiety before 25 years of age and the anxiety relapsed since last one year. The feelings that people are judging you, ideas that what others will think or say, self-consciousness are typical symptoms of social anxiety. Feelings that you are good for nothing and unproductive are due to co-morbid depressive symptoms of social anxiety. Do you have anxiety during a presentation or in group discussions? Do you feel shy or stutter while talking to some person of big stature or any problems in talking to females? In severe social anxiety such type of anxiety situations is also seen. Medicines especially selective serotonin reuptake inhibitors (SSRIs) are drugs of choice for social anxiety. I suggest you to use Escitalopram drug. The drug is started with 5 mg dose for about 10 days and then can be increased to 10 mg. The drug should be taken in the morning after meals and should be used for about three to four months. After four to six weeks the dose can be reduced gradually. I suggest you to use Propranolol for anxiety provoking situations. The drug can be taken about half to one hour before some situations like presentations or group discussions. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. These medicines will definitely help in improvement. Breathing exercise and relaxation exercises will help you to control anxiety. Apart from this relaxation exercise, behavior therapy also helps in reducing the symptoms. Revert back with answers to the above questions to a psychologist counsellor online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had X-ray done for shoulder bone. This was after a stiff neck and constant pain in the cervical region for the last six months. I did not take any medication. Also, there was a fracture in the lower back four years back."
},
{
"from": "assistant",
"value": "Hello. I have gone through your report and the above query (attachment removed to protect patient identity). X-ray report does not mention any bony abnormalities except reduced cervical lordosis. This is usually due to spasm of neck muscles. Usually, these problems arise due to inappropriate posture during work, excessive bending of the neck or lifting heavy loads. In this case, I would recommend for physiotherapy and exercise of neck muscles along with proper posture maintenance. You would easily find the instruction for exercises to follow on net otherwise you can take the help of physiotherapist near your house. Avoid use of pillows while sleeping. Also along with this, you can take Vitamin D and Calcium supplements to increase bone strength. I would be happy to help you further if you have any questions."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well."
},
{
"from": "assistant",
"value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help."
}
] |
[
{
"from": "human",
"value": "Hi doctor, 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 am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "assistant",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. My recent blood report shows high ESR level. I am having cough and fever in the evening. Doctor told me that I am having bronchitis and has given me antibiotics as well as cough syrup. I am sending you my x-ray and blood test report for verification. Please guide."
},
{
"from": "assistant",
"value": "Hi. I have seen your reports (attachments removed to protect patient identity). For further information consult a general practitioner online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "assistant",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hi! I am a 29 year old male with 171 cm height and 55kg weight and suffer from IBS. Every time I go to toilet, I have pain while defecating and after it, I have a burning sensation in the anus region for the whole day. Sometimes I also have abdominal pain but I think this is due to IBS. Before and after going to the toilet, my anal lining is normal but during defecation, something bulges out and I am not sure if these are hemoroids or this is mucosal rectal prolapse. After defecation I have burning sensation in my anus and mild pain in my left side. I also suffer from constipation (go to toilet 3 times per week) and almost always have to strain when going to toilet. When I am anxious, I suffer from diarrhea and my stool is mostly liquid. But if I am not anxious, I suffer from constipation. I already excluded all wheat / grain as it was causing me gases and pain and my IBS improved but I still have occasional abdominal pain (especially after defecation). Can you please help me understand if I have hemoroids or mucosal rectal prolapse and what I need to do to cure them?"
},
{
"from": "assistant",
"value": "Hi, Hope you are fine. 1) pain while defecating, and feeling of bulge, this is mostly a hemorrhoid, which sometimes could be associated with spot of blood on the toilet seat, and sometimes not. How to differentiate between a hemorrhoid and a rectal prolapse? to be examined by a surgeon, other wise it's difficult by history only. However, being young and healthy, it's unlikely to have a prolapse (it's a disease of elderly and anoreceptor intercourse). prolapse is usually completely circumferential, but hemorrhoids, usually one location (described as clockwise related 3,7,11 o'clock). 2) your abdominal pain, likely it's IBS, having intermittent diarrhea and constipation flavoring it. 3)- so to help ease your symptoms, we need to treat and fix your bowel habits, which is more fibers (green vegetables, avoid carbs), stool softener like Normacol (over the counter drug, which is basically fibers) 1 -2 sachet per day, till having soft easy stool. 4) part of IBS treatment, is psychological therapy, you need to relieve your stress, which will help you a lot with the diarrhea."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 18 years old female, 137 lbs, and on no medications. I have had irregular periods since I was 13. The longest I have gone without a period was three months. I have had multiple negative pregnancy tests. I have not had my period since last month and I am not pregnant. I am worried about my health although this has happened before."
},
{
"from": "assistant",
"value": "Hi. Please answer the following questions: 1. Putting on weight, and unable to lose that? 2. Acne? 3. Facial hair increased? 4. Hair loss? 5. Thick hairs on chest, back, thighs, arms, belly? 6. Any known hormonal issues? 7. Any long-term medication taken? 8. Sedentary lifestyle? 9. Are your parents diabetic or prediabetic? First few years of menarche can give you irregular periods, and that is normal as your hormonal axis is not matured enough to have a cycle, but by 15 years, it should generally be fine which in your case is not. You could be suffering from some hormonal imbalance. Work out the following: 1. A balanced diet containing loads of yellow fruits and green vegetables. 2. Regular physical exercise for 30 minutes to keep heart rate above 100 during the activity. 3. Add cinnamon and turmeric to your diet. These small changes can bring a lot of difference. Do it for the next three months. I can assure, you will feel the difference in a month but continue it. You also need to get USG pelvis done to rule out polycystic ovarian syndrome."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I got hit on the left side on cervical region almost two years from now. MRI does not show any injury or significant stenosis but the electromyography shows left moderate radiculopathy C5-C8 and recent results showed deterioration. Symptoms also still exist on left arm and trapezius but recently for the first time, I started feeling some irritations in the left leg too. My questions are the following: How this will progress you think? MRI shows nothing significant anatomically but radiculopathy deteriorates and emg results. Is this possible you think to start having the same problems in the leg too? This will constitute kind of myelopathy. Is it?"
},
{
"from": "assistant",
"value": "Hello. Regarding your concern, I would explain that as there are no signs of myelopathy or spinal canal compression on MRI, there is no reason to panic about myelopathy. The pain in this region is related to the nerve damage. Physiotherapy can help improve your situation. I would also recommend trying a cervical collar during pain exacerbation. I do not think that it will progress. It is also important avoiding heavy weight lifting and use an orthopedic pillow. Regarding the irritation on the leg, I would recommend performing a lumbar spine X-ray study in order to investigate for possible chronic degeneration or the lumbar vertebral column, which may mimic this clinical situation."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 36-year-old male. I was a daily drinker of hard alcohol for the past four years. I am in depression and anxiety. I consulted a doctor. The doctor gave me Zoloft and Propranolol. Before few days, I have removed a large ganglion cyst from my right wrist. I made a step to stop the habit of drinking alcohol. I started to have sweating from my head profusely and consistently. I had it for two weeks. Now, the sweating from my head has got subsided, and it moved to my legs. I tested for STD and HIV. It came negative. Why do I have sweating like this? Please help."
},
{
"from": "assistant",
"value": "Hi. I have gone through your problem, and I can understand your concern. Yes, these symptoms are due to alcohol withdrawal. As you have stopped drinking alcohol, you can have these symptoms along with other symptoms such as tremor, palpitations, anxiety, and other severe withdrawal symptoms such as seizure and delirium. Withdrawal symptoms usually decrease in intensity by one to two weeks. You can take Thiamine and Benzodiazepine. Benzodiazepine help in reducing these symptoms and promote good sleep. Thiamine is vitamin which is usually deficit in an alcoholic. As you have abstinent around two weeks, you need only a low dose of Benzodiazepine. It will provide adequate sleep and also cause a decrease in sweat. Take tablet Trazodone. It also helps in sleep. You can consult a doctor for a prescription."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have small watery bubbles on either side of my penis and they seem to have grown in number in the last few weeks. First they appeared around three months back, but very less in number. They do not cause any irritation, but increased in number and looks ugly. I have not used any medication for this. If it is not cleaned every day then some wax like white layer is formed around the head and the area covering foreskin. Please help me with this."
},
{
"from": "assistant",
"value": "Hi. I have read your query and can well understand your concern. Revert back with the details to a dermatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect."
},
{
"from": "assistant",
"value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am 52 years old, and I am hypertensive for the past 12 years and diabetic for the past seven years. I am using Tozaar 50, one tablet for my hypertension and Amaryl 1 mg, half tablet before break fast and half tablet before dinner, for my diabetes. Of late, during intercourse, I am not able to sustain an erection. But erections during sleep is good. I am unable to enjoy as I used to earlier. My doctor advised using Troynuron SR. I am afraid of using this with an apprehension of side effects. Please suggest me what can I take to enjoy my family life as earlier. I go for walking and do yoga regularly for maintaining my sugar levels, and they are under control. The fasting reading will usually be 125, and rarely if I neglect walking due to any reason, the reading will be 135. Post prandial level is always normal. Blood pressure is always 130/85."
},
{
"from": "assistant",
"value": "Hello. Any further queries, I will be happy to help you. For further queries consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My son is 4 months old and started chewing on his tongue. Is this due to teething?"
},
{
"from": "assistant",
"value": "Hello. Teething usually starts about six months of age, but at this time kids try to pet objects more often in the mouth because that is the way they try to learn about objects. It is very natural. But if your child is continually biting on the tongue and not occasionally, it could be something else. You can take a short video that would be more helpful. You can discuss with your doctor when you visit."
}
] |
[
{
"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 had taken a pill and got bleeding. I thought it was periods because I had little cramps but that bleeding was so light and it lasted for three to four days. After that I had protected sex two weeks back but to be complete sure I took another pill two days later and my periods was due a few days back and now I am not having any bleeding. That bleeding was my periods or what? And when next I am going to have my periods?"
},
{
"from": "assistant",
"value": "Hello. I-pill is emergency contraception. It should be taken not more than once or twice in a year. It has many serious side effects. Secondly, you took I-pill twice in one month would definitely create some hormonal imbalance which might take a couple of weeks to settle. It is difficult to tell whether earlier was your normal menses or withdrawal bleeding. Chances of pregnancy cannot be excluded without a blood test, you need to do a blood test to rule out pregnancy."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 33 years old single female. My hemoglobin is 10.5, RDW-CV is 18.3, MCHC 39.6, hematocrit is 26.5. Any issues, let me know and what you prefer for me? Please let me know."
},
{
"from": "assistant",
"value": "Hi. I have gone through your case and can well understand your genuine health concern. As per the values mentioned by you, the hemoglobin level is low which indicates anemia. RDW-CV is on the higher side (attachment removed to protect patient identity). Its normal value should be up to 15. A high RDW-CV favors iron deficiency anemia. But it can be seen in B12 and folate deficiency also. Hematocrit is low. The normal value should be between 37 to 48 % for women. All the three parameters are indicating towards iron deficiency anemia. Only MCHC is contradictory but in early stages, you can find normal or slightly high MCHC in iron deficiency anemia. To confirm it, I suggest you few blood tests like a peripheral smear, serum iron, total iron binding capacity, ferritin levels, serum B12, and folate. There are many causes of iron deficiency anemia like chronic blood loss from the gastrointestinal tract, menorrhagia, hookworm infestation, dietary deficiency, etc. In my opinion, you should consult a physician and get evaluated properly so that the cause of anemia could be found and proper treatment in the form of iron supplementation can be given. Iron deficiency anemia. Peripheral smear, serum iron, total iron binding capacity, serum ferritin, serum B12 and folate, stool occult blood."
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have had a fishy odor down there since I was in elementary school. I was not sexually active at all either. Just a couple years ago I realized I might have something called bacterial vaginosis. I went to the doctor for it a couple years ago and got prescribed Metronidazole and it did nothing for me. Ever since then I have not really gone to the doctor about it again. I am worried because I have read that BV left untreated can make you infertile. How common is it that this could happen? And do you have any tips for me?"
},
{
"from": "assistant",
"value": "Hello. Yes, you have heard right that if vaginal infections are left untreated they may lead to PID and infertility. It is a serious issue which must be dealt with promptly and appropriately. Bacterial vaginosis leads to change in vaginal flora and pH which results in fishy odor and discharge. Metronidazole is the recommended treatment for it but as you say it has not affected you then I would suggest that you must not neglect it and get yourself fully checked by having vaginal swabs tested and getting exact diagnosis and treatment. Secondly, hygiene is of very much importance with regards to vaginal discharge. Some tips are as below: Keep the vaginal area clean and wash with plain water as much as possible. Avoid any cosmetic products over the vaginal area and wear cotton rich undergarments."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had arthroscopy surgery of my right shoulder approximately five weeks ago. The surgeon repaired a rotator cuff tear, labrum tear, released one bicep tendon and did not reattach it, and subacromial decompression. The pain is still intense, and I am taking Oxycodone. I just started passive range of motion physiotherapy. How long can I expect the shoulder pain to last? It is far more than I thought, and for much longer than I anticipated."
},
{
"from": "assistant",
"value": "Hi. This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings. For more information consult an orthopaedician and traumatologist 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 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 twins, a boy and a girl aged 2 years. I noticed that the girl advanced in skills than the boy. In the first few months of life, my son was faster than his sister in the growth and everything. And then, it was reversed. I am a graduate of psychology. I have a brother suffering from autism and frankly, I have a fear of this disease. I do not care and I do not want to surrender to delusions. But, mom and dad insist on reminding me of everything you see them that my son is also the possibility of getting hurt. I started since 10 months; I am watching my son very much. I blame him if he did not implement what I am asking. He says dad and mom. He loves to play, laugh and shake hands if I asked him to do so. He looks into my eyes when I talk, but I do not feel that he understands what I am saying to him always. For example, if I asked him to bring me cheesed off the table, he does not focus with me and ignore me. On the other hand, if he feels he is thirsty, then he will come to me and say a bottle of water. I know this is probably because the rate of a normal IQ and concentration varies from one to another child. I want a word from the doctor that makes me serenely scream in the face of all of the notes that my son is not normal and I tell them that my son safe and sound. The question is how completely I know that my son is not suffering from any problems in communicating diseases or behavior?"
},
{
"from": "assistant",
"value": "Hi. I have gone through the query with keen interest and understand your concerns. Before making any opinions I need to inform you that take the things in objective manner and not on emotions I understand there is history of autism in the family and it does not mean your child suffers with autism. In a normal growing child there are many ups and downs and not responding on some occasions is not indicative of serious pathology like autism. We need to take notice that a child plays well with another child, responds to language on most occasions, cheerful, not having any abnormal repetitive stereotyped movements and communicates with the mother. Having said this I feel it will be appropriate to fill a simple questionnaire called Autism Spectrum Screening Questionnaire (ASSQ). This is a screening instrument for autism and you will know probably with sure that whether there is problem or not. If you still feel there is something abnormal, then you may contact the specialist doctor nearby for a physical evaluation. For further information consult a psychologist counsellor online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, For the past 10 months, my wife (age 32 years) started developing symptoms of bronchitis (complaints of SOB and fatigue). Her feet and ankles started to swell and used to take Lasix (to treat edema) on SOS basis for the past seven months, which gave her temporary relief. Next month she underwent checkups (did chest X-ray, echo and ECG) and everything was normal with exception of sinus tachycardia (HR was 110+). and slight fatty changes in liver. The doctor also advised taking Hep-B vaccine (Engerix-B), for which she has taken two doses already and the next one is due in a month. Two months back, she traveled for a period of three weeks. There she suffered from acute breathlessness, stomach bloating, feet and ankle swelling, bloating of the stomach. She could barely lie down on her back. After visiting a gastroenterologist and a pulmonologist, she was advised to undergo USG-abdomen. The USG revealed ascites, bilateral pelural effusion. We saw a cardiologist and was advised to do echo, ECG and chest X-ray. The echo resulted in very poor LV EF (25 %) and dilated LV, LA. She is under medication (Cardivas 6.25, Vymada 100, Nexpro RD 40, Rivotril 0.25, Bevon]. She was also advised to undergo cardiac MRI. The MRI results were pretty much the same as echo (did not result in anything conclusive). Blood tests were also conducted (Na, K are normal, NT-PRO BNP is high 504 pg/ml, bilirubin is a little high 1.14). I want to get an opinion and advise on the below. The cause of dilated cardiomyopathy in such a young person. Is it viral infection? She did not have a fever. What is the treatment? Is the condition reversible? Will the dilation get back to normal?"
},
{
"from": "assistant",
"value": "Hi. Your wife has multiple issues including dilated cardiomyopathy and PCOS (attachment removed to protect patient identity). There are multiple causes of dilated cardiomyopathy including viral infections, pregnancy, familial and idiopathic, tachycardia, PVCs, amyloidosis in late stages, etc. Treatment is going well which you told. Carvedilol dose can be increased if heart failure condition allows, Vymada can also be increased upto 200 mg if BP allows, Lasix can be added and Spironolactone should also be started at 25 mg per day. Doses should slowly be uptitrated. Yes sometimes condition is reversible, but after one year chances of reversibility are rare. Then a device called ICD is implanted in the heart to prevent cardiac arrest or CRTd for heart failure symptoms and to prevent cardiac arrest. For PCOS, consult a gynecologist. Praying for your wife's health."
}
] |
[
{
"from": "human",
"value": "Hello doctor, It has been four months since I have been suffering this problem. I have been to the sexual clinic. They say that all my tests were negative. They keep saying it is a non-sexual rash. I have had this white spot near my urethral opening for three months which is what is worrying me. What is it? On the corona, I also have this rash which seems to be spreading around the penis head. What is it? I have attached the images. All the STD and HIV tests were negative."
},
{
"from": "assistant",
"value": "Hello. The spots near the tip are a normal variation perhaps due to the keratinized mucous membrane near the tip as it is exposed and therefore it has a slightly rough texture. They are not warts. I am more concerned about the rash on the corona of the glans. It looks like eroded skin along the circumference of glans. I would like to rule out the possibilities of either candida or yeast infection or STDs (sexually transmitted diseases) like genital herpes. Do you have any associated symptoms of pain, burning, or itching? Are you sexually active? When was your last sexual contact? Was it protected or unprotected? For more information consult a dermatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 40 years old and my leg pains while walking. Can I please know what is the reason behind this? This problem started nine years ago. But, now my leg pains after walking even 20 to 30 meters. I am currently on Thyroxine 50 mg. I have had a Doppler ultrasound. Please help."
},
{
"from": "assistant",
"value": "Hello. There are many causes of leg pain. The most common is degenerative lumbar disc disease with radiculopathy due to compression of nerve root especially if the pain is only on one leg. The other causes are vitamin D and B deficiency especially if the pain is on both sides and vascular insufficiency. However, the last one is seen in smokers and elderly generally not at this age. For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had a medical abortion a month ago. My period came 29 days after the abortion. After the period I did an hCG test and it was positive. 37 days after abortion my hCG level is 18.21. After three days, the test showed 17.56. I also did an ultrasound and the doctor said I have 3 mm endometrial thickness on one spot. He prescribed me Duphaston to take from day 15th day to 25th day of my cycle. I am scared to take it and also I am scared that maybe I have some retained products but the doctor said I am fine. What should I do? Is it safe to take Duphaston in my condition?"
},
{
"from": "assistant",
"value": "Hello. First of all, there is no harm in taking Duphaston in your condition. It is just a progesterone hormonal analog, the same hormone is secreted from the ovaries once the egg is released after ovulation. So there is nothing to worry about taking it. I would like to know what was the indication for checking beta hCG (human chorionic gonadotropin) value at 37th-day post-abortion, when everything was fine, you even got your periods pretty much on time? Regarding your beta hCG value, I would like to tell you that beta hCG may be detected in maternal blood up to 4-6 weeks post first-trimester miscarriage or medical abortion. Did you had a missed miscarriage or was it an unwanted pregnancy that was terminated medically, and at how many weeks of gestation? This is important because sometimes missed miscarriage may harbor partial molar pregnancy which goes unnoticed, as biopsy or histopathological examination is not done for such cases. But yes, any persistence beyond 6 weeks of abortions should be monitored carefully as these may be a hint of development of gestational trophoblastic neoplasia (GTN). As your scan is normal, and also endometrial thickness of 3 mm is also a normal finding, so there is no chance of having any retained products. It would be helpful if you could share the ultrasound reports (pre and post-abortion), and the dates of the events along with the date of doing beta hCG levels to have a better idea of your situation. I would advise you to recheck your beta hCG value again after a week. Please revert back to me with the necessary details I requested you, so that I can guide you further. Serum beta hCG value after a week."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am male 22 years and 1 month completed. I have the eyesight of -6 for both eyes. Am I eligible for Lasik at 22 years or 23 years of age?"
},
{
"from": "assistant",
"value": "Hello. The decision of whether or not you can undergo Lasik or any other refractive surgery depends on three things. Your power should not change for at least a year. That is your power needs to be stable. Your corneal thickness must be adequate for the procedure. Your corneal curvature or shape must be normal. The first criteria are self-explanatory. The next two criteria can be known by a test called corneal topography, which is available at all Lasik centers. If you have satisfied all three, then the surgeon will take you up for surgery."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have toothache. I have an unfinished root canal for about eight months, temporary filling has also fallen out. Now I am with severe pain. Unable to drink, eat, etc. What should I do to relieve the pain? OTC is not working."
},
{
"from": "assistant",
"value": "Hi. I have read through your complaint and the relevant details. You said it is an eight months old treated tooth and also with incomplete root canal treatment. With this, I suspect that the tooth is severely infected and you might need to take a course of antibiotics along with pain killers as an emergency till you seek a dentist as soon as possible. Also do not worry that the temporary filling has fallen out. That is okay because if it was there, you would have got a swelling due to the severe infection pressurized within the boundaries of the tooth. Re-root canal treatment is highly questionable at this stage. Meanwhile, take the tablets as per the prescription. Capsule Amoxycillin 500 mg orally eight hourly for five days, tablet Metronidazole 400 mg orally 12 hourly for five days, tablet Ibuprofena and Paracetomol (200 mg and 500 mg) combination drug to be taken orally eight hourly for 2 to 3 days. Note: Please do not repeat the course unless prescribed again. All medicines are to be taken after food only. If you get any skin rashes or allergies immediately stop taking the medicine. If you having any gastric irritation during the course of the medicines, please take tablet Omeprazole 10 mg 12 hourly 30 minutes before food along with the other prescribed medicines. However, I advice you to visit a dentist as soon as possible to get it virtually treated because antibiotics are mere ad-ons to the actual treatment."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have chest pain for three months. I took ECG, Echo, TMT, my reports are normal. But still, I have the same problem. I take Solopose Beta 0.5 mg. My blood pressure suddenly rises to 120/90."
},
{
"from": "assistant",
"value": "Hello. I understand your concern and would like to explain that as all your cardiac tests have resulted in normal, a cardiac issue is almost excluded. A 24 hours ECG monitoring test (Holter) would be necessary to eliminate any abnormal arrhythmic event. Probably the most important aspect to explain your symptoms seems to be anxiety. It may exacerbate tachycardia and also unpleasant chest discomfort. But, before getting to that conclusion, I would recommend a cardiac magnetic resonance imaging test. Also, be careful with your current medication as it contains a beta blocker (Propranolol), which if not taken continuously may lead to a rebound effect (increased heart rate). I hope to have been helpful to you."
}
] |
[
{
"from": "human",
"value": "Hi doctor, This is about my elder sister who is 37 years old. She is diabetic since 4 years. I have attached the report and prescription of the same. Please check and give suggestion. Now she is suffering from swollen face. Is there any problem in kidney due to high sugar level?"
},
{
"from": "assistant",
"value": "Hello. Thanks for the query to this platform. Your sister is a known case of hypothyroidism with uncontrolled type 2 diabetes mellitus. Her sugar is constantly raised throughout the last 5-6 months as shown in the reports. She is on oral diabetic drugs and her blood sugar is not controlled. According to me, she needs to be started on insulin. Insulin is just the replacement for the insulin in the body which our body is unable to make.She is overweight which needs to be looked into. She needs to reduce her weight gradually by going for walk, avoiding lifts, avoid fatty foods, rice and chicken or mutton. As far as her kidneys are concerned, her creatinine and urea are within normal range. Her urine microalbumin is raised which points towards heart and kidney function. She needs to be started on statins after consulting her physician. Kidneys get affected in diabetic patients. Keep repeating her creatinine regularly which will show her kidney function. For now she is on diuretics which will subside her swelling in face. Diabetes. 1. High density lipoprotein (HDL). 2. Low -density lipoprotein (LDL). 3. Very low density lipoprotein (VLDL). 4. Cholesterol. 5. Fundus examination. 6. Two-dimensional echocardiogram (2D echo). Diabetes mellitus with hypothyroidism. Start on insulin with statins. 1. Avoid fatty foods, rice, chicken and mutton. 2. Start regular walking and avoid lifts."
}
] |
[
{
"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 suffer from chronic migraines, and I take Gabapentin, 1800 mg daily for prevention. Recently, a GP recommended Metoclopramide, 30 mg daily to help with nausea, but I have yet to take it, as I am concerned about the combination. Is this a safe pair of drugs to use together? Thank you."
},
{
"from": "assistant",
"value": "Hi. I read your query and understand your concerns. I hope this answers you. If you have more questions feel free to write back to me. Thanks and regards. For more information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "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 67 year old male. I am overweight, mildly diabetic and have high BP. I have pain on backside of my left heel. It increases in the evening. I think I have Achilles tendinitis. Please help."
},
{
"from": "assistant",
"value": "Hello. 1. Recent blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and serum uric acid. 2. X-ray ankle - lateral view. 3. A clinical picture showing exact site of pain and inflammation, so that the pathology can be estimated. 1. Achilles tendonitis (Achilles tendinitis). 2. Plantar Fasciitis. 3. Bony spurs. Follow up with investigations to an orthopaedician and traumatologist online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Why do people fix midline misalignment of teeth (the middle of upper and lower teeth do not line up), apart from appearance as the factor? I had undergone treatment with wire braces and removed them off just yesterday. I noticed that I have a little midline misalignment even after treatment. When I bring my jaws together (while biting) the edge of my left lower central incisor touches between (the back) of the upper central incisors. This makes me feel very uncomfortable. I have attached pictures for you to understand my issue."
},
{
"from": "assistant",
"value": "Hello. I have viewed the pictures (attachment removed to protect patient identity). Revert back to an orthodontist online for further follow up -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 29 year old. My doctor said that I have an umbilical hernia. Either open surgery or laparoscopy, which would be the best? After which surgery, can I lift heavy weights? I am a sports person and a bodybuilder. Please suggest."
},
{
"from": "assistant",
"value": "Hi. If your cardiovascular status that is heart and lung functions are fine, then you can go for laparoscopic surgery. That is cosmetically better and less invasive. The scar will be much bigger in open, so chances of scar rupture and dehiscence are higher in open. The possibility of strenuous exercise in the future will be less with open surgery. However, whenever you go for laparoscopy surgery the consent for open surgery is always taken. For further information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 24 year old female, who was diagnosed with dysmenorrhea about two years ago. Last year I was given Mefenamic acid by my doctor to take for the pain and nausea. But, the medicine is not helping me, I still have pain and vomiting. Is there anything else I can take for this?"
},
{
"from": "assistant",
"value": "Hi. Dysmenorrhea is not a diagnosis, it is only a symptom. Let me put few possible causes and their evaluation and treatment forward. At this young age, the most common cause is spasmodic dysmenorrhea. The cervix is tight and the blood when trying to make its way during periods, will stretch the canal and cause pain. Pain is only during periods, on day 1 and 2. After that, the main bleeding is over, and pain disappears. If the amount of bleeding is more than normal, you can get a scan to rule out any masses or adhesions. The pain can be controlled by taking birth control pills for six months or more. It will stop ovulation, reduce the amount of blood loss and has no side effects, and it can be taken for any number of years. If you are sexually active, then it can be infection around the uterus know as PID (pelvic inflammatory disease). Vaginal infection is transmitted during sex, so both you and your partner have to be treated at the same time, or else you will get infected again. You may have white or yellow or grayish discharge with or without itching, foul smell, pain during sex. Before treatment, confirm that you are not pregnant. I suggest you try taking the following. Do treat it, as delay may send the infection inwards and may affect both of you. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Another possibility is endometriosis, every month the blood flows out, but a small fraction also flows into the abdomen through the tubes. This can settle around the uterus and cause adhesions onto the surrounding muscles, ligaments, and bones. This causes throbbing lower abdomen pain before periods, which gradually increases and stays even after periods are over. Sex is very painful. A scan can be done and the restricted mobility of uterus can be seen. This can be solved by reducing flow or stopping periods with hormone pills. Get an ultrasound scan of the pelvis, to rule out any uterine polyp or fibroids. There may be nothing but pain only, gradually increasing every month. Hope I have clarified your doubts, do write back. For more 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, I have an eyelid bump which is not going away. What is the treatment?"
},
{
"from": "assistant",
"value": "Hello. Revert with more information to an eye care ophthalmologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 25 year old female with one year old baby. Suddenly from last 10 days when I feel asleep something blocks my breathing. When I wake up and stand for a while, I will get back my breathing slowly. Immediately after that I get some continuous burps. It feels that something has stuck in my throat and my husband says that some sound like water falling also comes in the process. The whole process lasts for two to three minutes and slowly comes to normal again. The problem occurs only when I feel asleep. I have been diagnosed for mucous, asthma, ECG, etc., but all showed normal conditions and the exact cause cannot be identified. I am taking Rablet D and another gas related tablet prescribed by the doctor. Please help."
},
{
"from": "assistant",
"value": "Hi. These symptoms look like purely gastritis. At the time of normal acid production while sleeping we will not have any problems. If acid production in stomach is more, then while lying down acid tends to come to esophagus (upwards from stomach). It can come up to throat. Acid causes irritation of diaphragm (sheet separating lungs from stomach), which can cause increased breathing. The sensation of something stuck in the throat is severe irritation of throat due to increase in acidity in stomach. If gastritis is present, then the acid comes up to the throat called regurgitation and causes this sensation. Burping is due to acid and air coming up due to gastritis. Rablet-D (Rabeprazole) is correct choice of a tablet. But, the potency and quality is very less. Gastritis can due to many reasons like not eating food at proper intervals, drinking too much coffee or tea, eating hot and spicy foods, cola and junk foods, less sleep, increased work pressure, tension and too much of worrying. Follow the points mentioned below for a month. Try tablet Pansec DSR (combination of Domperidone and Pantoprazole) one tablet before food in the morning and night. Also, take syrup Mucaine Gel 10 mL after food thrice a day for one month. Revert back after a month to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, In the case of twin pregnancy with a different placenta, the packet of amniotic fluid is also different or there is only one packet on which both babies are living?"
},
{
"from": "assistant",
"value": "Hi. Twin pregnancy is of four types. One with two amniotic sacs and two placentae which is known as a diamniotic dichorionic twin. If there is only one sac and one placenta it is called monochorionic monoamniotic twin. If there are just one sac and two placentae, it is monoamniotic dichorionic. If there are two sac and one placenta it is called dichorionic monoamniotic twin. However, if you have a doubt then get back to me."
}
] |
[
{
"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, After suffering with groin pain, I had a double operation 12 weeks ago. During the operation, I had a repair of left side inguinal hernia and right hand hydrocele. I am now in more pain than I was before the operation. My testicle thorns with pain constantly and I have stabbing pain on hernia side. It feels like someone is sticking a bottle in me. I am struggling to walk very far, climb stairs and drive. I am unable to have a sex life. Is it normal to do both operations at the same time? Can you explain any possible cause for pain?"
},
{
"from": "assistant",
"value": "Hi. Well, ideally if you have bilateral inguinal hernia, or inguinaĺ hernia on one side and hydrocele on the other, the surgery should be done for one first before the other, not simultaneously so that when you are fully recovered of one, then the other can be planned and done. Pain can be due to entrapment of a nerve like ileoinguinal or ileohypogastric nerves which run with the spermatic cords or it could be also present if there is improper repair with subsequent breakdown of the repair and subsequent herniation of the bowel content into the inguinal ring or it can be from infection of the operation site. 12 weeks is quite a long time for surgical pains to have disappeared. You will need to do an abdominal pelvic ultrasound scan to see if there is any reccurence or failure of the surgery or if there is entrapment of visceral content."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "assistant",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My penis size is small. Please advise what can be done."
},
{
"from": "assistant",
"value": "Hello. The size of the penis has no roles in sexual intercourse. Even a person with a small penis but good erection can satisfy any girl. Only a few centimeters of the vaginal wall has sensitivity. What is the size of your penis? If your erection is normal, then stop worrying for that. Jelqing is a home-based exercise that can be utilized to improve the size. The exercise is done in the semi-erected penis and some good lubricant can be used during this. Milking like action is done from base to tip in semi erected penis and this is repeated for around five minutes. This should be done 2 to 3 times a day and if done properly this provides good results. You can learn about this from the internet too."
}
] |
[
{
"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, My niece was born with a small hole in her heart. The hole was automatically closed when she was 18 months old. As per our doctor, the hole is permanently closed, and there will not be any problem in future. I just want to clarify that if there is any chance for problems in the future."
},
{
"from": "assistant",
"value": "Hi. It is less likely that a hole that has closed will open again. Hence as regards to the hole in the heart you need not worry if it has closed. A repeat 2D Echocardiogram would be advisable to see the exact status of the hole (if not done) to detect for any other anomalies and prospects regarding the heart."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am having irregular periods. Shall I take kalarchikai choornam?"
},
{
"from": "assistant",
"value": "Hi. There are several causes for irregular menstruation. PCOD is one of them. If you do have this issue then you can take kalarchikai choornam 3 gm twice a day with warm water after meals for three months regularly. To rule out this issue, once you should go for USG abdomen. PCOD, hypothyroidism, taking contraceptive or emergency pills, inflammatory pelvic diseases, climatic changes, food changes, etc. USG abdomen, thyroid profile. If you have an irregular period due to PCOD, then you can go through Kalarchikai choornam as the above-mentioned dose. Avoid spicy and fried junk foods, do regular kapalbhati, mandukasana and ardhamatsyendrasana."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My mouth stinks very badly. What shall I do?"
},
{
"from": "assistant",
"value": "Hi. You must get the cause identified. Treating the root cause will give a permanent solution for bad breath. If the halitosis remains even after the use of mouthwash for two weeks, consult a dentist online for further treatment."
}
] |
[
{
"from": "human",
"value": "Hello, I had a minor herniated disc L4 or L5 last year. (MRI confirmed nerve pinch, but no broken disc or liquid leaks) With heavy pain, I was hospitalized, but recovered within two weeks. With Ibuprofen and muscle relaxants, I was able to walk and function pretty normally. Sciatica (leg nerve pain) came and go during the time now and when I was in the hospital last year. Right now, I am experiencing almost no back pain, but the sciatica is heavy. Mostly on the back of my left upper leg, down till the end of the knee. I am doing stretching exercises, belly position, upper body up, or on the back, leg stretches towards the torso, plank training, etc. But I still have to sit a lot due to my job. I tried a standing desk, which resulted in feet pain and also more sciatia. Though I am sitting straight, the fascinating thing is that heat and cold are influencing sciatica. As long as I apply heat to the leg (not the lower back), the pain disappears instantly to an almost level of no pain. A bit of cold and the pain becomes very heavy immediately as well. Can there be an underlining other issue causing it?"
},
{
"from": "assistant",
"value": "Hello. As it is a year old injury now I will suggest doing some physical test like McKenzie maneuver to see if the radiating symptoms stops and the pain gets centralize to the lower back. The McKenzie maneuver is simple, and you can read about it and practice it. Now I think there is still a muscle weakness which is leading to nerve root entrapment like the lateral spinal muscles, paraspinal muscles, hip muscles, etc. I advice to not use cold therapy as it is aggravating the pain symptoms. Do proper exercise which will regain the strength in the muscles and avoid nerve root entrapment. In most cases, the pain is caused due to more of the muscle weakness, and it is common in most cases to have received the symptoms back. Doing proper exercise with proper guidance can resolve the matter."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My father was diagnosed with thyroid gland disorder wherein T3 and T4 levels come as normal in results while TSH is pretty much high. Sometimes, the TSH value rises to 100. He has been on Levothyroxine or Eltroxin 100 mcg for the last 17 to 18 years now. Lately, he was hospitalized for emergency due to low heart rate and breathlessness. After many tests like Holter test, the bradycardia or arrhythmia was seen."
},
{
"from": "assistant",
"value": "Hi. Firstly, from the reports (attachment removed to protect patient identity) it appears that he is having bradycardia and sinus arrhythmia, but no tachycardia. So, according to me, electrophysiology (EP) studies may be helpful, but not necessary. It could be due to thyroid illness as well. Your father's TSH (thyroid stimulating hormone) is slightly elevated and not very common to cause bradycardia at this TSH levels. Before going ahead, I think the dose of Thyroxine should be increased to 125 mcg and get TSH levels in normal range. Another possibility is sick sinus syndrome (sinoatrial node disease) if it persists after normalizing thyroid level. Treatment of which is pacemaker and EP study is not necessary if established he should go for it. You have mentioned about Epsolin (Phenytoin) to control heart rate. He already has low heart rate, so this should be reconfirmed. Because, he will need medicines to increase heart rate like Deriphyllin, Alupent (Metaproterenol), Asthalin (Salbutamol), etc., and not decrease heart rate. For further information consult an internal medicine physician 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 am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I always get bowl movements in the evening immediately after I drink one or two pegs of whiskey. It has been happening daily for the past 2 or 3 years. The stool floats and dark brown in color. Last night, I got stomach pain and stools are very loose. I have mild fever too and I am now on liquid diet. I am on Telma 80 and Acitrom as I have a clot in my right popliteal artery."
},
{
"from": "assistant",
"value": "Hello. I had gone through all the data posted. For further information consult an internal medicine physician online -->"
}
] |