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sajilperfects

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llama_medical_dataset_7k_qa

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[ { "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 a 35 year old woman. My perineal area burns if my urine touches this area while I urinate. Having sex is also very painful. Should I be concerned and what can I do to ease this?" }, { "from": "assistant", "value": "Hello. Your complaints are burning sensation around perineum whenever urine touches it, painful sexual intercourse and raw areas. It looks like that you might have a genital infection. To be more specific, if you have reddish colored lesions, erosions/vesicles over genitals, painful to touch, mucoid discharge along with above-mentioned complaints, then most likely you have contracted genital herpes. Genital herpes is caused by a virus named herpes simplex, contacted by having an unprotected vaginal/ anal/ oral sex. Usually, the first infection is severe as compared to recurrent infection. The frequency of recurrent infection is high. Diagnosis can be confirmed by ELISA detecting viral antigens. Treatment involves the following: I would suggest you consult a venereologist in person, before starting this treatment, to get a screening done for other sexually transmitted diseases as well." } ]

[ { "from": "human", "value": "Hello doctor, I am a 24 year old female. My period has been late by 13 days. I am sexually active. I took a home pregnancy test but that was negative. My period has been fairly regular in the past with them happening 4 days prior or after my date. I have taken emergency morning after pill in the past (thrice in the last 4 months). What could be the reason? Is there a possibility that I could still be pregnant after a negative test, though I have not had any other symptoms of pregnancy nor am I having any sought of discomfort?" }, { "from": "assistant", "value": "Hello. The striking point in your history is that you have taken morning after pill thrice in the last 4 months. It has to be understood that the most common side effect of an emergency contraceptive pill is delaying the next 2-3 menstrual cycles. As your pregnancy test is negative even after 13 days post period, it clearly indicates that you are not pregnant . Hence, the delay in periods is likely to be due to ipill side effect. Or another possible reason for the delay could be stress induced hormonal imbalance during this menstrual cycle. Stress including emotional, psychological, physical or social disturbances, all have a bearing on the reproductive hormones and can easily delay your menses, once pregnancy is ruled out. It is suggested that you can wait for another week to allow your menses to resume naturally , if not then you may opt for a withdrawal bleed with progesterone pills to resume your menses. As pregnancy test is negative, you can rest assured and wait for another week safely. For further queries, consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Have hypothyroidism last 2 years down to 75mg levothyroxine. The issue now is blood sugar levels. Over last one yr dr has put me on several meds which I reacted to. At that time level under 200. This yr changed dr. He said no medication. Lifestyle change . Has been difficult. Weight up sugar levels 299. Dr put me on januvia last week. Scared cuz of reviews n side effects of the medication I read online. Already feeling like neck swollen n pain in chest sometimes. Cant go to hospital now because of covid. Dont want to get infected. Is Januvia ok. What do you suggest" }, { "from": "assistant", "value": "Hi. Good day. Thanks for your query Ur weight is quite high with uncontrolled diabetes. Definitely u need to change lifestyle and thinking pattern as well. U need to trust a doctor and follow his advice. Every medication has effects otherwise it will not be effective but we always weigh risk and benefits. If ur sugar will not be controlled it can lead to badly effect all ur body especially it can lead to kidney failure stroke heart attack nerve problem and many more. Modification of lifestyle is the main stay of diabetes treatment. U need to reduce carbohydrates especially simple carbohydrates like sugar ice cream sugary juices. If can’t stop u have to 70% reduce bread rice pasta and potatoes. Eat fruits only as a sweet dish. Mango grapes and banana especially can increase sugar quickly. U have tried many medications and I’m not sure which are those medications. I will advise u to take Glyxambi 25/5 one tablet daily Check ur fasting sugars for few days and let me know to modify dose accordingly Ur fasting should be 100-130 Thanks" } ]

[ { "from": "human", "value": "Hello doctor, I have a sensation of burning in the anus and vagina. An ultrasound scan was done and a urine culture was also done. I have a UTI and a Bartholin cyst. The culture grew E. coli. As regards medicines, I have taken Urispas, Candid-V6 for 10 days. I also took Voveran injections two times because of pain. How can I be helped?" }, { "from": "assistant", "value": "Hello. I went through your post. For more information consult an internal medicine physician online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I have been frequently dealing with a red, swollen meatus as well as discoloration on the penis glans. It first began after unprotected oral and vaginal sex with a one night stand three years ago. About two weeks after the original encounter, I began experiencing a burning sensation while urinating along with itching of the penis glans, red swollen meatus and discharge. Believing it was chlamydia, I immediately went in for a full panel STD test. However, the results came back negative. Baffled, I began applying Neosporin to the infected area hoping for the best. While the symptoms remained the same, about two weeks after having the STD test I contracted strep throat and was given the antibiotic Azithromycin. Not only did this clear up the strep but also stopped the itching, burning and discharge. However, my meatus remained red and swollen. I went to my local clinic and the nurse who examined me said everything looked fine. Relieved, I went about my normal life until later noticing a small white spot on my penis glans. The spot was not irritating or painful. It was not raised at all just discolored. About two weeks later another similar spot appeared. I tried to just not think about it and hoped my symptoms would go away on its own. However, they did not go away and pretty soon I noticed that the entire underside of the head of my penis had turned a pale grayish color. I then went and saw urologist who ran multiple urinalyses and did blood work. All test came back negative and he told me I was fine and to just stop thinking about it. I tried my best. Now that brings me here, three years down the road from when the symptoms first arose. My meatus is still red and puffy and my glans still the same sickly gray color. There is no pain or irritation that still persists, but the red meatus and discolored glans are ruining my confidence. I have had sex with another partner about two years ago and after three weeks of the encounter she was treated for UTI. What could this possibly be with all the tests coming back negative?" }, { "from": "assistant", "value": "Hi. I have reviewed all the attached photographs (attachment removed to protect patient identity). I can appreciate slight color change of the glans. It can be pre-vitiligo, but it is too early to be absolutely sure. I would recommend you to keep a watch on it whether the color changes to more white or it spreads further. Presently, I do not think it needs any treatment, but you keep it under observation. As far as meatus is concerned, it is slightly red. Since, there are no symptoms and all your tests are negative, you do not have to worry. You do not have to be anxious as it is not looking like any sexually transmitted disease. For further information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had a filling done last week on my distal lateral incisor. It was pretty sensitive for a few days but it dissipated. This morning, after I brushed and flossed, the sensitivity to cold air returned and was getting progressively worse with throbbing and a headache. I took four 200 mg Ibuprofen which is stopping the throbbing. Is sensitivity like this normal? No allergies, no medications, 5'3'' height, weight 115." }, { "from": "assistant", "value": "Hi. I have gone through your question. I can understand your concern. I think there is a breach or dislodging of filling. You need to visit the dentist again and get a dental X-ray (IOPAR) done. It is reversible pulpitis and you will feel pain and sensitivity. Use fluoridated toothpaste and take Aceclofenac 200 mg twice daily till you visit the dentist." } ]

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

[ { "from": "human", "value": "Hello doctor, My 63 year old father is a diabetic patient. He suffered from a urinary tract infection of E.coli bacteria. He was treated and cured in a month. After this, he suffered from a scrotum pain and we got two ultrasounds done. In the first one, the report states 'Epididymo-orchitis'. Now, he is relieved of pain and the swelling is reduced, but not completely. The second ultrasound report states 'Enlarged left testis and epididymis altered echotexture, multiple hypoechoic areas are noted in the left testes measuring 16.1 by 9.5mm.' Can you please explain the second ultrasound report? What does it imply? What should we do next?" }, { "from": "assistant", "value": "Hello. Diabetic patients are always prone to infection like urinary tract infections and orchitis. For more information consult a urologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 22-year-old male. I have been getting hips, legs, knees, and back pain issues when masturbating. I usually masturbate four to five times a week, sometimes I can go two to three days without masturbating. I have cracking noises in my hips and knees and my quad muscles feel over stretched and tight. This problem has affected me and I am very limited in performing any activities such as sports. I am not physically active anymore, I used to play sports regularly but since I started having so many problems from the waist down, I stopped. Also, I get pain even when I am standing, sitting, or driving and get pain in the morning after waking up. I live abroad and to get any medical attention requires months of waiting. I currently have an MRI booked in five months but my symptoms are getting worse day by day and I do not have the patience to wait until then. Is masturbation the reason for my problems? How can I fix these issues and get my life back to normal? Is MRI necessary? If not, what do I need instead? Please help." }, { "from": "assistant", "value": "Hello. Sorry about your health condition. Masturbation usually may not cause weakness or muscle problems. So do not worry, the possible causes for your problem is 1. Panic attacks or anxiety which lead to increased tension in muscles. 2. Hypocalcemia. 3. Fibromyalgia. 4. Hypothyroidism. 5. Vitamin D deficiency. 6. Rheumatoid arthritis. 7. Myositis. Still, many possibilities are there. So use vitamin E capsule like Evion 400 mg twice a day for two weeks. Use tablet Aceclofenac 100 + Thiocolchicoside 4 mg twice a day for five days. Avoid excessive masturbation as it may lead to penile mucosal injuries, lack of sex drive, etc. Eat more green leafy vegetables and fruits. Do yoga and meditation regularly to release your muscle tension. Get done hemoglobin level, thyroid profile, serum calcium, and vitamin D levels. Also, do RA (rheumatoid factor) factor, ANA (antinuclear antibody), ASO (antistreptolysin) are also useful. If symptoms are not improved please consult with your physician or rheumatologist, he will examine and treat you accordingly." } ]

[ { "from": "human", "value": "Hello doctor, Three weeks ago, I had an internal stye and my doctor prescribed oral antibiotics. But, in the end, it became a chalazion, plus some pus was drained. Now, the stye is coming back and it itches a lot (I can see a big white spot in my eyelid margin). It is not as bad as it was before, but I am worried. Why is it happening? Is there a chance of antibiotic resistance?" }, { "from": "assistant", "value": "Hi. I can understand what you have been going through. Now, as you can see the pus point at the lid margin, it is an external hordeolum or stye. Recurrences can occur with respect to stye. The reasons being multiple. If possible, could you revert back with pictures of your eye so that I could make a more definitive diagnosis? The chances of antibiotic resistance with respect to stye is highly unlikely. Once it is drained, the neighboring meibomian duct might get inflamed resulting in a stye. However, recurrences are common in diabetics, uncorrected refractive error, and immunocompromised states. Kindly revert back with the picture of your eye." } ]

[ { "from": "human", "value": "Hello doctor, I have an abscessed tooth and have been on antibiotics for three days. I woke up this morning with an extremely swollen face, should I go to the ER?" }, { "from": "assistant", "value": "Hi. I have gone through your question and I can understand your concern about your toothache and facial swelling. You need IV (intravenous) route antibiotics like Ceftriaxone one gram after allergic test and for that, you must visit either a dentist or an emergency room. After your infection is over either get your teeth root canaled or extracted as per the condition of the tooth and your choice. Grossly decayed tooth. Cellulitis. Periapical periodontal abscess with related space infection. IV route antibiotics after test dose for allergic reaction. Root canal treatment or extraction." } ]

[ { "from": "human", "value": "Hi doctor, I would like to know more about my kids CBP blood report. Her age is 6 years. Last month she got a viral fever and we got her tested for CBP along with other tests. As part of that, we found that she has less absolute neutrophil count. Though pediatrician said it is fine, we were worried. So, repeated test after one month and looks this time some other values are in not expected range. We see she is having frequent colds but she is very active." }, { "from": "assistant", "value": "Hello. I have checked your attached reports (attachment removed to protect patient identity). Your latest reports show absolute neutrophil count slightly low. But your count improved as compared to the last month report. The frequent cold might be the reason for low absolute neutrophils and high lymphocytes. The peripheral smear examination report is normal and any specific abnormality is not mentioned in the peripheral smear report of WBC. So, you may need not to worry about your CBC report as per my opinion. If your kid has clinically improved, then no need to worry." } ]

[ { "from": "human", "value": "Hello doctor, The patient is a 50 years old female. She had a burn injury on the inner side of the hand three days back. I have attached the picture. Now, the skin over the area is darkened. The thin skin over it has started peeling this morning. She has pain, burning sensation and not able to sleep. What can be done about this? It is in the inner side of hand and it keeps hurting due to constant irritation. I would like to know some medication to relieve the pain and some topical application if needed. She is having gastritis and taking Pantocid 40 mg for three days." }, { "from": "assistant", "value": "Hi. Consult your doctor, discuss with him or her and take the medicine with consent. 1. Dermocalm lotion (Calamine) in the morning and afternoon. 2. Silverex cream at night (Silver sulfadiazine and Chlorhexidine). 3. Tablet Dolo 650 mg (Acetaminophen) twice daily for three days after food. For further information consult a dermatologist online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I am 19 years old, male, recently I have discovered that my crown hair is slightly thinning, however I think it is a cowlick, because the middle part of the crown where the swirl is thick but away from the swirl it is thinner. You can actually see my scalp lines or hairlines. You can see my top back hairline and side of the crown hairline." }, { "from": "assistant", "value": "Hi. I can see thinning of hair in the picture you have attached, but I cannot see the hair line (attachment removed to protect patient identity). It could be telogen effluvium (stress induced) or early androgenetic alopecia or visibility of scalp could be because of your short hair. Androgenetic alopecia or male pattern baldness starts with receding hair line on the temporal and frontal area of scalp then there will be thinning in the crown of scalp. I will have to see pictures taken from the front to visualize hair line receding to confirm androgenetic alopecia. Are you actively losing hairs everyday? Do you see more hairs while taking shower? Do you have family history of baldness? Any history of illness in the recent past? Any surgeries? Hospitalization? Hair needs protein for growth, diet rich in protein say 40 to 60 g of protein per day is very helpful. It depends on the body weight. Avoid hot water, use lukewarm water to wash scalp." } ]

[ { "from": "human", "value": "Hello doctor, I need your opinion regarding my future pregnancy. Five years ago, I gave birth to my son and had to have an emergency C-section. The doctor's report read 'upon entering the abdominal cavity, the patient was found to have a large uterine window consistent with a uterine rupture. However, there was a small thin area covered by serosa, with a blood clot underneath. The rupture extended along the upper right side into the right broad ligament and round ligament. The incision was closed in two layers, and most of the extension areas were closed and imbricated in two layers as well.' My question to you is with all I went through with my son, would you recommend that I get a cerclage if I decide to have another baby or will I be alright without one?" }, { "from": "assistant", "value": "Hello. How are you doing? Hope I have been of help to you. Do write back in case of more queries. All the best. For more information consult an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, For a couple of months, I have had a red area between my butt cheeks (not anus, further up where butt cheeks meet). This developed on the right side as a large area of redness which now feels scaly and a bit raised. At times it may feel moist, watery, not quite bleedy though. I tried an athlete's foot antifungal spray which I think helps a little bit, but it comes back again. Is it psoriasis or fungal infection or just irritation? I am a runner and sweat a lot due to heavy exercising every day. I took a picture, and I have attached it. Please advise." }, { "from": "assistant", "value": "Hi. After carefully reading your complaints and looking at your photographs, there seem to be three possibilities (attachment removed to protect patient identity). For making a clear cut diagnosis, I need the answers for a few questions: Looking forward to your response in order to help you." } ]

[ { "from": "human", "value": "Hello doctor, I am 25 years old. I got married six months back but I am not satisfied with my sex relationships because my penis is so small and not getting up for more time. So, please give me any suitable advice which can help my penis to get large and satisfy me and my partner." }, { "from": "assistant", "value": "Hi. I have read your problems carefully. Your complaints are of small penis and less pleasure in sex. At first, you have to know details about sex and female orgasm. Normal sexual time is 2 to 5 minutes. Sometimes, it may be more or less. And sexual pleasure not depends on time and size of the penis. It is a myth that a large penis is good. But it is not true. A large penis may be troublesome for your partner. Now coming to the solution. 1. Small penis: there is some exercise which may help. But do not expect more. Do not use the device. It may harm. 2. Sexual pleasure: sexual pleasure mainly depends on foreplay rather than sex. More foreplay gives your partner more pleasure. Even only with foreplay, fingering and oral sex can make your partner pleased. So concentrate on those. 3. Less time: time may be low or high. You should mind it that, anxiety make your sexual time low and less pleasurable. So do not be anxious. There is some way to make your sex lengthy. Such as coitus interrupts. When you think cum is coming, just withdraw, take some pause and start again. Make more foreplay in coitus. Doing sex slowly. Do not be in a hurry. You can try Duloxetine 20 to 30 mg, 30 minutes before bedtime. It may help. But you should keep in mind that, there is some side effect of Duloxetine such as nausea, dizziness. Do not worry about that." } ]

[ { "from": "human", "value": "Hi doctor, I have extreme pain in my left molar region, and I also have swollen gums that bleed while brushing. Please help." }, { "from": "assistant", "value": "Hi. I had gone through your question. For further queries consult a dentist online -->" } ]

[ { "from": "human", "value": "Hello doctor, Last one week, I am having issue with my erection at bed time. I am 35 years old. Please suggest me some medicines to be taken at bed time to make a relation with my wife without any problem. I am feeling very bad at bed. I have used an oil one week ago. Since then, I am having erection problem. Please suggest me some curable medicines right now." }, { "from": "assistant", "value": "Hello. Eerectile dysfunction has many causes and I would suggest you to get yourself fully assessed by some local expert before proceeding to further management and avoid self-medication. Now coming towards your problem, erectile dysfunction can be caused by diabetes, hypertension, anxiety and high cholesterol even and with increasing age and heavy smoking. So if any of these is the case with you? If yes, then you have to first eliminate those factors first. Maintaining a good diet and exercise may help resolving the issue. Thirdly, a product known as Natural Viagara is available in market. Its safety has been approved so that can be used as well but it will not relieve the actual underlying cause which is utmost important to consider." } ]

[ { "from": "human", "value": "Hello doctor,My mother is 59 years old and had undergone mitral valve replacement operation 15 days back. Now she is having breathing difficulty sometimes. SpO2 after exertion is 87 to 89 (without 02), the respiratory rate is around 28 to 30. I have attached the CT contrast thorax. There is no fever and wheezing. The echo shows only mild MR, and TR. No pulmonary hypertension and pleural effusion. She cannot take Duolin nebulization because she is a patient of atrial fibrillation, it increases her heart rate. But atrial fibrillation is under control by medicine. Please suggest the treatment." }, { "from": "assistant", "value": "Hello. I have gone through all the history you provided here. Your mother is currently suffering from two different problems. Mitral valve replacement followed by mild MR and TR as well as atrial fibrillation, are distinct cardiac problems. And according to you, she is taking prescribed medicines regularly.After going through the CT scans images (attachment removed to protect patient identity), it looks like she is suffering from some infective lesions in the lungs, most probably pulmonary tuberculosis (PTB). She is having breathing difficulty with low oxygen saturation, probably due to underlying lung infection. To confirm the diagnosis, further sputum tests are advised for sputum AFB (acid-fast bacilli) and culture tests. If no sputum sample is available, then induce sputum by nebulization with saline solution or perform a bronchoscopy. You are advised to consult pulmonologist doctor who will evaluate history and will advise recommended tests and medicines if required. Currently, symptomatic management includes oxygen supplementation with a high protein diet. Continue all cardiac medicines as advised. Depending upon the sputum AFB report, further treatment can be planned. I hope I have cleared all your doubts. In case you have any questions please do not hesitate to contact me again. Infection with PTB. Sputum AFB and Bactec AFB Culture. Depending upon sputum AFB report may require antitubercular treatment. Strictly use a mask while coughing and talking." } ]

[ { "from": "human", "value": "Hi doctor, I just wanted an opinion on what I need to do. I have been having pain in my left arm along with feeling like I am going to get sick and tired. My mom passed at 34 with a heart attack. Then presently my younger brother has a blockage. I am wondering if I may be over-reacting or should I go to the hospital?" }, { "from": "assistant", "value": "Hi. You have a strong family history of premature coronary artery disease, you are also at risk. Modify your lifestyle. Maintain weight with BMI less than 25, avoid tobacco and alcohol products if you consume. Reduce salt intake, and avoid fatty meals and fast foods. Have an ECG and echo done. Have fasting lipid profile done. Followup with reports. You have to manage it aggressively. Lipid profile, renal function test, ECG, echocardiography." } ]

[ { "from": "human", "value": "Hello doctor,My son is 3.5 years old. We live in a place which has a lot of dust along with cold weather. My son has been suffering from regular cold cough problems since he turned 1, on an average three times in a month. Sometimes, the gap is longer when we are too careful and maybe the weather is stable. Starts with a runny nose, then cough, coughing is too much when he lies down, at night and early morning. Many times he also gets fever.We have visited several doctors and have been told it is RAD, we still do not know what is he allergic to, could be dust. In the past 2.5 years, he has regularly (when suffering) taken Allegra/Cetrizine, Nasivion drops, finished several bottles of Beta2, Salbutamol, Asthaline syrups, Paracetamol, sometimes but less of Azithromycin when it is throat infection, once or twice taken Kidpred also, also he has taken Montelukast 4 mg for certain intervals like taken for a few months and stopped and again taken.Three weeks back he got cough, we went to pediatric pulmonologist and were advised to start Budecort 200 inhaler twice a day for a year. Also, Asthaline inhaler three times a day for a week but still has cough. Allegra for a week along with Montair 4 mg. We did not start Budecort but started with Asthaline inhaler, Montelukast and Allegra. It improved and third week again he has got cold and cough but intensity is little less.My question is should we start Budecort 200 inhaler for a year and stop Montelukast? Or should we not start Budecort right now and continue with Montelukast for some time and check if it works? Or should we give both Budecort and Montelukast? Also is it fine to start with Asthaline inhalers whenever he gets cough? Lastly is there any way which we can find out what things he is allergic to? Or a list of common allergies?" }, { "from": "assistant", "value": "Hi. Please note that Budecort inhaler is the medicine to prevent or reduce these instances and Asthalin is the emergency medicine to control sudden bouts. Hence, without fail you should start and continue using Budecort along with Montelukast and use Asthalin on SOS basis. As far as the question regarding allergy to certain items goes, it is best to observe the child for the same rather than doing umpteen number of tests just for finding the causative allergens. Any which ways the chances of you preventing the child from coming in contact with such an allergen would be less only. So do not worry much about the allergens point of view." } ]

[ { "from": "human", "value": "Hello doctor, I have had this spot on the side of my tongue for some time now. I noticed it six months back. No change in that amount time, although I will post a picture from that time to show. I have been told that it is a frictional thing from adjacent teeth, but I want to get a second opinion to make sure that it is nothing more sinister. There are no symptoms in this spot. When I run my finger over it, I do not feel anything hard, different or even a hole. I want to know if I have a serious problem or if this is something I can safely let go." }, { "from": "assistant", "value": "Hi. Yes, it is not even traumatic ulcer. It is simply hyperkeratinized epithelium. That means it is normal tissue which is bearing some sort of stress. I think your upper tooth has a rough surface that may be the issue causing this or even it may be because of food if you are chewing only from that side. You need to take foods with much Vitamin A and B complex, fruits and carrot. Even you can take supplements like that of Vitamin A. No it is not something that can be the cause of concern. It is not a cancerous or ulcerous lesion. So, do not be too apprehensive. It is a normal tissue with little keratinization." } ]

[ { "from": "human", "value": "Hello doctor, I have noticed some alopecia on my beard. It has been there for the past few months. I have never had any issues like this before and worried that the hair will not grow back. Is there anything I can do? I am currently taking Hydrocortisone for dermatitis in private area." }, { "from": "assistant", "value": "Hello. I can understand your concern. According to your statement, you have alopecia on beard. It has been there for the last few months and you are on medication like Hydrocortisone for dermatitis. You may be suffered from alopecia areata which is a peculiar form of hair loss that usually affects the scalp but can occur on any hair-bearing skin like your beard. For most patients the condition resolves without treatment within a year but the hair loss is sometimes permanent. The cause of alopecia areata is probably an autoimmune reaction. This means the body's immune system incorrectly attacks the body's own cells. In case of alopecia areata, the cells under attack are in the hair follicles (structure that grow hair), especially follicles within hair-bearing skin. Alopecia Areata can be resulted from autoimmune disorders such as atopy, allergy, thyroiditis, vitiligo, etc. Even some studies show that stress, family history of alopecia, vitamin deficiency like Biotin, Vitamin A, C, D, E, etc., nutritional deficiency like iron, zinc, protein, etc., can also cause alopecia areata. For the treatment of alopecia areata, you can use Intralesional corticosteroid injections, topical Minoxidil, Anthralin cream or ointment, and topical corticosteroids. By using any of the above-mentioned medication and taking vitamin and nutrition that are mentioned above, you can get rid of alopecia areata within some months." } ]

[ { "from": "human", "value": "Hello doctor, My fiancee has had a weird in-between period thing for about a week, and this just about a week ago. She had very slight bleeding for about a week with red to dark red to pink and sometimes brown. She had constant cramps for nine days during this as well. A week later her period is supposed to come on the 26th. She is fine and on birth control and tells me she feels good but her upper back has been hurting for the past four days and she is starting to get cramps on and off again. We had sex two days before her last period and I have a strong feeling that it is just the birth control doing this. I used a condom and made sure there were no holes. Before I finished I pulled out but the condom slipped off and it got stuck inside of her and she said nothing was coming out of her after this happened. Is birth control the cause of all of this?" }, { "from": "assistant", "value": "Hello. Any type of hormonal contraception may cause irregular bleeding that can be unpredictable in nature. If a birth control method is changed or if pills are missed, unscheduled bleeding can also occur. All birth control methods can fail, even with perfect use and unusual bleeding can also be a sign of pregnancy. A home pregnancy test is a good idea to make sure this is not the case. Upper back pain an unusual side effect of birth control, but cramping may be normal if it is during a period. Cramping or pelvic pain in the setting of abnormal or irregular bleeding could be caused by many things including ovarian cysts, early or abnormal pregnancy, urinary tract infections, sexually transmitted infections or PID (pelvic inflammatory disease). She would need an exam and further testing in order to confirm the exact cause of her symptoms." } ]

[ { "from": "human", "value": "Hello doctor, My 10-month-old baby is facing irritation in her ear with persistent itching." }, { "from": "assistant", "value": "Hello. I would like to know is there fever or any other complaints?" } ]

[ { "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 would like to begin with my dropped CD4 count of 350, which I had six years ago. Two weeks later, it raised to 398. The doctor said it could be entirely reasonable for a woman to have a count of CD4 around 400. The reason for dropping maybe due to a previous infection and stress. I had no any infection previously, but a low-risk exposure to HIV eight months before and no further risks ever since. Last year, I had my first ever HIV test (third generation antibody), which came back negative. I also had two more the same kind of test after that with negative results. Only recently, I am experiencing recurrent colds and blocked, runny nose, vaginal infections, fungi like discoloration on two of my fingers and red dots or spots, rashes on one of my shoulders. Could these symptoms be related anyhow to HIV or AIDS? Could my test be falsely negative due to late testing after my exposure of six plus years? Should I have another CD4 count or other tests? Thank you for your time and answer." }, { "from": "assistant", "value": "Hi. For further information consult a HIV AIDS specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hi, What happens to a person taking ATT medicines, when not having tuberculosis?" }, { "from": "assistant", "value": "Hi Consult a pulmonologist online for further queries regarding ATT medicines -->" } ]

[ { "from": "human", "value": "Hi doctor, My sister's right hand and wrist are aching continuously since the past few weeks. The pain has become much greater now. She says that under her little finger, the pain is comparatively greater than in the rest of her hand. Her palm has turned black and hard a little." }, { "from": "assistant", "value": "Hello. Revert with more information to an internal medicine physician 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 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 been married for almost three years now. My husband and I have not consummated our marriage. There is no intimacy and physical relationship in our marriage. Ours is a love marriage. But now, I am getting frustrated with our condition. From what I understand, my husband has a very low sexual desire and upon my extreme insistence, he tries to get physical but, the penetration does not happen at all. I want to make my marriage work but, we try to have sex only once a month and the penetration never happens. This gets my husband disappointed and he then says we have to try again next month. This once-a-month attitude frustrates me. Please help." }, { "from": "assistant", "value": "Hello. Relax and do not worry. Your husband may just require some basic blood tests. All the above tests are to be done at 8 AM in the morning. For further queries consult a urologist 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, My daughter has Erbs palsy but we did physiotherapy for three months and the doctor said she is fine but she is still struggling with the hand and this is about six months after the doctor discharged us. Please tell me what should I do." }, { "from": "assistant", "value": "Hello. Thank you for providing the brief history of your daughter. I am sorry firstly to hear that your daughter is being diagnosed with Erb's palsy. Well, I would suggest you to continue physiotherapy for atleast three days a week as it will be of good help for her. Usually, cases with Erb's palsy recovers well when they perform physiotherapy for over longer periods in infants. Firstly, in the initial stages the physiotherapist will do passive movements of the limb but off late it will be progressed to toy reaching where she can use the maximum of her efforts and learn proper movements. We need to teach brain the movement. In between there might be a use of infant stimulation which will be of use to activate the muscles which are not active. A competitive physiotherapist for using the stimulation over an infant is needed as they have to analyze to which muscle it has to be given. Also a precaution has to be taken while applying a stimulation to the infant as the kid might not like it, so a competitive physiotherapist is a must for this. In my clinical practice over a period of 12 years I have seen many infants with Erb's palsy. They have responded well with the physiotherapy and with careful attention. Breech delivery. Erb's palsy. Physiotherapy." } ]

[ { "from": "human", "value": "Hi doctor, I am 24 years old. I am married, and I am not taking any contraceptives. I have prolonged periods without pain for more than two weeks. My periods are not consistent for a few years. Sometimes, I get my periods once in two months. Last year, I started to have lactation. But I was not pregnant. What is happening in me? Please help me." }, { "from": "assistant", "value": "Hi. You are not ovulating regularly, and so you have irregular periods for years. If there is a lactation, then there is a deranged prolactin level. Check your serum prolactin hormone and thyroid profile. If there is an abnormality, correct it soon. If you are taking any antidepressants or antipsychotics or any other drugs to regulate periods now, it requires a change. Gaining weight deranges the hormone levels, and the ovulation process gets stopped. So try to reduce your weight. If you ovulate regularly, with a healthy hormonal balance, you can get pregnant. Do not worry. You will get fine soon." } ]

[ { "from": "human", "value": "Hi docor, Can I take Arjunarishta? I have high cholesterol and am using Rozavel 5 mg." }, { "from": "assistant", "value": "Hello sir, I just read your query. Arjunarishta is advised in conditions like high cholesterol level. As you have this problem, you can take it along with your current medicine. But keep some gap between your allopathic medicine and Arjunarishta. Arjunarishta is not advised in diabetic patients. So, if your sugar levels are controlled you can take it in the following dose. Take 10 ml of Arjunarishta with an equal amount of water two times a day after food for one month. Consult me or a nearby Ayurveda physician after one month regarding improvement and for further management. Hopefully, you will feel better results within a month. Poor eating habits and improper lifestyle. Lipid profile test after one month." } ]

[ { "from": "human", "value": "Hello doctor, I have a sore throat from last 15 days. Medications taken are Amoxicillin and Clavulanic acid taken for five days BD. The next course includes ZOCEF CV 500 BD for eight days. Levocetirizine 5 mg OD at night from the last 15 days and Betadine gargle thrice a day (both Levo and gargle, I stopped three days earlier)." }, { "from": "assistant", "value": "Hello. You may stop the Betadine gargle and start Benzydamine gargles diluted in water done twice daily after meals. Take a proton pump inhibitor which stops acid production twice daily before meals. Post meals, take an antacid syrup that neutralizes the acid produced. I would suggest you take an anti-inflammatory medicine to remove the congestion and edema inside the throat. The picture clearly shows granules in the posterior pharyngeal wall. If the condition does not improve, we may need to do a throat swab. If you need any further help do revert back. If there is any investigation that you have done please upload it so that we can have a look." } ]

[ { "from": "human", "value": "Hello doctor, My niece is currently 6 years old and her tooth is growing up behind her milk tooth that has not fallen out yet. What should we do?" }, { "from": "assistant", "value": "Hi. I got your chief complaint. Permanent teeth start erupting after 6 years of age and replace deciduous teeth. In this process, as deciduous teeth erupt, milk teeth fall down gradually. However, if milk teeth remain there, they are to be extracted to allow permanent tooth to erupt normally. However, it needs to be extracted if it is not falling, otherwise, it can cause malocclusion later." } ]

[ { "from": "human", "value": "Hello doctor, I developed right lower pelvic pain and was asked to do an ultrasound and diagnosed with the presence of hydrosalpinx 10 months ago and took antibiotic for two weeks. From then on I am suffering from right lower pelvic pain that pulls my veins till knee. It begins paining 10 days before my menstrual cycle, and I live with pain for two weeks a month until my period gets over. My period lasts for 8 to 9 days. Found with the bulky uterus and several small uterine fibroids also. I would be grateful if you suggest me some treatment that will bring back my regular life. My age is 37. I have two kids. Both are C-section babies." }, { "from": "assistant", "value": "Hi. Hydrosalpinx is a fallopian tube disorder. In this concern, fallopian tube blocks distally and forms a sausage-like structure. Sometimes it may become painful. A bulky uterus is due to chronic pelvic inflammatory issues. It may lead to irregular and painful menstruation. Fibroids also lead to such conditions. It may be due to genetical, hormonal imbalances or chronic pelvic inflammatory disorders. USG abdomen, estrogen, thyroid profile, lipid profile. Pelvic inflammatory disorders, PCOS, dysmenorrhoea, menororrhagia. If fibroids are present without symptoms then it can be managed naturally. Its size may change as per menstrual cycle. These ayurvedic medicines may be helpful. Rx, 1. Kuberakshadi Vati one tablet, Nityanand Rasa one tablet, Chandraprabha Vati one tablet, and Pushyanuga Churna 2 gm, Styplon one tablet with warm water after meals. 2. Ashokaristam 15 ml twice a day with an equal amount of water after meals. 3. Varunadi Kasayam 15 ml twice a day with an equal amount of water before meals. 1. Avoid spicy and fried junk foods. 2. Do regular Kapalbhati Mandukasana anuloma vilom nadi sodhan and bhramari." } ]

[ { "from": "human", "value": "Hello doctor, Today I went to the dentist for a checkup and cleaning. When I came out I realized that my two front teeth were loose. I guess they were too rough. When I was 7, I fell on my teeth and I have been told that the roots got extremely short after that. My dentist said there was nothing she could have done then. She suggested just using my back teeth and cutting my food into small pieces. I want to know if there was a way to make it not loose anymore or help it." }, { "from": "assistant", "value": "Hello. I have been through your query and I can understand your concern. After cleaning and scaling of the teeth, they generally become loose temporarily because of the ultrasonic movement of the instrument. You do not need to worry as it will get to the normal in coming days. I would suggest you not making the teeth more loose by moving them by your tongue or fingers. Just keep it like that and it will become normal after some days or a week. Follow up after one week." } ]

[ { "from": "human", "value": "Hello doctor, I am 24 yrs old female...my height is 156cm and I weigh 91kg... I had two abortions...and still no baby...yesterday night I had some blood on my stool...and earlier for few months I had gas problems... usually, gas comes for many times in a day...also, I feel like gas is stored in my abdominal area and feels like to visit toilet often... Feeling heavy in my lower abdominal area, for me It feels like gas... yesterday one time I got some blood on my stool and today I didn't get any blood... but my abdomen feels heavy...and it creates discomfort...what is my problem and what I need to do to get relief from this doctor? Will you please suggest me some opinion? Please doctor..." }, { "from": "assistant", "value": "Hello. I welcome you to icliniq. Actually the chronic problem of gas you mention is common in some one with overweight to obese-as in your case may be. Since your weight appears to be way beyond normal and this has definitely health consequences if not controlled. The blood in stool you mention, is somewhat alarming, and requires a thorough in person examination of the bottom, and looking for the causes such as anal fissure, hemorrhoids, to some serious disorders like inflammatory bowel disease. To summarize I want you to go and meet a gastroenterologist in your local area and get yourself examined to determine the cause. For your and foresee physician's ease just discuss above mentioned causes with him or her. So to finalize, the gas problem is benign (non alarming), but the blood you mention is alarming and need to be investigated. I hope this will help Small intestinal bacterial overgrowth Follow up after getting examined by physician in person" } ]

[ { "from": "human", "value": "Hello doctor, I have endometriosis, diagnostic or excision lap was done three years back. Recently I have had GI symptoms including extreme pain on defecation, rectal bleeding with a period, and tenesmus. Last exam showed a nodule in my vaginal wall and ultrasound showed left ovarian endometrioma. About a week ago I noticed my vaginal walls seemed to have collapsed so that they are both bulging and pressed together. I felt inside and noted that my cervix was about 1 to 2 inches past the vaginal opening and it is sideways, with the cervix opening to the right side. Does this sound like a rectocele or is it possible that my uterus has tipped over or something? I am not sure what to do as it is very difficult to get in to see my gynecologist. Please help. Currently, I am taking Dienogest 2 mg OD, Taro-Tramadol ER 200 mg OD, Apo-Tramadol 50 mg Q6H PRN, Paroxetine 20 mg OD, Lorazepam 0.5 mg SL PRN." }, { "from": "assistant", "value": "Hi. How are you doing? You seem to be suffering a lot at this young age of 25 years. From your history and examination findings, I feel there is deep infiltrating endometriosis. Usually, bowel symptoms, distended bowels into the vagina, nodules in ligament could mean that. But the uterus will be stuck and will never descend, especially after a surgery. But when you say cervix is outside the vagina, it means cervical descent or elongation. It could mean a nulliparous prolapse. The best method would be to have an examination done, scan taken, to know if any large cyst is pushing uterus out. If everything is normal, you can have 3 to 4 doses of monthly Lupreolide 3.75 mg i.m. Followed by tablet Ormeloxifene 60 mg weekly twice for any number of years. I have found it more effective than Dienogest. If prolapse is significant, it may resolve if any cyst of pressure from inside is relieved. You have bowel symptoms and you said cervix is pushed to the right, so there must be something on the left side, the location of the colon, sigmoid colon, and rectum. Have a scan anyway." } ]

[ { "from": "human", "value": "Hi doctor, I am 21 years old. My main concern is, I have a lot of stretch marks on my body. I had them on my shoulder and thighs since I was 10 years old. Now, I have them even on my belly and biceps area. For the past three months, I have been working out. I do not feel it is because of working out. Please have a look at the pictures and let me know if they can be cured? What other alternatives do I have? Kindly suggest." }, { "from": "assistant", "value": "Hi. I have checked the photographs (attachment removed to protect patient identity) and noticed that you have a lot of old stretch marks on your shoulders and abdomen. I would suggest you start topical application of Tretinoin cream 0.1% on the stretch marks daily at night. Use it for at least for a period of six weeks and check for any improvement. In case you do not achieve the desired results, then you can go for laser treatment. In chronic cases, Nd: YAG (neodymium-doped yttrium aluminium garnet) laser and fractional photothermolysis will be used. 1. Seen in adolescence and associated with rapid increase in size of particular region. 2. In weightlifters it is seen, when their muscle mass increases rapidly. Striae atrophicans." } ]

[ { "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 just had my wisdom tooth removal surgery 10 days back. The surgery was on the lower right side as my wisdom tooth was impacted and was inside the bone. Hence, I had to remove it as there was some TMJ discomfort. My recovery is going fine there is no numbness and I just want to take your suggestion on one thing. I still have a swelling type thing on my right side jaw where surgery happened, though my right cheek is fine. I just want to know, in how many weeks my jaw will be fine as there is something that I can feel like swelling or a hard lump near to my surgery area. When I do open my mouth there is pressure on my right side jaw. Since there is no pain, I just want to know that when can I expect my jaw swelling or hard lump in the surgery area to be fine?" }, { "from": "assistant", "value": "Hello. I have been through your query and I can understand your concern. Post-extraction swelling is normal as the tissues require a conducive environment for healing. Normally, an extraction site shows almost complete healing after 21 days provided you do not have any negative habits like smoking and have followed the instructions perfectly. In your case, it seems there was surgical removal of the tooth which requires an incision, bone cutting and sutures. If that was the case, it would take roughly around 4 or 5 weeks for the wound to heal completely. The swelling will also subside with the coming days. I would suggest you to wait and follow the instructions of your dentist. However, if the swelling continues to remain there for even longer time, and if you feel discomfort then I would suggest you to go to your dentist at that time. I would also suggest you doing normal saline oral rinses with warm water but very gently (in order to not destabilize the clot of the wound). Maintain good oral hygiene. Follow up after 15 days for the results." } ]

[ { "from": "human", "value": "Hello doctor,I am 34 years old, hypertensive since 18 months. A few months back, I suffered from erectile dysfunction with different groups like Amlodipine, Ramipril, Natrilix, and even Telmisartan. I am not obese and I practice three days a week. Recently, Tadalafil stopped giving an effect, while before I used to have three days of erection with one pill." }, { "from": "assistant", "value": "Hello. Get your blood pressure regularly checked and take your medicines to keep BP under control. Get your blood sugar levels checked in order to rule out diabetes which is one of the main causes of erectile dysfunction. Drugs like Tadalafil can be used on SOS basis for erection but if that is not helping, then you should take 5 mg tablet daily for at least four weeks and take 20 mg on SOS basis. This will help make your erection strong. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult a sexologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor,I am 34 years male. I have skin tags in underarms and neck. I have a skin tag in the shaft of the penis for the past four months. I consulted a doctor here in my town, and they said it is a skin tag. I want to re confirm it again. Please help." }, { "from": "assistant", "value": "Hello. Please send a clear picture of the affected lesions for better evaluation and guidance." } ]

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

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

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

[ { "from": "human", "value": "Hello doctor,How to reduce triglyceride levels, which is 262 as on today. I have a stent placed three years ago." }, { "from": "assistant", "value": "Hello. Hope this helps you. Get back if you have any doubts. For more information consult a cardiologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 56 years old female. I have heavy bleeding, and my endometrium is bulky. It is 15 mm. I have placed Mirena before four years, and I have removed it before two months. My doctor did a biopsy, and the report came as hyperplasia without atypia. Please suggest." }, { "from": "assistant", "value": "Hi. Please say whether you had any menopausal or perimenopausal symptoms. Please mention whether you had irregular bleeding or scanty periods or whether there is a stoppage of periods. You have placed Mirena before four years. You can also have side effects. The side effects should be subsided. Hormonal effects can also cause heavy bleeding or unscheduled irregular bleeding. Mirena is advised in endometrial hyperplasia with atypia. It usually gives scanty cycles, and there is a reduction in menstrual flow in some patients. In some patients, there is an increase in endometrial size after a long time due to a hormonal effect. In this age, it is better to have a total abdominal hysterectomy and bilateral salpingo-oophorectomy (removal of ovaries due to a risk of ovarian cancer). Please mention the history regarding obesity, family history of cancer, diabetes, and hypertension. All the factors should be followed when you are planning to have a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Please give a detailed history. For symptomatic relief, I suggest you take cyclic Norethisterone 10 mg from 4th day to 25th day for three cycles. You can take it for six cycles. You can have this for heavy periods and during unscheduled bleeding. For pain, you can take tablet Ponstan 500 (Mefenamic acid) for eight hours from the second day to the fifth day. If the bleeding is heavy, you can also take tablet Tranexamic acid 500 mg for eight hours along with Ponstan from the second day to the fifth day. Both these tablets can be stopped if you are asymptomatic. Check your complete blood count and thyroid function test also. Please decide for having surgery soon as you cannot take hormones for more than six months. Have a healthy diet and iron supplements. Have a walk daily and maintain a healthy BMI (body mass index)." } ]

[ { "from": "human", "value": "Hi doctor, I am facing problem of loose skin around eyes. Ophthalmologists have described it to be eye allergy. They have suggested anti-inflammatory drops Systane Ultra, but it did not help. Is this a case of plastic surgery? Also, why has this happened so quickly over a period of five months? I have low confidence and not interested in anything. Please help." }, { "from": "assistant", "value": "Hello. I have seen your pictures (attachments removed to protect patient identity) and can appreciate the puffiness below both eyes. Get these important tests done. Revert back after the tests to a cosmetologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had unprotected withdrawal method sex two days before ovulation and had one I-pill within 30 hours. Today, I am experiencing period like cramps from morning. I just saw some spotting which may or may not be my early period. I am regular in my periods. My last period was on 12th of last month and it lasted for five days. Now, is this an early period or implantation bleeding for pregnancy? When should I do urine pregnancy test?" }, { "from": "assistant", "value": "Hi. For further doubts consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, Six months back, I had an echocardiogram and a CT angiogram. My initial troponin T level was 0.44. After six hours it dropped back down to below 0.10. My test results from the CT angiogram were normal and the calcium level was 0. My echo was also normal. I wore a monitor for seven days and that too normal. I have read that because of my troponin raise I have a high chance of mortality within 1-3 years. My GP could not explain why my troponin was raised. I did have an agoraphobic panic attack. At that time I feel some pain travels from my heart down my arm to my thumb like a lightening bolt. This is the reason why I went to hospital and they kept me in due to the raised 0.44 level. They gave me the reports of CT angiogram and echo. Am I at risk of dying in the next 1-3 years because of elevated troponin? I have had heart attack symptoms such as intermittent central chest pain, bilateral arm pain, shortness of breath, palpitations, back ache, fast heart beat at 110 beats at resting and jaw pain for over six months. I am also suffering from nausea, IBS, gastritis (endoscopy diagnosed), severe fatigue, dizziness, possible costochondritis due to rib pain and intermittent pain when breathing. GTN spray helps by easing the pain but not to get rid off it." }, { "from": "assistant", "value": "Hi. Revert back with the answers for the above questions to a cardiologist online -->" } ]

[ { "from": "human", "value": "Not been feeling to good for more than 4 weeks now, no appetite so have lost weight, night sweats. Whole body feels weak and uncomfortable all day this has gotten worse during the past week and a half. Nose and throat feel like they are on fire, coughing more after eating. Stomach also feels like it's on fire, gets worse after eating. Stomach acid reflux after eating and burping. Burping a lot after eating sometimes burping up acid reflux. Calves have difficulty moving, very tired. No appetite More severe night sweats, wake up every half an hour just about each night. Very tired." }, { "from": "assistant", "value": "Hello, I am sorry to hear that you are not feeling so well. Reading about your symptoms the most common differential diagnosis would be GERD or Gastro esophageal reflux disease. It is basically reflux of the acidic content of the stomach into your food pipe or oesophagus that causes all these problems . And to confirm the diagnosis I suggest you to meet a gi specialist after the covid situation settles down who will then do an endoscopy to confirm the diagnosis. Till then try avoiding alcohol, citrus juice, tomato based products and coffee. After meals take a walk inside your premises and wait for 2-3 hours and then lie down. Keep an extra pillow to elevate your head while sleeping . Also stop taking omeprazole and start talking tablet esomeprazole/nexpro rd/nexpro. Have 1tsp of syrup sucralfate 30 minutes before taking esomeprazole. Endoscopy Urea breath test Tab esomeprazole -domperidone Syrup sucralfate" } ]

[ { "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 having pulmonary TB and this is the third month since taking medicine. I had blood in sputum few times and sputum test showed negative but based on CT scan, the doctor suspected pulmonary TB. I was recommended medicine for six months. I am feeling better after taking medicine and no more cough or blood in sputum. There is a marriage plan in the family but I have doubts about recovering from this disease. These are some queries in this regard. Whether any other treatments are required after completing six months of medicine? If yes, mention details. What is the chance of transmitting TB to partner after completion of medicine? How long one should wait for marriage after completion of TB medicine? What kind of risks a TB patient carries even after completion of medicine? Whether I am still infectious to others after taking medicine?" }, { "from": "assistant", "value": "Hi, Welcome to icliniq. com. I would need to know that have you got a repeat sputum test or chest X-ray after the treatment has started. I need to see that before I could answer your questions." } ]

[ { "from": "human", "value": "Hello doctor,What is your recommendation for someone with PTSD, depression, and anxiety?" }, { "from": "assistant", "value": "Hello. If a person is suffering from PTSD (posttraumatic stress disorder), depression and anxiety, they will probably need a combination of medication and psychological therapy to manage their condition. Lexapro (Escitalopram) is a good antidepressant that can be helpful in this situation. Based on more clinical information and formulation, psychological therapy can be considered. CBT (cognitive behavioral therapy) will be helpful in addressing depression and anxiety. If PTSD is the predominant primary condition, trauma-focused CBT or EMDR can be considered. Kindly discuss with your doctor locally. Also ensure, you follow the necessary self-help measures like healthy eating, adequate sleep, regular exercise, avoiding alcohol, etc. You can contact again if any further advice is needed." } ]

[ { "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 semi acute pain in my left ear due to someone slapped in my ear while ragging last year. I did not visit a doctor because I feel uncomfortable about discussing this issue. But nowadays I feel a sound that is like when water enters our ear. Now, I have feared of phonophobia. Please suggest." }, { "from": "assistant", "value": "Hi. You might have developed an eardrum hole i.e. perforation since the eardrum is a very delicate structure and cannot tolerate a high volume and high impact gush of air. In such a circumstance, you will definitely have symptoms such as ringing sensations, feeling of air coming out, irritation, unable to tolerate loud sounds, and even decreased hearing. There is nothing to worry as the eardrum heals on its own in four to six weeks provided you follow certain precautionary measures. Precautionary measures include not allowing water to enter the ear. Place sterile cotton in the outer ear and wear a shower cap as well while having a head bath. Cotton places have to be changed every six hours during the day. There is no medication as such required unless your ear has got infected and there is discharge. In such a situation, the healing process might take even more time or sometimes if adequate care and hygiene are not maintained, the hole or perforation might not heal at all and might require surgery to get it closed. I hope this helps." } ]

[ { "from": "human", "value": "Hello doctor, My son has a persistent headache since last 15 days. It started with headache. Consulted various neurologist. Got MRI and CT done, all clear. He gave various medicines, even Noxdorm 250, but no response." }, { "from": "assistant", "value": "Hello. I understand your concern and would explain that his symptoms could be related to a tension-type headache. Coming to this point, I agree with the doctors prescription about Citalopram and Sibelium (attachment removed to protect patient identity). But these drugs may need up to two weeks to show its effects. For this reason, you should be patient. If the situation does not improve in a couple of weeks, I would recommend trying Amitriptyline and Valproate combination. You should discuss with his doctor about these treatment options. Based on his test reports, I would conclude about a primary headache (benign, related to psychological stress)." } ]

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

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

[ { "from": "human", "value": "Hello doctor, My problem is I have a wavering mind and am overimagining everything. If I am watching some negative scenes in movies or shows, I am imagining as if it is happening to me in my real life and am scared that it will surely happen in my life also. I am imagining myself as a bad girl and am crying and convincing myself that am not. For two days, I will behave like this. Then, I will self-motivate myself. Then once again, I will start imagining. I want my old me. I am not myself nowadays. I feel like committing suicide. I want to come out of this problem. I want to be happy with my boyfriend, my family and I want to be successful. I am a good girl but scared to come out of my home. I am very much scared tat I will go wrong. I do not have self-confidence and I do not believe me at all. Please help me to solve this problem." }, { "from": "assistant", "value": "Hello. You have intrusive thoughts and these are resulting in distress. The intrusive thoughts are unwanted dominating thoughts which result in significant distress. The thoughts on seeing some negative scene that you are bad or imagining yourself in such situations are part of anxiety. If these are resulting in distress and you are not able to function properly then please visit a psychiatrist for help. Please do not delay the treatment because this might complicate into anxiety or obsessive-compulsive thoughts. Take care." } ]

[ { "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 small red patch of skin on my penis for over a month. There is no itchiness, no irritation, no pain." }, { "from": "assistant", "value": "Hi. Please send few good quality photographs taken in a natural light." } ]

[ { "from": "human", "value": "Hello doctor, When I am lying down my foot moves. What it means is like my whole foot will move up and down (if this makes sense) sometimes my hips too. I cannot remember when this started to happen but it only happens when I lie down." }, { "from": "assistant", "value": "Hello. You seem to be suffering from hyperkinetic movement disorders. Many people who suffer from mild or moderate PLMS (periodic limb movements during sleep) can successfully manage their condition without medication. People often report that relaxation exercises like yoga or meditation can help reduce their symptoms. Sometimes a hot bath or messaging one's legs before going to sleep will help with the movements as well. Try to have full body massage and if symptoms persist then visit any neurophysician. He will advise some tests and prescribe medications to you." } ]

[ { "from": "human", "value": "Hi doctor, I am a high school senior and about to graduate in two months. On the other side, I have a pilonidal cyst. I know that surgery is required to cure the infection on the inner side. My question is that after surgery, how many days of rest do I need? In short, how many days I have to miss? My symptoms include pain and a little blood sometimes." }, { "from": "assistant", "value": "Hi. For further information consult a general surgeon online -->" } ]

[ { "from": "human", "value": "Hello doctor, I want to leave cigarette smoking. So, please help me and give a solution. Is there any ayurvedic medicine available then please tell me." }, { "from": "assistant", "value": "Hi. There is no short cut to quit smoking. There are two methods you can try. The natural method. You decrease the number of cigarettes by 20 % each week till you reach to a point where you smoke only 4 to 5 cigarettes per day. Then reduce it by one each week. the other method is to substitute cigarettes with Nicotine chewing gums. These chewing gums are to be cheeked in the mouth like Khaini or Zarda. Along with it, start taking tablet Bupron XL 150. It will help in reducing the withdrawal effects of Nicotine." } ]

[ { "from": "human", "value": "Hello doctor, Is a human brain transplant possible?" }, { "from": "assistant", "value": "Hello. Human brain transplant or full body transplant is possible theoretically. Research is going on in this field where we have a case of head transplant from one dog to another where the dog died after a few days. There are a few reports of surgeons who believe it can be a reality in humans in 2 years. The most significant barrier in head transplant is the inability of the nerves to regenerate fully. A scarred nerve will not be able to transmit signals properly. Let us hope it would be possible someday and that would be a great achievement for humanity." } ]

[ { "from": "human", "value": "Hi doctor, I had plantar fascia release surgery three months ago and my doctor released me to work even though I was supposed to get one more x-ray. After getting the second X-ray, he said the x-ray looks good. But, still I am in a lot of pain. Also, the pain has spread to the outside of my foot along with the area of all the joints especially over the last three. Should I get a second opinion?" }, { "from": "assistant", "value": "Hi. Revert back after 10 days to 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": "Hi doctor, My daughter is 13 years old. She is having moderate to severe stomach pain for a year. We thought that it was related to constipation. After a few weeks, my daughter started to have a headache, feeling of dizziness, and shortness of breath. She had a habit of eating ice all the time. Her stomach pain got increased day by day. I took her to an urgent care. They did an iron deficiency panel. Can it be an iron deficiency anemia? Can I give her an iron supplement? Does her body is unable to convert iron to ferritin? Please help." }, { "from": "assistant", "value": "Hi. I have gone through the attached blood test results (attachment removed to protect patient identity). Your daughter's serum ferritin is low which reflects the low iron stores. Her hemoglobin is low. Her low ferritin levels support it. Her TIBC (total iron binding capacity) is high, and it is commonly seen in iron deficiency anemia. But her serum iron levels are not consistent with iron deficiency anemia. Her transferrin saturation of 66 % suggests an iron overload. A transferrin saturation of less than 20 % indicates iron deficiency, while transferrin saturation of more than 50 % suggests iron overload. Higher transferrin saturation values are found in high iron status, such as megaloblastic anemia, sideroblastic anemia, and iron overload status. She needs a detailed hematological workup, and she should avoid taking iron pills. You are correct in your thinking. Her iron is being absorbed, but it is not adequately processed and utilized by the body. The underlying cause is needed to be determined soon and treated accordingly." } ]

[ { "from": "human", "value": "Hi doctor, Is applying MMC in LASEK surgery safe enough? Concerning risk with corneal opacity from LASEK vs corneal 370 µm left after LASIK, which is greater?" }, { "from": "assistant", "value": "Hello. Applying MMC (Mitomycin-C) in LASEK is safer and in many studies, it has not caused any problems. So, you need not worry. Coming to your second question, LASIK with 370 µm left, is very safe as we take the safety level as 250 µm. Hence I feel LASIK risk is lower. For further queries consult an eye care ophthalmologist 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, Three months back, I started to have a small red dry patch on the skin developed on my chin. I tried to keep it moisturized but it seemed to get very dry so I put some Hydrocortisone cream on it for a few days, it seemed like it was gone so I stopped using the cream but within a week it was back but bigger now. I used Hydrocortisone cream for a few more days then stopped for a few days and the same thing happened, only it was spreading by the corners of my mouth now. I tried putting Zinc diaper cream on it and my skin got very inflamed. At this point, I went to walk in clinic as I do not have a family doctor, he was not sure but thought it could be rosacea and gave me Metro gel prescription. I have been using it for about three weeks and the bumps have gone down, but not as much from the Metro gel and the fact that I stopped putting anything on my face, I only wash with Cetaphil and use Cerave moisturizer. I wear makeup for even one day the bumps start coming back all over my chin and around my mouth. I did not use any new products just the same old makeup face wash and moisturizer I had been using for years. The only thing I did differently was my skin was getting really dry so I used a microdermabrasion device just before the red patch developed." }, { "from": "assistant", "value": "Hi. From your picture (attachment removed to protect patient identity), it is steroid induced rosacea or acneform eruption. Whatever was the original disease, you used steroid over it that altered the picture and now you have developed problem due to steroid (Hydrocortisone). First advice for you is that never apply steroid on the face and that without prescription. Now, regarding its management, you have to use a sunscreen of SPF 60, Metronidazole gel 0.75 % is correct treatment but mix it with cold cream and then apply, take non-sedating antihistamine tablet, once bumps will disappear then we will manage redness but in a step-wise manner. Wash your face with mild soap and water. Avoid Dettol and other irritants. Do not scratch or rub the lesion. Steroid induced rosacea, contact dermatitis, steroid induced acneform eruption. Sunscreen of SPF 60 from morning till evening. Apply Metronidazole gel 0.75 % plus cold cream at night. Take antihistamine tablet OD. Wash face with mild soap and water. Avoid using Dettol and other irritants." } ]

[ { "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, One of my relative aged about 36 years (married for 6 years) undergone frozen embryo transfer on 14th March and she got positive beta HCG (human chorionic gonadotropin) on 25th. She developed vaginal bleeding from 5th April varying from light spotting to moderate bleeding on three occasions. She was given Tranexamic acid for three days on two occasions and this time also advised to take the same. She is advised to stop Aspirin and Enoxoparin which she was on even prior to embryo transfer. Her scan is showing gestational age of 8 weeks 2 days with fetal heartbeat and SCH of 3 cm. She is on Duphaston 10 mg QID, Susten 400 QID, Progynova 2 mg QID, Folic acid, Mecobalamin, Aspirin and Enoxaparin 60 mg (daily which she stopped today). Please advice further management." }, { "from": "assistant", "value": "Hello, Welcome to iclinq.com. I can understand the struggle she is going through. The SCH (subchorionic hematoma), is big yet the positive thing is fetal growth of 8 weeks with FHR (fetal heart rate). She is on the right medications and I would like to add an antibiotic like Augmentin 625 mg along with the medication. She is already on medication for five days to avoid infected subchorionic hematoma (as its big 3 cm) nothing more could be done. Let her stay at rest with a sound and a happy mind. Threatened abortion. Threatened abortion. Reassurance, continue the same treatment with just an added antibiotic. Rest and stay positive." } ]

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

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

[ { "from": "human", "value": "Hello doctor, One week before three kidney stones came out, and I have a burning sensation while urinating after that. I went to the doctor he took some test and told that my creatinine level was 1.6. Is it dangerous? I have hypertension and my value is 150/100." }, { "from": "assistant", "value": "Hello. Based on your history you might be having a urinary tract infection. Urine infection is a known complication in patients with urine stones. Do you have other complaints in addition to burning sensation like fever with or without chills, abdomen pain, vomitings, and blood in urine? The rise in creatinine in your case can be due to a pre-existing renal disease due to hypertension, or the current urinary tract infection may also cause this. I advise you to get, 1) Complete urine examination for any urinary tract infection. 2) Urine culture and sensitivity to identify the specific organism causing infection and antibiotic sensitivity. 3) Ultrasound abdomen to look for any urine stones still present. 4) Complete renal function test. 5) Complete blood count. You are welcome back to me with any further queries." } ]

[ { "from": "human", "value": "Hi doctor, I am 44 years old. For the past one year, I have noticed dark spots on the fingers and near knuckles on the left hand. They do not hurt, but look like a burn. I also noticed numbness in the tip of my left middle finger. I have allergies, asthma and sleep apnea. I am also suffering from herpes 1 and 2. My current medications are Adipex, Zyrtec, Oxybutynin multivitamin, Valtrex (only when I have a flare-up) and Ventolin inhaler. Please suggest some advice." }, { "from": "assistant", "value": "Hello. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. You are most probably suffering from hand eczema or lichen simplex. Numbness in your finger does not seem to be related to this, however, it may be seen in case of certain orthopedic such as nerve compression or medical conditions like diabetes. For the dark patches, I suggest steroid ointment containing Clobetasol twice a day for two weeks. Consult your doctor, discuss with him or her and take the medicine with consent. 1. Avoid excessive use of soap. 2. I suggest apply an emollient or a moisturizing cream to your hand frequently during the daytime. Revert back after two weeks to a dermatologist 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 a problem in my eyes. My right eye is dry and left is normal. I use Systane Ultra eye drop from the last one year and Omega 3 capsule from last three months. No result was found. No improvement was found. Please suggest me how I can get relief in my right eye? I want to overcome dryness in my eyes." }, { "from": "assistant", "value": "Hello. Unfortunately, dry eye is a chronic condition and does not go away. First of all, you should use the eye drop in both eyes and not only on the one you feel the dryness in, second of all, the minimal quantity of drops that might help you during the day is four times but there are no limits, you can even use it every hour. The other option is to have punctum plugs inserted and that might reduce the quantity of drops you have to use or to use the only available medication for this condition which is called Restasis. For a more detailed advice please provide me with more information such as schirmer test results atleast." } ]

[ { "from": "human", "value": "Hi doctor,I am 18 years old. I had sexual intercourse. We used contraceptives like a condom. But the condom got broked. I do not know whether the sperm has gone inside. I washed my genitals quickly after knowing that the condom has got broken. I took a pregnancy test, and it came negative. Can I put my trust in the pregnancy test or should I have to consult a doctor? Is it possible to get pregnant in two days after having sexual intercourse?" }, { "from": "assistant", "value": "Hi. If you had intercourse around 10th to 17th day of your cycle, and if you have a regular menstrual cycle, then the possibility of conception increases with each day within that period when the condom has broken. In this situation, you can take an emergency pill within 72 hours of sexual intercourse to avoid pregnancy. Sperms can stay alive in the vaginal tract for up to seven days whereas the egg remains available for fertilization for 24 hours. In conception, you have to wait for at least a week to get a positive pregnancy test with urine dipstick. Serum beta hCG can be detected earlier, but you have to wait for a few days. You do not need to go to a doctor. Just repeat the urine pregnancy test after two weeks or get a blood pregnancy test done." } ]

[ { "from": "human", "value": "Hi doctor, I am suffering from indigestion, hyperacidity, constipation, and chronic premature ejaculation for many years. I am a chain smoker, and I had stopped drinking alcohol for the past two months. Kindly advice me a good medicine." }, { "from": "assistant", "value": "Hi. These health problems occur due to excessive drinking of alcohol and smoking. It is good to hear that you have stopped drinking alcohol. It will take some time to get back to normal health. I would advise you take Nux vomica 30c four pills or two drops in a half cup of water once a day at night for ten days. This homeopathic remedy will help to reduce the stomach problem and premature ejaculation problem to some extent. Please take this remedy for a long time or longer than ten days. Also, take Natrum Phos 6X tablet three tablets twice a day in the morning and evening for one month. Depending upon the improvement, you may need to change the remedy after a month. Kindly revert me after 15 days or one month if possible." } ]

[ { "from": "human", "value": "Hello doctor, I got married 2 days before. My penis got erected while doing foreplay. However, after some time penis gets loosen and become small. So, could not penetrate my penis. Is there any issue in my health? Or is this due to first time fear? How to approach this? Please advice." }, { "from": "assistant", "value": "Hi. Since you got proper erection during foreplay and there is no history of difficulty in erection it was the result of performance anxiety. This generally occurs in first timers and especially in young age. I do not think you need to be concerned at this level as occasional failure is rule rather than exception. Almost all men report such problem in erection psychologically on certain occasions without suffering from any disorder." } ]

[ { "from": "human", "value": "Hello doctor, I am a 19-year-old female. I woke up this morning with two medium sized red, itchy and scaly spots on my upper arms, I searched, and it seemed to me that this resembles an early stage of skin cancer (squamous cell carcinoma). What should I do?" }, { "from": "assistant", "value": "Hello. First I would like to reaasure you that squamous cell carcinoma can not appear all of a sudden (over night). Second, from the pics you attached it looks like fungal infection (attachment removed to protect patient identity), something called tinea corporis, which comes with the same look and other looks as well, in addition to the symptoms that you mentioned (specially itchiness). Please follow the treatment that I will provide you and kindly follow up with photos for the skin lesion in five to seven days. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Lamisil cream (Terbinafine), apply three times a day for 7 to 14 days or Daktacort cream (Miconazole, Hydrocortisone), apply three times a day for 7 to 14 days. Wash your own clothes and bed linens separately as it is infectious." } ]

[ { "from": "human", "value": "Hello doctor,I have an ulcer on top of the tooth on the gums (a white raised ulcer). Please help." }, { "from": "assistant", "value": "Hi. This is not an ulcer, infact it is big pus boil that has occurred due to some infection in your underlying tooth. You should start with an antibiotic regime immediately and get it treated. Most probably root canal treatment and scaling will be done of teeth under question. If it is not paining that does not mean it will remain silent for long. It can trigger up anytime. You must see the dentist as soon as possible. If you get a late appointment then I can prescribe medicine for you. Give me followup after a day for it." } ]

[ { "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 just got my wisdom tooth removed. So, I was wondering if I can get a guidance of the do's and dont's. Like tips regarding eating or drinking to avoid problems." }, { "from": "assistant", "value": "Hi. Take precautions for 24 hours if the wisdom tooth has been extracted non-surgically but, if the tooth has been removed by surgical intervention with sutures placed, then take precautions until the sutures are removed. Consult a dentist online for further help -->" } ]

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