text
listlengths 2
2
|
|---|
[
{
"from": "human",
"value": "Hi doctor, I have constipation, pain in stomach and gas for the past three to four days. I feel uncomfortable. I also have a burning sensation in the anal region. Please help me."
},
{
"from": "assistant",
"value": "Hi. You can have stomach inflammation and indigestion problem. For that, you can take Rabeprazole. For proper digestion, you can take Alcid MPS syrup (Aluminium hydroxide with Dimethicone). If the constipation is severe, you can take Bisacodyl. If there is a burning pain in the anal region, then you can do a proctoscopy rectal examination. Avoid taking excess spicy foods. Drink lots of water and avoid having a sedentary lifestyle. You can consult a physician for a physical examination."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had sex with CSW and my condom got broken. I have started feeling symptoms and have a cold sore throat and rashes on my back. I had tested 22nd day and 95th day both are antibody test and got negative and my doctor asked me to retest after six months. I had read that 84 days are enough to show up in the test. What is the rare condition to get antibodies? Should I retest?"
},
{
"from": "assistant",
"value": "Hi. Regarding HIV infection, the window period (or period in which a person might test negative for the virus but actually be positive because of a delayed immune response) is typically between 21 and 60 days. There is however some evidence that it can be as long as 180 days (six months). When there is a history of a potential transmission risk event, like having unprotected sexual intercourse, we recommend a final repeat of the antibody and antigen combo test at six months. Even though your symptoms could be explained by other infections, I would still recommend that you repeat the combo test at six months for your own peace of mind. It is also very important that you test yourself for syphilis as your symptoms, especially your rash, suggests a need to just exclude that, as it is highly treatable if found. I would strongly suggest as well that you consult with a trusted physician so that he or she can examine you clinically and help to exclude other diagnoses like upper respiratory tract infection and treat accordingly."
}
] |
[
{
"from": "human",
"value": "Hello Doctor, My doctor set me up with an FNP (Family nurse practitioner) who advised me to start taking Farxiga. I am not sure if I should take this medication.I am curious about other professional opinions on this newly FDA approved drug. Should I stop this drug?"
},
{
"from": "assistant",
"value": "Hi, Welcome to icliniq.com. For further follow up consult an endocrinologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am suffering from IBS for past one month. I have been taking Sporlac tablet from last 10 days. If I stop taking Sporlac I am suffering from heavy constipation. For how long I have to take Sporlac?"
},
{
"from": "assistant",
"value": "Hello. Sporlac contains lactobacillus and can be prescribed for 10 to 14 days. But duration is decided according to the need of it. Irritable bowel syndrome is functional bowel problem and stress is related to it. So, try to avoid stress if you are taking. Yoga, meditation are beneficial for that. Lubiprostone is a specific drug that is sometime used in irritable bowel syndrome. If you have constipation more, then fiber diet is recommended. Take high fiber diet like whole grain, wheat bran, green leafy vegetables, fruits, etc. Take care. For more information consult a general practitioner online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am spending more time in toilet daily as the stools keep on coming for every 10-15 minutes. Stools are semi-liquid and it feels like diarrhea. I have lost around 10-12 kg of weight in the last two years and four to five kg during the last six months alone. I have got the following tests done and found everything to be normal. Colonoscopy, biopsy for TB and Crohn's disease and also blood tests that including CBC, CRP, Mantoux, ESR, thyroid, HIV, LFT and KFT. I have been treated with the following medicines over the time. Namely Colospa (Mebeverine hydrochloride), Rixmin (Rifaximin), Librax, VSL3, Velgut capsules, Bifilac (Pre-probiotics), Nexpro 40 and also different fiber supplements, both soluble and insoluble. In addition to all these I have taken Oflomac and Metrogyl course several times. I am attaching the reports of my colonoscopy, biopsy and blood tests for your reference. Please guide. Thank you."
},
{
"from": "assistant",
"value": "Hi. We are here to help you. I have gone through your reports (attachments removed to protect patient identity). Revert back with the asked details to a medical gastroenterologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am 13 weeks pregnant. I vomit almost 10 times a day. I could not focus on regular works at home. Lost 6 kg in 20 days. Is that normal? Feel moody more at times. But will having sex affect my baby?"
},
{
"from": "assistant",
"value": "Hello. If you are vomiting frequently and has lost weight, you must see your local doctor as soon as possible for IV fluids and accurate management to control the vomiting. Excessive vomiting can adversely affect the baby as well as your health. And having sex does not affect the baby's health."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a 25 year old female, diagnosed with PCOD. Since last week, I am taking tablet Normoz for that. I had unprotected sex today, that is, on the 14th day of my menstrual cycle. I took the Unwanted-72 pill within one hour. What are the chances of conceiving? Can I get pregnant? Please help?"
},
{
"from": "assistant",
"value": "Hello. I have gone through your history and understand your concerns. Hope you found this useful. Good luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "assistant",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am having a problem with bowel movements with soft, pasty stools. Lots of small stools after the first bowel movement in the morning. All bowel movements take hours to develop once I feel I am in need of a bowel movement. Often times I have to manipulate bowel movement with a shallow enema. Most bowel movements are difficult and are a single push that leaves me feeling as it is incomplete. The build up to a movement either assisted or not is extremely uncomfortable. No sharp pains but gassy, bloated and a feeling of inflammation in lower bowel where sigmoid colon meets rectum. I have no problem with fiber in my diet and I eat fermented foods and take probiotics."
},
{
"from": "assistant",
"value": "Hello. So, this basically occurs due to constipation and incomplete evacuation. There are certain points you need to remember. Firstly, you need to have a healthy lifestyle which includes a healthy diet and regular exercises. In diet, you should eat a high-fiber diet like fruits (apple, banana, oranges), green leafy vegetables like spinach, raw cucumber, whole wheat, etc., and plenty of water, which will help your free passage of stools. Next thing, make use of morning gastrocolic reflex. Normally when one eats breakfast, one tends to get a bowel movement. So have a good breakfast and plenty of water which will give good gastrocolic reflex. Visit washroom after this reflex comes. Most importantly, effective and physiological treatment is fiber supplementation. You should have Psyllium husk 5 to 6 g with each meal and drink plenty of water after it so as to give good volume to your stools. Gradually, we can increase the dose as needed up to 10 g with each meal. If this is not effective we can try other laxatives like syrup Lactulose 15 to begin with and increased up to 30 ml at bedtime which is also quite effective. Linzess you have already been trying, Lubiprostone we can try later. But we try to avoid this as much as possible as it can lead to laxative abuse. Hope this helps you and get back if you have any doubts. For more information consult 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 have a balancing problem. I have low blood pressure in change of posture. I am on Midodrine. During a neurological examination, I was asked to tap my toes. Every time when I did that my heel involuntarily tapped several times. What is the reason? I am being examined for possible MSA."
},
{
"from": "assistant",
"value": "Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. I feel really sorry for the balance problems you have. I pray for the best of your health ahead. Yes, you have many symptoms that point my finger too towards the diagnosis of MSA (multiple system atrophy) although definitive studies are needed. Your age, balance and gait issues and postural hypotension all that concludes initially towards MSA. Your physician was actually examining the signs of cerebellar dysfunction and myoclonus (muscle twitching. Let me explain you the pathological meanings of MSA to understand more about your neurologist's intentions and your heel's presentation in doctor's office. MSA is a disease of old age. There is degeneration of neurons in brain that cause problem in relaying information passing to and from the brain and all those electrical circuits in brain's certain areas. Naming the areas of brain affected will be irrelevant here. But, it is worth mentioning that it is related to body's balance and gait controlling areas; areas that cause to keep our blood pressure normal in limits when we stand up and lie on the bed. The way your doctor tested you, he was finding the involuntary muscle contractions (specifically a group of muscles). This is then called MSA-C where C means cerebellar predominant. It is to differentiate diagnosis from MSA-P where P stands for Parkinsonism predominant type. You are taking Midodrine that is used to control postural hypotension. It means you have postural hypotension too, and this is also a feature of MSA. I need to ask some questions to assist you and prepare you more regarding knowledge about your disease, so that you may not be blank when you visit your doctor next time. You can discuss some important things with him. Please spare some time to give me details about: 1. Do you have ever felt tapping in head, palpitation or racing heart when you lie in your bed? 2. Do you have diabetes? Are you on any medications? 3. Have you felt dizzy and lightheaded ever after taking a meal? 4. Have you ever felt tremors in hands, muscle rigidity and any change in your handwriting? 5. Do you have sleep apnea diagnosed ever? Or I may ask do you get up from deep sleep due to lack of respiration and shortness of breath? 6. Do you have observed hoarseness of voice along with these gait problems?"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I a male, 27 years old. I got blood while pooping without pain today morning twice but without any pain."
},
{
"from": "assistant",
"value": "Hi. Blood in stools can have multiple reasons from simple hemorrhoids to some serious ailments. I would advise you to visit a gastroenterologist and get a sigmoidoscopy done. It is a simple test and takes hardly 10 minutes. It involves passing a small tube-shaped soft camera from the anus into the large intestine and trying to find the source of bleed. It is a painless procedure with the only sensation being mild bloating."
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have a very sore pimple on the inner side of my outer vagina lips. I have had the occasional one in the past on the same side and usually around the same area. It is like an ingrown hair or clogged follicle. I do shave down there. They usually go away on its own but this one seems very big and very sore and would like to know if there is a way to heal it faster. I only have one bump at a time. My PAP tests have come back normal aside from some yeast. Do you have any suggestions?"
},
{
"from": "assistant",
"value": "Hi. Shaving or waxing the intimate areas often lead to ingrown hairs, infected follicles out there. Either you can cut it out with scissors leaving a bit or go for laser hair removal. These problems settle down forever. Do use douches, just cleanse the area with water during bath. For the boil now, give hot fomentation to the local area. The problem will resolve once the pus comes out, the ingrown hair will be seen, and you can gently pull it out with a tweezer cleaned with alcohol."
}
] |
[
{
"from": "human",
"value": "Hi doctor, Over the past 3 months, my periods have become irregular. It was regular throughout my life. I faced spotting between periods and had been detected with a submucosal fibroid of 2 cm. For the past 3 months, I feel in the morning after passing bowels, that my bowel has not cleared. This feeling of incomplete evacuation of bowel remains till noon. I drink nearly 2 liters of water in the morning to noon. With more water, I feel bowel pressure, but do not need to pass it always. My usual bowel movement is one time a day and on some days it is twice."
},
{
"from": "assistant",
"value": "Hi. I understand that your periods are irregular and you have a feeling of incomplete evacuation of bowel. This type of combination is seen in hypothyroidism. So you need to check your thyroid function after consulting a physician. These two problems can also be totally unrelated in that case you need to consult a gynecologist for periods problem. For bowel, you can take high-fiber diets, specifically diet rich in fruits and green leafy vegetables. Regular timing of food and a good healthy breakfast are also very important. If the problem persistents, you may need medication. Initially, medicated fibers like Isabgol also known as Ispaghula and others after consulting physician or gastroenterologist."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My friend is going to adopt a 6 months old female child. Certain routine tests were performed on the child. I have attached the reports for your reference. The Hb electrophoresis for thalassemia screening is showing an abnormal hemoglobin pattern. The treating pediatrician is not sure about the prognosis that is whether the child will be symptomatic and transfusion dependent. Presently, the child is asymptomatic except for mild splenomegaly. Please suggest about the future prognosis of the child to facilitate the further course of action."
},
{
"from": "assistant",
"value": "Hi. Based on your query and attached report (attachment removed to protect patient identity), my opinion is as follows: For further information consult a hematologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiance is having diabetes type 2. And I want to know what will be the impact in the following scenario. Can she postpone her period by eight days as we have some rituals to perform during our wedding? What will be the impact if she uses contraceptive pills in case of birth control? Will she face any problem during pregnancy?"
},
{
"from": "assistant",
"value": "Hi. I read through your query and understood your concern. She can take Progesterone tablets (Medroxyprogesterone 10 mg twice daily) to postpone her period. These tablets may increase the requirement of antidiabetic medicines (tablets/insulin). So, she needs to monitor her blood sugar level (at least two to three times during the period she is taking tablets) to make sure that sugar control is fine. Contraceptive pills used nowadays are low dose pills and have little or no impact on diabetes. Even if sugar levels increase, it can be treated by increasing the dose of antidiabetic medicines. So, she can use low dose contraceptive pills. Just consult your physician before starting those pills to make sure that the medicines do not interact with each other. During pregnancy, if her sugar control is fine from three months before pregnancy, during pregnancy and till delivery of the baby, there will practically be no problem to the mother and baby. If sugar control is not good, there may be many problems about which there is no need to worry right now. Revert back to a gynaecologist online for further queries -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 26 years old. I have a problem with hyperthyroidism during my pregnancy. I am in my fourth month of pregnancy with TSH- 0.07, T4- 161, T3- 2.34. What are the complications with this? Is it good for me to take PTU."
},
{
"from": "assistant",
"value": "Hi. Hyperthyroidism in pregnancy is usually treated with Propylthiouracil 50-100 mg/day. Generally, treatment is withdrawn four weeks prior to delivery after which normal doses may be resumed. Your hormone levels are still very high, you need to increase your dose. Pregnancies complicated by uncontrolled hyperthyroidism may result in higher incidences of spontaneous abortion (miscarriage), preterm labor, low birth-weight babies, or stillbirths. Complications of pregnancy, including pre-eclampsia (a condition associated with hypertension, low blood platelet count, protein in the urine, and mental changes) may also occur. So please increase your dosage. Another thing I want to highlight is that you should do TSH (thyroid-stimulating hormone) receptor antibodies and to see what is the cause of your hyperthyroidism. Is it Graves’ disease. These antibodies can enter from the mother's blood to the baby's blood and stimulate the baby's thyroid gland. These antibodies should be measured in the mother during her second trimester of pregnancy because the values that are greater than five times normal have been associated with hyperthyroidism in the baby at birth."
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have hemorrhoids for a few years. My doctor has suggested me a colonoscopy to rule out cancer. Is there any simple test available to rule out colon or rectal cancer? Please mention an opinion regarding stool occult blood test."
},
{
"from": "assistant",
"value": "Hi. First of all, you get an MRI (magnetic resonance imaging) abdomen done. You can have a presence of mass when you have a colon or rectal cancer. If there is a mass seen, then you can do a colonoscopy. You can also do a CEA (carcinoembryonic antigen) as CEA show an increase in range when you have colon cancer. You can also do a stool DNA test. If the stool DNA test is positive, then you can also do a colonoscopy to confirm the diagnosis."
}
] |
[
{
"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 went to the dentist this morning for an extraction on a bottom molar on my left side. After being completely numbed he started the extraction and I had excruciating pain. He numbed me more but no matter how much he numbed, it hurt so bad. He eventually said he would refer me to a dental surgeon so I could be sedated. He was extremely nice about it the entire time but I could tell he just thought I was anxious and misinterpreting the pressure as pain. I was extremely nervous and anxious so I understand but I have had a tooth pulled before and I know the pressure, but this was an intense pain even though I was numbed. He said the dental surgeon would give me an IV that would relax me and make the procedure easier for me. I am worried that being sedated will not stop the pain. He said because I had a bad infection in the tooth that it could be causing the pain so he prescribed me some antibiotics to get rid of the infection. My questions are is this normal to have such terrible pain even while completely numb and will being sedated even help with this pain?"
},
{
"from": "assistant",
"value": "Hi. It is the best question I have got in my practice and the most frequent query is how and why. This is due to two reasons. Infected tooth with much inflammation or patient's anxious nature. So to tackle such cases it is better to prescribe antibiotics for five days then extract even if patient complaints, again it is better to give him or her tablet of Alprazolam before extraction one or two days to relieve anxiety. Moreover, before blocking the nerve, we can also give an injection of Dexamethasone which reduces inflammation."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My wife is 50 years and I am 54 years old. Last night we had sex with a condom, but I have doubt it may be unsafe. Her period occurs once in one and a half months. Other than this she does not have any gynecological problem. Can she take any contraceptive pill like Unwanted 72?"
},
{
"from": "assistant",
"value": "Hello, Welcome to icliniq.com. Though your wife is in the late part of her reproductive age and might be approaching her menopause, yet if she continues to have her menstrual cycles regularly there is a chance that she might be still ovulating and if intercourse happens in her fertile period she might conceive. It is better she takes Unwanted 72 this time. Unwanted 72 is safe for her from a medical point of view but it is not 100 percent effective in avoiding pregnancy and cannot substitute a routine contraceptive. So please do a pregnancy test also if she does not have her periods at the scheduled time. After her next periods follow up for an effective contraceptive with additional benefits for hormone replacement appropriate for her age."
}
] |
[
{
"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,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,"
},
{
"from": "assistant",
"value": "Hi. For further help consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have been getting a swollen eye once a week, usually in the mornings. I feel a slight irritation beforehand, itchiness. Then my eyelid swells to the size of a golfball. The eye is not red, I can see perfectly, there is no sign of cuts or scrapes. No discharge, maybe a little dryness beforehand. Please help."
},
{
"from": "assistant",
"value": "Hello. You are describing an allergic reaction of the eye to some factor. If you are not also suffering from sneezing and dry cough at night then you can use antihistamine eye drops such as Pataday once daily or Patanol or Zyrtec twice daily for a period of 10 days. If you have started using any kind of new cream or make up around the eyes, change it into something hypoallergenic. Best of luck."
}
] |
[
{
"from": "human",
"value": "Hi doctor, About three years ago, I went seven days without sleeping. I was hospitalized, and they tried everything to get me to sleep, but nothing worked. Finally, after seven days, they put me on Seroquel, and it worked. Now, I must take 800 mg every night to sleep. I tried to wean myself down, but as soon as I went down to 600 mg, I could not sleep. Will I have to be on this medication all my life?"
},
{
"from": "assistant",
"value": "Hello. I read your query and understand your concerns. First of all, I want to inform you that you are having insomnia, which means sleeplessness, Revert with more information to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "assistant",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have no sex drive whatsoever and cannot obtain an orgasm. Please help."
},
{
"from": "assistant",
"value": "Hi. I read your query with due interest and understand your concerns. Low sex drive is a common symptom of a variety of medical and psychiatric disorders. Before I speculate anything about it I need you to answer a few questions in detail. Once you answer the above questions it will be helpful to suggest the appropriate measures."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am currently trying to get over my seasonal sinus infection. However, after taking a nap a couple of days ago, I lost most hearing in my left ear. I went back to the urgent care and was told I had a ruptured eardrum. I was given drops to put in my ear. However, I cannot help but notice that around my ear on the left side is partly numb and the pain goes into my jaw joint. Should I be concerned about this numbness and the pain in my jaw? I told the Urgent Care NP about it, and she just gave me a confused look, saying that it is weird, offering no answers."
},
{
"from": "assistant",
"value": "Hi. If you have a ruptured drum, 1. Do not put ear drops. 2. Do not let water enter the ears. 3. Visit an ENT soon. 4. Assess the size of perforation. 5. Ask ENT if it will heal spontaneously. Some perforations are small and heal on their own in healthy individuals, but others do not. Regarding the pain in jaw joint and numbness, the perforation does not explain that. However, it could be that your sinus and nose problem resulted in rising of infection into the particular ear through the eustachian tube and caused a disease of the middle ear resulting in the discharge of pus through that ear eventually. In that case, the condition should heal on its own. But you need a course of antibiotic, nasal and systemic decongestant, antiallergic and painkiller."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My age is 18 years. Few days before I do not know somehow I had forgotten many easy spellings of those that I knew well before. And I have my HS examination on in a few days. Please tell me what shall I do to solve my problems."
},
{
"from": "assistant",
"value": "Hi. I just read through your complaints. It looks like absent-mindedness which is common in old age. But at a young age, it is not so common what I would advise is get me some basic blood investigations. Complete blood count, kidney function test, liver function test, and urine routine examination, serum vitamin B12, folic acid, and vitamin D. With that, I will be able to assess you what has been going. In the meantime, I would advise you to eat healthily, eat green leafy vegetables. A green leafy vegetable called Brahmi leaves help to improve your memory power and also reduces your absent-mindedness. Any fruits or any food that is rich in DHA most importantly I want you to eat dry fruits that includes walnut, pista, badam, cashews and whichever you like got a more amount of DHA that improve your nerve functions in your brain and it indirectly helps you remember things rather than forgetting things."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My son is 29 days old. He already has two teeth and one more is developing in the left upper jaw. What action do we need to take?"
},
{
"from": "assistant",
"value": "Hi. It is rare, but babies may be born with teeth. These are called natal teeth. I would like you to just keep a watch on your baby very often. You might have taken too much of calcium during your pregnancy, so it might have come out early for him. Since they do not have a very strong root support, usually these teeth fall off if they are very loose or they might stay until his permanent teeth come later in life. Newborn babies with teeth might injure their gums and tongue. So, just keep watching in case such things happen. If the teeth are very loose, that is hanging from the gums, and are going to fall off anytime, then please see your dentist. Nothing to worry. Some babies grow with teeth without any problems. For further information consult a paediatric dentist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have chest pain, back pain, left arm pain, and slightly shortness of breath for the past two years. The pain remains constant all the time. I also have irritation and tingling for the last two years continuously. I have done ECG, echo, TMT, and CT angiography twice, and everything is normal. What should I do?"
},
{
"from": "assistant",
"value": "Hello. Your symptoms do not seem to be due to a heart problem. Tingling sensations, irritation, etc., are not caused by the heart. Your symptoms more or less seem to be due to some nerve irritation which may be localized or generalized. I advise you to consult a neurologist for proper evaluation of symptoms. Sometimes nerves got entrapped between bones in the neck or vertebral column that causes pain, tingling, numbness in fingers, arms and hands. If you are a pure vegetarian, there may be vitamin B12 deficiency, which can cause such symptoms. Apart from these, there may be a problem in the peripheral and central nervous system. Therefore I advise you to have a visit a neurologist."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am having a bunch of bumps on my dick. I think it is because I jerk off a lot but I am not exactly sure what it is. I have no discomfort, no itching, no discharge."
},
{
"from": "assistant",
"value": "Hello Are you having any pain or burning sensation? These lesions look like herpes simplex virus infection. It may cause lesions on face and genitals also. Use Acivir cream (Acyclovir), and tablet Acivir 400 mg thrice a day for five days. If symptoms are not improved, please consult your doctor. He will examine and treat you accordingly. Take care."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 29 years old, and my partner is 22 years old. We started our life with unpleasant moments after marriage. After a year, we started our sexual life. We are trying for a baby for the past few months. I have a habit of masturbating regularly. Recently, my sperm count and motility got reduced entirely. I consulted a doctor, and the doctor gave me Popson tablets for increasing the sperm count. Also, my doctor did all the necessary scans for my prostate, and the results came normal. But I am unable to do intercourse properly, and my penis becomes small automatically after a few minutes of trying for insertion. I have irritation in penis and pain during urination. We are not doing any foreplay before sex as my partner is not interested in it. I am very much stressed and depressed. What can I do for my erection problem? Can taking tablets for erection become an addiction? Can I have any side effects? Please help me."
},
{
"from": "assistant",
"value": "Hi. You have a problem with erection. It occurs due to the stress of having a baby. Regarding masturbation and a decrease in motility of sperm and their count, there is no absolute relationship between these two things. Masturbation is a healthy and safe practice. It is better to assess the level of stress in you. Treat the cause responsible for it, and the problem will get better soon. Taking medicine under the guidance of a doctor will not become an addiction. Your doctor decides the medication, the duration of taking it and stopping it."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a 69 year old male. I am a diabetic patient using Cetapin XR 500 tablets since the last two years. My bloodsugar is almost in control, but I am losing weight. Can you help me?"
},
{
"from": "assistant",
"value": "Hello. Hope you find my advice beneficial. Good luck. For more information consult a diabetologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My problem is related to gas. I have farting at night."
},
{
"from": "assistant",
"value": "Hi. Please provide me details of your symptoms. Exactly what symptoms you have and since how long?"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "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 had sex with a prostitute and not sure if she has HIV or not. However, I have used a condom as a protection. Now, do I need to do an HIV test to check?"
},
{
"from": "assistant",
"value": "Hello. I have noted your concern. Protected sex is safe and there is no risk of HIV (human immunodeficiency virus). Regards. For more information consult an 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": "Hello doctor, What does both kidney slightly hyperechoic in an ultrasound indicate? I am 19 weeks pregnant and very worried about my baby."
},
{
"from": "assistant",
"value": "Hi. Hyperechogenicity in kidneys is seen in some congenital polycystic renal diseases leading to renal failure in late childhood or adulthood. But in fetuses, this marker has been studied sparsely. These studies have shown that if the amniotic fluid around the baby is adequate as per gestational age, outcomes are favorable like no kidney impairment. Please follow up with USG growth scan every three weeks to note the fluid level and liver echogenicity as well. If follow up reports remain within normal limits, it is just a normal variant. No need to worry in such conditions."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a 2 year old female child who is struggling to have a bowel movement. She struggles and tenses up so hard to pass stools. Is there something that can be given to overcome this?"
},
{
"from": "assistant",
"value": "Hi. Your child has constipation. The common causes of constipation are anal fissure and dietary factors. If it has been for less than one month, start lactulose 7 mL twice a day for 15 days and revert with results. Give her high-fiber diet and plenty of fluids. Make your child sit in warm water for about 15 minutes daily, such that her hips and buttocks are inside the water (sitz bath). If constipation has been there for more than a month, get these blood tests done:"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have mild scoliosis convex to the left and was wondering if a left knee arthroscopy can be the cause of my posture and/or pain issues. For example, sitting, standing. Also, having scoliosis, would that cause a blood clot (pulmonary embolism) after this surgery? With being a severe asthmatic."
},
{
"from": "assistant",
"value": "Hello. Scoliosis is a structural problem and knee pain will not cause this. Arthroscopy can rarely lead to a clot formation but is not necessarily a known risk factor for DVT (deep vein thrombosis) as you are likely to mobilize very quickly and the procedure is usually short. Scoliosis does not add to the risks either. For more information consult an orthopaedician and traumatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, This query is for my relative. She is 51 years old. Her height is 5'1\" and weight is 65 kg. She had an injection before 25 days in her buttocks. We do not know the medicine name. She had an issue of excessive menstruation and she consulted our family doctor and had the injection. Now she is under hormone tablets. She is also taking half tablet daily at night for depression. At the injection site, she developed a swelling after 10 days of injection. As per doctor's advice she gave hot and cold fomentation alternatively. She does not have severe pain in the swelling, but she has pain on touch. Now, it looks like the swelling is pointed and she has mild itching on the swelling. What could this be? How to treat this? We will be able to meet our doctor only after two days. Is it fine? Or this is an emergency? What is the immediate remedy, as of now? Please help."
},
{
"from": "assistant",
"value": "Hi. Revert back with the answers to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have two kids and recently diagnosed with PCOS. My last ultrasound showed I had 30 follicles in my left ovary and 25 in my right, with only one mature follicle, we have been trying medicated times intercourse with a trigger shot and it is not working. I am not getting pregnant. Why does PCOS affect with fertility so bad? Took Letrozole 2.5 mg three tablets once a day from day 3 to 7 and then did a trigger shot a week back- Ovidrel."
},
{
"from": "assistant",
"value": "Hello. PCOD is a polycystic ovarian disease which causes increase testosterone levels in women with androgenic features and multiple small cysts in ovaries. It is one of the most common reasons for irregular menses, especially oligomenorrhoea and primary or secondary female infertility. The increased androgen feels do not allow the follicles to mature and hence ovulate and also if delayed ovulation occurs, the quality of the egg is not optimum to fertilize and lead to pregnancy. You shall need to be placed on low dose oral contraceptive pills with Myoinositol supplementation with a reduction in weight with exercise and diet modification (majorly) and increasing your daily water intake. All these for 3 to 6 months have been advocated for treatment of PCOD."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male, and I am a doctor. From the past year, I have been suffering from delayed onset sleep disorder, I sleep at 4 AM and wake up after noon. I saw a psychiatrist, and he put me on Melatonin, Modafinil, and Zolfresh. But I am still unable to sleep at the desired time, and pressure of studies has put me into depression. I was unusually weepy, and it was difficult to concentrate. I saw a doctor again, and he put me on Sertraline, explaining that the symptoms were actually due to depression. I was prescribed Paroxetine 25 mg CR by another psychiatrist. I did not take them and suffered from depression for six months. I was finally convinced by a counselor to take the drug. I started with Pexep CR 25 mg every night, and I took it for two months regularly. My depressive symptoms were greatly resolved, but my sleep cycle was not helped at all. A few day before, I read about chronotherapy for delayed phase sleep disorder and wanted to give it a try. I practiced the schedule for seven days and was sleeping fine but, I stopped taking Paroxetine after taking half tablets for seven days. From past 4 to 5 days, I have been experiencing vivid dreams with awakenings. While awake, my head seems to spin every 10 to 15 minutes for 4 to 5 seconds, which is disturbing. I am unable to concentrate on studies, which is putting me through anxiety and weepy phases. I know these are withdrawal symptoms of Paroxetine, but I do not want to go back to that drug. I am fine, and the only issue I have is delayed sleep phase onset insomnia. Please help me with withdrawal symptoms and treatment for delayed sleep phase onset insomnia. Thank you."
},
{
"from": "assistant",
"value": "Hi. Thanks for this query. Hope my answer helped you. Regards. For more information consult a psychiatrist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, For controlling my hypertension, I was prescribed Benicar 40/12.5 mg once in the morning, Amlodipine 5 mg twice a day and Clonidine once in the evening. These were prescribed after ECG and blood work. Even, after taking the medication, my BP is usually 160/85 mmHg. What to do further. Please advise."
},
{
"from": "assistant",
"value": "Hello. I want to highlight a few important points here: Amlodipine should be used once daily. Instead of taking 5 mg twice daily you should take 10 mg once daily, which is the maximum dose. Clonidine on the other side can actually cause rebound hypertension, which can explain your high blood pressure. It should be the last resort of the treatment of hypertension. It would be nice to know the dose that you are taking these days. I would like to know when did you take your blood pressure and if you follow a low salt diet. Benicar - Olmesartan is a good medication. Please consult your specialist doctor and discuss my opinion. I would like to know if you have any other medical conditions like diabetes, stroke, high cholesterol or a heart attack to determine your blood pressure goal according to the latest guidelines. Revert back with the answers to the above questions 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": "Hello doctor, My mom is a glaucoma patient for the last 10 years. She has been on medications like eye drops including Azopt, Ganfort, Alphagan, Vigamox, and prior to them Cosopt (which did not suit her). She has gone through retina eye laser and also has been injected in both her eyes almost 22 times for retinal leakage as well, has also gone through cataract eye surgery 16 years ago. At the moment her eye pressure remains between 21 to 24. The doctor says implants are necessary as she can see very less now. Given her eye condition is sensitive, a doctor has suggested that it is best to operate her with Ahmed valve implant, however, it has its own risks. I wanted to know if it is better to try the latest option, called MIGS (minimally invasive glaucoma surgery) like Xen Gel Stent and InnFocus Microshunt as it has near to no complications. I want to get an opinion about this before thinking about Ahmed valve."
},
{
"from": "assistant",
"value": "Hello. I am very sorry to hear about your mother's eyes. I suspect that she must have undergone the retina laser and the injections for a condition called as diabetic retinopathy. I feel that most likely it is a complication of diabetic retinopathy that might have caused a high pressure in her eyes. Xen gel stent is currently FDA approved for refractory glaucoma not caused by diabetic neovascularization and Inn focus micro shunt is currently being tested for long term side effects and usefulness in such situations. I must be clear in letting you know that neovascular glaucoma is a very adamant disease to treat and the treatment may not be straightforward and may require multiple procedures and reviews with the treating doctor, yet the most often agreed upon surgery, across most hospitals in the world is currently Ahmed glaucoma valve, along with of course the laser and injections. In case you need further clarification or if your mother is not a diabetic, please send a scanned copy of all her doctors records and prescriptions. I will do my best in helping you understand the situation."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My daughter is 4 months old. She is suffering from loose motion for the last two weeks. The doctor already prescribed antibiotic Cefixime, but the condition is not much improved. Now she is pooping six to seven times daily, which contains mucus and color is green. A stool test shows 25 to 30 pus cells. Please advise us what to do?"
},
{
"from": "assistant",
"value": "Hello. I advise you to continue breastfeeding and prevent dehydration. It is unusual to have bacterial diarrhea in a four-month baby. Are you giving any top feeding? I mean other milk apart from breastfeeding like bottle feed? If yes, then please stop and give exclusive breastfeeding till six months of age. Please repeat stool test for reducing substance if possible. Have you given the rotavirus vaccine? Follow-up with the report. If you feel that she is sick, irritable, not taking feeds or not passing urine or anything unusual, then please visit a pediatrician as soon as possible. Stool for reducing substance. Dysentery or rotavirus. Econorm sachets one (Saccharomyces boulardii) BD (twice daily) for three days, syrup Zinc 2.5 mg once a day for 14 days, and ORS (oral rehydration solution)."
}
] |
[
{
"from": "human",
"value": "Hello doctor, What to do now? I was in love with a girl for five years when I was doing my college and then I told my parents and they did not agree. She also loved me back. In her home also they will not accept. Now both of us are not talking for the past one and half years. I am working now and she is studying now. I used to meet and send her texts when I got leave and miss her. Now she does not want to talk to me. This time I asked her if she is free to meet me. She told she is busy. Now, is she really over me or just protecting me? What should I do to get over her? Sometimes, I feel like everything is over between me and her but then suddenly I miss her a lot. Is this how it is going to be always?"
},
{
"from": "assistant",
"value": "Hi. The best answer is to ask yourself whether you wish to and looking forward to marrying her or not? If not, you need to move on. A girl, unlike man, cannot call and text you just for the sake of pleasing you. Girls are always under the radar of their family and society. They need 110 percent assurance from you. They just cannot be your time pass. In your case, it is difficult for you to persuade your and her family but not impossible. If you really love each other you may have a fighting chance. During the last one and a half year of non-communication, she has probably decided to move on with her life as she got no real assurance from you. So call her, and try to meet her if you really are interested in marrying her. Or else, let her be a part of your good memories and move on."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have scars and spots on face, hair fall and dry hair. Please help."
},
{
"from": "assistant",
"value": "Hi. I request you to kindly upload a few images of the affected area on the face so that I can guide you better. You may use Radant lite cream for dark spots. However, for scars, I suggest either chemical peeling or laser resurfacing. Kindly let me know if you have dandruff? As dandruff is an important cause of hair fall. Get a few basic investigations like thyroid screen, serum ferritin levels, vitamin D3 levels, vitamin B12 levels as deficiency can cause increased hair shedding. You may in the mean time take an oral Biotin supplement like tablet Revilus once a day. Use Renocia hair solution on scalp skin every night. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I think I suffer from liver and a gastric problem for the past two years. Food is not digested properly. Lower abdomen left side some burning sensation, swelling, and pain were there. Sometimes, I feel the hardness in the lower left abdomen. Bilirubin total is high and bilirubin direct and indirect are also high."
},
{
"from": "assistant",
"value": "Hello. Your liver tests are normal. The small increase in indirect billirubin alone (as the one you have) most commonly corresponds to Gilbert syndrome, which is totally harmless. This syndrome is hereditary but has no serious consequences. Mild jaundice may appear under conditions of exertion, stress, fasting (as the one you need for the laboratory tests), and infections. About your gastric problem, what do you mean by food is not digested properly? Do you mean you have rests of food in your stool? Do you mean you have bloating, nausea, vomiting? Chronic pain in the left abdomen especially after eating and with changes in your stool may be colitis or irritable bowel syndrome. For this, you may take over-the-counter medicines that contain Pinaverium bromide or/and Cinitapride. This should be taken every 12 hours for two weeks. This medication is to cease the swelling and irritation in this problem. About your thyroid tests. You have subclinical hypothyroidism (which is you have increased thyroid stimulating hormone and normal thyroid hormones). If you have other symptoms like intolerance to cold weather, increase in weight without another reason, constipation, then you may need thyroid replacing hormones. If you do not have these symptoms you may repeat this laboratory test in 4 to 6 months."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 19 years old. I have pain in the corner of my left eye for the past one year. I went to the doctor, and he gave me Sterdex. I used it and felt better. My pain went away. After a few months, I started to have pain, but it was not so severe as the first time. I wear glasses and lenses, and I am treating my eye allergy with Chibro Cadron 5 ml, and for dry eyes, I use Fluidabak after taking the lens. Whenever I do my yearly eye checkup, my eyesight gets worse because of the pain in the corner, and I am scared about my sight. I do not know whether I use an appropriate medicine to my eye. Whenever I consult the doctor, he gives me the same medication. Please help me."
},
{
"from": "assistant",
"value": "Hi. Minimize the use of steroids as much as possible to avoid side effects such as an increase in eye pressure leading to glaucoma. Both Sterdex (Dexamethasone) and Chibro are steroids. They may relieve your symptoms in the short run but may harm your eyes if used for long term. Pain in the corner should not affect your eyesight. Just use appropriate glasses. For lubricant, you can start with Carboxymethylcellulose containing drops, and it can be changed later if more lubrication is needed. For allergies, Olopatadine containing drops can be used. Keep in touch with your doctor."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My mother is 56 years old. She has been a diabetic for the last 20 years. Her health has deteriorated completely in the last year. We found out through a biopsy that her kidney has been damaged. Her gallbladder was removed as it was infected and had a stone as big as a marble. The mouth and the upper layer of the pancreas had ulcer wounds for which she was treated with medication three months ago. She is having indigestion, acute stomach pain, swelling from feet to waist, frequent diarrhea and vomiting. She has been urinating only about 15 mL. Doctor has suggested starting dialysis as they are unable to bring her swollen feet under control. Her blood pressure is normal. I have uploaded her recent test results. She is currently taking 21 tablets a day. I basically need some suggestion."
},
{
"from": "assistant",
"value": "Hi. Type 2 diabetes mellitus with chronic renal failure. Serum potassium, serum creatinine regularly, TSH (thyroid stimulating hormone), lipid profile, ultrasound abdomen to see corticomedullary differentiation status of the kidneys. 1. Nephrotic syndrome. 2. Uremia. Type 2 diabetes mellitus with diabetic nephropathy or chronic kidney failure (CKD). My suggestion is to get the following treatment under doctor's supervision. 1. Albumin 20% 2. For hyperkalemia, diuretics, Insulin infusion, Calcium gluconate and potassium bind resin. If hyperkalemia does not improve, then go for dialysis immediately. 1. Salt intake should be less than 1 g per day. 2. Avoid foods rich in potassium. 3. Protein intake should be less than 0.6 g/kg body weight. Revert back with the reports to a nephrologist online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have severe acne mainly on my cheeks and forehead for a year, and now it continues to get worse, and there are no improvements. No matter how many times I go to the doctors. I am currently taking Lymecycline capsules for a month and the Differin gel at night. I have seen no improvements, inspite of eating healthy food, and drinking more water. I need help because it ruins my confidence and is a daily struggle."
},
{
"from": "assistant",
"value": "Hello. During teenage, it is very common to get acne, especially on cheeks and forehead due to several reasons (primarily because of hormonal changes in puberty). It is advisable to wash your face multiple times to avoid the accumulation of dirt, which can lead to blockage of pores, and that results in acne formation. Use of a mild medicated facewash suggested by your dermatologist might help you to get rid of the present symptoms. I hope this helps."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am suffering from IBS since the last year. I am getting diarrhea whenever I eat outside food. Recently, I have been detected with chronic ileitis with activity after colonoscopy. I am ready to send the reports for kind perusal of gastroenterologist. Is it curable? I am now on Mesacol 800 mg three tablets daily and Folvite 5 mg one tablet daily. I am also taking some supplements like Amway nutrilite multivitamin once daily and cod liver oil capsule two to three daily. I have already taken medication for last one month with restricted foods such as no tea, no dairy product, no fried food, spice, etc. I also take cabbage juice as I have found that it is good for the disease. There is some burning feeling in the upper abdomen when I take lemon and tea. I am worried about what would happen? Will it lead to cancer? I have attached the reports of my stool, blood, urine, colonoscopy and ultrasound. I am eagerly looking for your kind reply. Thank you."
},
{
"from": "assistant",
"value": "Hi. Yes, these ulcers can be healed. But, it will take some time. Colonoscopy shows multiple ulcers in terminal ileum. The cause of these ulcers could be Crohn's disease, tubercular ulcers or chronic non-specific ulcers which heal by their own. But, your report does not suggest Crohn's disease or tuberculosis (attachment removed to protect patient identity) as the cause. So, you just have to adhere to medication and diet modification to heal them. Your gallbladder shows adenomyomatosis which is benign enlargement of gallbladder. But, your direct bilirubin and liver enzymes are raised suggesting liver injury and adenomyomatosis could be the cause for it. Please do not fear of cancer as histopathology report has ruled out cancer. Medication with strict adherence to diet that you are following will show good results soon. Cod liver oil should not be taken more than once in a day. For further information consult an medical gastroenterologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am suffering from a hiatus hernia, GERD and irritable bowel syndrome for the past two years. I have started taking homeopathy treatment. I am consuming it for about three weeks now. But after taking it, I am having a painful swelling and enlargement of my breast. It causes an unnatural heaviness and discomfort. What could be the reason behind it? I am taking Carbo vegetabilis 200C, Cantharis 200, Berberis vulgaris, Calcarea fluorica 12X, and Magnesium phosphoricum 12X."
},
{
"from": "assistant",
"value": "Hi. The heaviness of breast can occur due to premenstrual symptoms. The heaviness of chest can occur because of bloating and acidity. To get rid of acidity, you can take one spoon of Gulkand before and after taking meals. It has a soothing effect on the gastric tract. If you want, you can try these medicines. You can take Mercurius corrosivus 30. Take five pills every morning, noon, evening and night. Take Nux vomica 1m five pills at bedtime daily. Take Asafoetida 3x three tablet at morning, noon and evening. You will surely feel better by taking these medicines. Have a change in your food habit and sleep. It can help to recover soon. Avoid taking fried, oily, fermented, spicy, and fatty foods. Take proper rest and sleep. If you have a habit of overthinking, then try to stop it because it can worsen your complaints. The mental status of a person also affects the irritable bowel syndrome. Follow me for at least once a week."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 7 weeks pregnant. During the 6th week of pregnancy an ultrasound was done and a fibroid in the right side of the uterus measuring 8.7 * 7.0 cm was detected. Right now I am suffering from severe pain intermittently on the right side of pelvic region and right thigh. I am attaching the test reports and prescription herewith. At present I am taking only folic acid tablets and I have not yet started other tablets in the prescription. Kindly advice."
},
{
"from": "assistant",
"value": "Hello. I have gone through the reports (attachment removed to protect patient identity) and there is definitely a large intramural fibroid in the uterus impinging into the uterine cavity. Ideally this should have been operated upon before your planned conception but nevertheless as you are 7 weeks pregnant, now with a viable fetus and fibroid was an accidental finding during ultrasound so the present management approach would have to be focused on sustaining and preserving the pregnancy further. For info,there are high chances of threatened abortion or placental separation in the early weeks of pregnancy due to such large fibroids, as the pregnancy grows due to inadequate room for growth and fibroid generally not allowing the uterine wall to stretch leading to hemorrhage. Also no operative removal can be attempted now as there can be torrential bleed and chances would be that you may loose your pregnancy.So surgery is out. The management has to be conservative hence with an aim to prevent abnormal uterine contractions with Duvadilan tablet (Isoxsuprine) and progesterone support with Susten SR 400mg daily to allow adequate placentation and trophoblastic growth so that chances of separation are minimized. Immediate aim would be 14 weeks till tablet Duvadilan and Susten would be continued and if the pregnancy grows naturally and crosses 14 weeks, it is a good sign. Also once pregnancy would grow, the fibroid which is estrogen dependent for growth, in the present high progestogenic environment it shall start thinning out by 30 to 40 percent accomodating pregnancy further. Once 14 weeks are crossed then next aim would be 34 weeks as there are high chances of preterm labour and premature rupture of membranes after 24 weeks and before 36 weeks. This is to be watched for and regular obstetric check up would hence be diligently required. So, as of now start tablet Duvadilan and Susten SR without delay and prefer bed rest so as to avoid any bleeding /threatened abortion. Pain is likely to be there .You may use tab Paracetamol only 500mg as and when required for pain relief but in a gap of 8 hours. This is safe in pregnancy . Also hot fomentation for 15 minutes each thrice a day can be helpful. Bed rest is important for the initial 14 weeks. This is a high risk pregnancy due to large fibroid and should be vigilantly dealt under gynaecologist supervision. Any bleeding vaginally should be followed within 6 hours with an ultrasound by your gynaecologist, so be alert on that part. Initial 14 weeks are crucial. Folic acid 5 mg daily, Duvadilan 10 mg thrice a day and tablet Susten SR 400 mg once at night, for 4 weeks. Bed rest ideally till 12 to 14 weeks. For further queries, consult an obstetrician and gynaecologist online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I took antibiotics about a month ago, and ever since the fourth day of antibiotic treatment, I have been suffering from diarrhea or loose stools. On the fourth day, I had bad cramps and loose stools that lasted from the fourth day to the seventh day. This then returned afterward with even worse pains, but this time, I had yellow stool followed by diarrhea. Ever since I have been having loose stools on and off that is foul smelling and mushy. Is this because of the antibiotics, or is it an infection?"
},
{
"from": "assistant",
"value": "Hello. Your diarrhea could be a direct side effect of the antibiotic, in which case, it should resolve after stopping the antibiotic. It could also be due to a condition called Clostridium difficile infection (C. diff for short). C. diff is a bacterium typically found in the intestines of most people. But under certain circumstances (frequent exposure to antibiotics), a couple of strains of this bacteria can multiply and produce toxins (called C diff toxin A and B). This can provide diarrhea-sometimes bloody, with crampy abdominal pain. I suggest getting tested for C diff. You need to submit a stool sample for C diff toxin. If it is positive, there are treatments for it includes oral Vancomycin, Fidaxomicin, or Metronidazole. I hope this helps."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 25 year old and a triathlete. 3 months ago, I suffered from knee pain. Doctor checked McMurray test, and Apley grind test result was negative. Only when I twist (rotate) my knee I hear some clicking or popping sound. I took MRI and the result was shown anterior torn of lateral meniscus. It is very small tear. But, my symptoms are matching with patellofemoral compression syndrome. I am really confused. I am having Glucosamine and fish oil at present. I have attached my MRI report for your reference. Now I am doing swimming and simple knee strengthening exercise. After 2 months rest, I feel free when running continuously. When I rotate my knee, I here click or popping sound and no pain. I ran for 10 days and feel pain at the top of the knee cap. Would you recommend surgery or it will cure naturally? And can I do cycling? Does cycling affect meniscus? Please suggest."
},
{
"from": "assistant",
"value": "Hi. Thank you for giving me an opportunity to assist you. It looks like you injured your knee three months ago during an athletic activity, and have been having some mechanical symptoms of clicking and popping since then. Since the knee pain has come down, it is likely that your body is trying to take care of the tear for you. While it is often difficult to know from just an MRI report (attachment removed to protect patient identity) as to where exactly the tear is (which zone, etc), it is advisable to consult an orthopedic sports medicine specialist to see if a diagnostic arthroscopy is right for you. This procedure being minimally invasive can allow you to get back to activity very early in the postoperative period. Also, any minor tears and cysts that are causing mechanical obstacle to the normal frictionless movement of your knee joint can be taken care of during the procedure. If the clicking does not bother you much and does not prevent you from athletic activity, I would recommend only strengthening exercise for now. The location that you point out maybe related to a different source of pain. Anterior knee pain is commonly seen in athletes like you with overuse of the patellofemoral joint. 1. Lateral meniscal tear. 2. cyst. 3. Patellofemoral pain syndrome (PFPS). 1. Diagnostic arthroscopy if affecting activity level 2. Physiotherapy supervised quad strengthening. For further information consult an orthopaedician and traumatologist online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am an 18-year-old female, no current medications, no known conditions, family history of many different heart problems on both maternal and paternal sides, seen by a cardiologist for bigeminy and irregular heartbeat over the summer, palpations still happen pretty often, chest and shoulder pain both on the left side still happening occasionally. Told by my cardiologist that I have nothing to worry about at all, have not talked to her since then. Yesterday, I got my paperwork and my test results from wearing the 24 hour Holter monitor and I am extremely worried."
},
{
"from": "assistant",
"value": "Hi. What you have is called premature ventricular contractions (AKA PVCs), which are extra beats coming from the bottom chamber of the heart and in some occasions they present in every other beat (what is called ventricular bigeminy) (attachment removed to protect patient identity). These beats can be tolerated as normal in many individuals, However, there are two things that are the most important factors to consider: 1. What is the burden (amount or percentage of PVCs in 24 hours in your heart? While some people say that up to 6 PVCs per hour is normal, the number that cardiologist gets worried is more than 10,000 or more than 20,000 in 24 hours. The main reason we get worried with this number is because this is the limit when PVCs can be associated with impairment of the squeezing function of the heart. 2. What is the heart function, in particular, what is the ejection fraction (squeezing function) which in other words is the ability to pump the blood? If the ejection fraction is low, we have to explore the amount of PVCs (particularly if more than 10,000 in 24 hours) as a potential cause of this low pumping function. This is something that can be done with an ultrasound of the heart. If we do see that the pumping function is low and there are more than 10000 PVCs in 24 hours, we need to consider treating this with medications, a catheter-based procedure or both. Finally, it is important to determine if you have a lot of symptoms, in particular, palpitations, dizziness, fainting or chest pain, in a regular basis and if these symptoms are interfering with your life. PVCs. Echocardiogram, treadmill stress test, to assess if the PVCs get suppressed or not during exercise. PACs with aberrancy. PVCs. Echocardiogram, treadmill stress test. Low dose beta blocker (Metoprolol or Propanolol) can be used once we have a confirmatory burden in the Holter. Please verify if the Holter report has a percentage of PVCs in 24 hours. I did not see it in the attached picture."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My body is getting severe itching after taking a bath or while sweating. Initially, it used to happen only in winter 4 to 5 years back and then gradually started in rainy days also. Now in summer also while sweating. It is so irritating like that I am going to be mad. I have stopped using soap and also took Clonafit 0.25 mg and Betonix- 10 prescribed by a dermatologist but there is no improvement. Please help me out of this."
},
{
"from": "assistant",
"value": "Hello. 1. It looks like you are suffering from aquagenic pruritus. 2. Take the tablet I am prescribing and show me again after 15 days. 3. Get the investigation mentioned below done. Aquagenic pruritus. CBC. Aquagenic pruritus. Aquagenic pruritus. 1. Tablet Teczine-M (Monteleukast and Levocetirizine) 10 mg bd for 15 days."
}
] |
[
{
"from": "human",
"value": "Hi doctor,I have a history of genital herpes, and the infected area is at the base of my penis where condoms do not cover. Should I worry about HIV if I use condoms regularly in the future? Or will I get HIV despite using condoms because of my herpes infection?"
},
{
"from": "assistant",
"value": "Hi. An open wound or raw area is a potential focus for acquiring viral infections like HIV when contacted with an infected partner. However, once the wound heals, the risk falls back to that of normal skin as elsewhere. The risk for HIV in your case would be high only if you participate in intercourse when your genital herpes has not yet healed completely. It is advisable to abstain from all sexual activities for up to two weeks after an episode of herpes so that the infection resolves completely. You could continue to participate in sexual activities as normal people after two weeks. With the use of a condom, after the healing of the wound, your risk would be the same as any other person. For further information consult a HIV AIDS specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My daughter is ten months old, and her weight is 6.7 kilograms. She has vomiting and loose motion from the morning. We are giving her ORS. What is the medicine given for vomiting and loose motion?"
},
{
"from": "assistant",
"value": "Hi. Giving ORS (oral rehydration solution) is good. It will treat dehydration and try to make them in the right concentration. Try to have one sachet in one-liter water. You can give her syrup Zincolife 5 ml (Elemental zinc) once a day for 14 days, and syrup Ondem 2.5 ml (Ondansetron) can be given for vomiting. But if there is persistent vomiting and if the child is dizzy, lethargic, with, decreased urination, then you can consult a pediatrician soon."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have very small red blisters on the glans and corona with lot of itching. For that I have used Acivir ointment. There is temporary relief but it reoccurs. Please help."
},
{
"from": "assistant",
"value": "Hi. Small red blisters on the genitalia usually occur in herpes virus infection. But they are associated with pain and burning. You are complaining of itching which is unlikely for herpes infection. I would recommend you to upload the photographs of the blisters, so that I can have a clear picture of the condition and can guide you accordingly. What is the duration of the blisters? Are you sexually active? If yes, any similar history in your sexual partner? Do you have diabetes or any other ailment? Are you taking any medicine for some other ailment?"
}
] |
[
{
"from": "human",
"value": "Hello, I'm looking and would like to discuss my treatment options for my conditions. I've bipolar disorder II, social and generalised anxiety disorders, panic attacks and agoraphobia due to it. In past, I used escitalopram, venlafaxine, fluoxetine, sertraline, lithium, depakote, quetiapine, risperidone, anxiolytics. Venlafaxine was effective but had to discontinue it due to high blood pressure it caused. Other treatments mentioned didn't work for me. Anxiolytics worked, but now i don't have such options to continue this treatment because I'm getting used to Tranxene. Currently I'm taking Lamictal 200 mg and 10 mg olanzapine. I am afraid to go out from my flat, I am constantly alarmed, nervous, anxious, can't eat because of constant lump in my throat. Anxiety is debilitating, I can't work outside my home. At work I get so anxious that I have to take some free days from work, if I don't do that, I vomit from this anxiety. 1) Can duloxetine be effective? Is it common that it can increase pulse and blood pressure as Venlafaxine did? 2) How long does it take for escitalopram to take effect? 3) Can prozac decrease anxiety? 4) Is paroxetine an good option for me?"
},
{
"from": "assistant",
"value": "thank you for taking help from psychiatrist. you should continue medications on which you are stable at present. 1)duloxetine may be good option for you. it does not increases blood pressure. 2)tablet escitalopram takes around 4 weeks for full effect after starting medications. 3) yup,prozac can decrease anxiety but it belongs to same group as tablet escitalopram. 4) yup,paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine. you should follow below advice which can help your anxiety. hope you get your answer. thank you"
}
] |
[
{
"from": "human",
"value": "Hello,I am 28 years old and 18 weeks pregnant. Recently I have done Gravid Uterus - Obstetric Sonography and found the below result. Placenta is posterior, grade I, low lying - lower end is about 25 to 35 mm from internal OS. Left uterine artery shows high resistance flow. So, I wanted to know if there is any issue. What precautions should I take as I am doing routine work as housewife. I have also attached my sonography report. Please have a look and let me know what need to be done and what should be taken care of, as I am tensed."
},
{
"from": "assistant",
"value": "Hello. I have gone through your reports (attachment removed to protect patient identity). This level 2 anomaly scan is absolutely normal for the foetus pertaining to its growth and absence of any congenital anomalies. The concern regarding the low lying placenta at 18-19 weeks of gestation is not alarming as by 32 -36 weeks the placenta tends to go up once the lower segment formation takes place over uterus. Low lying or placenta previa shall be considered then at 32-36 weeks if the distance is less than 25 mm from internal os. High resistance flow in left uterine artery alone indicates a possible compression or hindrance in blood supply. There may be a subserosal fibroid or enlarged ovary probably which can cause external compression , but it is unlikely to affect the baby's growth as the other arterial flow is normal. At present this just needs to be followed up by a repeat uterine artery doppler after a month to check the same or increase in resistance flow. Revert back to an obstetrician and gynaecologist online after a month -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, Over the last few days, I have a problem with standing without feeling dizzy. I feel that while I am standing or sitting on a hard surface, that I am in an elevator or a boat. Sometimes it happens when I lay down too. I also feel that there is like a pressure or a wave inside my body that directs the way I feel dizzy. Sometimes I feel it in my legs and sometimes I feel it goes up to my head. I can literally feel it and feel how it is dropping from my head to the body. Every time I feel I will faint, however that has not happened yet, probably because I lay down straight away as soon as it happens. I have panic disorder and sometimes when I feel this I get anxious as I am scared that it may be something serious. Occasionally, I have a slight headache but is not severe at all. A few days ago, I tried smelling lavender and chamomile oil, which is something new to me and I do not know if it has anything to do with this dizziness. I also have dry mouth most days recently too. It has started controlling me as I always need to hold the door or the wall in order not to fall down. I saw my GP. He asked me to close my eyes tight. I was going to fall down if he did not hold me while I was standing. Please note that I used to feel like the floor is moving up and down at night before I sleep. However, now it has increased to the stage where I feel it since I wake up till the moment I sleep even if I am lying down sometimes. The more I am awake, the more I feel it. Finally, when I come to sleep. As soon as I close my eyes, I imagine spinning even though I know the room is not moving as well as sometimes pain is in one side of the head. Your advice would be appreciated."
},
{
"from": "assistant",
"value": "Hello. I passed carefully through your question and would explain that your symptoms could be related to orthostatic hypotension or thyroid gland dysfunction. Anxiety can mimic this clinical situation too. Coming to this point, I would recommend performing some tests: 1. Complete blood count for anemia. 2. Thyroid hormone levels for possible thyroid gland dysfunction. 3. Blood electrolytes for possible imbalances. 4. Vitamin B12 and vitamin D plasma levels for a possible deficiency. A head-up tilt test would help investigate for possible orthostatic hypotension. You should discuss with your doctor on the above tests. If all the above tests result normal you should consider anxiety as the main cause underlying your complaints."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 50-year-old male. I had genital warts five years ago, had them removed via cauterization and received three injections of HPV vaccine Gardasil. The doctor said the vaccine would cure the virus, but after a year, warts reappeared and until now they are still in my scrotum, and they are itchy but not painful. My question is that can I have sex with my partner given my current condition? Have I got cured by HPV vaccine?"
},
{
"from": "assistant",
"value": "Hello. HPV vaccine is not a cure. It is for the prevention of HPV. It prevents the virus from entering in your body. But, it cannot act on cells which are already infected with the virus. About sex, there is a chance that with contact, virus can spread to your partner if not already infected. And being on scrotum, the methods like condom will not help. You would need to get treatment first for warts. For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a male, and I am suffering from low libido and erection problem. I am attaching my reports of free testosterone and estradiol for your advice. Kindly guide and advise. Thanks."
},
{
"from": "assistant",
"value": "Hello. Your test reports (attachment removed to protect patient identity) appear absolutely normal. Hope you find my advice of some benefit. Good luck. For more information consult an endocrinologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I was eating a hot curry last week when the top of my mouth blistered over as if I had burnt the hard palate, which I thought was unusual as I felt the heat on my tongue first but did not. The blister has gone but left a small dent in my hard palate which I am concerned about as it is leaving a bad taste in my mouth. Is this common?"
},
{
"from": "assistant",
"value": "Hi. Yes, this is common. You do not need to worry. The mucosa of palate is very sensitive as compared to the tongue. So it gets affected easily. You just put an Oral gel Clinica (Chlorhexidine with Metronidazole) gel on the spot for three days and three times a day. Then give me a followup after five days. Hopefully, everything will be fine. New mucosa on palate grows after almost 10 days."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am currently on 90 mg of Nardil (Phenelzine), which has proven to be a miracle drug for me. I have found over the years that many drugs you are supposed to avoid while on MAOIs are really acceptable. For instance, in order to counteract the daytime sleepiness side effect, I am actually on a small dose of Wellbutrin (Bupropion), which is supposedly contraindicated with Nardil. But, I take it just fine with no impact on blood pressure. In fact, I have never had a hypertensive response. Over the years, my weight has increased due to the Nardil and I am looking to do something drastic about this and very soon. Specifically, I want to do a short run cycle of Cardarine (GW501516) in order to lose weight, while preserving muscle. Would it be dangerous to take this while on Nardil? By all accounts my levels of MAOI are pretty low."
},
{
"from": "assistant",
"value": "Hello. I understand your concern. For further information consult a pharmacologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, What complications could arise from breast cancer treatment (surgery, chemo, radiation, hormone therapy) if the patient is secretly using Methamphetamine? Can and should a DR refuse treatment if they know of a patient’s Meth use?"
},
{
"from": "assistant",
"value": "Hello. Methamphetamine is CNS stimulant, it can have a lot of own side effects, if the doctor is not aware of drug use, many of the side effects of drugs will be difficult to interpret for doctor, drug use can have interaction with chemo drugs and can increase toxicity of drug or under the effect of drug. It is a personal choice of doctor, he should refuse treatment or not."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My husband and I are currently trying to conceive, and hope to be pregnant in the next few months. My in-laws are planning a trip after three months, and I am trying to verify if there is still a risk for pregnant women in regards to the Zika virus. The CDC states to consult with our physician, which I, unfortunately, do not have one currently, especially a gynecologist. I am hoping to get even just pointed in the right direction if it is safe for a newly pregnant woman to travel for a week as I have read that pregnant women are at the highest risk during the first trimester. Kindly advice."
},
{
"from": "assistant",
"value": "Hello. Yes, Zika virus is affecting pregnancies and does have adverse effects on your baby if the mother gets exposed to it in her first trimester or either later in pregnancy. Unfortunately, no precautionary measures are available other than avoiding the exposure to it. I would suggest you to better avoid it in the first place rather than having remorse afterward. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am an 18-year-old, and I have experienced forgetfulness ever since I was in elementary. I usually ace my tests because I have a very short term memory, so cramming often makes do. But, I often tend to forget things when my body takes the so-called auto-pilot mode. During these times, I tend to do things with me, not really focusing on doing it because I was thinking of something else. I cannot really recall what exactly happened in a day when nothing special has occurred. I often forget where I put things, even when they are already in front of me, or in my hand. I seem to misplace habitually and it has pertrubed my parents. Now I am wandering if these are early symptoms of Alzheimer's. Please reply, and if you want to ask questions about me,feel free."
},
{
"from": "assistant",
"value": "Hello. I understand your concern and would explain that your symptoms are not related to dementia or Alzheimer. At your age, considering the description of your complaints, I would think about a concentration disorder (attention disorder). This could be related to ADHD or anxiety. For this reason, I would recommend consulting with a psychiatrist or psychologist to help determine the right cause. It is also important checking complete blood count for anemia and thyroid hormone levels for thyroid gland dysfunction."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect."
},
{
"from": "assistant",
"value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had a biochemical pregnancy before two months. Initially, my hCG test showed 11 and after a couple of days it was 9. Then, I had an endometrial lining scan and it showed a simple right ovarian cyst measuring 33 x 27 mm. So, doctor prescribed Meprate and I got my periods on the 27th of last month. When can I expect my periods of this month? Do I need to get any other scan? Please explain."
},
{
"from": "assistant",
"value": "Hello. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I have a squint in my right eye and it has moved outwards. I do not have a proper vision in my right. I cannot see clearly through my right eye; even I recognize thing pretty hard. I want to know whether it can be corrected, so that both my eyes work together. I am confused as I am now 26 years old. Is the correction going to be difficult at this age? I am looking up for a second opinion from you. Thank you."
},
{
"from": "assistant",
"value": "Hi. I have gone through the pictures of your eyes (attachment removed to protect patient identity). Revert with reports to an eye care ophthalmologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 33 year old female. I am married. I have two sons. I was diagnosed with hypothyroidism over ten years ago and I am on medication. I am having a horrible time with pms over last few months. I used to have terrible headaches and irritability before few days of my periods. Now it has been two weeks as my period is ten days late. I am having the worst time in my life right now. My headache and the pressure drive me crazy. I am having hard time. I am getting into deep depression. I do not know how to get through this. I cannot stop crying. I have an appointment finally with an endocrinologist in two weeks. Whenever the thing gets worse my gp will increase the dosage of my medicine. My hair is falling out. I am not the same person at all anymore. I feel like this is killing me. Need some help."
},
{
"from": "assistant",
"value": "Hi. I went through your query and I can understand your condition. First of all, I need to know whether your hypothyroidism is under control or not. Kindly upload your recent TSH (thyroid stimulating hormone) report. Now we need to see whether your headache and irritability is due to your PMS (premenstrual syndrome) or if there are some other reasons. Your endocrinologist will evaluate for that. But a simple way to know is to halt your periods for two months and observe what happens. Ask your general practitioner to prescribe you certain oral contraceptive pills. This shall halt your periods for a month or two and if you feel better then it is due to PMS. But if there is no improvement then other evaluations have to be done including your blood pressure testing, eye check up and if necessary brain scan. If there is an improvement then you can take the contraceptive pills for three to four months and then stop and observe."
}
] |
[
{
"from": "human",
"value": "Hello doctor, There is irregular bleeding from the vagina in varying amount. Before that, there were no periods for six months. Kindly help."
},
{
"from": "assistant",
"value": "Hello. You have to go for an ultrasound and some blood test in two to three days. If you are sexually active then vaginal examination must also be done."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I was born with two different color eyelashes. On my left eye is black and on my right eye is blonde. Also, I have blonde hair streaks on my right side and half of my eyebrow is blonde. What could be causing that?"
},
{
"from": "assistant",
"value": "Hello. This condition is called poliosis. This may be due to: 1. Wardenburg syndrome. 2. Tuberculosis. 3. Piebaldism, etc. 4. Thyroid problems. 5. Vogt-Koyanagi-Harada disease. Until examination and investigation are done, it is difficult to treat what is the cause. Usually treated with medical or laser therapy or hair transplantation. Take care."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have undergone penis augmentation using a cross-linked dextran gel injection. While doing sex, I got a cut in my penis, and it bled a little. While doing sex, I feel some pain at the contact point of the penis skin, and it is red. Please suggest medicine for this problem."
},
{
"from": "assistant",
"value": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Apply Bacitracin or Framycetin cream twice daily over the area. Before each application wash off the previous application with lukewarm water. Do not wear tight innerwear and prevent extreme sweating. Take care of the pubic area. It will get healed soon after two days. Try to restrain from sex or masturbation for a couple of days. Try to rule out condom allergy. If there is no wound healing or if there is any pus discharge or if you have a fever, then you can take antibiotics. Then revert to me with a fresh picture. Please mention about your age, habits, diabetic status, and drug history."
}
] |