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[
{
"from": "human",
"value": "Dear doctor, I had a small stiff boil in the middle of my eyelid for months. Then it disappeared and another one appeared in the outer corner of the same eye (right eye) and kept getting bigger and smaller and still has not disappeared. Then, about six months later, when I blinked it hurt, and I felt another boil under my eyelid and when I looked it was full of pus and I did not disturb it. The next day when I woke up, my whole eyelid was swollen and hurt really bad. But the pain went down in three hours or so. I then realized that another boil was inside my eyelid. The boil burst by itself though and now I have three boils in my eyelid and the third one is in the inner corner of my eye. Is this serious?"
},
{
"from": "assistant",
"value": "Hi. Your history indicates recurrent inflammatory swellings of the glands of the eyelids in the form of hordeolum/stye (focal infection of the glands of the eyelid). Since these swellings are recurrent and multiple, you require evaluation to treat the underlying predisposing factors. However, no need to worry as this is not a serious condition. The treatment for hordeolum is the use of antibiotic eye drops or eye ointments and anti-inflammatory drugs. Applying hot compression provides symptomatic relief. The common problems that need to be ruled out are refractive errors, blepharitis (chronic inflammation of the eyelid) and systemic conditions like diabetes. Consult an eye care ophthalmologist online regarding further investigations -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My mother aged 80 years is suffering from acute leg pain. She is a patient of filariasis in right leg and also femur fracture in the same leg. Reports of all recently done tests are normal. Please advice."
},
{
"from": "assistant",
"value": "Hi. What the patient needs to do is: Keep the affected leg elevated over two pillows. Take tablet Orthal forte thrice a day for three days. Take tablet Carnitor 500 mg twice a day for three days. Revert back with the x-rays and reports to an orthopaedician and traumatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Just had a baby three weeks ago. Three days ago it started to pain under left breast then under left armpit. The pain continued in a part of my arm, then a spot on my neck and then a spot on my shoulder. And I read about heart attack. And I have been under a lot of stress recently. Kindly advice."
},
{
"from": "assistant",
"value": "Hello. Unlikely to be a heart attack. This is atypical chest pain. I guess you do not have any shortness of breath. Considering your age group the possibility of heart attack is extremely low. Next, the pattern of pain is not consistent with the heart attack. Heart attack pain is sudden onset, retrosternal or left-sided rather than just below the breast, going to left arm associated with uneasiness sweating, etc. It usually does not persist for three days even without treatment. The possibilities in you are musculoskeletal pain, cervical causes, pain from breast itself due to hormonal changes and stretching of tissues due to breast enlargement, etc. Try to press over the site and see if pain reappears, if yes then it suggests that it is a local pain rather than due to the heart attack. So, unlikely to be related to heart attack, but should get examined by a local doctor and ECG done if necessary after examination. Examination of doctor will also help to assess the possibility of peripartum cardiomyopathy, which usually presents with shortness of breath rather than chest pain. Hope this helps you and get back if you have any doubts."
}
] |
[
{
"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 35 years old. My period was a month back. It sustained for four days. I generally use 3 to 4 pads in my periods. I had sex 10 days later. On the very next day, I had two Ovral G at around 9 AM and there after 12 hours again two Ovral G tablets. I noticed my period 12 days later, though it lasted for four days, the period was less and usually, my period happens four days earlier. In this month, it was six days earlier. I did hCG beta blood test. I am sending you the report. Can I be pregnant or conceive? Please advise because I want to abort. I am an unmarried woman. Can the blood test be wrong? What laboratory test I should do to get to know whether the fetus is there beyond uterus (ectopic pregnancy) as I m 35+. When should I go for ultrasound vagina testing to get the true picture? After that I did not have any sex, so then again can I be pregnant and that could not be detected now and can be detected on later?"
},
{
"from": "assistant",
"value": "Hi. The test result is <0.10 (attachment removed to protect patient identity) which means it is negative and you are not pregnant and your period was six days early this time. nothing else. Do not worry much. And if you still have doubt then do urine pregnancy test weekly for two weeks and if negative then there is no chance of pregnancy. Negative means a single line and positive means double line. You have to see the result within five minutes. No need to go for an ultrasound now. Do drink more water and be happy. There is no pregnancy as Ovral G (Norgestrel and Ethinylestradiol) has worked this time."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My semen test came back. The total sperm count is 54 m with motility of 5.5 % and progression of poor. What are my chances on IUI success? Post wash, the total sperm count was 12 m with a motility of 25 % and still poor progression. What does poor progression mean?"
},
{
"from": "assistant",
"value": "Hello. For more information consult an infertility specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 31 year old male. Recently, I have gone for an annual health checkup. Following are the areas which are highlighted as abnormal for which I seek consultation in evaluating it better. I would like to find the root cause for the same along with medication or lifestyle changes, if any, required in my case. I am attaching herewith all the report and highlighting the areas which are mentioned as abnormal in these reports. I request you to please go through all the reports in details and advice. The reports are CBC - RBC 5.59, PVC 50.1, absolute eosinophils 858.6 and overall comment on CBC is eosinophilia. Vitamin D total (25-OH) 15.6. Chemical examination of feces reaction (pH) – acidic (6.0). On microscopic examination, undigested particles present and concentration method for ova - no ova detected. Urine examination - blood and proteins traced in chemical examination and on microscopic examination leukocytes (pus cells) or hpf 2-3, red blood cells or hpf - occasional and epithelial cells or hpf 0-1. Lipid profile - total cholesterol serum 252.1, serum triglycerides 171.2, HDL cholesterol direct 50.2, non-HDL cholesterol 201.9, LDL cholesterol 181.8, total cholesterol and HDL cholesterol ratio 5, LDL and HDL ratio 3.6 and VLDL cholesterol 20.1. In USG liver, bright parenchymal echo pattern. In USG spleen, mildly enlarged in size 12.1 cm. In USG abdomen, there is evidence of a small umbilical hernia with omental herniation through an abdominal wall defect measuring 10.8mm. Overall impression Grade I fatty infiltration of liver, mild splenomegaly and small umbilical hernia. My BMI is 31.8 (self-calculated based on height and weight). Please evaluate and give detailed guidance."
},
{
"from": "assistant",
"value": "Hello. Revert back with the answers to the above questions to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "hi. I am a male aged 52yrs weight 80kg diabitic my doctor has recently advised me gabapentin nt 400 for neuropathy earlier i was on pregab150 so while checking about the reviews from the patients on net i found that 99% were against gabapentin which confused me and thought to have a 2nd opinion kindly advise"
},
{
"from": "assistant",
"value": "Hi. Welcome to icliniq. I am Dr Anshul Varshney for your help. It's an excellent drug. Infact it's an elder sister of Pregabalin only. Gabapentin is little more potent then Pregabalin. Only possible side effect of that drug is dizziness but since your mother has been on Pregabalin 150 mg then Gabapentin should suit her. Gabapin NT also contains Nortryptilline, which helps further in neuropathic pain. Dear, if you will check side effects / reviews of any drugs you would get for all. If in doubt, discuss with your doctor once again being empathetic. I use this drug very often and most of the Diabetologists use it. So, I would suggest you to start it and see if she gets any adverse effects, we can go for other options. Though to be very honest we don't have much options other then Pregabalin or Gabapentin in Diabetic Neuropathy. I hope it helps you. If you have any further questions please ask me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My family doctor referred me to an ENT to investigate a persistent sinus discharge problem that seemed to be causing voice hoarseness, likely from mucus building up in my throat. I thought the hoarseness might be a side effect of the Tamsulosin I take each day for BPH, but he did not think so. During the exam by the ENT, he found that my nostrils were almost completely blocked. Although I had not complained of problems breathing through my nose, so air could get through, his scope with the light and camera on the end could only be inserted part way through either nostril. As a result, I am being scheduled for (endoscopic?) surgery to reconstruct the separation between my nostrils and clear the airways through my nose. Apparently, it will take about 30 minutes and will not leave scars or require any packing or lengthy recovery time (just a few days). The ENT thinks that will clear up the nasal discharge and ultimately solve the hoarseness. Does this sound reasonable?"
},
{
"from": "assistant",
"value": "Hi. Have you had any complaints with nose before? Has a CT scan been done to check for sinus inflammation or pathology? How much is the nasal airway compromise? Has he given you any sprays? Has he ruled out allergy?"
}
] |
[
{
"from": "human",
"value": "Hello doctor,My amazing 67-year-old dad who runs 10 miles a day just had his first TIA. The hospital did an array of tests and did not see any sign of it afterward but they are sure that is what it was. He and my mom are changing their diet and I am researching supplements. They are changing his blood thinning medication so I am not exactly sure what he will be on. But I read that one should be careful in taking turmeric and blood thinning medications.However, it would be great for him to be on turmeric because of the other benefits. What precautions would you recommend when it comes to this supplement and preventing a stroke? Any other supplements he should get on right away or talk to his doctor about?"
},
{
"from": "assistant",
"value": "Hi. I would like to bring into your notice that he should avoid turmeric as well as Fenugreek seeds in diet, as they have blood thinning potential. However, the potential is low, but can get aggravated by blood thinner medicines. As far as diet is concerned, he should completely avoid fast food, oil, alcohol, and smoking. A regular walk should be done, but make sure it is not done during cold seasons. I do not recommend any supplements. You may ask your doctor to add Vitamin B12 and Vitamin D to his prescription. Make sure he takes his medications regularly and get his check-ups done regularly."
}
] |
[
{
"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, Around a month ago, I had a dental trauma on my lower three incisors. The teeth have moved slightly from their original position. My dentist has advised me for a root canal for all the three teeth. Now before two days, he started the process, and one of my teeth has turned black. What can I do now?"
},
{
"from": "assistant",
"value": "Hi. I can understand your concern. I feel that the dentist has to stabilize your teeth first if they are mobile. It can be done by splinting. RCT (root canal treatment) is usually done to the teeth if the trauma has involved the pulp. Discoloration or pink teeth usually occurs in injury. If the RCT is done, place a crown over the treated tooth, and the discoloration will go off definitely. I can guide you better if you send the photograph of the teeth with an X-ray."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I believe I have some form of social disorder. I do not have feelings like others. I do not feel empathy but can be empathetic on cue as I know the social cues. And I prefer to keep to myself. Can you please advise where I can be diagnosed? I have always thought it was anxiety as this has been a problem in the past. I realize I have never been in love and probably do not know what it really is. I have five kids and saw them all taking birth but I never felt joy or real happiness when they were born even though I knew I should be happy. I am taking Lexam 20 for anxiety."
},
{
"from": "assistant",
"value": "Hi. With the limited information you have provided, it is difficult to give an accurate opinion. It is possible you are describing some features of autism spectrum traits or Asperger syndrome which can manifest as social communication difficulties and anxiety. It is not uncommon and the majority do not even know they have autism spectrum traits. But whether you actually have enough features to reach the diagnostic threshold can only be confirmed after a detailed assessment. Usually, people with autism spectrum traits would have displayed symptoms from their childhood and would have faced peer relationship difficulties at school. Check with your parents and siblings. Also, these traits can run in families. If your social difficulties and anxiety developed later on in life, it is unlikely to be due to an underlying neuro-developmental condition like autism spectrum condition. If you actually want to know whether you have the condition, speak to your local GP or family doctor about a referral to appropriate local specialist services."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My baby boy is 8 months old and has trouble in passing stools. With Laxatives, doctor prescribed he is passing hard stools once in four to five days, and he is crying while passing stools. What can I do to improve his constipation? And what diet changes do I need to make? Currently, I am giving him oatmeal pear puree, pear puree, apple puree, and chikoo puree."
},
{
"from": "assistant",
"value": "Hello. Your kid is suffering from an anal fissure that is a cut at anal mucosa. Give syrup Duphalac (Lactulose) one teaspoon full once a day at night time after meals. Apply several ano ointments (Lidocaine, Metronidazole, Sucralfate) locally three times a day for 15 days with the applicator. According to me stop milk from 8 am to 8 pm and give semisolid diet like dal, dalia, khichdi alu kela rice, apple, upama, halwa, rab kadi idle poha satu custard, etc and from 8 pm to 8 am give mother milk is preferable if not give top milk without water and add sugar as per your taste . To start with stop milk for four hours for 15 days and give semisolid diet, next stop milk for eight hours and give semisolid food, lastly, stop milk from 8 am to 8 pm and provide semisolid diet. As 100 ml milk gives 70 calories of energy, 100 ml juices give 55 calories of energy, and 100 gm of semisolid food gives 350 calories of energy. When giving a semisolid diet, provide water as the baby requires. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Continue all the above for at least 2 years of age."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My mother was diagnosed to have herpes zoster. Also, her doctor says that the herpes has caused ulcers. I would like to know in how much time it will heal? Is herpes zoster a dangerous one?"
},
{
"from": "assistant",
"value": "Hi. As you know, Herpes zoster is a viral infection. It takes 7 to 10 days for the lesions to heal. But, in patients who are diabetic, old age, secondarily infected and with an incomplete antiviral dose or seropositive it can take up to 15 days to get cured. In elderly age group even after the skin lesions heal the patient might experience intense pain in that particular area. It is called as postherpetic neuralgia. Kapsi gel can be applied (Capsaicin) once the skin is completely healed to relieve pain. Consult your specialist doctor, discuss with him or her and take the medicine with consent. How many days before she was diagnosed? What is her age? Please send images of the area. Revert back with the answers to the above questions to a dermatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am having chest pain or esophagus pain while having food for the last two days. The pain is repeated for every 5 to 10 minutes. Please help."
},
{
"from": "assistant",
"value": "Hi. There are many causes of chest pain. Pain while eating food is related to esophageal disorders like esophagitis, esophageal erosions, gastroesophageal reflux disease, esophageal spasm or peptic ulcer disease. The serious causes of chest pain like heart related problems and myocardial infarction needs to be ruled out. So, I suggest you to get an ECG done (electrocardiogram) and consult a physician as soon as possible to make sure there is no heart problem. You can take some antacid syrup 10 mL thrice daily for five days. You can also take some antacid drug twice daily on an empty stomach for five days. Consult a gastroenterologist in person for a physical evaluation. Avoid tea, coffee, oily and spicy food. 1. Esophagitis. 2. Peptic ulcer disease. 3. Esophageal spasm. 4. Heart related problems. For further information consult an internal medicine physician online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,My site vision is -4. I have been using contacts for the last six years. This time, I tried the Toric lens. After using them for a week, I noticed the light used to spread out when I see the bulb. Now today my one eyeball color is a bit faded from the top. Also, I have a migraine."
},
{
"from": "assistant",
"value": "Hi. From the information you have given, your vision prescription is -4. You have not specified whether it is a spherical, cylindrical, or a compound power. You are also using a Toric contact lens, for the first time. The reason for seeing light spreading can be due to a faulty fitting contact lens, because, the Toric lens has to be perfectly fitting, since they carry an axis power. The other reason could due to corneal edema, again due to a faulty fitting contact lens. Take care."
}
] |
[
{
"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,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 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 a 14 year old female. My height is 5'5\", and I weigh about 140 pounds. I experience extreme pain in my hip. It is difficult for me to walk or climb stairs. Also, it keeps me awake at night. Please help."
},
{
"from": "assistant",
"value": "Hi. My worry here is that you may have a Slipped Capital Femoral Epiphysis (SCFE) and you need an urgent orthopedic opinion to help rule this out. The reason I say so is that the pain and limp from the hip in an adolescent has only a few causes one of which is SCFE. The other cause is an infection and it is equally important. I hope you ask your parents to arrange a visit to an orthopaedician for physical examination at the earliest. This will certainly help, as a full examination of the hip and x-rays and blood reports will help clear any doubts."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had intermittent twitching all over my body for the last two months. I finally went to see my GP and he ran a plethora of blood tests and said that my vitamin B12, iron, and vitamin D were all really low. Since starting my vitamin supplements two days ago, the twitching has subsided significantly. For the last two days or so, I have just been noticing minor twitching in my left hand that will happen three to four times a day for around 10 seconds. But, there is no weakness. I have been paranoid and freaking out for the past two months over life threatening neurological diseases like ALS. I also had a creatine kinase done and my levels were well within normal range. I am just wondering if this twitching continues, then is it something to be alarmed?"
},
{
"from": "assistant",
"value": "Hi. I have gone through the provided details and understand your concerns. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I was diagnosed with bipolar 2 and panic disorder. I currently take Zoloft and Klonopin. My psychologist believes I am functioning normally, but sometimes I worry that I may be in psychosis, or displaying symptoms. My only concern is that recently, I have been having paranoid thoughts. Nothing extremely delusional, but sometimes I feel like my parents think I am crazy or that they are lying to me. I also had a paranoid thought that my boyfriend was lying to me. The thoughts do not happen very often, but is this normal for bipolar type 2?"
},
{
"from": "assistant",
"value": "Hello. It is common to have some paranoid thoughts, especially when you are feeling stressed, anxious, and feeling low in confidence. From the way you have described your symptoms, psychosis appears very unlikely. You can recognize the paranoid nature of your thinking, and your thoughts do not seem to have delusional thinking. Your report says that you are functioning normally and so I think your psychologist is right. Continue with your psychological therapy to manage your mood and anxiety symptoms and challenge your distorted thinking pattern. I will recommend having regular follow-up with your prescribing doctor to monitor your mental state and seek review if you experience any new symptoms."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 23 years old. I have a baby tooth. My mother also had a baby tooth when she was 19 years old. My doctor advises me to remove the baby tooth. I am not willing to have braces. Is there any option for me to have Invisalign or braces that cannot be seen or do I need to use regular braces?"
},
{
"from": "assistant",
"value": "Hi. Dentistry has a lot of development over these years, and there are a lot of options available. First of all, to get your braces, you need to extract your baby tooth. Apart from metallic braces, there are other types of braces also. For example, ceramic braces, it is a tooth-colored material. There are lingual braces too. It is placed on the inner surface of the tooth, and it is not visible from outside."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I recently had a hearing test which indicated mild hearing loss at the 4k Hz level. The audiologist said not to worry about it at all, protect my ears and it will very unlikely worsen. He even mentioned that it may reverse itself. I am only 32 years old, so I understand any recording above the 20DB mark is not ideal. The values are for 250, 500, 1k, 2k, 4k and 8k Hz levels. Left is 10, 5, 15, 20, 25, 20 (air conduction), left is n/a, 10, 10, 20, 25, n/a (bone conduction). Right is 15, 10, 15, 15, 30, 15 (air conduction). So my direct questions are would you agree that this is a mild case of hearing loss and there should not be anything to worry about at this stage provided I look after my hearing and ensure I am not exposed to loud sounds too often? Is it likely that this will not worsen (excluding any age-related hearing loss as I get older)? Are my audiologist's comments that it may even reverse itself accurate? How severe is this level of hearing loss and what implications will it mean?"
},
{
"from": "assistant",
"value": "Hello. According to the reports indicated (attachment removed to protect patient identity), there is a dip at 4k which indicated a noise-induced hearing loss. Many people suggest that it is not a thing to be worried about, however, we cannot neglect it completely. There are various kinds of hearing loss having various reasons. In this kind of audiogram, it is clear that you have exposed yourself to loud sounds. Now as you have clarified you use headphones for 1 or 2 hours. Let me inform a headphone noise can have a different effect on different people. Some people are more susceptible to hearing loss. Check your work environment if it is noisy you may suffer from hearing loss too. It is not much likely to increase if you are careful. Your audiologist comments are not entirely accurate. The 4k dip is likely to reverse when the 4k area in the organ of corti get enough of blood supply to reverse the damage. The loss is not that severe which will affect your quality of life. But we need to be careful."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had D and C before a month and I bled for five to six days after that. I was given Xamic for three days and Primolut N for 21 days. I had brownish discharge 18 days after my D and C and then had bleeding for seven days. I am still spotting. My hCG three days prior to periods came 21 and my ultrasound while in periods came normal. The reason of my D and C was hydropic villi in placental tissue. Should I continue the tablet?"
},
{
"from": "assistant",
"value": "Hi. I understand your concern. 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 my fiance a month ago, and I did not use the condom. After 15 days the testicle pain started with abdominal pain, and then the small bubbles at penis glands. Now with the tiredness of the head, the headache is accompanied, and the sweat is high. I used to get testicle pain in only summer, three or four times per three months. The urine albumin present 1+ in the urine test, the urine epithelial cells 15 to 18 and the urine RBCs 10 to 12. What it could be?"
},
{
"from": "assistant",
"value": "Hello. I have gone through your query. I would like to know a few more details to answer your question better. Have you have had any fever, rashes or joint pains in the last two weeks? Based on your symptoms, it is most likely that you either have a urine infection or some infection of the genitalia. The urine test reports also suggest the same. It would be necessary to have a complete physical examination to find out what is the exact infection and treat it with medication which should be able to get you back to normal. You may require a urine culture test or urethral swab test to pinpoint what the infection is. I would suggest you to visit your local urologist at the earliest to get the tests. I hope this helps, feel free to revert with any other questions or concerns."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have shortness of breath sometimes, burning sensation in the chest after having a meal. Consult with the doctor and get prescribed Omez DSR in the morning. Also, do some medical test including ECG, so the report is herewith attached. Please confirm the test analysis. The patient is having a brain tumor (astrocytoma, grade 2) and surgery was done a year back."
},
{
"from": "assistant",
"value": "Hello. I have gone through your reports (attachment removed to protect patient identity). The only significant finding is of deranged cholesterol levels. Your LDL cholesterol is mildly elevated, so you should have a healthy lifestyle like avoiding fatty oily food and daily exercises like walking, etc. No need to take any medicines for it at present. You should repeat lipid profile after three months of lifestyle modifications. ECG is having minor changes only and no major and significant abnormalities are there, so nothing to worry about it. The symptoms are likely due to gastritis and reflux disease. So you have Omez DSR before breakfast for a week period and then whenever needed. Also, avoid spicy food, heavy meals and have some walk after meals for sometimes rather than resting immediately after food. However, if received any chemotherapy during treatment then should have one echo to rule out the possibility of heart damage due to chemotherapy."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 29 years old male. I have chest pain, abdominal pain from the last two months. Recently, I visited a gastroenterologist. He tested endoscopy, RUT and vitamin D. I have a small ulcer in the stomach, RUT test is also positive because of H.Pylori bacterial infection and vitamin D is below 10. I am using antibiotics from 10 days but chest pain was not controlled. I have taken ECG also, it is normal. Please suggest me how to reduce pain in my chest."
},
{
"from": "assistant",
"value": "Hello. An elaborate description of your chest pain would have helped much, but as you reported your ECG is fine. I do not think it is related to any cardiac cause. If the chest pain develops after some physical activity you must get yourself a TMT (treadmill test) done to rule out angina. As you told that you have got an upper GI endoscopy with rapid urease test done and an ulcer was found on UGIE. You must be on triple drug H.Pylori eradication therapy the duration of which is about 10 to 14 days. So do not worry, first finish off your HP kit. Your gastroenterologist will call you for a review endoscopy after four weeks to look out for ulcer healing. before that stop PPI (proton pump inhibitor) for at least seven days. and get a stool antigen for H.Pylori done or any other test to confirm eradication of H.Pylori. You can try the following lifestyle modifications. (Although they are of benefit in GERD only). Keep a few pillows while sleeping, to elevate your head end. Sleep on left-lateral position. Try reducing weight if you are overweight. Do regular exercise for about 30 to 45 minutes per day for at least five days a week. The following are of unproven benefit: Eat small evening meals, and avoid sleeping just after a heavy meal. Do not eat heavy late night. Reduce your tea or coffee intake. If it is pain due to GERD it will be reduced by the above measures. An ulcer pain, usually responds to the PPI therapy. Give some time for treatment to respond."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 18 years old and I have started to struggle with palpitations. When I was around 12 I started having high blood pressure and since then it has not stopped. I have gotten many tests done for my heart and all have turned out normal, but I am still concerned. I do have a poor diet and I am not very active. Could this be causing my heart problem or could it be something more worse?"
},
{
"from": "assistant",
"value": "Hi. You have done many tests with cardiac point of view? First of all, raised blood pressure in very young age, 12 years in your case, should be investigated. It must be secondary to some other disease. One of which is called pheochromocytoma. This condition causes both high BP and high pulse rate, along with sweating, fever. These symptoms are sudden and episodic. Pheochromocytoma is basically a tumor of adrenal glands. Other cause of high pulse rate may be hyperthyroidism in which thyroid gland is overfunctioning. Other symptoms include warm hands, sweaty hands, heat intolerance, weight loss despite good appetite, fine tremors, diarrhea, reduced sleep, thyroid gland may also be enlarged, some changes in eyes, etc. As you said your diet is not good, so it may have caused anemia. Anemia leads to fast heart rate. Another cause may be your sedentary lifestyle. As you said you are not active, it causes fast heart rate on slight activity. These are some non-cardiac causes of fast heart rate. Cardiac causes may be atrial fibrillation, inappropriate sinus tachycardia, atrial tachycardia, etc. Detection and differentiation of these requires ECG. If one of these is diagnosed, then next step is to detect the cause of it. Then treatment is done for the cause. So, possibilities of your condition are many. There is a huge list of differentials both cardiac and non-cardiac. Proper diagnosis requires focused investigations. Please provide your previous tests (ECG, holter, etc.) so that I may devise a plan for diagnosis of your condition which may require some other tests as well. Also send a record of daily BP and pulse rate of one week at least. Remember, if pheochromocytoma is the cause, then high BP and fast pulse may be present only during episodes and normal between episodes. Beta blocker is good to control heart rate. So please follow-up with your medical record and BP, pulse rate record."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 38-year-old female. I have extreme fear, suicidal thoughts, and fear of failure. I am not able to concentrate on my daily activities. How to overcome all these situations? I had an aortic valve replaced through open heart surgery. I was under Nexito and Rivotril for two years after my open heart surgery."
},
{
"from": "assistant",
"value": "Hello. Decrease in concentration, suicidal thought, fear of failure, and sleeplessness are features of a depressive episode. Why did you stop the medicines? Did you take the medications in the proper dose, and is there any episode similar to the illness has occurred previously? I think you should again start Nextio Fort (Escitalopram and Clonazepam) for the adequate duration, and if not improved, some second-generation antipsychotic can be added, or try cognitive behavior therapy. For sleep you can take help of sleep hygiene to wake up on fix time irrespective of sleeping hours. Avoid coffee or other stimulating agents, have a brisk walk, avoid food before three hours of sleep, and you can take a shower with lukewarm water."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have done my C1 and C2 surgery with screw fixation. After three months, my head is little flexible to move down and backward but not left and right (the surgery moto is not to turn my head). But for the past one week, I am facing that my neck is very stiff and my right shoulder feels like very tight and weight (sometimes I get pain). Because of this, my total head feels like very tight and with this, I am not able to move my head down (but can move backward). After I consulted with my doctor and took an X-ray and checking that there is no fault in my screw fixation, that is perfect and he gave me some tablets too. But still, I am facing neck, right shoulder (starting from neck till shoulder knee) stiffness."
},
{
"from": "assistant",
"value": "Hi. Your X-ray looks fine (attachment removed to protect patient identity). So, nothing to worry. Yes, you can travel but if you have pain and stiffness, then you need to use a soft cervical collar-size depending on your neck length, or it can be adjustable. If you do a sitting job, then you should get up once every 15 to 20 minutes and take a small walk for two minutes everytime. For the lower back, you need to do McKenzie back extension exercises (cautiously under the guidance of a physiotherapist, as the neck should not get a lot of strain while exercising)."
}
] |
[
{
"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 am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have an abscess on my top left gum that is now spreading to my cheeks. I am 19. I had an abscess in the same place at 10 or other young age. Last time I went to the dentist they did not do the cleaning in the first appointment so I did not get one, but wisdom teeth removal was suggested. I have good teeth, bad gums. Also cracked my teeth when younger. So one of my two front teeth has a fake bottom (do not know if that is relevant). I do use a gel and just learned that it could be contributing."
},
{
"from": "assistant",
"value": "Hi. Immediately start with these medicines. Tablet Augmentin 625 mg twice a day for five days, tablet Gramex 400 mg twice a day for five days, tablet Brufen 400 mg twice a day or thrice a day if the pain is severe for five days. Moreover, take some mustard oil or olive oil, put 1/4th teaspoon of salt in it. Make a paste and put it on gum line having the infection. Do it three times a day for three days. When swelling regress, put this paste on gums before sleeping. And start saline water mouth rinses. Take a 1/4th teaspoon of salt in lukewarm water and do its rinses 4 to 5 times a day for two weeks. And you must know this will only subside infection for some time but will go permanently after getting treatment from the dentist. Stay happy and blessed. Give me followup after three days."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home?"
},
{
"from": "assistant",
"value": "Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am planning for pregnancy aged about 36 years. But I am an OCD patient on a prescription of Clofranil 50 mg daily. So what are the risks involved, is it safe to use the medicine during pregnancy?"
},
{
"from": "assistant",
"value": "Hi, Welcome to iclinq.com. Clofranil (Clomipramine) should not be used in pregnancy. It is a category C drug that means if potential benefits justify the risk to the fetus, then you can use. As far as of now no well-controlled studies in humans, but it will not cause anomalies but it may affect your neonate after delivery like seizures, jitteriness, tremors, and dullness may occur. These symptoms will occur to your baby as withdrawal symptoms after delivery. But do not worry your doctor will manage during pregnancy by lowering your tablet dose and during delivery by tapering your tablet dose. But make sure that you take Folic acid tablets even preconceptionally."
}
] |
[
{
"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, Actually, I want to know something about my skin. In my armpits area, there is some kind of infection like I do not really know what that is but it looks like an infection and my sweat and sweat odor is due to that particular infection. Now I am describing the infection I used to wax my armpits and there is something that grows over my armpit hair a yellowish something and if I try to remove whatever the thing is, it gets out of the hair in powdered form. At first, I thought it as a fungal infection. I used a serum to remove fungus but nothing happened. It does not hurt but only if I use hair removal cream in the area."
},
{
"from": "assistant",
"value": "Hi. Yes, it is a condition in certain individuals that is called as trichomycosis axillaris. It is due to bacteria the coryneform bacteria and yellow color thing is their colonies. You need antibacterial not antifungal agents. And antiperspirant is the recommended treatment for this condition. Apply topical Aluminum chloride over it. Tricomycosis axillaris. Tablet Erythromycin 500 mg QID. Apply Aluminum chloride antiperspirant over the area. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My father is having enlarged prostate and has to undergo prostatectomy surgery. But, it is getting delayed due to ITP (idiopathic thrombocytopenic purpura). Right now he is under urine catheter. From past 12 days he is using Silodal-D 8 mg. Doctor said that after 20 days the prostate gland will reduce. Through ultrasound test we came to know the size of prostate enlarged is 54.6 cc. My doubt is, if it is enlarged to 54, is it possible that it can reduce through tablets? Or is it a must to undergo surgery? Right now the platelet count is 40,000. Please suggest a solution for this."
},
{
"from": "assistant",
"value": "Hi. Your father was on medication and has history of urine retention in the past. Currently, he is on catheter. Chances of medical management will not be successful. He needs surgery of either TURP (transurethral resection of the prostate) or HoLEP (Holmium laser enucleation of the prostate) for prostate. Size is never a criteria for surgery. Enlarged prostate can shrink by 30% if Dutasteride is given. But, this does not guarantee that the patient will become catheter free. However, it reduces blood vessels in prostate and helps decrease blood loss in surgery. Dutas-T (Dutasteride and Tamsulosin) also contains similar medicines as Silodal D (combination of Dutasteride and Silodosin). His ITP needs to be tackled and with all due precautions and keeping platelet concentrates on standby. He can undergo endoscopic surgery with due risks. Laser surgery - HoLEP will be better for him if available."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am concerned about excessive weight gain by my fiance. He is a 29 year old male, whose height is approximately 6 feet, and he weighs 150 kg. Over the last two years, my fiance had lost around 40 kg using the Banting diet, common in our country. It is based on the principles of no carbohydrates, starches or sugars and higher protein, but does allow the odd cheat meal. Since then, in the last eight months, he has had two attempts at quitting smoking and was put on Pendine 5 and Zartan CO for high blood pressure. He has a family history of hypertension. As a result, he has gained weight at quite a quick pace despite sticking to his Banting diet. The meal sizes have not changed, and he has an active lifestyle. We hike or do vigorous walks of 5 to 8 km on most days. At this stage, he has almost gained the full 40 kg back in less than a year, which seems very excessive and way above normal for quitting smoking. I was wondering if perhaps he has some thyroid issues, as his mother has hypothyroidism. Or could it be a side effect of the medication? We need some advice. We are at a loss at what to do. I would like to add that he struggled with weight issues since childhood. Also, we are currently not in his country, so visiting a doctor may be difficult."
},
{
"from": "assistant",
"value": "Hello. Keep up the diet and exercise. Do not get disheartened. The tests should shed some light on the cause of the excessive weight gain. For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have had a CT scan on head, neck and chest. My doctor told me that I have chronic sinus. I already knew these things and had sinus surgery. But, in the report it was mentioned as mild emphysema. Can that get fixed if I stop smoking? I am using Advair for years for asthma. I visited pulmonologist before CT scan and he said that my spirometry was good. After seeing my chest x-ray, he said that he could take me off Advair. I am really confused and scared. Please help."
},
{
"from": "assistant",
"value": "Hi. We are here to help you. For further information consult a pulmonologist 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, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help."
},
{
"from": "assistant",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?"
},
{
"from": "assistant",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,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 am 29 years old. I am suffering from acidity problem and hypertension. My SGPT 107, SGOT 112, bilirubin 1.1 and fasting blood sugar 83 mg/dL. All other blood test reports like lipid profile and uric acid are normal. My USG report is normal. My ECG shows RBBB and no abnormality found in the echocardiogram. I am on Atenolol 50 mg and Amlodipine 2.5 mg for the last one year."
},
{
"from": "assistant",
"value": "Hi. I have seen your reports (attachment removed to protect patient identity), which are quite acceptable. For further information consult a general medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am scheduled next week for out-patient surgery to have a malignant tumor removed from my bladder via a catheter inserted into my urethra. Before that, the anesthesiologist will administer a general anesthetic as well as a muscle-relaxant to keep me from kicking when under. The procedure also involves administration of something. I am not clear whether it is anesthetic or just oxygen via face mask. Here is my question. I have invested the past couple of years in growing a full, bushy beard. The RN assigned by my HMO told me I would have to shave, or trim down (way down), my beard in order to get a good seal for the mask. Is this really necessary? Is it possible that the nurse was speaking on the basis of a hygienic or even aesthetic concern about my beard rather than on the basis of a sincere concern about the possibility of a little gas (be it anesthetic or oxygen) escaping out the side of the mask? I mean, if the concern is really a hygienic one, I will be happy to shampoo the beard the night before as I had planned to do anyway."
},
{
"from": "assistant",
"value": "Hi. That is worth a concern for both for your anesthesiologist and you too. Let me elaborate it to you. General anesthesia involves making a person unconscious and making him totally relaxed by giving a medication called muscle relaxant. With unconsciousness and muscle relaxation, a person cannot breathe by himself under general anesthesia so he has to be administered oxygen with help of a bag and mask ventilation supplying positive airway pressure so that his lungs expand during controlled inspiration and relax during passive expiration. Hence this procedure requires a good mask fit on your face so that your anesthesiologist is able to ventilate your lungs with life-sustaining oxygen. Also as I read in your history you are weighing 97.52 kg with a BMI of 41.99. You are considerably overweight which means you would require more concentration of oxygen during general anesthesia. So an overweight patient with a bushy beard is always a challenge for an anesthesiologist. To achieve a good mask fit in such a patient is always difficult in order to provide oxygen and other inhalational anesthetic agents effectively. So, it is not that hygiene is a concern but it is a safe administration of general anesthesia a major concern in your case. I would suggest, consult your anesthesiologist for a spinal anesthesia which involves anesthetizing lower half of your body in which bladder tumor surgery can be performed. This would avoid general anesthesia and would also save your beard. For more information consult an anesthesiologist 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, My lab tests are as follows: Seven months ago: blood glucose of 105 mg/dl, GTT one hour 160 mg/dl, two hours 118 mg/dl, morning insulin 6.2 μU/ml, HbA1c 5.2 %, A1 6.1 %. This month: BG 110 mg/dl, GTT one hour 184 mg/dl, two hours 115 mg/dl, morning insulin 5.3 μU/ml. Every other blood test within normal ranges. I am male 32 years old 1.86 cm 93 kg 13 to 14 % body fat athletic with healthy nutrition habits. No history of diabetes in the family. Could I be having cancer in pancreas judging from the insulin values you are seeing? I have had many years to do a blood test and with this random one seven months ago. I was told by my doctor that I had to keep monitoring my blood glucose since I could develop diabetes later on, and since I have never had a problem with blood sugar as a kid and no family history of diabetes, I was wondering what might be going on cause insulin levels dropped from my last test and since my diet was pretty much same with healthy choices why is this happening. My doctor for the last seven months kept telling me to calm down and that I do not have anything cause stressing is bad for my blood glucose too. Should I be telling him to get a pancreas MRI done?"
},
{
"from": "assistant",
"value": "Hello. I just read your query and from what you have mentioned I would like to say that the reason that your insulin levels are dropping is because of your beta cells of the pancreas are getting exhausted and are not gradually decreasing the production of insulin. Pancreatic cancer does not have these manifestations at all. So testing for cancer without any strong family history or clinical manifestations is just not recommended. Continue with your healthy lifestyle and try to workout more as they reduce insulin resistance and thereby decrease fatigue of your pancreatic cells. For more information consult a diabetologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My daughter is now 2 years old. She has been detected with a soft cleft palate six months back. As of now, she does not have issue while eating as well as hearing. She used to drink milk with normal milk bottle we are in the process of removing her habit of milk bottle. Our pediatrician asked us to take her to a plastic surgeon and he said to do it in between 3 to 4 years of age, so that she can be little strong. Is it compulsory to go for surgery in case of soft cleft palate? Is it fine if we go in between 3 to 4 years of age? Or what is the proper age for surgery? She is just 2 years old and so we are a bit worried with the surgery part. How long this surgery will take place? Will she be alright after this surgery and will able to speak all words? Is there any dangerous situation involved in this surgery? How anesthesia will be given to her? Will she feel the pain? Please explain me."
},
{
"from": "assistant",
"value": "Hi. I understand your concern for your child. For further information consult a paediatrician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have protected sex with stranger and after that I get inflammation in urinary tract. Should I get worried about it?"
},
{
"from": "assistant",
"value": "Hello. If you have symptoms of inflammation of urinary tract than you have to rule out urinary tract infection. For that, I suggest you investigate with urine routine microscopic examination report and urine culture for primary work-up. You can revert back with reports once done. Meanwhile, drink lots of water and avoid excess spicy foods intake. Cranberry juice extract tablet also needs to be taken for seven days. You have done protected sex so chance of sexually transmitted diseases is very unlikely."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect."
},
{
"from": "assistant",
"value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a 26 year old female. At the beginning of this year, I had a bad cold, and two weeks later, I had a tingling in the wrists, feet, and legs, which the doctor said was reactive arthritis which lasted a few weeks. Then, the first time my left hand felt weak was five months back. It felt weak, more so at rest but, when I had to grip things, I was able to. I went to a physio and had a neck massage as my back was also tense and the next day, the weakness was gone. So, the massage helped it. Now, more recently, I had foot weakness on the left side and a weakness and very mild tingling in hand. Again, my back is very tense and tight from gym and work position. As soon as I get this, I get very anxious, and I feel the tingling gets worse. The only difference in daily activities is lifting weights at the gym, weighted squats, and heavier arm exercises. I used the foam roller on my foot last night, and today the foot weakness was gone. The foot weakness lasted 12 hours on and off. There are no problems walking or anything like that. It just felt weaker but, it was not. The weakness always comes randomly but, I do seem to always have a tight back when the weakness occurs as well. Could this be MS? Does it sound like it? I am extremely worried now. I have never been diagnosed with it. I have just read about it online. What could this be from? I went to the opticians last week, and my eyes were fine. There were no eye symptoms. It was just a standard check-up. My eyes were said to be perfect. I do not have any bladder or bowel symptoms and no other weakness anywhere else."
},
{
"from": "assistant",
"value": "Hello. For more information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, The query is about sanded grout exposure. I am quite concerned about my girlfriend’s exposure to silica dust. We were doing a home renovation. I left for about 1.5 hours while she was removing tile in a kitchen. When I had come back I saw she was removing grout with a grinder and no dust mask. The room was filled with dust in the air. The room is about 10x9 with 12” tiles. This makes for a total cut distance of 1100” with the grinder. Assuming a 1/8” cut with a depth of 3/8” and this works out to 51.56 cubic inches of dust released into the air. Assuming an average of 25 % silica content in the grout and weight of 38 g per cu inch for the dust, that is about 490 grams of silica dust releases into the air. The room was open to adjacent rooms so I estimated about 90 cubic meter space, wich would work out to 5.4 g/m^3. She was doing this for about an hour and a half so I estimate about 1 m^3 was inhaled. From what I have read this is really high-level exposure. Is my math wrong? Did I miss something? I am making her go to the doctor and we will monitor her health closely. I am really concerned this could lead to serious problems in the near future."
},
{
"from": "assistant",
"value": "Hi. Looking at the history, it is quite a high-level exposure and it can cause some kind of pneumonitis feature called hypersensitivity pneumonitis or toxic dust syndrome. If she develops symptoms of a cough, breathlessness, better to get a CT thorax to see her lungs and if possible lung function tests also. Kindly get back if you need more information."
}
] |
[
{
"from": "human",
"value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?"
},
{
"from": "assistant",
"value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Dear Doctor, I am a 24 year old female, was prescribed with Celexa 20mg once daily and Buspar 5mg twice daily for severe anxiety/panic attacks. Both of these medicines are SSRIs though, and I read about it online that everyone/every source says never to take them at the same time due to risk of serotonin syndrome. Today, after taking the Buspar, I felt cold and shivered constantly. I could not get warm and I was very sleepy. Now I am scared to take the night time dose of Buspar and Celexa. I would like to have a second opinion on the safety of taking these medications together. If it is not safe, can I take only one instead? Which one would you recommend, the Buspar or the Celexa? Thank you in advance."
},
{
"from": "assistant",
"value": "Hi. You are not on too high a dose of celexa or buspar. However serotonin syndrome is not always dose dependant. I feel just the chills and sedation are too general to be indicative of serotonin syndrome. You should have some level of muscle rigidity, high fever, muscular contractions (myoclonus) to suggest that. In my professional opinion I do not have much faith in Buspar. Celexa is good enough as an antidepressant (SSRI) to eventually help you have a full remission of depression, anxiety and panic attacks. If I was your treating psychiatrist, I would have supplemented the celexa with clonazepam (Klonopin) on a as needed basis, between 0.5 and 1mg every 8 hours PRN anxiety. If you are feeling cold and shivering constantly you might need to see your PCP (Primary Care Physician) to urgently address if you have an active urinary tract infection and also have him check your thyroid function. In effect, I advise you to stop the Buspar for now. Hope it helps. Get back to a psychiatrist online for further help -->"
}
] |
[
{
"from": "human",
"value": "i have very thin loose motions , and pain in abdominal area, since 2 days and feeling weakness, taken flaygel medicine today, please recommend any medicine and precautions and diet plz"
},
{
"from": "assistant",
"value": "Dear, Welcome to.icliniq.com With history of 2 days diarrhea with weakness seems that you are on dehydration side. 1st of all most important step for you is to keep yourself well hydrated and replace electrolytes.Use ORS.Mix in 1 litre water and take as maximum as you can. Avoid spices,fried,outside meals .Take liquid or soft food for 2,3 days At least and eat less. Add yogurt and Ispagul and banana in your diet. continue with flagyl 400mg three times a day.Take ciprofloxacin 250mg after breakfast and dinner for 3 days.Also Take Mebeverine 135mg before breakfast and dinner.Also take antibiotics like Enflor sachet once daily for 5 days. I hope you will be fine soon.In case issue persists after 3 days ,please let me know . Take care !Stay healthy"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My cousin, a newborn baby, was born four days before, male, 51 cm and 3.1 kg. He is crying, and we think that he cannot poop. He drinks breast milk. And every time he farts he cries and, we thought he has a hard time getting it out. I would also like to ask if he is allowed to drink water and if we can do mixed feeding (alternate drinking of breast milk and formula milk)."
},
{
"from": "assistant",
"value": "Hello. Please note that a child may cry either because he is hungry, has passed urine or stool, or wants to seek attention. Take note of the same. Other than that whatever you have described is normal and it persists till the age of six months. Hence do not worry. Giving water is not required as milk already contains water. However, giving boiled and cooled clean water is harmless. You can mix feeds and give. It is not an issue."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My brother is suffering from extreme numbness and pain in soles and palms. He also experiences constipation, weight loss, dizziness and lack of appetite. Please help."
},
{
"from": "assistant",
"value": "Hello. I had gone through the data you have posted. For further information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I need to find out about something that I am very nervous about. I made out with a woman and realized that there was a bump on the side of her mouth. She also perform oral on me. The bump looked yellowish with brown edges. I have no idea whether it was oral herpes. But, I am freaking out. Last week, I was itching near my thigh, pelvis and below the belly. I do not know whether it was because I recently shaved down there. But, the itching was on and off. I did not notice anything unusual until I saw two pimples near my pelvic area. I popped it and pus came out and got cleared. A few days later, I saw something looked like healing razor bumps. The bumps were not crusty, but they were itchy. It has been a few days and the bump have not left. I did a herpes vinegar test and the lesions become white after I applied the vinegar. Today, the bumps have a black scab. Do all these symptoms sound like herpes? I also took a photo of the bumps. Please explain."
},
{
"from": "assistant",
"value": "Hi. I have read your query in detail and do understand your concern. Also, viewed the attached pictures (attachment removed to protect patient identity). A lesion on the side of her mouth may or may not be herpes. Lesions on your pubic area are not herpes or any STD (sexually transmitted disease). They seem to be those of folliculitis due to bacterial infection or razor bumps. Moreover, herpetic lesions do not cause itching, but pain and inflammation are the predominant symptom. So, your lesions and symptoms do not sound like herpes. For further information consult a venereologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My father had a heart attack three weeks ago. Now, he is under medication and in complete rest at home. But echocardiogram report says his LVEF rate is 29 %. Some cardiac enzymes are high. How can we improve the rate of LVEF? Can this percentage get improved by rest or diet or something? His blood pressure, cholesterol, and sugar levels are normal. There are no blood clots present. He feels tired if he walks at home even more than 15 minutes."
},
{
"from": "assistant",
"value": "Hi. Your father had a heart attack and from his echocardiography report, (attachment removed to protect patient identity) the affected areas are thinned out and akinetic. It means that the heart muscles have lost their function in these areas. He can take drugs like beta blockers, ACE inhibitors (Carvedilol and Ramipril) to improve the cardiac function. What are the medicines given? The other method is to assess if there are any other blocks present in the coronary arteries and get removed either by CABG (coronary artery bypass graft surgery) or angioplasty. But I would suggest first do a myocardial viability study to see if the thinned out akinetic areas have any living muscle present to improve his cardiac function. For more information consult a cardiologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have depression, anxiety, lack of confidence, lack of energy and sleep, excess sweating, fast heartbeat from last 18 years. I have tried several ayurvedic treatments, then went to psychiatric treatment but no benefit. Previously doctor prescribed me Nexito Forte and Pronol 10 in morning and evening and Prestiq 50 in the night. I had taken it for two years but feel some benefit only. It causes me excess sweating.Then I consulted another doctor and he suggested me Paxep CR 12.5 in morning and Buspar 10 in morning and evening. But it creates a problem in sleeping and some weakness. Then I consulted another doctor, he prescribed me Nexito 10 and Clonazepam 0.5 in the morning and evening and Mirtazapine 15 in the night. But it created excess sleep and stomach upset. But I feel slightly better mentally. I am really confused that which treatment of medicine I should follow for a long term to get rid of my problem completely. Which will be a better option for me? Please help."
},
{
"from": "assistant",
"value": "Hi. I understand you are suffering a lot due to your depression and anxiety. Most medications given for depression as well as anxiety have similar efficacy. As per the history given by you, I think you have benefited from treatment suggested by the last doctor. I would advise you to continue tablet Nexito 10 mg in the morning and tablet Mirtaz at night around two hours before sleep. You can withhold tablet Clonazepam if you feel too sleepy. Along with medicines, I would advise you to focus on your diet and sleep hygiene. You can choose a physical activity and continue it. It will help you. There are some relaxation exercises like Jacobson's muscular relaxation techniques. These will help reduce the physical symptoms of your anxiety. Please follow up regularly with your doctor and continue medicines started for atleast six months."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 29-year-old male. Recently, I got married and tried having sex with my wife two days ago. It was my first time and I got discharged during foreplay only and could not achieve erection throughout that night. Even when I got an erection, I tried penetration but just lost erection during penetration. I did not feel aroused and the same symptoms are continuing for the last three days. Either I am unable to penetrate due to weak erections or get discharged within seconds. But, before the marriage, I used to masturbate once or twice a week and always got a very hard erection. I was feeling fatigue and weakness in the body for the last one week and even done bp, blood and urine test and all reports came normal apart from a minor infection which could be due to kidney stone as I have one. So, I request you to suggest me on this matter."
},
{
"from": "assistant",
"value": "Hi. For providing you the proper treatment I need to know the answers of following questions. What is your age? How long you had been in a physical relationship? Any sexual encounter with a commercial sex-worker? Any history of diabetes and hypertension? Is the condition persistent or deteriorating with time? Does the condition remain constant with other sexual partners, if any? Smoking or alcoholic? Hyperlipidemia? On any medications or hormonal therapy? Any marked curvature in the penis? Any history of trauma, surgery or neurological disorder? Do you have any of these features: Persistent low mood, loss of interest in work, low energy, lack of concentration, disturbed sleep, ideas of hopelessness, helpless, guilt or suicide, change in the appetite, headache, forgetfulness, excessive sweating, the shakiness of hands?"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My face and body color are different. My face is getting dark and black day-by-day. What should I do to increase my fairness and get glowing skin? Shall I use some night cream?"
},
{
"from": "assistant",
"value": "Hi. I have read your problem carefully. What is your nature of work? Will you get exposed to sunlight? Are you allergic to any drug or disease? There are a lot of causes of skin darkening. The most common reason is sunlight exposure. For treatment, 1. You can use a cap or umbrella when you go for an outing.2. Sunscreen (30SPF), 10-20 minutes before an outing.3. Regular washing with good face wash. Please do not use whitening cream. It may cause harm to your skin. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a back pain which has made me stay in bed for two weeks. Now the pain has reduced but I have very limited movement, just to go to the bathroom but still, there is a pain when I want to stand up. I did the MRI test, the result was showing lumbar lordosis is decreased with scoliosis, disc dehydration and small central disc protrusion are seen at L3 to L4 level, disc dehydration and left paracentral disc extrusion are seen at L4 to L5 level with moderate central canal stenosis, disc dehydration and central disc protrusion are seen at L5 to S1 level with lateral recess stenosis and S1 nerve root impression. Please advice the best treatment option according to my situation, preferably non-surgery option."
},
{
"from": "assistant",
"value": "Hello. Your MRI report shows evidence of wear and tear of the lumbar disc with some pressure on the nerves (attachment removed to protect patient identity). It is difficult to suggest the treatment without examining you in person. However, generally speaking, it is possible to treat lumbar disc disease without surgery with medication and physiotherapy. Wishing you a speedy recovery."
}
] |
[
{
"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, Are pomegranate seeds good or bad for gallstones?"
},
{
"from": "assistant",
"value": "Hello. I just read your query. For more information consult an ayurveda specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I was diagnosed with a 9 mm diffusely calcified meningioma and have been having symptoms such as dizziness, loss of balance, ringing in ears and more frequent headaches. I was told it was a big nothing. But I am not sure. Six months back I went to the ER with a pain in my head around right ear and back of the skull, no one could touch it or me. I had never experienced such pain."
},
{
"from": "assistant",
"value": "Hello. I have reviewed your CT scan and it showed a meningioma at the right cerebropontine angle (attachment removed to protect patient identity). This tumor is small however if this cause you dizziness. The best way to approach it is to take medication like Betahistine 16 mg tablet twice a day. It is wiser to observe this tumor if it is not causing harm like compression on the brainstem and cranial nerves. Contemplating on surgery is not a choice at this moment because it is not guaranteed that you will preserve your hearing after the surgery. Waiting for tumor growth outweighs surgery at this time, but if you are worried about it, you can seek to consult with a neurosurgeon and discuss gamma knife surgery wherein it halts the progression of growth. This should help you as your guide."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have developed symptoms of nerve dysfunction (burning, tingling, etc.) but all the nerve related tests were normal. Over the past 9 to 12 months, my diet was poor, I am about 70 pounds overweight, age 40, and have high LDL. My blood glucose last year was 86, then it went up to 97 by the fall, and then up to 106 this year. I went on a diet and lost 20 lbs so far, but the test this week was at 101 after a 12-hour fast. My question is this: Can a blood glucose around 100 to 105 and high lipids for numerous months cause any nerve related symptoms?"
},
{
"from": "assistant",
"value": "Hello. I have seen the details given. The glucose levels mentioned are normal. Only 106 mg shows a pre-diabetic fasting level. These levels are unlikely to affect the nerve function. From your information, I get a feeling that you do not have diabetes. Is that right? In that case the nerve related issue is not due to glucose levels at all. It may be related to your obesity. With a BMI of 37.07 kg/sq meter (normal < 25 kg/sq meter) you are already in grade 2 obesity. Your ideal body weight should be 77 kg (169.4 pounds). Which means there is an excess of over 81 pounds. That could be the culprit. Plus it can be the cause for precipitating diabetes in the coming years."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?"
},
{
"from": "assistant",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, 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 am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance."
},
{
"from": "assistant",
"value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?"
},
{
"from": "assistant",
"value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, 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, When I was younger, I had a bottle rocket blow up in my eye. It left a scar in front of my pupil, so I am no longer able to see out of the eye, and am considered legally blind. My pupil stays dilated all the time, and where it is not able to focus on anything, it wonders to the right. I was wondering if there is any new surgery, that could possibly help."
},
{
"from": "assistant",
"value": "Hello. Thankfully only one eye was affected and I hope your other eye is intact and fully functional. Unfortunately, a dilated pupil that does not react to light in the affected eye means that it is no longer transmitting information to the brain and therefore is considered non functional. In most cases those changes are irreversible and the eye is no longer considered a functioning organ. But, hope dies last, and to cheer you up a bit, there are many ongoing clinical researches on the restoration of vision in blind eyes and mainly involve implanting a chip in the retina and connecting it to the brain and although the results are not what a patient would expect, nonetheless it helps the eye detect objects on a very primitive level. As I said earlier, thank God that only one eye was affected and you should take care of it by undergoing a yearly comprehensive eye exam. I wish you best of luck."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had sex with a prostitute last week. I used a condom, but I played her vagina with my hand. I came back home that night and had sex with my wife again. I also played her vagina with my hand. Next day, she had her periods and felt itchy at her vagina (I think genital herpes). So she scratched her vagina, and it became a damaged spot under the vagina. But it is better now and is about to heal. Is this STD or not?"
},
{
"from": "assistant",
"value": "Hello. It may be normal, but I cannot deny from STD (sexually transmitted disease), and it may be herpes and vaginitis too. 1. Apply Betnovate-N locally up to deep in the vagina, after proper wash two times a day till required. 2. Ciplox TZ (Ciprofloxacin, Tinidazole) two times a day after food for three days. 3. Candid veginal tablet at night for six nights.It will be fine. And it means you believe in polygamy, which is one day become dangerous. Be loyal, and you can use her ten times a day. So she will remain healthy so as you. If she has vaginitis, you also can get the infection."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am not sexually active. But my fiance did foreplay and ejaculated on my hand. I washed my hand with soap after that. I do not remember the semen going near my vagina. I am still virgin and he did not penetrate me. However, the next day I got worried and took an emergency pill. I still have not got my period and it has been a week. I also have PCOD. Have I missed my period because of PCOD? Or could I be pregnant? Please let me know."
},
{
"from": "assistant",
"value": "Hello. Please do not be worried. There are no chances of pregnancy at all. Firstly, because you had washed your hand with soap which carried the sperms and sperms do not survive on contact with detergent or soap. Secondly, you have taken an i-pill within 72 hours. Hence, your menses are likely to be delayed due to high progesterone pill you have taken. Now, you should get a withdrawal bleed within next 7-10 days from the day of pill intake. So, you should be patient and wait for the withdrawal. However, if you are anxious then as on today you may get a serum beta hCG test done to rule out any pregnancy conclusively. If the hCG levels are less than 5ng/dL then you are surely pregnancy safe and you can then calmly wait for your menses to arrive naturally."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I want some advice on my blocked ears. My ears are also paining since 7 days. Since last week, I have been suffering from cough and cold. As both the ears are blocked, I have been suffering a hearing problem too. I think wax is stuck inside my ears. I have been using an ear drops twice a day. What should I do?"
},
{
"from": "assistant",
"value": "HiWelcome to icliniq.com.I understand your concern, and most likely you are suffering from eustachian tube catarrh. This is a clinical condition arises due to eustachian tube dysfunction. The eustachian tube is a tubular connection between the middle ear and throat. Main function of this is to maintain air pressure in the middle ear equal to that of the external atmosphere. But whenever this tube gets blocked by cold and sore throat, the patient feels blockade of the ears.I would like to suggest you try: Mostly, the above treatment will solve your problem."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My wife is 27 years old. She is feeling the following problems frequently. Short of breath, fatigue, body pain, gained some weight around 2 to 3 kg in the last two to three months, anxiety, hair loss, and dizziness. Can you please guide us? How to overcome it?"
},
{
"from": "assistant",
"value": "Hi. Please get her a thyroid hormonal profile test including T3, T4 and TSH (thyroid-stimulating hormone)."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am newly married. My husband is 26 years old and I am six months younger to him. My family members say that my husband is over-possessive and controlling. How can I know if my husband is over-possessive and controlling?"
},
{
"from": "assistant",
"value": "Hi. Most of the persons who are over-possessive of their partner show certain kinds of behavior that is uncommon in the general population. They feel less secure and this sense of insecurity is the driving force for the over-possessive nature. Someone who is insecure may doubt their partner's dedication and may, therefore, try to control them. In short, they feel vulnerable and will do anything to make sure they are not hurt. The sense of insecurity can stem from a number of situations including parents leaving a child, a past romantic partner who was unfaithful and many more. To control the possessiveness: Consult a psychiatrist online in case of further assistance in overcoming this situation -->"
}
] |
[
{
"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 got ulcers in my mouth due to chewing pan masala, and I have stopped eating it now. I am unable to eat spicy food and hot foods. I have developed stiffness in my inner mouth. So I am unable to open my mouth. Please suggest."
},
{
"from": "assistant",
"value": "Hi. Your symptoms and signs indicate that you have a white lesion. I need to check your cheek area and if you can send a photograph with an open mouth, focus on the cheek region so that I can precisely see and say you the current condition. It can be oral submucous fibrosis, fungal infection, and lichen planus. I have gone through the attachment (attachment removed to protect patient identity). Your inner side of the cheek looks that you have a white lesion and due to that, you have all these symptoms. Please send a photograph with a mouth opening and measure the mouth opening with a scale from the edge of the central tooth to the lower edge of the central tooth. There is a need for having further information to initiate treatment. If it is a case of oral submucous fibrosis, you need to take it seriously. The other two conditions require treatment. But they are minor. Stop smoking."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My wife is 47 years old. Suddenly in sleep, she felt palpitations two to three days back and we went to the hospital and found ECG normal. Echo test is normal, Trop I test is normal but TMT is positive. The doctor advised to go for angiography but another doctor says that before angiography we should go for stress echo test. Please advise what has to be done first."
},
{
"from": "assistant",
"value": "Hello. Firstly, let me know if she has any risk factors like hypertension, diabetes, deranged lipid profile or family history of heart disease. Usually, what we do, since angiography is an invasive test, we make sure that the patient needs it or not. So initially, subjects the patients to minor tests like TMT (treadmill test) or stress echo or stress thallium. If either of the tests is abnormal then it is better to subject to the patient to angiography. Now, in our case, since her TMT is positive, it is better to subject her for angiography. There is no harm in having stress echo, but suppose it is positive then certainly she will need angiography. But if it is negative then we can again land up in a dilemma of which test to be relied upon. Then she will need some more tests like stress or CT coronary angiography to prove TMT was negative. So it is better to get an angiography done and clear all our doubts. There is sufficient evidence of abnormalities and angiography is a gold standard test. Also, discuss how strongly was TMT positive. If it is strongly positive then nothing to think and go ahead with angiography and if it is mild positive then you may think of stress echo. So overall, it is better to undergo angiography and no harm in stress echo if your doctor insists. For more information consult a cardiologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?"
},
{
"from": "assistant",
"value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have candida balanoposthitis. I consulted a doctor, and he gave me Glospor DS 200 mg for a week with Livafin ointment. But still, I am having red spots on the penis. My penis is uncircumcised. Please provide your suggestion."
},
{
"from": "assistant",
"value": "Hi. Please say whether you have diabetes. Please tell whether you are sexually active, with a regular partner and whether you use a condom. Please upload the appropriate images of the present condition, so that, I can guide you further."
}
] |
[
{
"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 36 years old suffering from UTI and urine retention. I am a father of two, height is six feet and weighing 87 kg. I was suffering from mild constipation (first poop is easy but clearing remaining used to take some time from past few months. I used to spend at least 15-20 minutes in loo. This is when I observed urine retention and mild constipation). From past few months, even my rectum was paining. History of UTI: It all started with severe pain after the passage of urine five months back. It was diagnosed as seminal vesiculitis and urologist said that it is common among men and advised sitz bath whenever it pains and advised me to have sex regularly. Though sitting in hot water tub helped me and it relieved me from pain, but the pain was recurring every 20 to 30 days. This continued for almost 18 months. Four months back, I had few drinks (I never consumed alcohol earlier) continuously for a few days, and that triggered severe pain after urination. One day it was so severe that I noticed blood in urine (hematuria) and urination was very frequent on that day. I suffered from fever also that day. The very next day I went to a urologist and got it diagnosed. This time my doctor advised for the following lab test: Hemogram (automated), glucose – random, glycated hemoglobin (HbA1c), creatinine – serum, urine routine, microscopy (qualitative method), urine culture, imaging – ultrasound abdomen (including post void residue) and uroflowmetry. It was diagnosed as UTI infection with below observations (latest report): a.\tMajor impressions: i.\tCystitis. ii.\tPre void/post void – 270 cc/90 cc (significant). b.\tLiver – Normal. c.\tGallbladder: Distended. Wall of the gallbladder is within normal limits. No calculi seen. d.\tSpleen: Normal in size and show normal echo pattern. No focal lesion. e.\tAorta: Normal in course and caliber. f.\tPancreas: Normal in size and shows normal echo pattern. g.\tKidneys: Both kidneys are normal in size and shows normal corticomedullary echogenicity. No calculi or hydronephrosis seen. h.\tUrinary bladder: Distended. Increased wall thickening noted measuring 5 mm with mucosal irregularity and multiple floating internal echoes notes. Pre void: 270 cc and post void: 90 cc. i.\tProstrate: Normal in size. Normal in shape and shows normal echotexture. No focal lesion. No paraaortic nodes or free fluid in the abdomen. j.\tCulture report - Organism isolate: E coli with colony count: >1,00,000 cfu/ml. k. Serum creatinine: 0.90 (within biological reference range). l.\tSerum glucose (Random) : 121 mg/dl. m.\tGlycated Hb (whole blood) : 4.90 %. n.\tWBC count: 17300/cu.mm. o.\tRBC count: 4.95 million cells/cubic mm. p.\tHemoglobin: 14.90 mg/dl. q.\tHematocrit: 43.10 %. r.\tMCV: 87.20 fl. s.\tMCH: 30 pg. t.\tMCHCV: 34.40 g/dl. u.\tPlatelet count : 297000 / cu mm. v.\tDifferential count. i. Neutrophils: 83.00# above range (40.00 – 75:00). ii.\tLymphocytes: 12.00# less than range (20.00 – 45.00). iii.\tMonocytes: 4.00 % (2 -10). iv.\tEosinophils: 1.0 (0.00 -7.00). v.\tESR: 32.00/1st hour (0.00 -10). w.\tPeripheral Smear examination: i.\tRBCs are normocytic normochromic with an increase in rouleaux formation. ii.\tWBCs show neutrophilic leucocytosis. iii.\tPlatelets are adequate. x.\tRoutine urine analysis i.\tMicroscopic description 1.\tColour: Pale yellow. 2.\tAppearance: Slightly turbid. 3.\tReaction (PH)- 6.5. 4.\tSpecific gravity: 1.01. ii.\tChemical examination: 1.\tProtein/albumin – Present 1+. 2.\tGlucose – NIL. 3.\tKetone bodies – NIL. 4.\tUrobilinogen – Normal. 5.\tBile salts – Negative. 6.\tBile Pigments - NIL. iii.\tMicroscopic Examination: 1.\tWBC/pus cells: Numerous/hpf. 2.\tRBC – Nil. 3.\tEpithelial cells – 10-15 hpf. The doctor prescribed Septra (Trimethoprim and Sulfamethoxazole) (2-0-2) for seven days & Sildoo 8 (Silodosin) once daily for one month – I took Septra course for seven days but did not take Sildoo considering its side effects and dependency. Meanwhile, I started taking ayurvedic medicine, and my urinary pain (during and post-urination pain) and rectal pain are no more, but urine retention persists. Current lifestyle changes that I have made. 1.\tNot having coffee or tea. 2.\tOnly occasional outside food. 3.\tHaving plenty of water and fluids. 4.\tYoga or exercising regularly. My questions: 1.\tCan I take Sildoo 8? Will this harm me in future? Can I discontinue Sildoo 8 after this courseor will I be dependent on Sildoo for lifetime? 2.\tCan urine retention be cured completely? 3.\tCan recurring UTI be completely cured? 4.\tMy prostate is normal in size, but I am prescribed Sildoo. Can I take Sildoo even without prostate enlargement? 5.\tWill Sildoo effect my sex life? How to overcome its side effects?"
},
{
"from": "assistant",
"value": "Hi. With your elaborate history what I could make out is that you had a severe episode of acute prostatitis which was undertreated and now it is chronic prostatitis syndrome. Also, you have severe constipation. Sildoo is silodosin which is a highly potent alpha-blocker. I would like to place you on an alpha-blocker like Alfuzosin which will not produce any retrograde ejaculation in young males. Consult your specialist doctor, discuss with him or her and take medications with their consent. Also, you have to correct your constipation. Could you send a picture of uroflowmetry with the date? I would like to do a fresh uroflowmetry with post void residue for you. Prostatic symptoms at times are not related to its size rather to the alpha receptor overactivity. For more information consult a urologist 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": "Hi doctor, I have a resistant hypertension. Even five drugs failed with a lot of side effects. I was safe on Methyldopa for 2 years with Hydrochlorothiazide. Now, there is no supply of this medicine. I started Nebivolol 5 mg with Chlorthalidone last night. I have the feel of chest tightening and slight giddiness. All my blood pictures are normal, including cardiac markers. What would be the best for me? Telmisartan 80 mg, Metoprolol, Prazosin and Ramipril combination does not seem to work. Blurred and double vision, steatorrhea, giddiness and palpitations were the problems I had and they all went off with Methyldopa. Please suggest any best combinations. Thank you."
},
{
"from": "assistant",
"value": "Hi. Most likely pheochromocytoma or renal artery stenosis. Complete cardiac checkup, 2D echo, treadmill test, renal artery Doppler, MRI kidney to rule out pheochromocytoma, serum vanillylmandelic acid and serum metanephrines. Medications as advised. Revert back with the detailed history and reports to a cardiologist online.--->"
}
] |