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[ { "from": "human", "value": "Hi doctor, I am a 28 year old female. Before 10 months, I got left side abdominal pain with mild fever. I went to the ER. After blood tests and CT scan, they said it as diverticulitis. After using antibiotics, it got cleared. Every couple of months I feel pain when I press my abdomen but no fever. When I take liquid diet for two days, the pain will go away. Even though my bowel movements are regular, sometimes the stool is hard and I can see blood. I am drinking lots of water at least 2 liters a day and stopped junk food. But, still I am suffering with pain. Sometimes, I feel a sharp pain inside the rectum. Recently, I went for an annual checkup. After checking the reports, my GP said that it may or may not be diverticulitis. He said it might be colitis and nothing to worry. My last blood in stool was two months ago. Sometimes, my stool is mushy and fluffy. I am very much worried about this. Please help me out." }, { "from": "assistant", "value": "Hello. For further doubts consult a medical gastroenterologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have been diagnosed with chronic tension headache. Next, to the headache, I have observed a decline in my cognitive skills (learning, concentration). I can take care of the headache using meditation techniques, however, I am not able to deal with the decline, which is causing degradation of my private and work-related performance. Apparently, there is a medicine available that can enhance cognitive performance- Modafinil. I wanted to ask you for an opinion, how to take the medicine, what should I pay attention to (dosage, cycles)." }, { "from": "assistant", "value": "Hello. I understand your concern and would explain that Modafinil is a drug used in other medical conditions, but I do not think that this drug is appropriate in your clinical condition. This drug is usually indicated in persons suffering from increased daily sleepiness or sleep apnea. I do not think that this is the case. You should know that chronic tension headache does not lead to cognitive decline, especially at your age. The cognitive decline in your case could be attributed to the lack of concentration due to accumulated psychological stress. When you cannot concentrate, you cannot learn, and this makes you think that you suffer from a cognitive decline, which is not true. The good news is that this is quite a reversible situation, with the proper therapy. That is also the main cause underlying tension-type headache. Coming to this point, I would recommend starting SSRI (Fluoxetine, Paroxetine, Sertraline, etc.), which can help reduce the tension-type headache and also improve your concentration and your cognitive skills. Yoga can also help improve your situation. Psychological stress. Troubles with concentration. Tension-type headache and troubles with concentration. SSRI." } ]

[ { "from": "human", "value": "Hello doctor, After unsafe exposure, I got 49 days ELISA antibody test done, 71 days HIV proviral DNA PCR test, 87 days ELISA antibody test. All were negative. The antibody test I took is not a fourth generation test. Is it conclusive or should I take another test? If I repeat the HIV test after six months what is the chance of staying negative? I am facing the problem like small bumps in the tongue, from the last two days a little bit of pain below ear region and it is a little swollen. Is it due to HIV? I am stressed, scared, full of tension. These are hampering my life. I do not know what to do. Today I am in the 107th day of exposure." }, { "from": "assistant", "value": "Hi. Your tests are conclusive and you are not infected. No need for further tests. Ear ache and tongue papilla are not due to HIV and may be a simple bacterial infection. Consult ENT specialist for an examination to rule out otitis externa. You will remain negative even after six months and one-year post exposure and no need for further testing. Weight loss may be a stress-related issue. Just leave this HIV issue here and you will regain weight soon." } ]

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

[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I was awakened this morning by a pain in my vagina. I have the urge to urinate often and a constant uneasy feeling in my vagina. There is no pain in the kidney area. I am thinking vaginitis or urinary tract infection. Any suggestions? Because I cannot get to my gyno until next week. I have had vaginitis and UTI, but it has been years." }, { "from": "assistant", "value": "Hello. You have not mentioned your previous medical, obstetrics, gynecological, and drug history here. As per your history, you have pain in the vagina and frequent urination since today morning. You have a history of vaginitis and urinary tract infection years back. I really do not know if have u been treated for any disease like diabetes, hypertension or any other like thyroid. If yes, then try to have a full treatment. For your present problem, try to have a urinalysis, urine culture and vaginal swab for ruling out urine infection and pelvic infection. If you have not had your cervical smear within three years, then it is better to have that also as it is better to have this at least three yearly at this age if no cervical pathology previously. If symptoms are unbearable, I suggest having Paracetamol 1 g eighth hourly, but if severe pain, can increase to sixth hourly. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. If no vaginal discharge, but an increase in the frequency of urine and urine infection, I suggest tablet Augmentin 625 mg eight hourly for five days. Follow reports and discuss here or with your gynecologist. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My mother had a urinary infection caused by Escherichia coli. She was treated with a 10 days course of Nitrofurantoin. The count of bacteria in her urine then was 500 hpf and 50 WBCs. Her symptoms were relieved. But after a week, she feels slight burning sensation now. During the infection period and now she has been having an urge to go to the toilet quite often and some irritation while passing the stools too. The stool is watery. We got her routine blood tests done and her WBC count in blood is slightly higher. She has no fever. Please advice." }, { "from": "assistant", "value": "Hello. I reviewed all the attached reports (attachments removed to protect patient identity). Your mother has the stomach irritation and loose stools due to the medicines she had taken. She will be relieved from this in 2 or 3 days. She has iron deficiency anemia. So, you should give her foods which are rich in iron like spinach, red meat, and eggs. Also, you should give her plenty of fluids and cranberry juice. This will help her in her urinary tract infection (UTI). I suggest the following medicines for her." } ]

[ { "from": "human", "value": "Hi doctor, I had unprotected sex 19 days back. My period is always regular and my expected date was in the first week the following month. I had uneasiness and fatigue by the end of last month. Left side upper abdominal pain started a week back. It comes occasionally and goes on its own. Occasionally, the pain shifted to right side upper abdominal pain, then lower left side abdominal pain etc. My periods did not appear on the expected date. I did a pregnancy test yesterday, but the result was negative. Since yesterday, my appetite has reduced. After having dinner, my abdominal pain started increasing and it only stopped after I intentionally puked out half of the food I ate. Today morning there was severe abdominal pain, periods like pain, and some drops of blood came out. After that I was revealed. Now the bleeding again stopped. Periods like pain persists and uneasiness after taking food. I wonder, whether I am pregnant and is that implantation bleeding. I read that the implantation bleeding occurs after seven to ten days of intercourse and before your missed period. In my case, there is a long gap and it is two days after the missed period. What could it be? I have no other symptoms of sore breast or nausea. Except, I feel fatigue especially in mornings and has become an early sleeper. I also have uneasiness after having food. No aversion or special interest to any food. But, not at all feeling hungry. Frequent periods like pain in the center lower abdomen. If there is a possibility of pregnancy, when can I again do a urine pregnancy test?" }, { "from": "assistant", "value": "Hello. The symptoms appear more of premenstrual syndrome and as you had a day of bleeding with on and off lower abdominal pain off and on. There is likelihood that your menses shall resume again in few days unless you have conceived. Urine pregnancy test is not sensitive until eight days post missed periods and hence it is advised that you should opt for a blood based serum beta-hCG (human chorionic gonadotropin) test to rule out pregnancy conclusively. If the hCG levels are less than 5 ng/dL then you are surely not pregnant. But if they are higher then you are surely pregnant and the bleed that you had was an implantation bleed possibly or an early sign of threatened miscarriage. So, please get a serum beta-hCG test done to have a clear idea with regards to possible pregnancy as you had sex during your fertile period. Revert back after the test to an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 40-year-old male. I am married with two kids. I have been experiencing erection problems for the past eight months. I am able to get erection most of the time but it doest last until intercourse. My morning erections have disappeared. I have no diabetic history, no blood pressure nor high cholesterol, or other medical conditions. My desire is lower than before. I used to have a very good and active sex life with my partner until last year. Please advice." }, { "from": "assistant", "value": "Hi. I have some questions from my side. Do partial erection occurs only during intercourse or during masturbation? Are you able to insert during intercourse or that is also not possible? Do you have any history of diabetes or hypertension? Are you a smoker or alcoholic?" } ]

[ { "from": "human", "value": "Hello doctor, My wife is 24 years old and her height is 4'10\" and weight is 61 kg. She is a bit overweight and also has PCOD problem. We got married 2 years back and she cannot get pregnant. Please send the diet chart to reduce her weight. What are all the foods that she can take to improve fertility? Thank you and looking forward for your reply." }, { "from": "assistant", "value": "Hello, Welcome back to icliniq.com. Thanks for your query. From your information, I got to know that she is obese. She needs to reduce approximately 6 kg. It is too much weight for her height but no worry she can reduce it by diet and some exercises. She needs very low calorie diet of about 1200 kilocalories a day. Rice intake has to be as low as 50 g as well as 50 g whole wheat. Carbohydrate group not more than 150 g. Only brown rice, brown breads, and more fiber containing products like whole grains to be taken. Take more vegetables from gourd family and 300 g fruits have to be taken. Reduce sugar intake to minimum 1 teaspoon per day or have less sweets. Avoid the following food items: She can take the following foods to reduce her weight: Should not sleep at daytime, maximum keep working and follow dynamic lifestyle. Yoga or mild home based exercises are very helpful. If she is not serious about her diet, activities and lifestyle then she would face more complications. Improper food habits and improper meal planning. 1. PCOD (polycystic ovarian disease). 2. Food habits. 1. Junk foods. 2. Foods containing high carbohydrate. 3. Wrong foodings. Very low cholesterol and a bland diet. Proper small but frequent balanced diet to be followed." } ]

[ { "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 been taking steroids on and off for the past three years. I got artial fibrallation a year ago (never again since then). My blood pressure was quite high 152/90 at the doctor. LV is normal and LVEDD is 53 mm, normal systolic function, no regional wall movement abnormalities. LVH - 14 mm and beginning diastolic dysfunction (E/A=1, E/E‘ 8-15), LA 21 cm^2. I already lost 24 kg and now I am weighing 110 kg at 194 cm, my goal is 93 kg. I also stopped steroids and now my blood pressure is 123/75. Will my diastolic function recover once I managed to reverse the LVH?" }, { "from": "assistant", "value": "Hello. I have gone through your query. Can I know why were you on steroids? Was there any particular disease that was diagnosed and started you with steroids? As there are many determinants causing diastolic dysfunction, one of the common cause is hypertension. And yes, diastolic dysfunction is reversible in the majority of the cases over a period of time if you properly control your BP, obesity, and start doing regular exercise, consume a healthy diet, and lifestyle modification. You should also stop any addictions like smoking or alcohol if any. Also, get your blood sugar levels and thyroid profile checked. Get back with details about your disease and indication for steroids for further discussion and management." } ]

[ { "from": "human", "value": "Hello doctor, I am getting married three weeks from tomorrow. I am taking the Progestin only birth control pill as I cannot take the combination pill due to my migraines with aura. I talked to my gynecologist a couple of weeks ago to see if there is a way to adjust my period date so that I do not get it during my honeymoon. She told me to go off of my pill this week so that I will get it this week (which I did) and my period would not come for my honeymoon. However, I am certain that she told me the wrong dates as now I am right on schedule to get it again for my honeymoon. I am just wondering if there is anything I can do now. Would it work to go back in the pill for the next week and then go off again and get my period again so that I can push it back and I do not get it in my honeymoon? Or will that probably mess with my system too much?" }, { "from": "assistant", "value": "Hi. How are you doing? As you have already stopped the pill, you should be getting the periods any day next week. In that case, it was a right advise. Once you get the periods start the same pills again, without any break, till the date you want to postpone the periods. This will be a good cycle controller and a contraception. But, if you feel the periods are going to be delayed to the end of this month, then better start the same pill till the date you want to postpone the periods. Do not forget any pill in between or you will have periods in between. Just for an information, migraine can be cured by clearing the cause. Noone has found the etiology of migraine. Predisposing factors are lack of good sleep, sleeping too late, using the screens with bright blue light at close distance for long (tab, mobile, laptops, TV, etc.), missing timely meals, sweating a lot, taking too much of physical or mental strain, etc. So trying to make few changes will relieve you of this migraine. You can even start on combined pills, which are more effective than these Progestin pills." } ]

[ { "from": "human", "value": "Hi doctor,I am feeling a slight pain in the left side of my chest while taking a deep breath. Can you help me with the medicine to cure this pain?" }, { "from": "assistant", "value": "Hello, Welcome back to icliniq.com. I had gone through all the data posted. We need more details of the problem. Revert back with the answers to the above questions to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 18 years old, 120 pounds, 5'7\", teeth are not good. I do not have pain but have pressure and I feel like all my teeth move a little, not much. There is a swelling on one whole tooth, no pain though. What is going on? I went to my dentist today and he gave me antibiotics for swelling." }, { "from": "assistant", "value": "Hi. I have gone through your question and I can understand your concern. As per your history, signs, and symptoms, it seems to me that you might have apical periodontitis in the swollen single tooth. You need to take antibiotics as directed by your dentist. Pressure is also because of that. The problem of mobility of the tooth, if you feel it in early in the morning, that is normal and it is physiological because the periodontic ligament is relaxed and there seems to mobility. You need to get your teeth cleaned (dental scaling) after the antibiotics are over. Carious tooth. IOPAR X-ray. Acute pulpitis. Acute apical periodontitis." } ]

[ { "from": "human", "value": "Hello doctor, My father is 68 years old and has undergone ileal conduit surgery ten years back. Then parastomal hernia repair seven years back and again four years back. Now he has again developed a parastomal hernia. Now the surgeon is not ready to operate further. Please advice." }, { "from": "assistant", "value": "Hi. Sorry to hear about your father's condition. There are two options now. Due to elderly age and recurrent problem and anesthesia risk, we can manage it conservatively trying to avoid complications. It will be a safe position. If you wish to take the risk, we can approach laparoscopically. It will be high risk and technically demanding. We need to shift to higher facility and pose a high risk because of previous surgeries. So, the choice is yours." } ]

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

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

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

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

[ { "from": "human", "value": "Hi doctor, I am a sexually active female. After a day of such vigorous activity, I am suffering with symptoms such as stinging and burning sensation while peeing. I am getting the urge to pee again and again while actually do not pee much. I still feel that my bladder is not fully emptied. There is a little pressure in the pelvic area with mild pain and discomfort. My urine is smelly too. As per what I read over the internet it seemed to be UTI. So, I ignored it for a day or two but the symptoms are still there and strong. I would very much appreciate you to get a solution for this as soon as possible." }, { "from": "assistant", "value": "Hi. For further information consult an urologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My mom had a heart attack three days ago and she is having treatment and my doctor said after angiogram she had three heart blocks: one is (90-95 %), second (90 to 98 %), and third (60 to 70 %). So, how much time do I have to do the angioplasty? I mean he said she needed two rings and I am looking for the best treatment. Here the doctor is saying that she does not have time. It has to be done within two days. Some extra information: she had diabetes for a long duration and before this heart attack she had several symptoms like she could not sleep properly for two days and had problems with breathing and yes on treatment, here on the first day, the doctor said there is some water in lungs which has been cleaned now and some injuries in kidney which has been stabled with medicines. So, I am now confused about what should I do now. Do I have to fix ring on heart according to this doctor or do I have time for waiting for the best treatment? And yeah she is having now some saline and some medicines but I do not know this names now. Her physical condition is better. She is breathing and talking fluently." }, { "from": "assistant", "value": "Hi. Your mother suffered a heart attack and angiograph shows triple vessels disease of which two are having a critical block with diabetes (attachment removed to protect patient identity). In diabetic patients, coronary artery disease is very common. At the present moment, it is not wise to shift the patient. However, wherever you go you will have to trust the attending doctor. It is better you follow the advice and go for it. Do not make any delay. Have faith in God. He will take care. Treat diabetes adequately simultaneously. For more information consult a cardiologist 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 father has motion problem. For the past one month he is taking psychiatric medicines. Motion problem is there for the past 10 days. Actually he goes motion daily but only very little. Rarely twice a year he gets this problem but after taking medicines it will get cures. But this time still it continues. He is taking Ramistar for BP, Gride M forte and Galvus 50 for sugar, Stamlo 5 mg, Ecosprin, Quetiapine and Daxid for anxiety and Softovac SF for three days. Please guide me." }, { "from": "assistant", "value": "Hi. Please try the following combo to get rid of constipation: For further information consult a medical gastroenterologist online -->" } ]

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

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

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

[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor,I am 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 father, who is 58 years old, having diabetes for the last 23 years. He always takes Insulin and other sugar tablets. His weight is 67 kg and height is 5'5\". For the last two months, he has been taking Aspirin 75 mg. He had a minor headache for the last few days. Also, he had a cold and cough and took Azithromycin. Six days back, some blood came out through cough and he was advised to stop Aspirin. So, he did not take Aspirin for the last five days. Yesterday, he felt nauseous and vomited continuously. He had blurred vision, felt an imbalance while standing and had severe headaches. Then, he had a CT scan and a subdural blood clot was found. CT scan report summary NCCT of the brain suggests subacute on chronic subdural hemorrhage in right cerebral convexity with mass effect. So, our neurosurgeon suggests for operation, but due to Aspirin he kept the operation on hold for four to five days. But, my father is still unconscious. He is in ICU and under observation. But, in this condition, is it right decision to keep the operation on hold? In this condition, can we move the patient by flight to another place for better treatment?" }, { "from": "assistant", "value": "Hi. For further information consult a neuro surgeon online -->" } ]

[ { "from": "human", "value": "Hello doctor, I want to ask is it possible for me to transmit HIV through hand cut, (I have attached a picture) because I had anxiety when shaking hands. I am almost certainly HIV negative according to tests, but still anxious. Kindly advice." }, { "from": "assistant", "value": "Hello. No, unless you put your hands in HIV positive blood." } ]

[ { "from": "human", "value": "Hi doctor,About two years ago, I did LASIK surgery to correct short-sightedness. I recovered from it and have a normal vision now. The trouble note is my eyes gets dry soon. And sometimes when I wake up I cannot even open my eyes as it is too dry and I need to keep it closed until it waters which causes discomfort and pain. I am traveling by bike now to the office every day which causes dryness and ultimately stressful eyes. Is there any medication that I can try to get eyeball lubricated and protect the eyes from dust and irritation?" }, { "from": "assistant", "value": "Hello. I am sorry, but there is no permanent treatment or cure for dry eyes, but yes with treatment, your life will become comfortable. All these measures together help. For more information consult an eye care ophthalmologist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, I am getting tingling sensation in my head and my perception changes. Sometimes I feel fine but sometime depressed and anxious. This process goes on in a cycle and I feel very difficult to continue my life like this. I do not have any motivation and there is no sense of pleasure. I am always unsatisfied. Is it schizophrenia?" }, { "from": "assistant", "value": "Hi. You need not worry by diagnosing yourself. Kindly answer the questions given below. Revert back with the answers for the above questions to an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, About every year, I have this problem but this year it is there for a long time. I am a girl that have these eye problems. Burning eyes and redness of the eye, puffing around the eyes with pain, tears from the involuntary eye, blurred vision, and the doctor did not diagnose my problem. So, my age is 18 and not going to school because of this problem. Please help me." }, { "from": "assistant", "value": "Hello. Since you mentioned that you get this problem every year, this suggests the cause as seasonal allergic conjunctivitis. This problem frequently causes dry eyes, which causes a feeling of burning sensation. So all these problems go hand in hand. To be honest, there is no permanent cure. But, this problem can be lessened and avoided by following the steps given below: Avoid rubbing the eyes (is most important). Use over-the-counter anti-allergic drops like Olopatadine 0.1/0.2 % along with lubricants like Carboxymethylcellulose Acetate 0.5 % (these are mostly free of side-effects, so it can be used over prolonged periods). Close your eyes and apply ice cubes over them. Visit your ophthalmologists in case of the following. Pain, sticking together of eyelids, drop in vision, non-resolution of symptoms despite treatment for around 10 days." } ]

[ { "from": "human", "value": "Hello doctor, I am a 27-year-old female who is 5 feet 3 inches weighing 140 pounds. For the past four months, I have been dealing with stomach problems such as diarrhea and bloating and lack of appetite. It did turn out that my gallbladder was functioning at 18% and just last week I had a laparoscopic surgery and had it removed. I have never had stomach problems in my life and they do not run in my family either. The only family medical history is heart disease. Anyways, I am a bit paranoid. I have never had issues with my stomach and it has been a week since the surgery and I still do not have a great appetite. I have problems with my stools too. In the morning they are horrible then later I have semi-solid stools. I would probably have to go two more times and I find yellowy diarrhea. In the harder stools, I have noticed little red spots that make me nervous. What can these red spots be? The surgeon told me that everything looks good. But, can there be cancer or Crohn's? I have not been eating any items red in color. I actually still have quite a healthy and a low-fat diet. Please help." }, { "from": "assistant", "value": "Hello. I went through your detailed summary. Hope your queries are cleared. For more information consult a medical gastroenterologist 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, 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 feel a pressure in one of my front teeth. It is not painful and does not hurt to eat. Just feel pressure. I remember biting something the other day and it felt a little like I had bitten it too hard. No visible change to any of my teeth and it is not painful. The pressure is inconsistent." }, { "from": "assistant", "value": "Hi. I had gone through your question and I can understand your concern. As per your history, it looks because of biting on hard substance, periodontal ligament has been damaged transiently, it is a thin membrane between teeth and bone. There is nothing to worry, it will selfheal within three to four days. Remember that do not keep touching it, this may be enjoyable but it can lead to periodontal tissue damage. Also, take soft foods and do not bite on hard fruits like apple or even hard meat too." } ]

[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have had these multiple skin lumps on the very tip of my elbow for a couple of years now. I have attached the photos for your reference. They look like a wart but are clustered together. Every medication I have used on them has done absolutely nothing. Recently, they have begun to grow and become sensitive. My elbow feels tender right above them. What could they be? I am currently on 75 mg Zoloft, 50 mg Seroquel and 1 mg Ativan (only when required)." }, { "from": "assistant", "value": "Hi. For further information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 38 years old and a little obese. I have noticed two or three cherry color spots on my chest and back. Are they something to be worried about? I hope it is not a sign of some serious disease. Secondly, I am experiencing some generalized itching on my body. Last year same time of the year, I felt the same. Is it due to winter and dry skin? I am putting coconut oil and it gets better and also having Allegra 180." }, { "from": "assistant", "value": "Hi. I have gone through your case. These red spots are called cherry angioma and these are nothing to worry. They are just like black moles which normally do occur on our skin. These are due to swelling of the blood vessel. In winter we take bath with hot water which makes our skin more dry by evaporating water from our skin. Heaters do the same. As a result, the skin becomes drier. Use mild to moderate hot water, coconut oil or liquid paraffin both are fine. Or mix one teaspoon of Betamethasone lotion with two tablespoons of olive oil and apply two times a day for five days only. Take Allegra for five days only. However, if other family members are also having an itch then it is not due to winter issue." } ]

[ { "from": "human", "value": "Hello Doctor I am a 30 year old male, married for 2 years. I do not smoke or drink. There is no medical history. My penis is circumcised from childhood. The problem which I am facing is that I do not feel any sensation in my penis glans at the time of sex or while masturbating.In normal state, my penis is dry. I use lubricants while having sex. But still the penis remains numb. Only a few seconds before ejaculation I feel the sensation in my penis. I started masturbating 10 years back. Is this a reason for this numbness? I do not have any erectile dysfunction. But still I am not able to enjoy sex due to this problem. Is there any medication to enhance sensation? Please help me overcome this problem." }, { "from": "assistant", "value": "Hello. I read your query and understand your concerns. Having less or no sensation in penis while having sex is generally due to local factors. The systemic illnesses rarely affect in this way. Masturbation is normal and it does not have any adverse effects either on sensation or erection. So it is time to realize that the sensation problem is not due to chronic masturbation. The possible reason as per available history is dryness of penis which makes the nerve endings non-functional over a course of time. To counter this problem it is essential to use oil based soap (rather than traditional soap) and skin moisturizer which prevent the dryness of skin of glans penis. It can be said that you can use any branded moisturizer for application to penis and local area after taking bath every day. During love making session I advise you to use Durex real feel which is available across the globe for increasing sensation and making the sex more pleasurable. Unfortunately there are no medicines for this purpose and lubricants which I have mentioned above will be helpful to a large extent. Revert back to a sexologist online for further follow up -->" } ]

[ { "from": "human", "value": "Hi doctor, I have undergone preventive blood test. There is abnormality in cholesterol level. I have enclosed the reports for your reference. Kindly advise what to do based on my reports. Thank you." }, { "from": "assistant", "value": "Hi. I have read through your query in detail. Based on your report (attachment removed to protect patient identity) these are my observations: Diabetes screening, chloride content, pancreatic amylase, iron levels, liver function test, thyroid function test, kidney function test and digestive enzyme lipase are all normal. Slight variation is observed in blood cells. Calcium content is slightly low. Cholesterol is in borderline and triglycerides are high. I would like to give you few suggestions:" } ]

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

[ { "from": "human", "value": "Hello doctor, My wife is 25 years old. She has been developing lot of moles on her body especially on hands and face. Initially they are very light almost like a small brown spot, but gradually they are becoming darker. They are incrementing periodically. What would be the reason for it? Is there any medication for it to stop and eradicate the issue? Thank you." }, { "from": "assistant", "value": "Hi. As you explained the disease that your wife has multiple small moles over face and hands, it certainly indicates solar lentigines. It is a multiple freckles type mole due to sun exposure. Now, let me explain the treatment and precautions. Avoid exposure to sunlight as much as you can. Cover body with clothes and cap while going out. Use sunscreen over face and hand every four hourly till evening. This will prevent further development of disease. Now to treat existing lentigines we can opt for laser. Creams will not be of much helpful in this. Q-switched Nd:YAG laser (neodymium-doped yttrium aluminium garnet) will be very useful. You can consult a doctor around you for this laser. One or two sitting would be enough to remove it completely. There is no side effect. It could be costlier, but results are good." } ]

[ { "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, A few days back, I got hit on my finger with a tennis ball. I am unable to fold the finger from that time. I thought it as normal and applied ice. Also, I am using an ointment given by an RMP. It is almost two days now and still, I am unable to fold the finger. If there are three joints in a finger, then I am getting pain in the middle joint whenever my dad or mom does some massage with ice. Kindly help me with the above issue. Thanking you in advance." }, { "from": "assistant", "value": "Hi. I know how it feels when the finger got hit and unable to fold. First of all, after applying ice for 10-15 minutes ask someone to hold the finger from hand to the first joint. As you know there are three joints in a finger, ask them to slowly move the first joint without disturbing the second joint, and then do the same with the second joint by holding the first and the third joint. Repeat this for at least four times a day. If unable to do movements, then you can visit a surgical shop and ask for a single finger grip. which helps in the immobility of fingers. If available, can take Paraffin wax used in physio treatment. Melt the wax and apply it on the finger for 10 minutes. The wax therapy will be available at any Physiotherapy Centre. I hope these remedies will provide some relief from pain and gives mobility of the finger. Follow up after a week for the further treatment plans. Thank you." } ]

[ { "from": "human", "value": "Hello doctor, I am 49 years old, moderately active, all biochemical parameters mid-range normal. Fasting sugar levels steady at 147 to 149, PP 159 to 250, drops to 80 to 105 at about 6 PM, after lunch at 1.30 to 2 PM. I am having (Glycomet Trio1 and Glycomet GP1) twice a day. Am unable to understand how to get these levels down to fasting." }, { "from": "assistant", "value": "Hi. I understand your concerns. Great fluctuations in blood sugar level are common in diabetics. Your treatment is suitable but it may require some small modifications. My advice in order to have better control is that you have to eat a small meal between the main meals. Stay strictly with the diabetic diet. You can miss one dose if you are not going to eat the meal or you are going to eat a very small amount of food. If you tolerate Metformin well, I suggest that you increase the dose to 1000 twice daily after food and decrease the dose of Glimipride as Metformin decrease the sugar level back to normal but not causing hypoglycemia like Glimipride (after consulting your physician). Measuring HbA1c will give us a good idea about how the blood sugar was controlled over the last three months. I need to know about your meals timings and your medications timings . Do you take both medications twice, so that you are taking four tablets in total or you take one in the morning and the other in the evening? So you take only two tablets? Please provide me with your feedback. For further advice, please do not hesitate to send follow up query." } ]

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

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

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

[ { "from": "human", "value": "Hi doctor,I have a quick question. I have fatigue, some soreness in my throat. I might have a high temperature and some dry lips (dehydration). I also am worried because I had a handjob from a stripper about two weeks ago. We did not have sex but she did spit saliva on my penis. There was some rubbing from her ass on my penis but we did not have anal sex. I am not sure if I should be worried about HIV. I am not sure if I really have a fever and if I have something from the flu season." }, { "from": "assistant", "value": "Hello. I have noted your concern. A handjob is not a risk. Saliva is not infectious unless it has blood contaminated from bleeding gums or open sores in her mouth. Anal rubbing without actual penetration is not a risk unless she had open weeping sores in the perianal area or anal rim. Otherwise contact with outer perianal skin is not a risk for HIV (human immunodeficiency virus). Regards. For more information consult an HIV AIDS specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 38-year-old female. I have anxiety, stress, breathing difficulty, dizziness, and, loose stools. Also, I am not able to eat. Currently, I am not under any medication. But a few years back, I had a medicine called Typlin C. Kindly help." }, { "from": "assistant", "value": "Hello. Your symptoms could be related to a panic disorder. For this reason, I would recommend consulting with a psychologist or psychiatrist. Starting Typlin C again or another type of antidepressant (SSRI) may be necessary. I would also recommend checking thyroid hormone levels for possible thyroid gland dysfunction. In the meantime, I recommend avoiding coffee intake and start practicing yoga and meditation. Recreational sports can help too. I remain at your disposal for any further questions whenever you need." } ]

[ { "from": "human", "value": "Hello doctor, I have pain in my neck whenever I turn it to the left, occurring in the back left-hand side of my neck, and this has been happening for the last six months. I am currently on no medication. I am a female, age 15, 5'5\"." }, { "from": "assistant", "value": "Hello. I have read your concern. I feel that there could be some facet irritation that can lead to this restriction and pain on your left side of the neck. Do not worry. I suggest you to kindly use a neck pillow or support your neck properly while sleeping. At least make sure you support the neck curvature with a rolled towel. Keep icing frequently over the painful area. Drink water adequately. Hydration will help relax muscles. Have proper sleep. Avoid stress. Gentle massage over your neck help reduce stiffness and pain. Mild gentle stretching of the neck help maintains range. Revert back to me once pain comes down to suggest you strengthening program." } ]

[ { "from": "human", "value": "Hello doctor, I want to buy contact lenses. I have a spectacle power on both my eyes. The power in my right eye is -2.75, cylinder - 0.50, and axis 20. In the left eye - 2.75, cylinder - 0.75, and axis 20. Please recommend what lens I should opt for. I need a recommendation for both regular wear and daily disposables. I am unable to find anything, especially for my right eye." }, { "from": "assistant", "value": "Hello. Hope I have answered your question and the information is helpful to you. For more information consult an eye care ophthalmologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, What ppm and percentage of fluoride are good for adults? I am trying to figure out what kind of toothpaste is good, but I hate mint, so I am trying to check the percentages of fluoride that is good for an adult." }, { "from": "assistant", "value": "Hello. Fluoride content can be around 1000 to 1200 ppm which is more than enough for the prevention of cavities. No need to go higher than that. More important is the proper brushing technique. Go for up-down or circular brushing technique without too much pressure onto the teeth to prevent wearing away of enamel in the long term due to abrasion." } ]

[ { "from": "human", "value": "Hello doctor, My daughter is 9 years old and has a typical headache at right temple. The headache, she says, is more or less constant and not severe in the day but is intense at night. She sleeps at around 10:00 PM and wakes up around 12:15 AM to 12:30 AM. This is when she cries as she is not able to bear the pain. She gets up from the pain itself. We have already done head X-ray and sinuses is ruled out. Even though the medicine is for antibiotics and I am not sure that it is working, as there is no improvement for last four nights (saving the first night when there was no pain and she could sleep the entire night). During her night pains when we give her Crocin, she is better after 10 to 15 minutes and then typically sleeps the rest of the night. We are trying to get appointment for silent MRI and have our fingers crossed. However, as you are very experienced and could identify a pattern or known case or cause, please do share. Again, the pain is only at right temple and nowhere else" }, { "from": "assistant", "value": "Hello. I understand your concern and would explain that this type of headache could be related to hipnic headache. Anyway, a brain MRI or CT scan is necessary in order to exclude a possible brain lesion, as the headache is always located in the right temple. I would also recommend performing PCR and ESR for inflammation. Temporal arteritis is another possible disorder, which could lead to pain in this region. In such case steroids would be needed. A Doppler ultrasound of the temporal artery is needed too. In case the brain MRI, inflammation tests and transcranial doppler of the temporal artery is normal, I would recommend considering hipnic headache as a possible cause. In such case Flunarizine or Topiramate would help improve her situation." } ]

[ { "from": "human", "value": "Hello doctor, My pregnancy test is negative. But my period is not coming. I checked my pregnancy five times with pregnancy kit. Every time it shows negative. But my period has not started. I take Regesterone 5 mg for three days. I took my last dose two days before but not yet got my periods. So what should I do now?" }, { "from": "assistant", "value": "Hello. Since your urine pregnancy test is negative, there is nothing to worry about. The delay could be because of hormonal changes. After taking Regesterone it will take a week or so to get your periods. So relax and do not worry. Wait for a week or so and if you do not get periods by then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause. Do get back to me with reports so that I can guide you further on." } ]

[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "assistant", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]

[ { "from": "human", "value": "Hello doctor, My mom is suffering from NAFLD. Is she supposed to avoid both saturated fats and unsaturated fats? Can she eat nuts like cashew and groundnut?" }, { "from": "assistant", "value": "Hello. Dear, she may take unsaturated fats like omega-3 fatty acids or fish oils or cod liver oil, etc. Avoid spicy food and saturated fats. Vitamin E and Vitamin C are useful to reduce fat in the liver. Use tablet Pantoprazole before breakfast for one week in case of acidity or indigestion which is more common in fatty liver disease. Regular exercise, weight reduction may be useful. Please consult your physician for a follow-up scan and blood tests. Take care." } ]

[ { "from": "human", "value": "Hello doctor, I am having itching and burning problem on my penis. I cannot lift my foreskin upward. It is painful to upward the foreskin. I think I have acquired a fungal infection. My wife was under treatment of heavy menstruation periods for her menopause phase. She had passed through heavy blood flow during her periods. Used 5 to 6 pads during the day. Now, she is perfectly alright for the last 20 days. We had intercourse before seven days and then I developed this symptom of fungal and itching. She is also having the same complaint but she is having itching experience only which is too less compared to me. I have taken one Fluconazole 150 and using skin cream named Castor-NF suggested by the family doctor. Please suggest treatment and medicines to us." }, { "from": "assistant", "value": "Hi. Can you forward a few pictures of the affected area, if possible? Your concern may be balanoposthitis most probably. Continue Fluconazole 150 mg. Have them weekly once after dinner for four consecutive weeks and for your spouse advise her Fluconazole 150 mg two tablets with a gap of 15 days. That is two weeks. Use Cetaphil cleanser for genital wash and Seriva cream twice daily after wash for 30 days. Check your fasting and post prandial blood sugar levels and thyroid profile and report me once you get your reports." } ]

[ { "from": "human", "value": "Hi doctor, My son is 3 years 9 months now. He has been diagnosed with benign childhood epilepsy. He is taking Clobazam 15 mg at night and Topiramate 100 mg per day for last four months. His seizures are under control and he attends LKG. The issue is that he is not able to concentrate in his studies and he does not like to sit with patience for a while. I am worried whether he is disturbed by his medicines? Please clarify the dosage too as his present weight is 15 kg." }, { "from": "assistant", "value": "Hi Welcome to icliniq.com. I have read your question in detail. The initial dose of Topiramate is 1 mg/kg/day which is gradually increased to 5-10 mg/kg/day. Your child is getting 100 mg Topiramate which is around 6 mg/kg/day. So, the dosage of Topiramate is correct. There are some side effects like anorexia, weight loss, blurring of vision and glaucoma. But these occur at late stages and when higher doses are given. So, in my opinion, Topiramate is not causing any problems in your child. Secondly, the initial dose of Clobazam is 0.1mg/kg/day which is gradually increased to 0.3 to 1 mg/kg/day. In your case, your child is getting 15 mg daily which comes to 1 mg/kg /day. Side effects of Clobazam are constipation, behavior changes, aggression, sleep disturbance, weight gain. So, I think that aggression and behavior changes in your child could be due to Clobazam. You should meet your doctor and ask him to lower the dose of Clobazam or substitute it with another antiepileptic drug." } ]

[ { "from": "human", "value": "Hi doctor, I had an appendectomy last week and they have started me on antibiotics, Flagyl, through an IV. Would this affect my birth control? Should I be using other protection?" }, { "from": "assistant", "value": "Hi. Flagyl (Metronidazole) as such has no effect on birth control. You need not take any extra precautions for the sake of Flagyl itself. But, if you were on pills earlier and had to discontinue due to surgery, then, of course, you need other protection. To know the methods of birth control consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 29-year-old male, weigh 90 kg, height is 182, non-smoker, non-alcohol drinker. I do not have any symptoms or signs, normal eye, and skin color. I am taking Cipralex 15 mg for the past one year. Had a history of bladder stone and it required admission for one week until it passed normally by medications without surgical intervention. When I reviewed my blood test results, I found out the bilirubin level is bit higher than normal. I was overthinking, so I kept repeating the test weekly. What do you think of my case? Could we consider bilirubin high? If yes, what might be the causes?" }, { "from": "assistant", "value": "Hi. If Mmol means micron mol, then it is fine (attachment removed to protect patient identity). It looks like a normal variant of hyperbilirubinemia. Most common cause of the condition is hemolysis, Gilbert syndrome is also a common cause of such a situation. In both the conditions, we find the unconjugated bilirubin. I hope your urine is not yellow. Another issue is you have high BMI. It is obesity. So, you may have a fatty liver disease, that could be the cause of high ALT. I want to do a fibroscan and repeat ultrasound for fatty liver and TATA box mutation for Gilbert syndrome and reticulocyte counts with smear examination and G6PD level in blood. Rest of the workup you have already done. You may provide the complete reports of the investigation, including the previous investigation. So it will be good for us and help to interpret. Hemolysis (thalassemia variant or G6PD deficiency), Gilbert syndrome, fatty liver disease. Do fibroscan and repeat ultrasound for fatty liver. TATA box mutation for Gilbert syndrome, reticulocyte counts with smear examination and G6PD level in blood, liver function tests, fasting blood glucose, HbA1c. Hemolysis (thalassemia variant or G6PD deficiency), Gilbert syndrome, fatty liver disease. Provide the reports. Do regular exercise, at least 1 to 2 hours a day. A low-fat diet. Target weight is 75 to 80 kg, lose 5 kg in the next three months. Stop alcohol, if you are addicted to that. Capsule Vitamin E, 400 mg once in a day." } ]

[ { "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": "Dear doctor, I am 33 years old. I have no desire for sex. There is no erection in the penis since the last three months. I am a regular tobacco user. Give me advice." }, { "from": "assistant", "value": "Hi. Kindly quit tobacco immediately. Tobacco usage is one of the causes for sexual dysfunction. You can take capsule Nano-Leo two capsules in the morning and night after food for three months, which is slow acting. After a month, let me know how you feel. If it is not effective after three months, you have to undergo investigations. So, get back to a sexologist online after a month -->" } ]

[ { "from": "human", "value": "Hello doctor, My wife is 25 years old and she had her period on the 14th of last month. On the 1st of this month, while having intercourse, unfortunately, the condom broke. She had taken I-pill within two hours. Can you please advise if the tablet will work or not?" }, { "from": "assistant", "value": "Hello. I have gone through your history and understand your concerns. As you had I-pill, the chances of pregnancy are not there in your case. Delayed menses, if any, are due to hormonal imbalance caused by I-pill. Just wait and watch for your menses. For more information consult an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor,I met someone yesterday and we were speaking to each other seating closely and touching hands. I came to know later he was advised by doctor for TB medicine suspecting TB in him day before. He was not sneezing or coughing at the time of the meeting. However, since the evening I started having frequent cough and fever in my body. These are some queries about this. Are there any chances of myself getting TB? Which medical test should I do now? What preventive medicines I can take to avoid chances of getting TB? How long it may take to confirm whether I have infected TB?" }, { "from": "assistant", "value": "Hi. To help you better, I need to know first of all that that person has TB of which organ of body? Like TB lungs, TB bone, TB lymph node?" } ]

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

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

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

[ { "from": "human", "value": "Hi doctor, My sister is 23 years old. She had unhygienic sex a couple of weeks ago. She started feeling itchy on her vagina. I am worried it might be herpes but I need confirmation from a specialist before we visit the doctor. It looks clustered and yellow. No hard lump under and it just looks inflamed. She does not complain of pain anywhere else. There is no pain inside the urethra, no burning sensation while urinating and the discharge is whitish-yellowish and watery. She does not have any sign of fever. She bought labia herpes cream yesterday. After application it changed the color today to darker yellow and some of it fell off. What could this be?" }, { "from": "assistant", "value": "Hi. I have reviewed the attached photographs (attachment removed to protect patient identity). The closely grouped fluid filled blisters and yellow crusted lesions seem to be most likely herpes infection. You do not have to apply Acyclovir cream as it will not be much effective in genital herpes. You should start with oral antiviral like tablet Acyclovir 400 mg thrice daily for a week and apply topical antibiotic like Mupirocin cream on the lesions twice daily. Do not use soap over the affected areas and wash only with plain water. Caused by herpes virus; either HSV1 or HSV2 (herpes simplex virus 1 or 2). Herpes genitalis. Avoid intercourse till the healing of lesions." } ]

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

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

[ { "from": "human", "value": "Hi doctor, Recently, I took out my bottom left wisdom tooth. I have got stitches over the extracted site. I have been taking Paracetamol and Ibuprofen 400 mg. Still, I have pain in the extracted region. There is no pus coming out from the gums. It looks swollen, and it is not red. Is the pain normal? Please guide me." }, { "from": "assistant", "value": "Hi. It is not normal, and it is a sign of infection. There can be a root tip or a bony spicule left in the extracted site. Consult your dentist soon. Kindly take a radiograph of the extracted site soon and correct the problem if there is a presence of root tip or bony spicule in the extracted region. You can take tablet Ofloxacin 200 mg and Ornidazole 500 mg two times a day for five days." } ]

[ { "from": "human", "value": "Hi doctor, I am a 22 year old woman. I took three I-pill tablets within two weeks. Will it have any side effects? Are my chances of pregnancy low? Also, I have polycystic ovaries. Waiting for your answer." }, { "from": "assistant", "value": "Hi. I-pill should not be taken more than once in a cycle. If you need to take it three times within two weeks, then it is better to take regular contraceptive pills for three weeks and repeat after a week gap. It will treat your polycystic disease and prevent pregnancy. Chances of pregnancy are low, but many I-pills may disturb the menstrual cycle. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I just recently started urinating blood when I go to the restroom. I have a constant urge to urine and I have no idea why out of the blue this is happening. I am a male, 36 years old, 6’2\", 190 lbs. I have no medical issues or past history of kidney problems or cancer. Can it be due to STD?" }, { "from": "assistant", "value": "Hi. Painless hematuria must be evaluated thoroughly and some factors must be taken into consideration like smoking, occupational exposure to certain substances, family history of kidney disease or cancer. Do not get scared sometimes it is something simple like urinary tract infection or mild trauma in the urinary tract or mild stone. Please get the following investigations done so that proper treatment can be initiated. Infection, trauma. Urine routine and microscopic examination, abdominal ultrasound, abdominal CT scan." } ]

[ { "from": "human", "value": "Dear Doctor, I have hypothyroidism and I am on medicines for it. Also hysterectomy was done 3 years back. I want to reduce my weight now. Please advise appropriate diet and exercise for me. Age - 52 years/ female.Weight - 75kgs, height - 5'4\"." }, { "from": "assistant", "value": "Hi. Your weight gain may be partially due to hypothyroidism.You may start with brisk walking for 20 minutes daily and gradually increase it to 45 minutes daily. Please do not lift heavy weights at this age. This may cause more harm than benefit. Please tell me how much thyroxine are you taking and your TSH level and medicine details so that I can see whether thyroid is not the cause of your problem. Please note: Definitely you will lose weight if you follow this. Revert back to an endocrinologist online for further help -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

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

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

[ { "from": "human", "value": "Hi doctor, I have a regular cycle of 28 to 30 days cycle. I got my last period last month, and I had bleeding for five days. But I had unprotected sex on the third day of my periods, and I took I-pill within 10 hours. I have not got a withdrawal bleed, and also, I have not got my periods this month. Can I be pregnant? When can I get my periods? Is there anything to worry? Please suggest." }, { "from": "assistant", "value": "Hi. I have seen many ladies taking I-pill post unprotected sex are unable to get withdrawal bleed. But they can have heavy bleeding in the same menses during which they had sex, or they can have prolonged bleeding during the periods when the I-pill was taken in the proper dose, timings and without vomiting. You can also do a blood pregnancy test if you feel anxious. The result would be less likely positive as the sex was not under a fertile period. You can have a menstrual induction. Take tablet Primolut 10 mg (Norethisterone) twice daily for five days and wait for bleeding for one to weeks." } ]

[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "assistant", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]

[ { "from": "human", "value": "Hi doctor, 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, My 5 year old son has a lump on his neck. He had a similar lump about two years back, but it disappeared. The size of the lump is a little bigger this time. What to do?" }, { "from": "assistant", "value": "Hi. Lump in the neck is due to an enlarged lymph node caused by an infection. If the node is enlarged, then a course of antibiotic has to be given after consulting a pediatrician. If it responds to the antibiotics, then nothing more is required. But if the lump is increasing in spite of antibiotics, then the following tests need to be done to know the type of pathology:" } ]

[ { "from": "human", "value": "Hi doctor, I have two tiny kidney stones of size 3 mm in my left kidney. Is there any ayurvedic medicine to treat kidney stones? Can you please suggest some medicines so that the stones pass in my urine easily." }, { "from": "assistant", "value": "Hi. Renal calculus can be removed easily by ayurvedic medicines. As you mentioned 3 mm sized two stones is present in your left kidney, the size of the stone is small and easy to remove. I suggest you try taking the following. The probable causes of renal stones are drinking less than sufficient amount of water, having a sedentary lifestyle, eating fried and spicy junk foods. Try the following preventive measures. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Follow-up after 15 days. Revert after 15 days to an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am losing my hair day by day. Can I use Finasteride? I have hydrocele. Is it related to my testosterone?" }, { "from": "assistant", "value": "Hi. Please do not go to Finasteride straight away. First, the cause and the pattern of your hair loss have to be assessed. It could vary from seborrheic dermatitis to androgenic alopecia to any other skin disorders too. Then, treatment can be planned. Have a consultation with a dermatologist for physical evaluation and get your problem assessed. Hydrocele is not related to testosterone. It is just a fluid collection in the sac. So, please do not get confused. For further information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hi doctor,My son is 5 years old. He occasionally complains of burning sensation in urine. Before five months, he complained of burning sensation, and we did a urine test which showed pus cells 2 to 3 and albumin haziness. The doctor said that as fine and just advise to give more fluids. We did two more urine tests in the following three months, and they were normal. He occasionally complains about burning and sometimes, has puffy eyes in the mornings. I searched on the internet and got scared. Please advise if there is any need of worrying." }, { "from": "assistant", "value": "Hi. I understand your concerns. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am having trouble in my relationship, my partner has not been contacting me for the past one month and it is affecting me a lot. I am talking to myself considering that I am talking to him, I am making up stories of why he is doing this, sometimes the story is against him and somtimes it is supporting him. I am scared of waking up in the morning thinking that I have to now go throught one more day suffoctaing and crying for the same reason. I am even scared to lock my doors because I feel totally all alone like if there is noone for me, even though I stay with my parents and dog. Please help me to get out of this situation. I seriously need your help." }, { "from": "assistant", "value": "Hello. This will last for some more weeks and you will then get adjusted to new change in your life. If he is not contacting you and is totally ignoring you then in that case there is no benefit in thinking about him. If he is so stubborn that he has no contact with you for the last one month then he should get the reply in the method he deserves. You should focus on yourself, whenever you have thoughts about him you should call your friends or your family members. Try to distract your mind. You can go for shopping to distract yourself. One month has passed already so I think you have developed good strength. Try to consolidate your strength. This is the age at which you should focus on your studies and career. He should be ignored totally. If you will ignore him, you will get more strength." } ]

[ { "from": "human", "value": "Hello doctor, I started feeling fatigued and nauseous three days ago. I threw up once three days and the nausea went away shortly after. Yesterday morning I started having diarrhea. I went to the bathroom 15 to 20 times for diarrhea despite taking Pepto-Bismol several times. I am still having diarrhea today but I only had to go to the bathroom three times in five hours. I am still feeling exhausted and have little appetite. I am a 20-year-old, female, with no other health conditions. I am currently taking Aubra (Levonorgestrel and Ethinylestradiol tablets) 0.1 mg/0.02 mg once daily." }, { "from": "assistant", "value": "Hi. You have lost quite a bit of fluid. You need to get rehydrated again. If your loose motion has not stopped, you need to take tablet Loperamide once, and you need IV saline to bring your BP up. It is better to get to the ER and get the IV saline first. Please go to the hospital now or ask someone to come over to your place to give you the IV saline. If you have a vomiting, do not eat anything as this will cause more vomiting and you will lose more fluid and electrolytes." } ]

[ { "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 undergone cystectomy in my left ovary to remove a chocolate cyst of 9 cm. It was done before two years. After that, I got conceived, and my baby boy is five months old now. I got my first period after three months of delivery, and I experienced mild pain in my left lower abdomen. I am experiencing mild constant lower abdomen pain. I have done an ultrasound and found the existence of the cyst with a size of 3 cm. As I was feeding my baby, I was told to wait for the baby to reach six months. I am worried about the cyst growth. I am looking for solutions to stop them growing. Please help." }, { "from": "assistant", "value": "Hi. Ovarian cysts are commonly known as PCOD. A cyst is a form of an immature ovum. It occurs due to hormonal imbalance, and it causes irregular menstruation. In this concern, some ayurvedic medicines taken along with yoga practices are beneficial. You need to have a regular check-up of your thyroid profile and USG abdomen. You can take the following medicines to prevent the further growth of cyst and to regulate the periods. Take Hyponid charak two tablets twice a day with warm water after meals. Take Kanchanara Guggulu (Kanchanara with Varuna) two tablets twice a day with warm water after meals. You can consume M2 tone syrup (Ashoka with Ashwagandha) 10 ml twice a day after meals. You can take Arogyavardhini Vati (Shuddha Guggulu with Shilajit) one tablet twice a day with warm water after meals. Do regular yoga like kapalbhati, Mandukasana and Ardhamatsyendrasana, Pranayama like anuloma vilom, Nadi sodhan and bhramari. These are very effective. Avoid eating spicy and fried junk foods. Drink plenty of water. Eat fibrous foods and fruits as well as green leafy vegetables. Do these things and provide your valuable feedback after a month." } ]

[ { "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 regular periods every month. I missed my period 10 months back and until now I have not received my period. I took two pregnancy tests a month later and both came out to be negative. I would sometimes get light cramps and discharge (clear). I want to know is this normal or is something wrong with my body? Could I still be pregnant? Please let me know I am desperate for help." }, { "from": "assistant", "value": "Hello. If your prime concern is pregnancy alone, then you can get a serum beta hCG test done which is the gold standard and conclusive. If the hCG levels are less than 5 mIY then you are surely not pregnant and the delay of menses could be stress induced as in most women. You can then opt for a withdrawal bleed with Progesterones. The other most common causes of oligomenorrhoea are PCOS, hypothyroidism, and hyperprolactinemia. So you may get a hormonal profile to get these levels checked as well and an ultrasound pelvis to rule out polycystic ovaries which are again very common in young women." } ]

[ { "from": "human", "value": "Hello doctor,I am 21 years old. Today I noticed a small black spot on my toenail, I did a little research and found out that it might be a melanoma cancer, but also it could be a fungus infection. After a bit more research, I noticed that an unusual cystic pimple between my chest that I have had for two months now might also sign of melanoma. I spend little to no time in the sun. Do I have melanoma? The black spot on my toenail might be because of the tight shoes I have been wearing lately, my toe also hurts a little bit from those shoes. The red pimple between my chest appeared five to six month ago, then disappeared and reappeared multiple times, I squeezed it, and blood and fluid came out of it." }, { "from": "assistant", "value": "Hello. I understand your concern. The thing on the chest looks more of a sebaceous cyst, (attachment removed to protect patient identity) which comes and goes even if you pop out the contents as it needs to be excised completely to prevent the recurrence. For the toenail spot, I am not sure that it is melanoma, it can be other things like a subungual traumatic hematoma, or pseudomonas nail infection. Nonetheless, you need to keep observing it for any color or size changes. The two conditions you mentioned do not seem to be related, though. Use the following medication for two weeks, and if it is because of infection it will improve 1. Tablet Ciprofloxacin 500 mg twice a day for two weeks. And avoid tight footwear." } ]

[ { "from": "human", "value": "Hello doctor, My father had surgery a month back for stomach cancer bleeding tumor and in the histopathological report after surgery showed that metastatic deposits of the tumor have been found in six lymph nodes. I request you to kindly advice what would be the best possible treatment in this scenario." }, { "from": "assistant", "value": "Hello. As seen in your reports, your father had stomach cancer, which is stage III. He will definitely need further treatment to avoid recurrence of the tumor. Usually, treatment should be started within 6 to 8 weeks. He has two options: Only chemotherapy or Chemotherapy and radiotherapy. Before that, I would advise you for CT scan and tumor markers like CEA and CA 19.9 to look for any evidence of residual disease at four weeks after surgery as residual disease after surgery will be taken as high risk. If you are able to get a PET CT then it is better. There are certain poor markers in his tumor (attachment removed to protect patient identity) like signet ring histology, lymphovascular and perineural invasion, node positivity, and a bit close margin. These all factors make him a high risk for recurrence. Though there is no definite advantage of chemo and radio vs chemo only, those who are at high risk for recurrence benefit from chemo and radio. So in his case, I would opt for chemo and radiotherapy. But before going ahead with this, I will definitely need to assess the patient's general condition and how he is taking his nutrition. Whether he is fit to receive this treatment. Otherwise, I would opt for chemotherapy only. Therefore, I would advise you to take further treatment at the center which has both facilities. Depending on what type of chemo regime is followed the duration of treatment will be around six months. On an average, around 50 % patient with stage III stomach cancer will be alive at the end for three years if they receive adequate treatment." } ]

[ { "from": "human", "value": "Hi doctor, About two and a half months ago, I was at work with one leg tucked under the other in a computer chair. When I got up to use the restroom, I noticed tingling in my lower leg and developed drop foot as a result. My first visit was to a podiatrist and he suggested me to visit a neurologist. The neurologist did not run any scientific test and determined I likely crushed my peroneal nerve and said to return in four to six weeks for physical therapy. About two weeks later, while lying in bed on my side, I noticed my arm tingle a bit and when I got up to shake it out the tingling eventually subsided. But, I have experienced weakness in that arm. Last night while sitting upright on my bed, my left leg began to experience a similar sensation. The limbs are still functional and the tingling does not persist, but it feels weak. The uncertainty due to the lack of scientific testing is weighing very heavily on me and the troubling issue is the onset of additional symptoms which are causing occasional unsettling stomach feelings due to the mental anguish I have been experiencing. Mainly the fact that all of my limbs feel weak are making me very concerned." }, { "from": "assistant", "value": "Hi. I have read your complaints and first of all I should compliment you for having patiently written a thorough history of events. Let us analyze your problems You have tingling in all four limbs and weakness in all four limbs. That is upper limbs and lower limbs on both sides, but onset on various days. The next important point which you have told is the mode of onset and the tingling eventually subsided. The following parameters can be found out only by a clinical examination and they are most important to fix the diagnosis. In the same way, need to get at least two investigations, nerve conduction studies and MRI spine. It can be either a peripheral vascular disease leading to low perfusion or a peripheral neuropathy. I would strongly recommend as well as request you to consult your neurologist immediately and treat these symptoms as top priority. 1. Nerve conduction studies. 2. MRI spine. The symptoms suggest either it could be peripheral neuropathy or peripheral vascular disease. Revert back with the investigation report to a neurologist online.--->" } ]