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[ { "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": "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 recently took a general blood test. I request you to go through my blood test report and give me suggestions. Especially, I would like to mention about alanine transaminase (SGPT) value, which is 56.2 U/L. It is very much higher than the normal range. My previous surgical history includes elbow complication. So, I had two surgeries in the last two years. For weight loss, I am taking Ayur slim capsules from Himalaya Herbals, two capsules twice a day after meals." }, { "from": "assistant", "value": "Hi. We are here to help you. Revert back with the investigation reports to a medical gastroenterologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, This is my CBC report and everything is normal except RBC. In it, RBC shows anisopoikilocytosis predominantly microcytic hypochromic cells along with normocytic hypochromic cells and few targets cells. WBC is within normal limits. Platelets: adequate. (MCV) mean corpuscular volume72.0 fL, normal range 80 to100 fL. (MCH) mean corpuscular Hb. 18.6 pg, normal range 30 to 36 pg. (MCHC) mean Corpuscular Hb. Concentration 30.0 g/dl, normal range 32 to 36 g/dl. I will attach the report. Please suggests cause and solution for this." }, { "from": "assistant", "value": "Hello. Your report is suggestive of microcytic hypochromic anemia. Do not worry about that. It is a treatable condition. With the recovery of hemoglobin level by tablet, your PS (peripheral smear) will be reverted to normal. It is not an alarming condition. But I suggest the following work up for you. 1. Serum ferritin estimation. 2. Serum transferrin saturation. 3 Serum FEP. 4. Serum TIBC. These four investigations, help in rule out iron deficiency anemia. 5. HB electrophoresis. This fifth investigation will rule out any hemoglobinopathy if present. Kindly revert back with these reports so that I can guide you further. Hope I have answered your question." } ]

[ { "from": "human", "value": "Hello doctor,I have a fever of 101 C. It has been almost 12 hours. I cannot breathe properly. My eyes are burning. I ate a Paracetamol 650 mg about one hour ago. Head feels heavy. Dizziness and confusion are the symptoms." }, { "from": "assistant", "value": "Hello. After careful analysis of the history provided, I would like to assure you that having symptoms of eye burns, dizziness and confusion while having a viral fever is normal. You do not have to worry about that. Having said that, since you have mentioned that you have been having similar episodes in the past, I would like to suggest you to: As of now, Stay healthy and positive. For more information consult a general practitioner online -->" } ]

[ { "from": "human", "value": "Hi doctor, My wife could not be able to see through her left eye. She has some pain near her eye like a headache, but there is no numbness or vomiting scenario. Now, her vision is at CF. We had our first visit before 10 days. The doctor did not find anything except the pressure is 29 and he suggested Tobramycin and Dexamethasone ophthalmic suspension for every six hours for a week. In the follow-up visit, the doctor found that her vision came down than earlier and the pressure raised to 40. He suggested an emergency MRI scan of the head, and it was normal. Then he suggested Travatan and Combigan and no cause identified. All these reports shared with our primary care doctor, and he advised to make another visit to the eye doctor and a neurologist checkup. As per his suggestion, we had another follow-up visit, and nothing found abnormal. They wanted to wait for a neurologist check, and until then my wife was asked to continue Travatan and Combigan. The report says everything is normal, but nothing is improved on her vision side. Can you please suggest us what we should do now?" }, { "from": "assistant", "value": "Hello. I understand your concern. Please do not worry. In my opinion, there are two issues. It can be a POAG, primary open angle glaucoma and the treatment is antiglaucoma medicine. If the pressure is normal and optic disc is normal, then glaucoma is under control, and it is not the cause of low vision. There is a very low vision in the left eye with RAPD (relative afferent pupillary defect) in left eye along and temporal pallor of the optic disc. It is suggestive of optic disc pathology and most likely optic neuritis (retrobulbar neuritis). The treatment plan is as follows. MRI with contrast is the ideal investigation to look for demyelinating lesions in the brain as well as on optic nerve. Once the diagnosis is confirmed, we start high dose Methylprednisolone intravenously. Here, the prognosis is good, but some patients do not improve. Revert with the reports to an eye care ophthalmologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, Last weekend, I ended up in the ER department after an overdose on THC capsules. Very scary experience my heart was going crazy, very bad chest pain, shortness of breath, tremor, etc., for about five hours. I had an ECG done in the hospital which said sinus tachycardia. My blood was taken (all fine apart from low magnesium and potassium), chest X-ray was done (all fine). I was given Diazepam and on discharge had another ECG done and it said sinus rhythm although my heart bpm was still over 100 bpm. The doctor said it is probably due to anxiety and let me go. Two days after this experience, I started getting weird symptoms (slight pain in the chest, lightheadedness). So, I went to my doctor, he measured my blood pressure, heart bpm, etc., all fine but put this machine in between my hands and could see my heartbeat was irregular. He prescribed me Digoxin for five days to see if it would get it under control. I went back again because I was concerned about the lightheadedness, he again measured heart bpm, etc., all fine, listened to my chest and said it is back in more of a regular beat and prescribed Digoxin for five more days and to come back again but at the moment, he is not overly concerned. I think I do not have bradycardia or tachycardia but I think I could have developed Afib from my experience in the hospital, is this possible?" }, { "from": "assistant", "value": "Hello. Yes, it is possible, but a likely possibility is of ventricular ectopics (or other causes) rather than Afib which could also cause irregular heartbeats on the machine. Even in normal individuals, the machine may falsely show irregular beats. Few points which are against are fibrillations are normal ECG especially if you had it done while having symptoms, even examination by a doctor for pulse and auscultation will help in diagnosing Afib. Also, the pulse rate is expected to vary to a large extent and cross the 100 bpm. You may also feel irregularly beating heart within your chest. Also, you can keep a finger over the pulse and feel irregularity and missing pulse. So, it could be an ectopic which is now settling. The only way to definitely confirm is ECG. If this continues, you may a get an ECG done or buy a home-based rhythm monitor like Alivecor Kardia device which records the ECG for interpretation. So, overall unlikely to Afib, but either ECG or examination by the doctor can confirm this. The other cause for pain in such settings is gastritis or reflux, which can commonly cause such symptoms. Also, ectopics may cause pain as well. Anxiety can also cause similar symptoms. Have plenty of water and adequate intake. If you are having these drugs for a long time then the possibility of withdrawal should also be kept. Hope this helps you and get back if you have any doubts." } ]

[ { "from": "human", "value": "Hello doctor, I am six months pregnant. I have swollen feet and ankles. It hurts when water runs over them. I also have lower back pain and some dizziness. Kindly help." }, { "from": "assistant", "value": "Hello. A pregnant woman usually has edema (swollen lower extremities) especially if she has been standing quite long. However, it is never tender but just heavy. It spontaneously resolves when she places her feet at least two pillows higher than her body or only by little elevation. In your case, we must rule out the possibility of cellulitis. Its is a condition such as how you described, swollen feet or ankle, usually pinkish or erythematous and tender to touch, sometimes warm to touch. Your symptoms are not the usual finding on a pregnant woman and must be seen immediately at the emergency room to give you first aid of a possibility of infection. It is also best that you have your blood pressure taken since the pregnant patient with edema usually has elevated blood pressure." } ]

[ { "from": "human", "value": "Hi doctor, I am 20 years old. My weight is 53 kg and height is 167 cm. I look small for my age. There is no appropriate growth. Can you suggest any medication or supplement for this?" }, { "from": "assistant", "value": "Hi. I have gone through your history and I would like to suggest you some natural way to increase your body growth. There are many factors that affect the body height and weight such as gender, age, genetics, lifestyle, diet, etc. If there is no weight gain despite eating a calorie rich food, then you should be investigated for a malabsorption syndrome. It is a condition which will prevent absorption of nutrient from food into the body. Your weight is also determined by genetic factors. If you have very slim parents then you too will be slim. I am happy that you are very concerned about your health. It is known that 7,700 calories will put on as 1 kg in weight. You should increase the physical activity as well as your routine diet to increase weight. Dip handful of whole grains (black grams, peas, peanuts and pulses) in a cup of water overnight and eat. Take curd with fat twice a day. Increase the intake of carbohydrate like rice and bread in your food but do not have at late night. You can take cereals, milk and egg for breakfast. I suggest you to start exercise with adequate protein intake. This will help your muscles to build and gain weight. Start with a jog and then mild exercise like cardio, pushups, cycling and swimming. Try out moderate exercises and not the high intensity ones. Along with it have a protein-rich diet including milk, cottage cheese, banana, egg whites and lean meat. Slowly increase your calorie intake by 500 calories every week up to 2000 calories. Have a good amount of water of around 2 liters per day. Do not consume fatty food. It will increase fat deposition in your body and will make you obese. Try this natural way instead of any medication for weight gain. For further information consult a dietician 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 a 30 year old woman. I was healthy and normal. But before two months, I was detected with a 2 cm x 1.8 cm x 2 cm submucosal fibroid in the uterus due to which I am feeling very dejected now. Please guide me." }, { "from": "assistant", "value": "Hi. I can understand your concern. A lot of females are diagnosed with incidental fibroids and in most cases these can be resected easily. These does not pose serious risk to fertility and do not worry about it. The feeling of dejection can occur due to mild depression or rather I would call this as adjustment disorder. Try to remain relaxed. Discuss the prognosis with your gynaecologist and do not remain dejected. In some case, medicines like low dose SSRIs (selective serotonin reuptake inhibitor) as Fluoxetine or Sertraline can be used. These medicines will help to improve the mood and will help to give you positive mood. Do not remain worried. If there are no symptoms and fibroid is incidental then this would not cause any serious effects on your health. For further information consult a psychiatrist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, I have low energy for a few days now. I have done a blood test, and I have a ferritin level of 10 ng/mL. After taking supplements, my ferritin got increased to 16 ng/mL. But, still, I suffer from weakness. My doctor advised me to have an iron infusion to raise my levels. I still have low energy, and it is affecting my daily life. Can I take an infusion now? Can it help me? Please suggest." }, { "from": "assistant", "value": "Hi. It also depends on the level of hemoglobin. There are no additional benefits seen while having an infusion. It gives a rapid rise in hemoglobin. If you have responded to oral treatment, then it is not necessary. Please send your blood reports soon. If everything is fine, then do a thyroid test." } ]

[ { "from": "human", "value": "Hello doctor, Is it possible to prepone my periods by a few days?" }, { "from": "assistant", "value": "Hi. I do understand that when we want our periods to be earlier rather than later. But unfortunately delaying cycles is usually better. If you have 28 days cycles then this month your cycles will start on the expected date. But, if you have 30 or more days cycles I will suggest starting tablet Meprate (Progestin) 10 mg twice daily from two days before the expected date till the day you do not want your periods. After stopping tablet, the cycles will start in 2 or 3 days. They might be heavier than usual but no worries." } ]

[ { "from": "human", "value": "Hi doctor, I got my last period in the mid of the last month. I had sex on the last day of the month, and the next day I took an I-pill. After three days, I have got a dark brown discharge sometimes it is pale yellow. I have it for the past four days. I am having a pain in my stomach like periods. My period is expected to be in the mid of the month, and my average length is 31 days. I am not pregnant because he did not discharge inside me. Is I-pill safe? When should I expect my periods?" }, { "from": "assistant", "value": "Hi. I-Pill is a high dose of Progesterone hormone. It is the same hormone which is produced in the body in the second half of the period after ovulation. This pill will suddenly increase the thickness of the inner lining of the uterus, making it unfavorable for a possible pregnancy to implant. As it is a single dose, it has no strength to stand on, so it falls off, and you will get periods or bleeding of increased thickness within seven to ten days of taking the I-pill. This bleeding will be thick, fleshy pieces, dark red or brown, with slight lower abdominal pain until there is a reduction in bleeding. You have taken I-pill very close to the date of ovulation. As he did not ejaculate inside you, the chances of pregnancy are low. But the I-pill will disturb your hormonal balance, which causes the thick white discharge, and this thickness is coming out, which cause the pain. I-pill is very effective. Just wait and within a few days, you will have the periods. So periods may be mostly at the expected date. For more information consult an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I am a 54-year-old hypertension patient and in control with medicines Ramipril 10 mg, Natrilix 2.5 suspense release and Rosuvastatin 10 mg. Ramipril was causing dry cough and was nanaging until recently. But now cough becomes very sensitive due to current COVID 19 situation and so visited another clinic for an opinion and the doctor changed to Concor 5mg and Amaasc 5 mg at least for three months until the current situation improves as constant cough due to Ramipril concerns me and others as well." }, { "from": "assistant", "value": "Hi. I read and understand that your concern is about the side effects of the newly prescribed drugs. Reduction of sexual drive is one of the side effects of beta-blocker group of drugs. Concor contains Bisoprolol which is a cardioselective beta-blocker. The systemic side effects of cardioselective beta-blockers are less compared to the general beta-blockers. So the effect of Concor on the sexual drive would not be that significant to affect your usual life. And the combination prescribed is safe to take. There are no significant drug-drug interactions between these group of drugs." } ]

[ { "from": "human", "value": "Hi. I am 20 years old, and a student. I am currently having obsessive thoughts and I find it hard to control the thoughts. I have fears and getting anxious that something might happen to me yet, I am trying to convince myself to not to. But then again, i've been seeking for help from psychiatrists that offer free consultations because, as I said I am just a student wanting to know more about my condition. I hope someone could help me. I have ear problems and mitral valve prolapse. I for now, have medical prescriptions for mitral valve prolapse and haven't checked up for this ear problems of mine. I am currently taking Propanolol." }, { "from": "assistant", "value": "hello, I can understand that you are suffering from obsessive compulsive disorder and having distressing obsessive thoughts. OCD is quite resistant illness which involve serotonin a kind of chemical in the brain. we generally prescribe antidepressants to increase level of serotonin in the brain. antidepressant require in higher amount because you know oCD symptoms are very resistant more than depression. there is also a talk therapy which is called as exposure and response prevention it's a kind of cognitive behaviour therapy . I would suggest you to visit your psychiatrist again and ask for this talk therapy. this will definitely help you hope my answer help you thank you kind regards feel free to ask further" } ]

[ { "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,The stomach blossoms without food, even in the morning. It is felt more in the upper part of the stomach." }, { "from": "assistant", "value": "Hello, Welcome to the icliniq.com. You can have a gas problem due to functional indigestion. I suggest you take gelusil MPS like syrup before bedtime for one week. It is advisable to take Rabeprazole like antacid for the week also. If there is no improvement than USG abdomen scan should be done for further workup, meanwhile avoid gas forming foods like cabbage, cauliflower, etc. Carbonated drinks should be restricted. I hope I have answered your question. Let me know if I can assist you further." } ]

[ { "from": "human", "value": "Hi doctor, Before a month, someone who has labial herpes kissed me on my cheek. After that, my lips were burning, but I did not apply any lotion on the lips till now. I am a little bit hypochondriac. Before two days I met my boyfriend and I kissed him on the cheeks. The next day, I feel pain on my chin and after that I had something like acne there and then I had two aphthous ulcers at an interval of two to three days. One under my tongue and another inside the cheek or lip. Now, my boyfriend has headache and throat pain. He thinks it is the beginning of an upper respiratory tract infection. Could it be his primary infection? Did I pass herpes to him? Can we do a viral culture of his throat to know whether HSV-1 is present or not? Is am I HSV positive? Please help." }, { "from": "assistant", "value": "Hi. As I understand you are conscious about you and your friend's health. But, no need to worry. First, I would like to tell you that herpes infection are transmitted by direct contact like kissing and manifest with multiple painful vesicle, which may develop to ulceration associated with pharyngitis or ulcer over oral mucosa. So, if you had a kiss by a confirm case of Herpes labialis, you may get such infection. But, it is not always an infection to convert into a disease as body's immune system protects us from such kind of pathogen. I do not think to go for viral culture as it will not help in deciding treatment plan. Viral infection usually gets cured itself within 10 to 14 days. We need to do symptomatic treatment and maintain good nutrition and hydration. You may be having a herpes infection, but do not worry. For further information consult a microbiologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am feeling too cold, and a cough is there. I am 27 years old, 169 cm height, blood group A+, and weight 61 kg." }, { "from": "assistant", "value": "Hi. I have read your query. It looks like you have a common cold. Please do saline water gargles several times a day to give you relief from the cough. Drink warm beverages. Keep yourself hydrated by taking plenty of fluids. You can also do steam inhalation to get relief. Take one tablespoon of Benadryl cough syrup once a day preferably before going to bed as it causes sleepiness. If there is a cough during the day, you can take one tablespoon in the day too. Please check for the fever with a thermometer. Fever is body temperature above 100.4° F. If you have a fever, please take tablet Paracetamol (500 mg) whenever you have a fever. The gap between two doses of Paracetamol should be 6 hours. If the symptoms do not subside, you need to consult a local doctor who will prescribe you antibiotics." } ]

[ { "from": "human", "value": "Hello doctor, I had a crown in one of my teeth on the lower left bottom. The crown came off. I went to the dentist who suggested root canal even when I did not have any problem. The root canal was completed and the crown was placed. After a few days, my teeth used to pain only on consuming hot water. I went to the dentist and she performed RCT again and now she has left it open because now I have a constant pain which is there a from two weeks. The dentist said I might be allergic to calcium hydroxide and then she said it could be an infection. I am not sure what is happening. Kindly help. Pain is unbearable." }, { "from": "assistant", "value": "Hi. I had gone through your question I can understand your concern. The pain may be because of post RCT infection or because of the accessory canal in the root that becomes sometimes difficult to manage. In case it in infection you need to take antibiotics and that will help you. If you had antibiotics and pain still persist, please let me know about the name of antibiotics because you may be resistant to it. You can also upload the pictures of X-ray done during root canal treatment so that I can tell you, if RCT is done properly or not. An allergic reaction does not precipitate in the form of pain only there could be certain associated complications too." } ]

[ { "from": "human", "value": "Hello doctor, I was diagnosed with PCOS at 16, but have had successful pregnancies (other things I had zero breast change and less than once a day of milk production). We have never used any form of birth control yet our youngest is now almost 5. We have been actively trying for almost two years now. My periods during the last six months have been on time and consistent. I am 31. Why are we not able to get pregnant after two babies?" }, { "from": "assistant", "value": "Hello. As I have learned that your last pregnancy was five years back and that your menses have been regular since last six months and you have been trying for last two years without any use of contraceptive practices to conceive. This qualifies for secondary infertility treatment. Now the first thing which needs to be checked is to get your partner's semen analysis done to check for quantity and quality of sperms as of now. There are chances that the count may have gone down or the quality may have depreciated which can be treated accordingly. In middle age men, such male infertility is common and needs to be addressed first before a lady is subjected to tests and examinations for evaluation of secondary infertility. Hence, it is requested that you may please get his semen analysis and culture test done first and review with reports. In the meantime, you may send across any ultrasound pelvis reports or hormonal profile tests (from the last six months) that you may have undertaken for review (if the element of PCOS still persists or not). Semen analysis and culture for the male partner. Male infertility. Secondary infertility. As per reports (awaited)." } ]

[ { "from": "human", "value": "Hello doctor, I have an eye disorder (keratoconus). I would like to know whether I can continue wearing soft lens. The hard lens/RGP lens provides a lot of discomfort. Do I have other options apart from glasses?" }, { "from": "assistant", "value": "Hi. Keratoconus is a degenerative eye disorder. This causes corneal thinning and leads to a conical shaped cornea. Soft lenses can be used, the silicone lens with hydrogel based ones in particular. Though RGP (rigid gas permeable) lens are preferred for better vision outcomes, a combination of soft and rigid lenses are also available. If this option fails, then go in for surgical options like microwave thermokeratoplasty." } ]

[ { "from": "human", "value": "Hi doctor, I am having a polyp in my sinus and have been suffering from frequent cold for a long time. Now, I am facing a fluttering sound in my ear. What should be done?" }, { "from": "assistant", "value": "Hi. Generally, polyp in sinus needs to be removed. If ethmoidal polyp, then it can be treated with steroid spray. Ear problem can or cannot be due to a polyp. You need to tell your complaint in detail. Sometimes, polyp can block the eustachian tube and ears and it can cause ringing or fluttering in the ear. Kindly tell me in detail so that I can guide the treatment. If you have got a CT scan done, then you can send me or else you must get a CT scan PNS (paranasal sinus) done. Revert back with detailed history to an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, My ECG shows low voltage with QRS 86 mm. I am physically fit and active with no such issue a year ago. What could be the cause and solution?" }, { "from": "assistant", "value": "Hello. Could you upload your ECG picture? It must be 86 msec, I guess. Low voltage ECG may be seen as a normal variant, also seen in obese individuals, smoker or patients with heart disease like fluid around the heart or in lung disease. But, if you do not have any symptoms then it is likely a normal variant. Patients with a disease will have other symptoms too." } ]

[ { "from": "human", "value": "Hello doctor, I had unprotected sex with my husband a month back and my LMP five days before that. I took Plan B pill within 10 hours of intercourse. My cycle is usually 25 days and I have not got periods yet. I tested 10 times, all were negative. Should I go to gynecologist and request for an ultrasound? Will ultrasound detect early pregnancy?" }, { "from": "assistant", "value": "Hi. I can understand your concern. The possibility of pregnancy is very less and the possibility of hormonal imbalance is more likely. Please let me know. Do you have any other symptoms like breast tenderness, abdominal pain or fullness? Have you taken Plan B before? In my opinion, you should wait for 1 to 2 weeks more before going to the gynecologist for an ultrasound. Please reply me with answers to the above-asked questions, so that I can guide you better. I will be happy to help you further." } ]

[ { "from": "human", "value": "Hello doctor, I have recurrent folliculitis. The most common areas are in my upper legs and skin where my pubic hair lies. I hope you can help me out in explaining why this happens to me. I have this for almost two years now. I was given antibiotics once in the past." }, { "from": "assistant", "value": "Hi. Recurrent folliculitis occurs in people who has deficiency to fight staphylococcus aureus bacteria. These are small boils which occur repeatedly at multiple sites of the body. Antibiotic heals them but they again appear after a few weeks or days. It can develop any time during life and may vanish within a short period. Repeated antibiotic courses has to be done but precautions which I am writing down if taken properly mitigate this problem. First thing is you have to take an antibiotic course for the presenting complaint. Take Amoxiclav 625 mg (Amoxicillin and Clavulanic acid) thrice daily for five days and Mupirocin ointment twice daily. This has to be continued for a longer period of up to 1 month. Apply it inside the nostril, in the axilla, in the pubic area, in umbilicus daily twice. Use antibacterial soap like Cetrilak (Cetrimide). Do not touch the parts of the body repeatedly like scratching, as it also transmits this bacteria. In some people, if Amoxiclav does not work we give other antibiotics but you have to try this first. Review after four weeks." } ]

[ { "from": "human", "value": "Hi doctor, I have the acne problem. My doctor prescribed me to use Nicotinamide gel. Should I wash my face immediately after using Nicotinamide gel? Please explain." }, { "from": "assistant", "value": "Hello. For further information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My 25-year-old wife is planning to use Glutathione as one of her dietary supplements. She is still trying to conceive. Is that okay? Is it safe? Will it still be okay to take Glutathione during pregnancy? What other dietary supplements would you recommend?" }, { "from": "assistant", "value": "Hello. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I gave birth to my child before four weeks. I am providing breastfeeding to my child from her birth. My breastfeeding was fine before three days. But now, my milk supply has got dropped. My baby seems to have a loss of weight, and she is not peeing often. Yesterday, she pooped a light green colored poop. She is not sucking as long as she was before. But she sleeps up to two to three hours. I am well hydrated, eating well and resting well. I am not taking medication. What is the cause of having a reduction in milk production in me? I am worried. Please help." }, { "from": "assistant", "value": "Hi. Start giving top feeds to the child for some time and take some days off from breastfeeding. Weight loss and a reduced urine output of the child is because of low milk intake. Low milk production may occur due to many reasons, the most common one being stress. So take rest for some time and start giving top feeds to the baby. It will provide benefits to both of you." } ]

[ { "from": "human", "value": "Hello doctor, I had my left lower wisdom teeth extracted before a week and stitches are still there and yet to be removed. I am on Paracetamol and other painkillers. The problem is I do not have any pain in my mouth. But, I feel exhausted, restless and I just cannot wake up from my bed. Also, my bowel movements are not perfect. I feel like going to the bathroom again and again like irritable bowel syndrome. Can you please tell me about my sickness? I am a 23 year old male. My height is 5'7\", and weight is 72 kg." }, { "from": "assistant", "value": "Hi. I have read your complaint and the relevant details. For further doubts consult a dentist 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, The symptoms I have are bad cold or strep throat, itchy eyes and throat but no cough. I do not have tonsils, but seems like there is a whitish puffiness on one side of my throat. It started five days ago and it has been getting mildly worse since then. I have been loading up on fruits, vegetables, preventative vitamins, raw garlic and even tried a saline sinus rinse. I just moved to a place where it is very dry and I am used to very humid climate. I have never had hay fever or sinus issues or been affected by pollen. Am I sick? Or is this a severe reaction to the blanket of green pine pollen all over the town? Can pine tree pollen cause swollen throat, earache and headache only on one side of my face?" }, { "from": "assistant", "value": "Hello. Revert back to an allergy specialist online for further follow up -->" } ]

[ { "from": "human", "value": "Hi doctor, My sister is having some neurological problem. She is normal, but at times she feel uneasy and head spinning. We have consulted with a doctor since one year and a few days back for the same issue her doctor prescribed Metmax injection to be taken one per day for the next five days. But, after taking one injection, she is feeling very drowsy and not able to remember things and forgetting the past. I request you to kindly let me know the details of Metmax injection. Is it the right treatment?" }, { "from": "assistant", "value": "Hi. Revert back with the answers to the above questions to a neurologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, Yesterday, my son went to a local salon for a haircut. He received small scratches on the neck while getting his haircut. I noticed that it was done with a used blade, which was not cleaned properly. Is there a risk of an HIV or other viral infection due to this? Please guide me." }, { "from": "assistant", "value": "Hello. The likelihood of HIV (human immunodeficiency virus) transmission, in this case, is 1 in 300. Firstly, you are not sure that the person, on whom the blade was used previously, was HIV positive. More importantly, HIV rarely survives in dried blood. So, in the case the person's blood was on the blade, it would have dried in 15 minutes. Hence it is less likely that the HIV would survive. In spite of all this, I would say precaution is the best. Always ask the barber to use a new blade. Also, the chances of getting a Hepatitis B and C infection are higher than that of an HIV. To prevent this, I suggest getting a Hepatitis B vaccine. Please consult your local clinic in case you experience any unexplained and non-recovering fever. If you are still worried, consult your local clinic and get an HIV test done after one to three months. For more information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 22 years old. I have to get my periods this week. But I am getting black or brown discharge. Is this normal?" }, { "from": "assistant", "value": "Hi. It is known as irregular shedding. It is caused due to stress-induced hormonal imbalances during a cycle. You have to do an ultrasound pelvis to check endometrial thickness. If the endometrial thickness is less than 8 mm, then you can have a progesterone deficiency. It needs to be evaluated soon." } ]

[ { "from": "human", "value": "Hello doctor,I have sagged skin in lower abs. Please help." }, { "from": "assistant", "value": "Hello. Thank you for sharing the pictures (attachment removed to protect patient identity). Definitely, the excess fat in the flanks and the sagging skin on the anterior tummy can be removed. We do call the procedure as a mini tummy tuck. That will help you in getting a good shape for the abdomen." } ]

[ { "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 HbA1c is around 6.0 %. Several years ago, it was used to be at 5.2 %. Can you recommend some supplements to reduce HbA1c?" }, { "from": "assistant", "value": "Hi. HbA1c level (glycated hemoglobin) goes up when your body is unable to control glucose accurately and when the insulin sensitivity is low. You have not mentioned the treatment taken for diabetes. I assume that you are prediabetic and I am giving the following instructions. You have to change your lifestyle and diet. Or else you will become prone to diabetic. Please follow these instructions to increase the sensitivity to insulin and to decrease your HbA1c. Daily exercise improves your glycemic control and insulin resistance. You should do both strength training exercise and aerobic exercise. It helps you to reduce body fat and improves the skeletal muscle mass and strength. You should have a low GI (glycemic index) diet. You should focus on eating foods with a GI less than 55 and take fiber-rich foods such as apples, grapefruit, legumes, onions and garlic, dense, grainy bread and wholegrain cereals such as whole oats. Try to reduce taking sugary foods, processed foods, and concentrated carbohydrates. Take a fiber-rich diet. Consume soluble fiber at least 40 grams per day. Take good sources of soluble fibers such as vegetables, oats, whole grain rice and legumes. Dietary fibers are also beneficial. Reduce taking saturated fat and increase the consumption of omega 3 rich foods and monounsaturated foods. Eat antioxidant-rich foods containing vitamin B, vitamin C, and vitamin E. Eat foods that contain low GI, bioflavonoid and anthocyanin-rich foods such as blueberry, raspberry, strawberry, blackberry, citrus fruits, and onion. Take cinnamon regularly in the diet. It helps to lower the postprandial glucose. Take 50 to 100 ml bitter melon juice containing 100-gram fruit in 100 ml. It reduces the fasting and postprandial glucose levels. Reduce taking tea and coffee. Instead, drink plenty of water. Tea and coffee inhibit the absorption of essential nutrients especially when consumed close to the meals. Take Chromium 200 microgram per day. It helps us to have glucose control. Take Magnesium 400 mg per day. Magnesium deficiency aggravates insulin resistance. Taking a good quantity of vitamins, minerals and antioxidant supplement provide essential micronutrients. Take omega 3 fish oil 1000 mg three times a day. Take vitamin E 500 IU daily. Take Alpha-lipoic acid 600 micrograms in divided doses." } ]

[ { "from": "human", "value": "Hello doctor, I am 32 years old PCOD patient with primary infertility. My LMP was 10 days before. I took tablet Letrozole 2.5 mg once a day for five days from the next day of my periods. Today is my eighth day. I had a USG today. Findings are, ET 3.6 mm, right ovary follicle is 11 mm, left ovary follicle is 1.8X1.2X1.8 cm. What am I supposed to do now? Shall I take tablet Progynova to build up endometrium. Is that follicle on left ovary a cyst? Please guide me in the further course of action. You can prescribe me medicines, I can take it, as I am a gynecologist and I need guidance from an infertility specialist." }, { "from": "assistant", "value": "Hello. As you are on day 8, ET (endometrial thickness) is low for the day of the cycle. You should be starting on Progynova (Estradiol) 2 mg one tablet twice a day for the next seven days. Your follicular scan days should be on day 11, 15 and 17. The follicles are appropriate for the age in the right ovary and are developing. The left ovary may be a simple cyst or late recruited follicle from the previous cycle but needs to follow-up with scan. At a follicular size of 20 mm, you should be opting for injection hCG 10000 IU intramuscularly for initiating ovulation. If this is a timed intercourse cycle and not an IUI cycle, then intercourse should be started daily from the day of hCG injection, else IUI to be done after 36 hours of injection hCG administration after a TVS scan (transvaginal ultrasound) to confirm rupture of follicle and also endometrial thickness (target 8 to 9 mm). Also progesterone-like tablet Susten (Natural Micronised Progesterone) 2000 mg one tablet twice a day can be started from day 16 for the next 10 days, to support pregnancy if fertilization occurs. On day 14 post ovulation, you may get a serum beta hCG test done to check for conclusive results with regards to pregnancy." } ]

[ { "from": "human", "value": "Hello doctor, I am a 17-year-old male. I have been masturbating for three to four years. I am too much addicted to this habit and porn. I cannot remember how many times I do it a day. It has ruined my life. I was a topper in studies, with good physical and mental fitness three years ago. But now my whole health and study are destroyed because of this habit. I am suffering from fatigue, depression, hypersomnia, mental stress, etc. I forget things very quickly. I cannot concentrate on anything, and I usually spend my day alone, staring at my mobile. I am very worried and stressed. I want to leave this habit forever and be physically and mentally fit again. My confidence level is very low. Please help me." }, { "from": "assistant", "value": "Hello. This is not an issue that you can feel comfortable by sharing with someone else. For porn addiction, or any other addiction, please work cyclically. If we want to come out of it, then we need to break the cycle. For example, have a count of how many hours in a day, and at what time do you watch porn? If it is for 4 hours, try adding one thing in your life which you can do for 30 minutes, like exercise or playing with friends. From tomorrow for the next seven days, do that for 30 minutes. Then next week increase the time off the screen and slowly build other habits which can use your time and keep you distracted. It will take some time, but you will come out of it if you work hard. You can always share your progress or concerns." } ]

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

[ { "from": "human", "value": "Hello doctor, Is beta thalassemia trait a serious case?" }, { "from": "assistant", "value": "Hi. Let me explain you about beta thalassemia trait. It is good that you are aware of using online health portal. Beta thalassemia trait is the heterozygous condition and the patient can live a normal life. If nutrition is not maintained properly and if any unusual excess bleeding occurs because of some reason then sometimes Hb can be decreased and the patient feels weakness because of that. But as such thalassemia minor patient have no any problem which hampers usual lifestyle. You have to take precaution while doing marriage. Before marriage, your fiance thalassemia report should be done. If she is also having thalassemia minor then the chance of the baby having thalassemia major is 25 %. And thalassemia major is danger condition. Hence just keep in mind that before marriage your fiance should also be checked for thalassemia minor. If you are not having thalassemia minor then no need for further testing of your fiance." } ]

[ { "from": "human", "value": "Hello doctor, I recently got married but when I started having sex with my wife, I started noticing that my penis is not becoming hard enough to have sexual intercourse. Also, sexual arousal is also not happening. I believe I am suffering from erectile dysfunction. Kindly advice what I should do." }, { "from": "assistant", "value": "Hi. Erectile dysfunction can occur because of many factors like diabetes, hypertension, thyroid disorder and also due to stress and psychological problems. So, visit a nearby psychiatrist to find the exact cause and then act accordingly. If there is no physical or medical condition then, Sildenafil or Tadalafil will help in erection and these drugs can only be used after discussing with your doctor. Meanwhile, spend enough time on foreplay. You can take few days for only foreplay and proceed to sexual intercourse only when you feel that you are fully erect. Avoid any substance abuse like alcohol or tobacco. Take adequate sleep. Do regular exercise like morning walk for 45 minutes daily. Do exercises of pelvic muscle like kegels exercises." } ]

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

[ { "from": "human", "value": "Hello doctor, I have a 23 year old son. He admits to current marijuana use once or twice a week. He admits to a variety of drugs including cocaine, meth, heroin, LSD in the past year. His ex-mother in law says he currently uses cocaine and meth. He denies current drug use beyond pot. He says he has not done cocaine for a few months. He swears he is only currently using pot occasionally now and no other drugs. I realize he may be lying. In the last month, he has had several extended blackouts where he was fully functioning, walking around town, having conversations with people, damaging property, etc. Sometimes friends cannot wake him, and they think he is having a seizure. He does not remember drinking any alcohol on that day. In fact, he has no memory of that day, until waking up at home. Everyone told him about the events the next day. He has no memory of these events. Some are as short as an hour. Some are as long as 48 hours or more. I live 6,000 miles away from him and flew in this week to see him. I only have a few days with him to try to convince him to see a doctor, and I am trying to see if this is just drug use, him lying, being in denial or if there is a severe neurological condition that is not being treated because everyone is assuming he is on drugs. He has a history of serious sleepwalking when he was a child. He would rush out of his room, frantically searching for something but unable to describe it. He would carry on whole conversations, very agitated, would go outside, walk around the house and come to the back door crying and try to get in but be unable to turn the knob. It was like a walking nightmare or dream. We would get him back to bed and back to sleep. The next day he would have no memory of it. This current behavior sounds similar to me but on a much more extreme level. His sister had night terrors similar to this when she was a child. I, as their biological father, have a history of talking in my sleep, and some sleepwalking when I was a child but never this extreme. So, there seems to be some family history as a possible explanation outside of drug use being the probable cause. He sleeps very little. His current girlfriend says he is extremely sleep deprived. He lived with me until a few months ago and was extremely sleep deprived then. I realize you cannot give a definitive answer without personal examination and tests and such. What I am looking for right now is the answer to these three questions. Can cocaine and meth use actually result in these kinds of fully functional blackouts? Can just marijuana, (without any other drugs) or just alcohol or just marijuana and alcohol, combined with sleep deprivation and extreme stress cause these kinds of blackouts? Are there any other possible explanations for this kind of blackouts that are not drug related, for example, sleep deprivation and stress, a tumor, or other neurological or medical conditions? What might some of those possibilities be? Thank you for your help. I am distraught and confused." }, { "from": "assistant", "value": "Hello. I understand your concern. For more information consult a neurologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, Last week, I had two specialists check me for throat discomfort. Both suggested antihistamines and proton pump blockers. I also had a wisdom tooth surgery the same week and now my inflammation has subsided after antibiotics and NSAID with serratiopeptidase. I had been anxious and was told to have cancer phobia by doctors. However, yesterday while inspecting my mouth, I discovered a tiny lump-like swelling just beside the uvula. It is almost the same color as the mucosa or maybe very slightly yellowish. It does not pain or bleed on touch, but I can feel it as a grain on touch. I have attached a picture. I am very worked up and I need your help. It is painless and about the same color as the mucous membrane. It is the size of a tiny grain. I am currently taking Pantoprazole and Losartan." }, { "from": "assistant", "value": "Hello. For more information consult an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, What is the best tan removal treatment for me? I am suffering from tan since 16. I am now 23. My tan is all over my face, but when I put on a beard for a month and then shave it off, it all goes away back to original. Is my tan deep or stubborn or easily removable? Sunscreen application is recommended every two hours. I am thinking of day Vitamin C serum application. I need to wash my face with water before re-applying sunscreen? Can I wash my face? Will washing off for sunscreen reapplication deter the efficacy of Vitamin C serum?" }, { "from": "assistant", "value": "Hi. Tanning is due to sun. When you grow beard your hair protects the underneath skin hence it looks fair when you shave. Tan is not deep or stubborn. (attachment removed to protect patient identity). Keep Vitamin C application in evening and night and sunscreen should be used only when you go out in sun. It is useless to use sunscreen when at home. Any medication applied leave it for 2 to 3 hours before washing." } ]

[ { "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 child is one year old. On routine examination his eye has a power of minus 3.5 and minus 2.5 refractive error. What is the normal refractive error at this age as refraction continues to change? Doctor said to follow up after six months as glasses may be needed if power increases. Please help." }, { "from": "assistant", "value": "Hello. First of all, let me tell you that visual development takes until the age of puberty. As your child grows, his vision parameters will change because his eyeball grows with him as he ages. So visual stability will continue to change until the age of 18-20 years old. Normally the child is born with a plus refractive error unlike the case here. Your child has a condition called myopia which is a refractive error with a minus as you said. But that is completely fixable as the child grows whether by glasses, contact lenses, or LASIK surgery if it continues and he needs to take glasses off later. The most important examination in his age is something called a red reflex. You should ask your doctor if he has done it to him. Also, I would ask about the fundus examination too. If both were normal, I would not have any concerns. I want to reassure you that your child's eyes are in good health. He just needs to be examined precisely every follow up every six months as your doctor suggested, just to make sure everything is going right and to treat anything if something happens early. The glasses will not be tolerated by a child as his age is too small, as soon as he can tolerate glasses, put them on. That could happen in two years. If you need further assistance do not hesitate to contact me." } ]

[ { "from": "human", "value": "Hello doctor,I had receptive oral sex (received fellation) with an escort girl three weeks ago. Since then, I have got urethritis three days after. I have been treated with Levofloxacin for 10 days. The urethritis got cured, but I kept getting some strange burning sensations in my scrotum and the top of my buttock, but no lesions or bumps were visible. Only redness.The symptoms then disappeared then for four days, I got ticklings on my back, arms, chests, but again nothing visible on my skin. Since two days I have got paresthesia on my left foot, left arm and left hand that does not seems to stop (sometimes I feel it more or less) and sometimes some cramps in my leg or arm. I got a 4th generation HIV test at three weeks, which was negative. Do you think I have a chance to have HIV? Do I need to retest at four weeks or six weeks? If you do not think I have a chance of getting HIV, what options should I look for?" }, { "from": "assistant", "value": "Hello. Oral sex is least related to HIV. Symptoms are very bizarre and mostly by oral sex HSV, and STI is common. The tickling sensation is different as such, may be seen in vitamin B 12 deficiency, and anxiety. Symptoms come but goes in a particular time. You can still go for the HSV test. And STD panel test. No signs you had related to both. Till then you can take, Tablet Mecobalamin (Methylcobalamin) 1500 mg one at night for one month. If you feel better, you can continue for another a month if at all required. Tablet Escitalopram 10 mg (esitelop10) one at night for ten to fifteen days if at all needed. It is not at all HIV. I hope you have understood." } ]

[ { "from": "human", "value": "Hello doctor, Most of the time, I have sneezing and running nose with water for the past 2 to 3 years. I took Cetirizine for it but sometimes I feel better but after that, I face the same problem. Presently, I am not taking medicine. My age is 25 years and I am a male. l am not having past history and report, during this period sometimes I am also facing inhalation problem." }, { "from": "assistant", "value": "Hello. This is a common problem these days with a lot of industrialization and pollution around. Check your eosinophil count by doing a routine blood examination. Check blood IgE level. Do a skin prick allergy test to find out the major cause that triggers this anaphylactic response. Some conservative measures that have proven helpful in my patients are: 1. Warm steam inhalations once at night during the entire spring and autumn months. 2. Warm foot bath every night before going to bed. 3. Breathing exercises. 4. Probiotics for three months." } ]

[ { "from": "human", "value": "Hello doctor, I am suicidal. I feel so manipulated and exploited. My parents never listen to what I say and indirectly or directly cause some very unpleasant memories. Maybe I just want to be an ordinary kid, I want to play computer games and stuff, maybe I do not need to do academic stuff all the time, but they will not listen, instead, they push me down to a bottomless hole and they drive me crazy." }, { "from": "assistant", "value": "Hi. Suicide is not a solution to any problem. There is no problem in the world which does not have any solution. Just we have to see from a different view. Take a break in your life. Think about what you want to do in the future. If you are not interested in the study, leave it but what you want to do to survive in this world, think about it. If you have something fruitful to do except study than talk about it with your parents. Make sure that they believe in your plan. Strictly stay away from any form of recreational drugs or alcohol. Stay away from social media or limit the use of it. Do not live a virtual life, come to the reality of life and the world. If your parents do not listen then someone elder who believe in you and then ask that elder to talk with your parents. Ask your parents what they want from you and why they want it. Talk politely with parents. Do not do any unnecessary argument. It is a very tender age and do not take any decisions in a hurry. Relax and think. Life is very beautiful. Enjoy it." } ]

[ { "from": "human", "value": "Hi doctor, My wife is 28 years old. She is suffering from shoulder and arm pain. She has more pain during night-time and not able to get good sleep. First we consulted a doctor; he gave some multivitamin and Calcium tablets. Also advised her to do some exercise, but there is no effect. Then we consulted another doctor and he advised for a blood test. The result came back as hemoglobin 10.5 and serum uric acid 5.98. I have attached the medical prescription given by then for 20 days. He also told to avoid pillows. My wife started avoiding milk, milk products, meat, pulses etc. She is feeling fine now. After 20 days when she went for consultation some new doctor was there. He told that the uric acid is in range and no need to continue these medicines. Now again pain is there. Please tell us what test we need to do now to find the problem. Please tell the medicines which would be helpful in this case. Thanks in advance." }, { "from": "assistant", "value": "Hi. For further doubts 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": "Hello doctor, My one year old daughter had a fever for four days, with one episode of seizure on the fourth day which lasted less than a minute. There was no post ictal confusion or drowsiness. At first, the doctors started with Ceftriaxone and Amikacin for four days, then a lumbar puncture was done showing leucocytes. The report said 135 with 80 % lymphocytes and 20 % monocytes. The day before lumbar puncture, she was started on Vancomycin. The blood culture done before starting Ceftriaxone showed Staphylococcus growth with 50 thousand colonies. They said it may be contaminated. Urine culture showed enterococcus faecium, but repeat test came negative. All subsequent tests came negative. Now the child is doing well, without fever for four days. They stopped both Vancomycin and Amikacin and told to continue Ceftriaxone for two weeks. I am awaiting the CSF culture reports. My concern is whether it is alright not to give Vancomycin." }, { "from": "assistant", "value": "Hello. I can understand your concerns. I hope this helps. Take care. For more information consult a child health specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 31 years old. Last month I had periods on 10th and then we had sex on 22, 23, 25 as those were the fertile days. Also I am doing yoga from past 1 month. This my date was supposed to come before 10 as I normally get period before date. But got my periods today on 14th. Is it because I am doing yoga so I got my periods and failed to conceive? As initially in this month I was having frequent urination, sore breast symptoms but sadly I failed to conceive. Can you suggest shall I continue yoga and is it advisable to do yoga after having sex? Current medications: Folvite and Neurobion forte." }, { "from": "assistant", "value": "Hello. Nothing to worry. Smaller changes in cycle pattern can be hormonal. Yoga is good, it relaxes you, nothing to worry about. The cycle fecundity is 12 to 15 percent (means every trying cycle has a chance of pregnancy only 12 percent) it takes 1 year of unprotected intercourse for better pregnancy rate. No worries. Considering your age if the trying period is more than 8 to 10 months get a baseline TVS to look for ovarian reserve and also a baseline semen analysis for your partner. hormonal Semen analysis& TVS hormonal reassurance if queries" } ]

[ { "from": "human", "value": "Hello doctor, Actually, I had sex with my partner during period. And after that, I have taken i-pill within 12 hours. After two days my period stopped and now about one month passed but my period did not start yet and I tested with pregnancy kit with negative results. Some white liquid is leaking and some symptoms make me to feel like I am pregnant. What should I do? I am confused because the kit shows negative. Please help." }, { "from": "assistant", "value": "Hello, Welcome to icliniq.com. I have gone through your query. As the urine pregnancy test is negative, you are definitely not pregnant right now. Sometimes the premenstrual symptoms can also be similar to pregnancy because of similar hormones acting in both the situations. Some amount of menstrual disturbances are known side effects of the emergency contraceptive pill. So if you still have a doubt you can recheck it again after three to four days with an early morning sample. If still negative, you can be sure you are not pregnant. Just wait for a week for periods to come. Please use a better and consistent method of birth control in the future like oral contraceptive pills or condoms, and repeated emergency contraceptive pill can take a toll on your hormonal balance. I hope this helps." } ]

[ { "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 had my first cataract surgery in the right eye four years back. Now again this year, I just had cataract surgery in the left eye. Just today, after three days of my second cataract surgery in the left eye, the vision in my right eye is not clear. When I am seeing contact names on my phone from close, it is appearing blurry. I am not getting it as to why my unoperated right eye has become like this, after the recent surgery in my left eye. In both the eyes, I have Toric IOL lens, and the surgery is phacoemulsification in both. Please advice me." }, { "from": "assistant", "value": "Hello. I understand your concern and want to assure you that it is usually just a benign increase in tearing in both eyes after surgery that causes such a picture. It settles down on its own and will not need any further treatment than your post-operative medication. In case, you are experiencing problems only in your right and do not have any problems with the left and there is no tearing, then please bring up this issue with the operating surgeons during your post-surgery follow up. It needs further examination and tests, especially if there is a retinal problem. In case you need any further information, please send me a scanned copy of your doctors records and surgical notes, I will do my best to help you." } ]

[ { "from": "human", "value": "Hello doctor, I and my fiancee had unprotected sex a month back. I had an orgasm before having but not during sex. She has PCOD so her periods are irregular. She went to the doctor and doctor suggested having Regestrone 5 mg three tablets for three days. She started taking it 13 days later and finished after three days. The day before yesterday, she got her periods. But she did not have blood clots and flow is very slow. Is there any chance of pregnancy?" }, { "from": "assistant", "value": "Hi. How are you doing? As she has PCOD (polycystic ovarian disease), her ovulation date cannot be predicted. So there is always a chance of pregnancy. But as she had bleeding after having tablet Regestrone, pregnancy is not possible. Bleeding after having hormones will be thicker and lesser than normal, that is expected. Once the bleeding occurs, the inner lining of the uterus has fully been shed, so there is no chance of a possible pregnancy to get implanted on the post bleeding, thinned out uterine inner lining. So I do not see any chance of her being pregnant. But if you are still not satisfied or want a further confirmation, have her blood serum beta hCG tested. This can detect the smallest of pregnancy anywhere in the body." } ]

[ { "from": "human", "value": "Hello doctor, I am a 35 year old female. For four years, my right leg has swollen once in a year in the summer or when I go for agricultural works in mud fields. Initially it starts with fever, vomiting, body pain, chillness and then my leg will change to light red color and the swelling will start. Now, I am undergoing treatment. I am attaching the medical reports and the photo of my leg. My doctor told me that the swelling is due to mosquito bite. Please tell me the possible reasons for the swelling and the medical tests if any required. Please suggest the specialty doctor whom I should consult." }, { "from": "assistant", "value": "Hello. It looks like you had cellulitis. You might have scratched your leg and later on it has developed an infection. I think you are accumulating gas in your foot and in your leg. I think you should be seen by an orthopedic surgeon sooner rather than later. You need a complete examination of that foot with x-ray, CT scan and blood cultures. I am also afraid, if you are bone has been involved with the infection known as osteomyelitis. I do not think it is because of a mosquito bite.Please let me know if you need any further assistance. I will need to know the results of the x-ray and the blood cultures to suggest any antibiotics. 1. Gas gangrene. 2. Osteomyelitis. CBC (complete blood count), kidney and liver function test, electrolytes, CRP (C-reactive protein), x-ray of the foot and lower leg. Consider CT scan of the leg as well. Revert back with the reports to an internal medicine physician online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I am a 36-year-old woman and I take Paxil for OCD, 40 mg a day. When I went off the medicines several years ago, I had a long period of time before I had symptoms again, but then they did return. So after some time, I began the Paxil again. I had been very slowly weaning off and I had been taking 7 mg or less per day for five months before I noticed any problems. Before that, I was taking about 14 mg per day for another five months. Is that normal? I mean it makes me wonder if I really need the medication because I had a long time on a low dose or none at all without symptoms." }, { "from": "assistant", "value": "Hi. Medicines are prescribed in little high doses to quell the acute symptoms and then maintenance doses to maintain the minimum threshold. Weaning off is to maintain the satisfactory threshold and to stop. But in the majority of the cases, weaning off or rather the whole process of treatment should be augmented with psychotherapies associated with the diagnosed condition. In your case, CBT (cognitive behavior therapy) should be augmented with the medicine. Combining medicines with CBT provides the brain with the much-required equilibrium and help maintain the chemical balance. Thus, when you wean off the medicine, the natural threshold can be maintained without medicine and with CBT. Talk to your psychiatrist or therapist regarding the procedure. Take care." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I am an 18-year-old female. I have a cold with chest pain, fatigue and difficulty breathing for three days up till now, without physically consulting a doctor. I have had pneumonia last year and I am afraid that I might get again as I am starting to show some symptoms of pneumonia. Should I be concerned?" }, { "from": "assistant", "value": "Hi. Just saw your letter that you been having a difficulty breathing and you are concerned about pneumonia. I would like to get some more information in terms of fever, difficulty breathing, bringing up sputum. Is it yellow color or white color. If you are having all the symptoms you have to get chest X-ray and medications. We will have to take Paracetamol 650 mg three times a day, antibiotics Amoxicillin-Clavulanic acid 625 milligrams twice daily for five days and take a tablet Fexofenadine 120 milligram at night for five days. In addition, you can take tablet Pantocid 40 mg 30 minutes before food for five days. Despite all this medication, if you continue to have a fever and the symptoms are not better, seek medical attention from a nearby doctor." } ]

[ { "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 got dog bite before 17 days, and the wounds are categorized as a category -II. Within an hour, I got a Rabipure vaccine and TT at the hip area. However, the next day morning, one more dose of Rabivax has been given in the shoulder and continued the schedule from the second day. My doubts are, 1) Will there be any side effect due to the extra dose given within 24 hours? 2) Will, it make any difference in giving, first-day Rabipure and subsequently Rabivax? 3) Is there any food restriction after a dog bite? 4) Do I require booster vaccination every year?" }, { "from": "assistant", "value": "Hello. Yes, there is no problem in injecting two dosages within 24 hours. Usually, the first, two shots are given after one another. Apart from that Tetanus toxoid is must that you have taken. It is not the case that the vaccine is ineffective. This is the usual protocol that is followed for safety concerns. Overall, five shots are given within one month. You do not worry but follow your physician. There is no restriction on foods provided as you are fine with your stomach. However, you should avoid intoxicated drinks like alcohol and other things. Vaccination is recommended for high-risk cases. You can get vaccinated that is for safety after year, and it is recommended in case of risks. Rest do not worry as the majority of the times dogs are not rabid, and you might be aware of that." } ]

[ { "from": "human", "value": "Hello doctor, I have depression, anxiety, lack of confidence, lack of energy, palpitation, and excess sweating for the past 18 years. I have consulted so many psychiatrists. My current doctor prescribes me Nexito Forte, Prothiaden 25 mg, and Toficalm 100 in morning and evening. But I feel some sleep issue and sweating. I have also consulted one of a top psychiatrist, and he prescribed me Nexito 10 and Clonazepam 0.5 mg in morning and evening and Mirtazapine 15 mg in night. But it causes me some stomach problem as I have IBS, diarrhea too. Unable to understand that which combination of medicine is better for long term use. Please suggest." }, { "from": "assistant", "value": "Hello. You should go with Escitalopram (Escitalopram Oxalate), Clonazepam and Mirtaz (Mirtazapine). These combinations have a minimal side effect. You take antacid with it. Please do not take the above medications in an empty stomach. You must lose your weight. Do the daily exercise for 30 to 45 minutes and practice meditation for 10 to 20 minutes daily. Avoid junk foods, eat healthy home-cooked meal. Stop alcohol, smoking tobacco or stay away from any type of substance abuse. Spend quality time with friends and family. Spend time for your creative hobbies like read good books, write journals, do paintings, learn new skills or music, etc. Take enough seven to eight hours of sleep. Take a cold shower. Drink three liters of water daily. Live your life, do not just spend. Go for a vacation, spend time with nature. Stay away from social media as much as you can. Prothiaden (Dosulepin) will cause constipation. And low energy can be due to depression or anemia or thyroid abnormalities. It is less likely due to medication. Toficalm (Tofisopam) and Prothiaden will cause you oversedation or make you drowsy the next day." } ]

[ { "from": "human", "value": "Hello doctor, I am 13 weeks pregnant. I have been diagnosed with subseptate uterus with the live fetus in the left horn. Baby is good, with heartbeat and growth. My doctor has advised me proper rest and some medicines. I want to know in detail about this subseptate uterus." }, { "from": "assistant", "value": "Hello. Let me start with a few basic facts and further clinical correlates and effects. Every lady has two uterine tubes, which fuse at birth, and over time, the wall between the two tubes disappear. Now the uterus is converted into a single cavity uterus. The upper ends of tubes remain separate as two fallopian tubes. Sometimes the fusion is complete, but the partition does not disappear. If the tubes do not touch others or do not fuse at all, then you get bicornuate uterus. But if only the wall is partially removed, it forms subseptate uterus. If the wall does not disappear at all, then the septate uterus is formed. Now in both the last two conditions, the main problem is that the space inside the uterus is compromised. The best option was to have a hysteroscopic resection of septa then get pregnant. Having rest makes no difference. At 14 to 16 the week, she can undergo an elective cervical cerclage. Due to septa, uterus loses its polarity, and she is prone to cervical insufficiency. As space inside the uterus is compromised, she can have preterm pains, preterm labor. Due to septate, the baby presentation may not be head down. I hope I have clarified your query, do write back if any more questions." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I am 18 years old, boy and I have a very tight foreskin and I have not even pulled it back. I tried to do it once using oil but it was of no use." }, { "from": "assistant", "value": "Hello. The mentioned history is suggestive of phimosis in which foreskin cannot be retracted back over glans. Topical steroid cream can be beneficial in mild case. But, in severe case like in your case, if foreskin cannot be retracted, then circumcision like day care minor surgery can be done. So, I suggest you consult Urologist for your examination and operation." } ]

[ { "from": "human", "value": "Hello doctor, I am a 67-year-old female. I have a significant past medical history of TB and a lifetime history of bronchitis. My arthritis is currently being treated with Remicade. Last month, while in a temporary job I developed severe altitude sickness (SOB, fatigue, and confusion) followed by bronchitis (stuffy nose and productive cough). While there I needed to schedule a Remicade infusion and the doctor there said she heard crackles in my lungs and sent me for an immediate chest x-ray, high-resolution CT scan and a multitude of labs. To my surprise, I was diagnosed with RA, not PSA as my rheumatologist had diagnosed me before itself. Anyway, the radiology results state honeycomb lung damage amongst other ominous findings. At my follow up I was told I have RA-ILD. I am now back to my place and have no symptoms to alert me of any lung problems. I followed up with my PCP last week and she did not hear crackles in my lungs. My peak flow rate is 400 and my O2 sat is 100% at rest and 98% with fast walking. I will send my radiology report and lab results. My question is, can the latent TB lung scaring be misdiagnosed as RA-ILD or IPF? I would appreciate your opinion." }, { "from": "assistant", "value": "Hello. I can understand your concern. According to your statement, you have been suffering from chronic bronchitis with rheumatoid arthritis with recently diagnosed with RA related interstitial lung disease or idiopathic pulmonary fibrosis. You had a history of PTB and taking anti-tubercular drugs. You are concerned about your recent diagnosis based on HRCT chest whether it is RA-ILD/IPF or latent TB related complications for your past sufferings and now you feel a lot better. Your HRCT of chest reveals (attachment removed to protect patient identity), interstitial fibrosis characterized by peripheral traction bronchiectasis, irregular reticulation in all lobes, microtubules with calcification in mid and lower lungs, lower lobe predominant microcystic changes without significant ground glass opacifications, hilar calcified lymph nodes consistent with chronic granulomatous disease, and bronchial wall thickening bilaterally. Similar type of radiological findings can be found in post TB fibrosis, chronic obstructive pulmonary disease which includes two key components chronic bronchitis and emphysema, RA-ILD or IPF, etc. You may not tell your doctor about your previous history of Latent TB. For that reason his diagnosis was RA-ILD or IPF as you are suffering from RA. So he was not wrong as your radiological reports suggest the above mentioned differential diagnosis. Again, on high altitude, your doctor found crackles as you are suffering from COPD and it may be associated with infections that time and now it not heard as your infection was subsided." } ]

[ { "from": "human", "value": "Hi doctor, I had unprotected sex with my girlfriend and she took the pill(Unwanted 72) within an hour. Two days later, after taking second pill accidentally we had unprotected sex. But, in both the cases I did not ejaculate in her vagina. Now, five days got over and she did not get her periods yet. What are the chances of pregnancy?" }, { "from": "assistant", "value": "Hi. Firstly, I would like to inform you that taking an I-pill will not cause periods. The periods will come at its own time, maybe slightly late too. Delay in periods after I-pill is a common and expected side effect. Secondly, I would suggest you not to take more than one pill a month as one pill can cause serious hormonal changes. Also, it is best to take it only in emergency. Casual and frequent use can cause long-term problems. For further doubts consult an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor,I am 36 years old, male, 6'1\", 265 lbs. I have a question about total bilirubin. I had it checked four weeks ago and it was at .41 mg/dl and one month later it jumped to .82 mg/dl. My alkaline phosphatase is at 1.173 ukat/l and four weeks ago was at 1.003 ukat/l. The doctor was not concerned by this but the highest I have seen it was three years ago when it was at .53 (total bilirubin).However, during the last month, I went from 282 lbs to 265. I have been extremely stressed out about it. Health problems and my anxiety are high. I barely slept the night before the tests and am possibly dehydrated. Could these factors have contributed to the increase? I am concerned about bile duct obstruction." }, { "from": "assistant", "value": "Hello. Since this question was posted under diabetology, I am wondering if you have any endocrine issues. The question asked here is about gastroenterology. The liver tests would be concerning for a liver process like gallstone if the enzymes were not coming back down or if you had pain in your right abdomen. Any fever? Dehydration can sometimes cause the numbers to be slightly up. It is important to have a follow up with your GP. You can also run the query through a gastroenterologist on icliniq." } ]

[ { "from": "human", "value": "Hi doctor, My brother is suffering from fever for more than 45 days. All the tests and scans are done. Bone marrow and hepatitis report came as negative. AB culture and TB culture report are yet to come. There was a bacteria Weil-Felix - rickettsia came as positive. His WBC count is 22000. He had medication for two weeks (Doxy tablet), but there was no improvement in fever. On assumption doctor has given AKT-4, which is making him tired day by day. He had stopped all the tablets now and the fever was below 100 degree in the last five days, but again now he is having fever. Please help." }, { "from": "assistant", "value": "Hi. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 33 year old male. I was diagnosed to have low vitamin D thrice over a span of 5 years. My current level is 17 ng/mL, which I understand is below normal. My lifestyle does not permit me to have enough sun exposure. Hence, I think that the supplements are the only option. Could you please suggest me the supplements? One gentleman from the medical fraternity suggested Calciferol sachet once a month for six months. Is it safe? I would not prefer the one with serious side effects. Please review the attached report and let me know your comments." }, { "from": "assistant", "value": "Hello. I have gone through your investigations (attachment removed to protect patient identity) and you definitely have a low vitamin D levels, which is very common. Lack of exposure to sunlight and sedentary lifestyle. Revert back after three months to an orthopaedician and traumatologist.--->" } ]

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

[ { "from": "human", "value": "Hi doctor, My baby is 2.6 months old. He is suffering from loose motions for the past three days. The stools are watery. He is currently on Enzylac syrup, Dexolac dry milk, Racigyl-O syrup and Bacillus clausii spores suspension -Tufpro. Please help us." }, { "from": "assistant", "value": "Hi. For further information consult a paediatrician online -->" } ]

[ { "from": "human", "value": "Hello doctor, 1 year and 10 months old boy got injured by boiling water, the doctor pricked some of the blisters. The hospital could not say which degree of burn it is, so we are concerned and want to get a second opinion since he is crying a lot and is in pain, the doctor did not advise anything further. He is around 10 kg. The genital parts also have some blisters. Picture has been attached. The white area on the picture is Flammazine cream that the doctor prescribed. Should we find another hospital, is it serious?" }, { "from": "assistant", "value": "Hi. This qualifies for approximately 9 percent burns (attachment removed to protect patient identity). The child will need to take some painkiller medications like syrup Crocin DS (250 mg/5 ml), 2.5 ml thrice a day for 3 to 5 days to reduce the pain. As regarding the cream, it is good, please continue using it. Unfortunately, I will not be able to judge from the picture if the child needs Bactigrass application or no to the burn site. This can only be assessed by a surgeon. Hence, it is advisable to get the child physically evaluated by a surgeon as early as possible. If required, the surgeon will clean up the wound and debride or leave the skin as it is and can assess if the child needs Bactigrass sheet application or no." } ]

[ { "from": "human", "value": "Hi doctor, I have sebaceous cyst in my face near cheeks. It is painless and about 0.5 cm in size. It looks awkward in my face. I need to remove it. Please suggest me the best treatment for the same." }, { "from": "assistant", "value": "Hi. For further information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My D-dimer is getting higher from 1.5 to 5.9 within the last four months. My heart has been checked, and I had a chest x-ray, CT of heart, aorta, abdomen, and pelvic floor and Doppler of my legs. All are clear. Blood work is normal apart from D-Dimer and c-reactive protein which is 12.6 mg/L. What can it be?" }, { "from": "assistant", "value": "Hello. Following is my opinion about your asked question. D-dimer is usually elevated in some thrombotic events in the body like DIC (disseminated intravascular coagulation), deep vein thrombosis or pulmonary embolism. But your CT chest and Doppler leg are normal as per history. So pulmonary embolism and DVT can be excluded. The other causes for elevated D-dimer can be liver disease, heart disease, inflammation, post-surgery, and pregnancy as well. Your heart is normal as per history, so heart disease can be excluded. You can rule out the liver disease by SGPT (serum glutamic pyruvic transaminase), SGOT (serum glutamic-oxaloacetic transaminase), and serum protein estimation. If you have pregnancy or surgery history than it can be the cause. PT (prothrombin time), PTT (partial thromboplastin time) and coagulation profile can be planned by your doctor if D- dimer remains persistently high. Kindly attach your report to give further comments if possible." } ]

[ { "from": "human", "value": "Hello doctor, I am a 29-year-old male. I am having severe pain in abdomen and I was diagnosed with stones in the right kidney and ureter. The USG report shows right nephrolithiasis, right lower ureteric calculus with mild to moderate with hydroureteronephrosis. I am currently under Tamsukem Plus for 15 days and Alkaston B6 200 ml syrup. Can you help me?" }, { "from": "assistant", "value": "Hello. As it has been prescribed in the USG, the kidney stone that has moved within the urinary pathways have caused the pain you experienced. Alkaston B6 (Magnesium Citrate, Potassium Citrate, Pyridoxine) will help dissolve the stones. Increase water intake. Take uva-ursi, cranberry, and fern tea or supplement to help dissolve the stones. Take Mefenamic acid or Ibuprofen for the pain. Keep following up with a urologist." } ]

[ { "from": "human", "value": "Hi doctor, I have this skin reaction for around a month now. They are itchy, red and tiny bumps. My doctor gave my Zatamil ointment to use but after that ointment I feel it as spreading. Is there any other ointment that can help to get rid of it quickly?" }, { "from": "assistant", "value": "Hi. I feel sorry for this situation. Revert back with the answers to the above questions to an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I think my right side bottom wisdom tooth is coming as there is a ball on the back side of my gum that is really swollen. It almost feels like a pimple and the area around it has white lines on the inner cheek wall. What should I do?" }, { "from": "assistant", "value": "Hello. If there is not much pain, it is better to let it grow fully. It may take a month or two to fully come out. If it does not, and the area gets painful then better to get an X-ray done for its exact position. Use warm salt water gargle twice a day for a week or two. Use a chewing gum on that side, it helps in faster growth of the tooth into occlusion." } ]

[ { "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, I went to the doctors with four bouts of chest pain. Lasted under a minute each time. The pain went into the left arm. The doctor ordered ECG. No breathlessness, unless exercising. Can you please review and provide feedback on a recent ECG?" }, { "from": "assistant", "value": "Hi. Significant findings in ECG are: 1. Early repolarization in V5 and V6. This is a normal finding at your age. 2. Deep S wave in lead V3. This can suggest left ventricular hypertrophy (by Cornell voltage criteria). However, there are no other changes in ECG to suggest LVH and deep S wave can sometimes be seen normally in young people. You can get echocardiography to remove any doubt regarding LVH (left ventricular hypertrophy). Echocardiography." } ]

[ { "from": "human", "value": "Hi doctor, My doctor says that glucose reading given by home monitor is always 10% higher than the actual glucose reading from the laboratory test result. So, if my reading in the home monitor is 90 mg/dl, then my actual glucose is 81 (90 minus 9, 10% of 90). Is he right? Do you agree with this?" }, { "from": "assistant", "value": "Hi. It is not like home glucose monitor will be 10% higher. It can be higher or the same or even lower than laboratory results. In fact, in my observations, I have noticed it be slightly lower than the laboratory test result. What I recommend is calibrate your home glucose monitor with the actual laboratory test report. I mean to say do the blood check immediately when the blood sample is being taken for laboratory test." } ]

[ { "from": "human", "value": "Hi doctor, One of my relatives is HIV positive. He says that it is functional and the virus is not affecting him in any way and he will not transmit the infection to anyone. As per him he does not require the antiviral medicine also but taking it as he is extra cautious. 1. Please help me on how can I be sure of his claims as truth in this relation is very important for me. 2. Also, can you please let me know the prognosis of this disease. As per him, he will live a normal life and there is no threat of developing AIDS as he is a special case. Please let me know if this is true and how can it be proved." }, { "from": "assistant", "value": "Hi. There is nothing like functional HIV infection. Confirm, whether he is HIV 1 or 2 because HIV 2 is less infectious and less violent than 1. If he is infected with 1, then there will be slow progressor or rapid progressor. If he is rapid, then he will have a low CD4 count below 350 by two years, and if he is slow progressor then it will take 4 to 5 years but inevitable to land in AIDS if he will not take medicines. 1. Get his viral load and CD4 report to know the current status to assess his claims. 2. Prognosis is very good at current age owing to very good use of HAART medication. They can live a normal life with medicine." } ]

[ { "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 -->" } ]