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

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

[ { "from": "human", "value": "Hello doctor, My 3 year old son is suffering from cold and has regular cough. His temperature is normal and he did not have fever. But at times, he is throwing up whatever he eat or drink while coughing. Please suggest any medication and test if required. Thank you." }, { "from": "assistant", "value": "Hi. I understand your concern. Revert back with the answers to the above questions to a paediatrician online -->" } ]

[ { "from": "human", "value": "Hello doctor, My wife is 36-year-old with a height of 5.6 and weight 69.1 kg. She had NT or NB scan and double marker test in obstetrical ultrasound. The nuchal thickness is 1.0 mm. Presence of nasal bone. DV flow is normal, but in double marker test, free beta hCG is 46.20 and PAPP-A is 2.58. Trisomy 21 -screen positive cut off 1: 250. Mother's cut off free beta hCG is greater than or equal to 1.98 PAPP-A." }, { "from": "assistant", "value": "Hello. 1 in 250 means that if we take 250 women of the same results as your wife had then only one will have a baby with Down syndrome. So this is the explanation of the calculated risk of down syndrome. Secondly, NT (nuchal translucency) and blood tests which she underwent are screening tests. Screening tests are not diagnostic. They only detect who is at risk. If they become positive, that does not mean that particular is at risk. It just says that specific condition may or may not be there which is then confirmed by diagnostic tests. In your case, CVS (chorionic villus sampling, taking a sample from the baby) will diagnose if the Down syndrome is there or not which you will be offered at 12 to 13 weeks most probably. I hope it has helped you. If you require any further queries, please do not hesitate to contact me." } ]

[ { "from": "human", "value": "Hello doctor,I am a female, 18 years old, 5 feet. I weigh 50 kg. I am having a problem with my wisdom teeth. They are impacted and causing me a lot of pain." }, { "from": "assistant", "value": "Hi. I understand the pain you are experiencing due to impacted wisdom teeth. These teeth should be removed to alleviate the pain. They are removed by surgical procedure mostly under local anesthesia. Sometimes they are done under conscious sedation also. It would be great if you could send me the X-rays pictures. I could diagnose and let you know the difficulty in removal. For pain reduction, you can continue the same medication. Kindly rinse your mouth using salt in lukewarm water frequently around 4 to 5 times daily till the wisdom teeth are extracted." } ]

[ { "from": "human", "value": "Hi doctor, My wife is suffering from body pain and a feeling of weakness every day. She is calcium deficient. Will any protein supplement help?" }, { "from": "assistant", "value": "Hi. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Dear doctor,I would like to know if I can take kalarchi churna. I have PCOS with irregular periods and ovulation issues. I was on Clomid stimulation which was giving prompt follicle growth and ovulation but could not conceive. Now I am given FSH injectables for stimulation. Can I have kalachi churna when having these injections? Will they interfere with follicle growth? Also, my testosterone levels are high. What to take to control that?" }, { "from": "assistant", "value": "Hi. PCOS (polycystic ovarian syndrome) is not a single disease, it is a group of diseases. It occurs due to hormonal imbalance, development of immature ovum due to hormonal imbalance and converted into a fluid-filled cyst. It leads to irregular menstruation and raised level of androgen hormones. It can be managed through ayurvedic medicines and yoga practices. Kalarchi choornam is a Siddha medicine. It is widely used in PCOS. You can take this 2 g twice a day after meals. Do regular Kapalabhati and Mandukasana as well as pranayamas like Anuloma vilom, Nadi shodan and Bhramari. It helps to improve your metabolism. Avoid spicy and fried junk foods. Eat fibrous foods and fruits as well as green leafy vegetables. Drink plenty of water. For more information consult an ayurveda specialist online -->" } ]

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

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

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

[ { "from": "human", "value": "Hello doctor, I have developed many pimple marks on my face. My face mostly remains oily. Pimples still appear on my face at the age of 22." }, { "from": "assistant", "value": "Hi. Can you please upload a few pictures if possible to advice proper treatment?" } ]

[ { "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, A few years back, I suddenly developed constant dyspepsia, bloating, and reflux. Also on and off stomach pain. I was prescribed Lansoprazole and it took away the symptoms until a few weeks back. Symptoms have suddenly returned despite still taking PPI. Can an ulcer develop whilst taking Lansoprazole? I am also having minor pain under the right ribcage. Can an ulcer develop or worsen whilst taking a PPI?" }, { "from": "assistant", "value": "Hello. Peptic ulcer disease is mostly related to the presence of Helicobacter pylori infection (a bacteria that is transmitted via saliva and is present in around 70 % of adults). The first step of the treatment is actually PPI. When this stops working (yes, you may develop more serious symptoms. Whilst taking PPI's) you have some options like add antiacids whenever you have symptoms like Magaldrate-Simethicone 3 to 4 times a day. Add H1 blockers (Ranitidine 150 mg tablets) every 2 to 3 times a day. Avoid over-the-counter pain-killers (with some exceptions such as COX2 inhibitors). If symptoms continue despite this, you need to do an H.pylori testing, if positive you need to take the medication for its eradication (it includes two antibiotics). This usually improves very much the symptoms for months or years." } ]

[ { "from": "human", "value": "Hey doctor, In previous one year my right eye is looking bigger than other and it is paining sometime. Why does it happen and the solution for it?" }, { "from": "assistant", "value": "Hello. The two common causes of such a presentation could be that either: 1. One of your eyes is either big in size. 2. That the eyelids of your other eye have swollen up or one is pushed out or one eye has a squint, giving an apparent prominence of the other. Both causes are dangerous in that, they both can hamper your vision in several forms. Rare instances of life-threatening tumors are also reported, I have run into patients with such problems. Given that you have pain, I guess that it could be one of the latter causes. I recommend that you see an ophthalmologist for your issue. In case you need more help, please send me a picture of your eyes, pointing to where exactly it pains, I will do my best to help." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I have little bumps on my genital area that could be genital warts. How do I know for sure, and what do I do to remove them and prevent infection?" }, { "from": "assistant", "value": "Hello. I have read your query. I have seen the attached photograph also (attachment removed to protect patient identity). As per details, these are the following possibilities for your symptoms: The confirmation of diagnosis is done by clinical examination and if needed, a skin biopsy is done. Treatment depends on the diagnosis. Broadly, Radiofrequency ablation (RFA) works in all the above-mentioned conditions. You should visit your doctor for clinical examination." } ]

[ { "from": "human", "value": "Hello doctor, Almost two years back, I was diagnosed with psychosis. I improved in two months after taking treatment. I took medicine (Olanzapine) for nearly 9 to 10 months then I stopped taking the medication as I recovered from it completely. I did not consult doctors. Still, my condition is good, and I face no such psychological problems. But I had a blackout episode lately when I was heavily drunk. Should I start taking the same medicine Olanzapine? As I do not want to go to for check-up any more." }, { "from": "assistant", "value": "Hello. Psychosis should not be taken lightly because psychosis is a term that reflects a variety of explanation like it may be schizophrenia, it may be due to depression, may be secondary to alcohol or any other condition, so diagnosis is very important, that your primary doctor knows better. And every diagnosis has a different course of treatment, as for as you alcohol is a concern that blackout means you should be more concern and should be adequately treated. Do not stop it suddenly, and try not to drink heavily. Go to your doctor and tell your history he would help you to deal with the problem and you need to have health check-up and lab investigation for sure." } ]

[ { "from": "human", "value": "Hello doctor, I have severe and uncomfortable abdominal pain when I have my monthly period. My menstrual cycle and pain last for 5 to 6 days each month." }, { "from": "assistant", "value": "Hi. I have read your symptoms. It looks like the regular pain that comes on during the menstrual cycle. So I just want to know if you have any medical conditions like hypothyroidism, diabetes or any other general medical conditions if you have had any surgery in the past, is there any symptoms like vomiting, loose stools associated with this. I would like to know your diet habit and if you have a family history. This looks like inflammatory muscle pain. I would advise you to take Mefenamic acid 250 milligrams with Dicyclomine 10 mg twice daily whenever you have this pain and also drink a lot of fluids that will help you with reducing pain. Drink plenty of fluids. That is very important. Inflammatory muscle pain during the menstrual cycle. Mefenamic acid 250 mg and Dicyclomine 10 mg as needed. Plenty of fluids to drink." } ]

[ { "from": "human", "value": "Hi doctor, I have pain in my feet and wrist sometimes, and I take painkillers. It goes and comes back again after a few months or weeks. It is not due to external injury. I got a blood test, and my uric acid was high at 10 mg/dL. Now, I take Feburic 40 mg for some time. Today again, I had a pain on my feet, and I am sending the location of pain present on my feet. Is it due to high uric acid? I eat chicken more. Does eating chicken cause an increase in uric acid? I am overweight, and I am trying to reduce my weight. My weight is 99 kilograms, and my height is 177 cm. Do I have the pain due to a nerve disorder or fibromyalgia? My mother had fibromyalgia. What should I have to do? What diet should I need to take?" }, { "from": "assistant", "value": "Hi. I have gone through the attachment (attachment removed to protect patient identity). As the uric acid is high at 10 mg/dL, it is likely a cause of arthritis. Febuxostat that you are using now should be used every day even when you are not having pain. This medication is used to treat acute gout, and it prevents recurrent attacks. Check your uric acid level if you are taking Feburic 40 mg. Increase the dose to 80 mg and recheck uric acid in four weeks. Uric acid should be less than 6 mg/dL. Avoid drinking alcohol, and you can add proteins to the diet such as chicken, beef, mutton, or fish. But not in excess and it should not be taken every day. Do these blood tests such as CBC (complete blood count), ANA (antinuclear antibodies), rheumatoid factor, anti-CCP (anti-cyclic citrullinated peptide) antibodies, and ESR (erythrocyte sedimentation rate) to rule out other possible diseases." } ]

[ { "from": "human", "value": "Hello doctor, I have been experiencing bleeding, pain, and discomfort during sex. It started about three weeks ago when my fiance and I had multiple sexes in a day for almost a week. At first, the bleeding was very little, only during intercourse, and stopped immediately after the intercourse. We had sex before three days, and the bleeding was minimal. But now the bleeding continues. I can tell that it is coming from my vagina wall (near the entrance) instead of the uterus. Neither of us has STI or STD. I am on combination pill Rigevidon for almost a year. The pain goes away immediately after intercourse, and it is not that intense. What could be the problem? I also do not have a yeast infection." }, { "from": "assistant", "value": "Hello. The most common cause of post-coital bleeding is either vaginal mucous frictional lesions, and the other is cervical erosions or cervicitis (lesions over the cervix which bleed due to frictional injury during intercourse). It is essential that you should get speculum examination, and pap smear done to check for cervicitis, and any vaginal mucous lesions if any. Please avoid intercourse. If diagnosed then this may require a course of antibiotics for the next 10 days as would be advised by a gynecologist after evaluation. Please consult your gynecologist." } ]

[ { "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 25 years old male. My problem is redness of the genitals. It has been two months now. It first started from my penis head with four or five red bumps like spots. Then I consulted a dermatologist. He gave me Candid-B cream to apply and some anti-fungal tablets. But I mistakenly use liquid Dettol in water to wash my penis, and it spread badly to my scrotum area. Whole red no itching and no pain just a little red nerves beneath. I have used creams like Onabet, Dermiford k5 prescribed by doctors. And have done 25 days course of Itraconazole 200 mg two times per day. And that with Onabet cream and glycerin lotion. The last cream I used was Betnovate gm, which damaged my penis and gave me a burning sensation on scrotum and foreskin. Now I am applying no cream, only keeping ice pack, and I consulted another doctor. He said after seeing pictures that there is no fungus just irritant contact dermatitis. Please help." }, { "from": "assistant", "value": "Hello. According to the history given by you, it could be irritant contact dermatitis followed by application of dettol. Since you have used most of the creams and few of it containing steroids, your skin has got thinned, and that is why you could see red colored vessels. It is advisable that you should not apply any cream which contains steroids it could worsen your lesions. Apply coconut oil before taking a bath, no soap on the affected area during bath. Please share pictures of it so that we could start with the treatment. You might need to take oral steroids to improve your condition, but no topical cream. You can take tablet Levocetirizine 5 mg at night time for five days. This is to reduce the itching or burning part but not going to cure it. It is advisable to consult a dermatologist." } ]

[ { "from": "human", "value": "Hello doctor, I want to grow more hair and hair thickness and avoid losing hair and thinning hair. Please check my pictures and advise me a perfect solution." }, { "from": "assistant", "value": "Hello. I understand your concern. Your condition is known as androgenetic alopecia or male pattern baldness, which has genetic as well as hormonal factors as the causative factors. You need to use treatment for this condition regularly and it takes about 3 to 4 months to start showing the results as hair cycle itself takes this much time. Start the following medications: A. Tablet Finpecia/Propecia 1 mg, take one tablet once a day. B. Rogaine (Minoxidil) 5 % lotion apply 1 ml twice a day. C. Nizoral shampoo three days per week. Do this initially for two months and follow up after that." } ]

[ { "from": "human", "value": "Hello doctor, I had a blood test today and the results show hemoglobin is 18.05 and the RBC are 5.8 and hematocrit is 42 %. Should I be worried?" }, { "from": "assistant", "value": "Hi. Your hemoglobin and RBC are certainly high. So your diagnosis can be polycythemia. It can be secondary erythrocytosis for which you can investigate with EKG and chest X-ray to rule out the cardiac or respiratory cause. If you have any dehydration or prolonged fasting history, then provide history regarding that. Kindly provide your full CBC report and any clinical history if present to guide you further. After your reports and total WBC count review, I can guide you further." } ]

[ { "from": "human", "value": "Hi doctor, I have been detected with 4 mm stone in right vesicoureteral junction. It gives me immense pain. The doctors have performed flush therapy twice. But there is no good result. My serum creatinine is 1.4 mg/dL. They have given me Neeri syrup. Can I take tablet Cystone along with this syrup for the stone to get dissolved? What can I do now?" }, { "from": "assistant", "value": "Hi. I can understand your concern. 4 mm stone can be dissolved quickly. You are taking the right medicines for this. You can add tablet Cystone along with it. In the case of pain, which is not bearable, you can take painkillers. Avoid spicy and fried junk foods. Drink plenty of water. You can take these ayurvedic medicines to dissolve stone quickly: For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My sister is 6 months 20 days pregnant with ART. She is having premature ovarian dysfunction. She was on Lonopin 40 mg with Ecosprin tablets. She had undergone two time ART procedure. All her reports were fine, but the fetus had no pulsations. So, she underwent two times for abortion. Now this time everything is fine, and her doctor advised to stop Lonopin. He said nothing to be worried about and no need to take an injection. Do you think she needs to take these injections and if she takes these injections full time, can it bring some complications?" }, { "from": "assistant", "value": "Hello. No, she should not stop low molecular weight injection and instead take a good brand either Enoxaparin or LMWX and tablet Ecosprin 150 mg, as her previous history is such that we should not ignore it. If not taken, then she is at high risk for early development of high BP, slow growth of the baby, water level around the baby remains low and some time bleeding can occur during pregnancy. So you have to be very careful." } ]

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

[ { "from": "human", "value": "Hi doctor, I am 42 years old, and I had a bacterial infection. I took anti-bacterial and anti-fungus medication. Now, I have a burning sensation while going pee and I feel like I have an unemptied bladder. I have an urge to pee. I also have a feeling of having leakage. I am taking the following medication for other causes such as Zyloric, Aspirin, Zantac, Coversyl, and Hypothyroid. Please suggest." }, { "from": "assistant", "value": "Hi. You are suffering from recurrent urinary tract infection. Please explain about the bacterial infection you had and about the medication taken. Please explain the reason for taking Aspirin." } ]

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

[ { "from": "human", "value": "Hi doctor, I have a big problem in terms of loosening of upper and lower eyelids. Please check the attached pictures. I have been wearing rings on my fingers which have created pressure on my eyes and l believe have led to my condition. I am extremely worried as nonverbal communication is affected and I am having staring look. My confidence level goes down with this. I have shown to ophthalmologist for sight since the last six months and they have been prescribing drops such as Fusion, Systane ultra, anti-inflammatory eye drops and tablets but my condition is not improving. I have been using cold and hot compress as well and changed my diet. Please advise." }, { "from": "assistant", "value": "Hello. I have gone through the pictures (attachments removed to protect patient identity) of your eyes. As I can see, there is nothing abnormal with your eyes. Cosmetically, there are some fat deposits around the upper and lower eyelids. This condition is not in need of treatment now. If you want to improve appearance, cosmetic surgery can be done to correct the fat deposition. Fusion (combination of Sodium hyaluronate, Carboxymethylcellulose and Glycerin), Systane ultra, anti-inflammatory eyes drops or any other treatment will not help you in any way. Wearing rings is no way related to your eye appearance." } ]

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

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

[ { "from": "human", "value": "Hello doctor, This question is in regards to my 12 year old daughter. She had a routine eye exam at the optometrist's who noticed that she had blurred disc margins. We were given a referral to an eye specialist, who checked her eyes and said that her vision and peripherals were perfect, but yes, there is a slight bulge behind her discs bilaterally. She assumed it was probably just a calcium deposit, but it was best to get an MRI to be sure. We have done the MRI and now are waiting to see the specialist again. But of course, we are panicking and thinking of worst case scenarios. I have viewed the MRI and can see a very small white dot on two different angles of the scan (see attached images). Does this look like something? Would love to get some feedback as soon as possible as we cannot handle waiting anymore. My daughter is asymptomatic at the moment. There is no loss of sight, no headaches, or dizziness. She seems fine. But we would like to be sure. Thank you." }, { "from": "assistant", "value": "Hello. Please do not worry. I hope this will help you. Regards. For more information consult an eye care ophthalmologist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, My friend is a 40 year old female. She met with an accident before 10 days. Her arms and shoulders got fractured. Her ribs too got injured. She is having chest pain, breathing problem and clot in blood vein. I have attached all her CT scan and x-ray reports with this. Please advise what treatment is required." }, { "from": "assistant", "value": "HiAs per the reports (attachment removed to protect patient identity) submitted, I understand that it was a major accident. She has multiple injuries to various parts. Usually, with such injuries, it is difficult to isolate each problem and provide a solution without seeing the patient as multiple organs are involved. As it has been 10 days since her accident, I assume that she is clinically stable by which I mean that her pulse rate and blood pressure are normal or near normal. Both the bones are fractured in her arm. So, an internal fixation (installing plate) done by operation would be ideal. For the shoulder, I cannot make out any fracture which needs surgery. Anything minor can be managed by support and strapping for clavicle. Chest pain and breathing problem will be there due to multiple rib fractures. CT suggests minimal blood in the thorax. She will require chest tubes (which might already have been put) on both sides, but the decision is clinically based. High dose analgesics (painkillers) will be required for the pain, to help her breathe. Also, she may require ventilatory support for the sometime as she may not be able to breathe well due to the pain. I could not see any report suggesting blood clot in the veins whether it is in the upper limbs or lower limb. If it is associated with the fracture in the upper limb, then the best treatment is surgical removal during fracture fixation. Lower limb clot also may need surgery based on the extent of involvement, and it is a clinical decision. It is usually done at the earliest. As it has already been 10 days since the accident, I do not understand which clot they are talking about. Remaining supportive care is going on as required as you have written. Her last hemoglobin was 8.3. I believe she was given blood transfusions after that. If not, she needs blood transfusion too." } ]

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

[ { "from": "human", "value": "Hi doctor, I feel fatigue despite good sleep of about 7 to 8 hours. I have sporadic pain in the body. I feel cold and freeze rapidly especially on air conditioning. Otherwise, constant palm sweat is present. I am getting discomfort with lights. I have a sense of fullness in the head as if I were on a plane. I am getting fear of the future, especially of disease and death. I could not identify the source of these symptoms. If these are psychological, then what is the solution?" }, { "from": "assistant", "value": "Hi. I want to assure you do not 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. Such an issue happens due to either of the following causes. Thyroid disease, diabetes mellitus, hepatic disease, heart disease as endocarditis, hypertension and autoimmune disease where body's immune system gets against the body's own tissues. Situation like this may also have a psychological part of the disease. Can you please tell me how much time elapsed for such symptoms? Is this a continuous one or on and off? Do you or anyone else at your home know that you snore while sleeping? What are your blood pressure, pulse rate, and respiratory rate today? Respiratory rate is when you sit quiet and count for one minute that how many times you inhale and exhale, a complete respiratory cycle. Pulse rate, you may count by keeping the finger on wrist and counting the feeling of pulse in one minute. Do you have fever? How active are you? Can you please upload the tests you went for? Diagnosis is the key to proper treatment. We can rule out certain causes from diagnostic tests. If not available, no problem I have written all the necessary tests. You must get it done as soon as possible so that we may proceed further. Get the following investigations done and upload the report: 1. CBC (complete blood count) with ESR (erythrocyte sedimentation rate) and differentials. 2. Fasting blood sugar levels. 3. Fasting lipid profile. 4. Thyroid profile. 5. EKG (electrocardiogram). 6. Total CPK (creatine phosphokinase) levels. 7. HBSAg (hepatitis B surface antigen) and Anti-HCV (anti-hepatitis C virus) levels. It will be decided on follow up details. Do not worry, it can be managed." } ]

[ { "from": "human", "value": "Hello doctor, My daughter is suffering from cough for the past four weeks. She started it out very gently and it is getting worse. Last weekend she was coughing almost non-stop. I took her to a Walk-in clinic and they gave her a cough syrup and an antibiotic. I was told to start the antibiotic four days later if she does not get better. I have started the antibiotics after six days. But, she was getting weaker and coughing with choking. I took her back to the doctor. They told me that she might have whooping cough. I was not entirely surprised as she had hypoxia at birth and she did not get that one vaccine: the pertussis. She only got DT. From chest x-ray, we came to know that she had pneumonia too. But, not on both lungs and the x-ray was not entirely white, so it was a smaller pneumonia. By that time we were on day three of the antibiotics. They made a sample test from the nose for whooping cough. I was told that even if she has it the results might come back negative as she took Azithromycin. We were told to wait and see after the antibiotic. The result came back negative. The same night her cough got so bad that she was not getting any air. She was coughing without being able to breathe. She was vomiting and a tone of white long, phlegm or mucus came out with the vomiting. It was white, sticky and lots of it. In the emergency room they turned out that she had bronchospasm. They treated her with Albuterol and steroids. She was put on Albuterol for two hours there, then we came home with an inhaler. She has been using that three to four times a day ever since then. She has been very weak. They checked her again for whooping cough and that too came back negative. She took the second dose of Prednisone three pills. She felt better and was so happy. But, the next day she did not feel that good. Today, she had more coughs and it is a second sound behind the usual cough sound. This second one is like the laryngitis cough, but not barking sound. It is just a deeper cough. I am totally lost. I do not what to do anymore. She had a different kind of cough sounds throughout for almost a period of four weeks. Intense, barking, whooping cough like, silent, more loud and now this strange one. She is allergic on Amoxicillin, Ceftin, Bactrim and Cefalosporins. I gave her Mucinex to loosen the mucus. I would like to know what to do. Should I go and see a pulmonologist in person?" }, { "from": "assistant", "value": "Hi. I have read your daughter's story in detail. I also heard the quality of cough you provided in the sound clip (attachment removed to protect patient identity). Allergy. Spirometry (PFT). Pneumonia. Regular steroid inhalers and Albuterol inhaler (SOS). Avoid dusts and cold drinks For further information consult a pulmonologist online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I had protected sex with my fiancee, but the condom leaked. She had an I-pill within two hours. It was just after her period cycle. She had spotting after a week which lasted for a day and again after 15 days. It has been 17 days now since she missed her regular period date. We took a urine pregnancy test on the 5th and 11th day of missed periods, and it was negative. Is there any chance of pregnancy? Should we consider taking medicines to avoid any possibility of the pregnancy and get her periods back? Please suggest something as she is very scared with her periods getting delayed and considering pregnancy. She never had her periods delayed before this. When can we expect her periods to come?" }, { "from": "assistant", "value": "Hi. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,I have 10 months old baby. Since yesterday, she is suffering from diarrhea. Yesterday five times, today three times, and I have not used any medication for this. Can you please suggest any medications?" }, { "from": "assistant", "value": "Hi. Diarrhea is most viral in nature in children. Requires symptomatic treatment. Replace fluid loss with ORS. Add Zinc supplement (2 mg/kg) for 14 days. Watch for urine output. Give syrup Vizylac 2.5 ml BD as probiotics. If severe dehydration, visit the hospital. Any episode of vomiting?" } ]

[ { "from": "human", "value": "Hi doctor, I have stomach pain below the breast on the left side with difficulty in depositing waste. I also get a fever during the early morning. Please help." }, { "from": "assistant", "value": "Hi. You are suffering from constipation. Because of it, you have stomach pain below the breast on the left side with difficulty in depositing waste. When there is constipation, the waste does not get clear entirely from the bowel. This results in bowel enlargement which puts pressure on the diaphragm on the left side causing pain. Once you treat constipation, you will have no pain. Getting fever in the early morning occur due to a recent viral infection, or it can happen due to change in climate. Sometimes, hormonal changes also cause a feeling of fevering. If it persists, you have to check your thyroid hormones." } ]

[ { "from": "human", "value": "Hello doctor, I am writing this letter for my mother-in-law. She is 65 years old and seems to be healthy. Recently she was suffering ill (fever, sleepless at night, body pain, etc.) thus visited a doctor (physician). After a physical examination and studying certain blood tests (that he was suggested to test), the physician advised us to consult with a hematologist ASAP. Soon, we consulted with hematologist. He advised us to check certain tests such as protein electrophoresis and free light chain, HbA1c, LFT, USG abdomen and pelvis. He also pointed out that she may undergo bone marrow examination subject to test results. The reports are as follows. We shall see the hematologist by next week. Before meeting him, we wish to know an expert opinion about the interpretation of the test results and further course of action. HbA1c- 6.65, bilirubin- 1.5, bilirubin direct- 1, SGOT-54, SGPT-30, alkaline phosphatase 04-304, T protein- 7.1, S. albumin- 3.8, S. globulin- 3.3, calcium- 8.3, phosphorus- 3, uric acid- 6.1. USG remarks: Chronic liver parenchymal disease with PHT, no ascitesat present, other organs normal free kappa (light chain) serum– 46, free lambda (light chain) serum– 33.10, free kappa-lambda ratio– 1.39, total protein- 6.8, serum albumin– 3.7, alpha 1 globulin– 0.19, alpha2 globulin- 0.46, beta 1 globulin– 0.39, beta 2 globulin– 0.42, gamma globulin– 1.65, albumin-globulin ratio– 1.19, comments– electrophoresis shows elevated gamma globulin. No significant change in the other fractions. No M band seen. Kindly look into the above and revert with your valuable suggestions." }, { "from": "assistant", "value": "Hello. Your electrophoresis report shows increased gamma globulin level (attachment removed to protect patient identity). So your doctor might suspect plasma cell dyscrasia, especially multiple myeloma like condition. So referred you to a hematologist. But in electrophoresis report, M band is not seen which is classically seen in plasma cell dyscrasia. Moreover, Kappa to Lamba chain ratio is normal in the report. So, the chance of multiple myeloma seems to be less. But increased gamma globulin need further work up in form of CBC, serum calcium level, etc. In the case of multiple myeloma, the osteolytic bone lesion is also present. For that X-ray can be done in the suspected area. The gamma globulin increased in infection or inflammation as well. So your physical examination is necessary. Moreover, your cirrhosis with portal hypertension needs treatment in the form of beta blocker to reduce portal hypertension. The elevated bilirubin can be due to liver damage by cirrhosis." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I have 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": "Hi doctor, Three days back, I had food for dinner. The food was spicy. Next day, in the morning, I vomited it completely. I suffer from diarrhea for the past two days, and I feel tired. Please suggest me." }, { "from": "assistant", "value": "Hi. You are suffering from acute gastroenteritis. As you are feeling tired, you must take ORS (oral rehydration solution) after passing of each stool. Otherwise, you would become dehydrated. Take plenty of water and ORS. Avoid taking spicy foods. Avoid eating foods from outside. Take a healthy homemade meal. For vomiting, you must take antiemetics. You can take tablet Emistat 8 mg (Ondansetron) one tablet in the morning, afternoon and evening before having a meal for three days. Please say whether you have abdominal pain. You should not take medication on your own without consulting a doctor. Follow these instructions. If there is no improvement, then you can take an antibiotic." } ]

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

[ { "from": "human", "value": "Hello doctor, I have 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": "Hi doctor, I have got a pigmented line in my fourth toenail. It started as a freckle that was tan in color quite quickly over in four or five months it has turned darker. It is not growing out but spreading in width. The bottom left part of my skin and cuticle area is very itchy at times and it feels tender in my toe and top of foot at times too. I have not had any trauma to my foot, knocked it or dropped anything on it. Is it something that will just disappear? I am a 31 year old female, currently on Amitriptyline 50 mg at night." }, { "from": "assistant", "value": "Hi. I have examined the submitted details and will do my best to help you overcome the problem. Close examination shows the dark band appearance that is often seen in individuals who get an infection due to a fungus. To most of my clinic patients, I suggest tablet Fluconazole 150 mg weekly and Miconazole or similar antifungal lotion twice a day. It takes some weeks before the results are apparent. If there is itching in adjacent areas, Zyrtec (Cetirizine) or another antiallergic can be a great help, taken once a day. With proper care, avoidance of moisture in the area, and well fitting footwear, the problem is manageable. Best wishes." } ]

[ { "from": "human", "value": "Hello doctor, I recently had an abortion pill. I took Mifepristone tablet first then after 36 hours, I took four tablets of Misoprostol of 200 mcg orally. At first, there was light bleeding during one hour then after some time I had heavy bleeding and it almost soaked two pads and it continued for almost two to four hours. After that, I am having light bleeding. There is little blood coming out from the vagina. I thought abortion process was not completed so again after 24 hours I took four more Misoprostol of 200 mcg but after that, there is still no result of heavy bleeding. I wanted to know what to do next and whether the abortion process is completed or not. Please help me through this. I have nausea, vomiting and abdominal pain along with it." }, { "from": "assistant", "value": "Hello. I guess you have not passed any tissue or mass like structures out of the vagina. So we cannot be sure about the complete termination of pregnancy. Presence of just bleeding does not ensure the complete termination. So our priority is to confirm it. Now it is a time for you to get yourself examined by a gynecologist, an ultrasound of the pelvis to look for complete or incomplete termination. Ultrasound will confirm the status of pregnancy. However, it is not recommended to have excess doses of Misoprostol now. Also, although the risk of infection is not high, keep watch for fever and if developed then have antibiotics started immediately. So overall, next most important step is an ultrasound of pelvis and if incomplete termination then an evacuation. For more information consult an internal medicine physician 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, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "assistant", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 21 years old. I was wondering due to my shoulder being really bad and after doing surgery and still, even after that I am always dislocating it. I have been trying to tape it but I am not 100 % sure how to do that, so it will minimize the chances of it dislocating while snowboarding. I have been wondering whether the kino tape would be better or just a normal sports tape and if you could give me tips on how to tape my shoulder, it will be really helpful. I do exercises to try to stabilize shoulder but not with alot of progress." }, { "from": "assistant", "value": "Hi. I read your concern. In your case, taping can help you little in stabilizing the joint. However, Kinesio tape helps you to recruit or inhibit muscle and is of less help in providing stability to the joint. If you want to tape, then go for rigid tape. If you were my patient, I would honestly suggest you go to a good arthroscopic surgery and get your stabilization surgery properly and follow the proper rehabilitation protocol before attempting to start your sport. You have to first regain your stability range and strength before introducing to your sport again. If you are really keen only in taping, then tape your shoulder in that position which limits your sideways lifting and outward rotation of the shoulder which is actually a difficult position to limit. Stabilize your scapular muscles and can limit the scapular movement limiting the shoulder mobility. However, in a long run, this will not help you to make you independent. Just think about getting a good arthroscopic stabilization to your shoulder." } ]

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

[ { "from": "human", "value": "Hello doctor,I am a 60-year-old man. I have had a bypass operation 17 years back. I am on alpha and beta blockers. Is it possible to take Actifed and Otrivine nasal drops together?" }, { "from": "assistant", "value": "Hi. I would suggest it is better to space these out at least two hours apart. Give a gap of two hours before taking other after taking one. Pseudoephedrine and Oxymetazoline have common alpha agonist activity, can increase, give a surge in BP, especially if your BP already remains at the borderline. Another thing that I am concerned is, if you have underlying subclinical BPH, taking these two together can precipitate urinary retention and you will not be able to empty bladder." } ]

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

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

[ { "from": "human", "value": "Hi doctor, This query is with regard to one of my friends. He got an accident five months back. He was hospitalized in ICU. Blood came from his ear and so had a CT scan done. An ENT doctor said that his ear is fine and no hearing problem. Later he was shifted to his native. He was in ICU there. His oxygen level is up to 97% and heart beat 50 bpm. He is in conscious state of mind and understands everything. He recognized everyone. Also all kind of bleeding has stopped. He is with saline and local antibiotics only. A neurosurgeon advised for an operation now. So, I need a second opinion here. Thanks in advance." }, { "from": "assistant", "value": "Hi. We are here to help you. Probably your friend has got head injury that is causing the brain edema which is causing the low heart rate known as bradycardia. He should get a repeat CT done. We usually give saline, antibiotics and Mannitol to reduce the swelling that is in brain edema. If no relief or edema increases that is determined by clinical signs including both the pupils we go ahead for surgery. Revert back after the repeat CT scan to a neurologist 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 have a question. My uncle had pterygium excision with conjunctival autograft surgery on his right eye. He was given Ofloxacin ophthalmic solution 0.3% drops for eyes. After using the drop 4 times a day for 4 days, things did not seem right. After peeling the label of the bottle he saw, he was given Ofloxacin otic solution 0.3% for ears only. I am wondering if this could have caused the issues. He is currently having a feeling as though his eyelid is thick, heavy as well as very dry. And also he is feeling as though there is a film over his eye. Do you think this could have caused permanent damage? Presently he is taking medicines for high blood pressure and cholesterol. Please help." }, { "from": "assistant", "value": "Hi. The cause for his present complaint is due to the surgical trauma induced by the surgery. In pterygium surgery, the mass of tissue is cut and scraped off and then a graft is placed to cover the defect. Our eyes are so sensitive, that even when an eyelash accidentally falls in the eye, it becomes so uncomfortable. Now a whole area has been actually cut and the graft sutured, so definitely, until the healing is completed the symptoms of heaviness, dryness will continue. This usually takes about a month to heal. Regarding the eye drop, I do not think it should matter much. If you can change it easily for any ophthalmic drop, then it will be better." } ]

[ { "from": "human", "value": "Hi doctor, My child, who is 9 years old, has bedwetting problem. Please suggest me." }, { "from": "assistant", "value": "Hi. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, My wife is 33 years old. We had six IVF failures. Recently, she had undergone a third pick up cycle. Nine eggs were retrieved, out of which eight eggs were mature, five were fertilized and three embryos reach day 3 stage with two embryos grade A (eight cells) and one embryo grade B (six cells). I was disappointed to hear that only three embryos are developed because in her previous two pick-up cycles 10 embryos each were developed which were of either grade 1 or 2. However the worst part was our doctor told us that the egg quality was not good and there is very little chances of implantation with these embryos and asked us to go for donor egg. Doctor is planning to transfer our own embryos as well as donor egg embryos in single cycle to enhance success rate. I am surprised to hear this as I believed that grade A embryos have a very good chance of implantation. I would be grateful if you could answer my below queries: 1. Can poor egg quality produce grade A embryos? 2. If yes, does chances of these grade A embryos getting implanted are minimal? 3. What would be your recommendation in our case? Should we go for IVF with our own embryos or donor egg embryos?" }, { "from": "assistant", "value": "Hi. How are you doing today? I would like to put forth a few facts of IVF or embryology. 1. Your wife is in the perfect age for pregnancy. 19 to 35 years is the best age. 2. Her body weight is normal, so a hormonal imbalance is ruled out. 3. She has given nine eggs, which is perfect. Of course, 15 or so would have been great. But 9 to 10 is excellent. Of these 8 are mature, so it means egg quality is good, otherwise, they would not have matured. 4. Out of 8 mature eggs, only 3 embryos formed, so I would be more concerned about the health of sperms. Some problem in sperm is not allowing good embryos to be formed. The egg has a lot of corrective capacity. Even if the sperm is damaged, it can correct it. Sperm movement and number may be normal, but if the morphology or health is not up to the mark then there is a lot of chances for the sperm factor to be evaluated and treated. Mixing of donor and self-embryos especially if self embryos are good grade is not a good idea. For your queries: 1. You are right. If eggs are not good, embryo quality will be bad, you cannot get grade A. 2. The grade is only to classify embryos. We get a healthy pregnancy from poor grade and no pregnancy from the best grade of embryos. It alone cannot be used to predict pregnancy chances. 3. I would suggest you have semen factor re-evaluated. You need examination, good antibiotic cover and hormonal priming of sperms, then if needed, go for IVF or if no other causes IUI or ovulation induction, try for few months, you never know, she may get pregnant with these simple, small but very effective methods. An indication of IVF also needs to be thought of." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I have a problem controlling my anger and anxieties which leads to erratic, eruptive behavior. It is hard to let bad things go for me. My expectations from others are very high and that leads to making them feel bad for not doing enough." }, { "from": "assistant", "value": "Hello. Could you please provide more details about the problem? Do you think that the anger issues are persistent since years or are these issues occurring in episodes? Like you become irritable and have anger outbursts for a few weeks and then you are totally alright? The repetitive anger outbursts could occur in some mood disorders like bipolar disorder. But other symptoms like stubbornness, increased activity, the risk-taking behavior, decreased need for sleep, disinhibited behavior, etc., are also seen. These symptoms usually occur in episodes. This could be due to intermittent explosive disorders. Episodes of anger outbursts are seen usually and sometimes after that, individuals feel guilty because of their behavior. Even atypical depression can present with irritability which cannot be explained. Low mood, sensitivity to rejection, anxiety, etc., are seen. You should visit a psychiatrist for evaluation and treatment. Drugs like Sodium Valproate can be used for controlling mood and will reduce the anger episodes." } ]

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

[ { "from": "human", "value": "Hi doctor, My partner has a problem while urinating. She gets blood coming along with it and also, has pain while doing it. She has this problem after having sex. I think that her private parts got injured and so, she has bleeding while urinating. Please suggest something to get relief." }, { "from": "assistant", "value": "Hi. If there is bleeding in urine, then consult a doctor soon and test her urine. If there is blood, do not take it lightly and it may require sonography and other tests to find out the cause. If it is bleeding from a private part and if it is not related to urination, then give time for healing and do not have sex for at least four to six weeks. If the bleeding is not stopped, then consult a nearby gynecologist to see the source of infection clinically. If she has bled every time after having sex, then consult a nearby gynecologist and check for a cervical lesion clinically." } ]

[ { "from": "human", "value": "Hi doctor, Recently, I have gone for all relevant test for checking infertility. My AMH and thyroid report are both normal. My HSG report is showing issues about the left tube. I am attaching my report kindly review and let me know if I can conceive naturally or next what should I do?" }, { "from": "assistant", "value": "Hello. The HSG (hysterosalpingogram) report (attachment removed to protect patient identity) shows that there is a left sided cornual block of the left fallopian tube but the right is patent, so pregnancy is possible, but that would depend on the ovarian side which ovulates. The chance would be high if the right ovary ovulates and not left. Though there is a possibility of an intraperitoneal transfer, but it is rare. So, the next best step shall be to opt for hysteroscopic tubal canalization and an opening of the block which shall increase your chances of conception." } ]

[ { "from": "human", "value": "Hi doctor,I can get violent in my sleep and attack my wife. I also talk, sing and shout. I also suffer from headaches, migraine, and tremors in my hands." }, { "from": "assistant", "value": "Hi. With your limited history, it seems you have REM sleep behavior disorder. This would need further evaluation by a neurologist. Do you have tremor at rest or both during rest and motion? You can try Melatonin 10 mg at bedtime (OTC medicine). This should help you with your sleep behavior. Also, an alternative is Clonazepam (this would need physician prescription). You would need polysomnography for definitive diagnosis of REM sleep disorder. Also, neurological evaluation to make sure you do not have early Parkinson symptoms. REM sleep behavioral disorder." } ]

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

[ { "from": "human", "value": "Hi doctor, My aunt has colon cancer for the past three years. She has a tumor of 8 cm. As all other organs are not compromised, she stopped with the chemotherapy like one year ago. Now, she has peritoneal pseudomyxoma and ascites. In the hospital, the doctors say that the liquid in her abdominal cavity cannot be drained with normal methods because of the density of it. They sent her home to die slowly without any treatment. What can be done to get that thing out of her? I have attached her clinical history for your reference. Please help." }, { "from": "assistant", "value": "Hello. For further information consult an internal medicine physician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have undergone angioplasty (2 stents) before four months. The doctor prescribed Clopitab 75 in the morning and Metoprolol 25 mg in night. I am having a fast heartbeat of 84 to 100. Can I take Hawthorn or Motherwort or Valerian? What should be the dosage and where will this be available in?" }, { "from": "assistant", "value": "Hello. You have ischemic heart disease so your heart rate should be kept low as much as possible to prevent from further deterioration. For this purpose, you are taking Metoprolol 25 mg one time daily still your heart rate is high. Moreover, you are asking about some herbs or herbal products for heart disease. Regarding these herbs, there are no consistent results in clinical trials for heart conditions. Moreover, these products have not been studied widely as for as there beneficial effects on ischemic heart disease are concerned. Also, their side effects have not been assessed in the long term. So, in such case, these herbs cannot be recommended provided there are many evidence-based medicines available for reducing morbidity and mortality one of which is Metoprolol you are taking. There many trials of Metoprolol in ischemic heart disease and heart failure which shows beneficial effects. Regarding your heart rate, I recommend to increase the dose of Metoprolol. There are two forms of Metoprolol available in the market, short-acting Metoprolol Tartrate and long-acting Metoprolol Succinate. Hope you are taking long-acting Metoprolol Succinate because short-acting Tartrate form is to be taken two to three times per 24 hours to reduce heart rate and reap benefits. I advise you to take long-acting Succinate form 50 mg per 24 hours to reduce heart rate. Apart from these, adopt a healthy lifestyle, take a heart-healthy diet low in salt, low in trans fats, low in saturated fats, high in fiber, fruits, vegetables, poultry, low-fat dairy products, dry fruits, legumes, lentils, etc. Please send me your angioplasty and echo report and all medicines you are taking so that I may advise you proper medicine dosages and guide you further regarding your heart." } ]

[ { "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, The top of my belly button, that is, the skin of my belly button is hard and firm, and the rest of my belly button is not. I feel as if there is something under the surface. I changed my diet, so I lost some weight. I was 168 lbs, and now I am 135 lbs. If I place two fingers over my belly button and do wide circles, I feel like there is something hard underneath. Is this a hernia or where my umbilical cord was? I do not have pain or symptoms, but I just feel it firm and hard. What is this?" }, { "from": "assistant", "value": "Hello. For further queries consult a family physician 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,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "assistant", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My wife is 24 years old and she has PCOD. We have been trying to conceive for the past 2 years, but no result. We went to infertility specialist six months ago. He started the treatment through medicines and one IUI. But, all the treatments failed. Then, he decided to go for IVF. Our doctor said that my semen sample is normal. In this IVF cycle 15 eggs were retrieved. Out of the 15 eggs they decided 8 eggs for IVF and 7 eggs for ICSI. Later, the doctor said that all 8 IVF eggs failed to be fertile because egg layer was very strong and And all the 5 eggs with ICSI are fertile. He transferred two embryos today and said that the embryo quality is good. Is ICSI a safe process? Will it affect the IQ of the baby or cause any birth defect? What about the fertility status during their adulthood? And finally, why is egg layer so thick?" }, { "from": "assistant", "value": "Hi. I can understand your concerns. Revert back to an infertility specialist online for further follow up -->" } ]

[ { "from": "human", "value": "Hello doctor, I have a strong itching and hot feeling in the space between my left thigh and vagina. What could be causing this? I am really not able to tell if there is a color change." }, { "from": "assistant", "value": "Hi. Intense itching as you describe mostly indicates a fungal infection. It is possible that you might be working in a hot environment or maybe sweating too much there along with wearing tight clothes. That prevents aeration of the area and promotes fungal growth. Try using antifungal or Cotrimoxazole ointments on the area to get relief. Hope you get well soon." } ]

[ { "from": "human", "value": "Hi doctor, I am 22 years old. My height is 147 cm, and weight is 45 kg. I have pcod problem, but no thyroid. Now I missed my periods for three months. So, I am using kalarchikai with pepper everyday morning. I have been eating this for about 25 days now. How long should I take this for getting my period and make it regular?" }, { "from": "assistant", "value": "Hi. I would like to help. Kalarchikai choornam is a well-known medicine to manage PCOD. Its dose and duration depend on the condition. You should take this choornam 3 g twice a day with warm water after meals for 90 days regularly. USG abdomen. PCOD. Kalarchikai choornam 3 g twice a day with warm water after meals. 1. Avoid spicy and fried junk foods. 2. Drink plenty of lukewarm water. 3. Do regular kapalbhati Mandukasana and Ardha Matsyendrasana as well as pranayama like anuloma viloma nadi shodhan and bhramari." } ]

[ { "from": "human", "value": "Hello doctor, I have an obsessive compulsive disorder. When I was taking Uvox for four years, it was all fine. Now it relapsed, and I am taking Uvox before I used to take Stalopam. Can I get back to my healthy life and go office rgularly where I have to do brain work for nine hours? Please let me know. When I will get my healthy life back?" }, { "from": "assistant", "value": "Hello. OCD responds well to medication (SSRIs - selective serotonin reuptake inhibitors) and psychological therapy (CBT - cognitive behavioral therapy). I presume you are on Fluvoxamine which is useful in OCD. You need to be monitored by your doctor to optimize the dose and monitor for any side effects. If there is no adequate response, alternative SSRI like Sertraline can be tried. Once your symptoms are under control, you can continue to work and function normally. There are lots of people with OCD who are on medication and continue to work well. Also, try to have CBT for OCD which will help to prevent relapse in the future." } ]

[ { "from": "human", "value": "Hello doctor, I have a pea sized lump between my right buttock and thigh (groin area) that I just noticed a few weeks ago after accidentally shaving over it. It is not painful, but a little sore like a scrape would be. It appears to be solid in the middle and darker, but has almost an inner tube look around it that is pinkish. It does not look like it has fluid in it." }, { "from": "assistant", "value": "Hi. What your photo shows is a skin ulcer (attachment removed to protect patient identity). There are many reasons for skin ulceration in the groin area. We have to rule out sexually transmitted diseases first of all. I would like to know if you are sexually active, whether your partner has any such problems. How about your general health? Do you have any kind of problems in your other body systems? For the ulcer, you can apply a topical antibiotic like T-Bact cream daily thrice. It will help it heal if it is a simple bacterial infection. I would suggest you apply it for two weeks, then approach a local dermatologist for a full checkup, in case it is not responding. Get well soon." } ]

[ { "from": "human", "value": "Hi doctor, I have a lot of chest pain and arm pain for the last few months. Especially my underarm and sides of the chest, and under chest worsens when pressed. All my reports are clear (blood and urine test, barium swallow, neck sonography, ECG, chest and arm X-ray). Though arm X-ray had slight calcification on the shoulder. For the last few days, I feel some kind of movement inside my chest whenever I make sudden movements. It also feels like something is moving and popping (majorly) in my left chest, sometimes in the right one, and just under the breast bone. Please help. What could the cause of this be? I did all my tests before this started happening so I do not know what is the next step." }, { "from": "assistant", "value": "Hello. From what you have mentioned, most likely you have musculoskeletal pain. Which may be due to trauma or strenuous exercise. Please provide me with a chest X-ray in order to exclude other serious diseases. Musculoskeletal pain is characterised with pain with inspiration plus tenderness when pressing. My advice is to use Voltaren gel thrice per day for three weeks. Deep heat thrice per day for three weeks." } ]

[ { "from": "human", "value": "Hi doctor, I am a 38 year old male. My weight is 85 kg and height is 5'11\". I had the problem of blood in stool before a year and that got cured with medicine. Now again I feel very difficult to go toilet. I think it as constipation. I feel hard to pass stool. I used to wake up around 6.30 AM. After drinking a glass of lukewarm water, I used to walk for 30 minutes and then will have a cup of tea with two biscuits by 7.30 AM. After half an hour again I will have a glass of warm water at 8 AM. Despite all these, I used to pass stool with difficulty. So, please give me some valuable advice to cure my problem. I also have a problem in my legs below the knees. I feel restless in my leg all the time and after doing some work like visit to market and any other thing I feel my leg has been very tired and should take rest. But, when I take rest I feel very uncomfortable. So, I have to move my legs time to time. I have taken many medicines and multivitamin but there has been no benefit. Because of this trouble, I do feel lazy and avoid traveling as I cannot stand for long time. I cannot have both hot and cold food because of the uneasiness in my tongue and teeth. Please help." }, { "from": "assistant", "value": "Hello. Revert back after a week to an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, My son is 11 years, weight 33 kg, height 134 cm, father's height 165 cm, mother's height 155 cm. The increment in height in the last 2 years was 4 cm/year. Does he need growth hormone therapy? What are the investigations needed?" }, { "from": "assistant", "value": "Hi. Your son's height falls just below the 10th percentile of height for age (WHO standard). Given that your height (parents' height) is in low to mid normal range compared to the average height of the population at large, your son's height is not lagging behind that far. His height gain in the previous two years is on the lower side. However, his main height gain will be in the forthcoming years when he enters puberty. So at this stage, growth hormone therapy is not warranted, unless a recent head injury or a recently developed pituitary gland tumor has put his growth and development at risk. If he does not have a headache, decreased field of vision or seizure disorder or take steroids for any other illness or have kidney or liver disorder, he can be just observed over the next three to six months. Maybe you can assess his nutrition intake, activity level and check his serum IGF-1 (Insulin-like Growth Factor-1), serum bilirubin, SGOT, SGPT, serum protein and albumin, hemoglobin, serum creatinine, free T4, TSH and inform me the reports (just to rule out any major disorder). Revert back with the reports to an endocrinologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I had an ear perforation two months before. My ear was healing really well. The doctor told me to clean my ear by ear syringing. He gave me two shots of syringing. After that, earwax clean up. My ear had gone bad. I feel like my eardrum is hardened. Whenever I put my finger in my ear to pop up my eardrum, my eardrum does not flexibly move at all. It is like it got stuck in one place. It does not move up and down when I put my finger. It is just fixed up in one place and the tinnitus has also gone bad. It vibrates really bad when anyone talks to me or I talk to anyone. I am so worried. Will my eardrum heal again?" }, { "from": "assistant", "value": "Hello. First of all, tympanic membrane is anchored to bone and does not move up and down but moves inward and outward because of sound. Secondly, it is placed 2.5 cm from external ear orifice and cannot be moved with a finger. Since you had a perforation two years back, it might not have healed at all. The other symptom you are talking about is tinnitus. It is possible to have in presence of a perforation. You should get the ear examined. Also, I would like to know if you have any discharge now." } ]

[ { "from": "human", "value": "Hello doctor, I am 29 years old. I got five teeth extracted, three of them being impacted wisdom teeth, before a week. My jaw is killing me. I have this nasty taste in my mouth. My holes look fine with blood clot present. What could be wrong? I cannot keep taking Ibuprofen and Tylenol, it is making me sick. I am just honestly in pain, I cannot eat. It is really bad. Please help. I do salt water rinses and I brush my teeth and the reason I can eat is food gets stuck in the holes and I hate getting it out, it hurts really bad. How many more days will this be like this?" }, { "from": "assistant", "value": "Hi. I reckon you had a traumatic extraction experience as you had five teeth pulled out in one go. This will definitely take sometime to get back to normal. The bad taste in your mouth is due to certain fluids oozing out during the healing process. But you have also mentioned, food getting stuck in those holes.This gives me a question of dry socket. Ideally in seven days time, the gums would have shrunk atleast one-third. For severe pain, you might need to get a prescription for Paracetomol with Codeine from your dentist. And possibly take antibiotics as well. Meanwhile, try to rinse out with Savacol mouth rinse two to three times daily (10 ml of rinse in a cup of water) to get rid of the bad taste and clearing off bacteria." } ]

[ { "from": "human", "value": "Hello doctor, The last year my skin complexion changed on my hand and then it spread up to my elbow. I consulted the doctor and he advised for biopsy test. The result of which was fine. From this year my arm is paining because of this and the mark has spread up to my shoulder. Please help me in this regard." }, { "from": "assistant", "value": "Hi. Can you please attach the picture of your hand? And also the biopsy report? Is it on just one side? Or both the arms? What do you mean by complexion change? Is it becoming dark or light?" } ]

[ { "from": "human", "value": "Hello doctor,For the last 15 days, my mother is facing problems while breathing due to the current weather condition here in our place. There is too much pollution, humid weather and it is also rainy season here. She was having cold earlier, but that has been treated. Right now she is having little cough and problems while breathing. She says she feels something choking while she breathes. She has been taking homeopathy medicines but it seems it is not working anymore for her. For now, she is taking 300 mg Deriphyllin to get the ease of that blockage, but it seems it is also not working for her. Due to this, she is not able to work or roam around. She is facing real difficulty in doing household work. Please advice." }, { "from": "assistant", "value": "Hello Sir. Asthma has many triggers. They are cold weather, dust, mist, rain and as you said, pollution is also a cause. Since her symptoms do not come down with Deriphyllin, I am suggesting the following. She needs one antibiotic to completely remove the pathogen. Also some medications to reduce cold and wheezing. Once her symptoms are reduced, we can start single-drug therapy for a month to prevent wheezing coming back again. All the above medications have to be taken twice a day. She will get some sleep due to these medications. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. How to use the inhaler? Take the inhaler, remove the white mouth cap, keep the inhaler in the mouth, and while inhaling press the container downwards once, and breathe deeply while closing the mouth. Repeat the inhaler after two minutes. Like this, she has to do in the morning and at night.Please start medications as soon as possible. After 5 days, once her symptoms reduce, stop all the drugs and start the following drug: Tablet Montair LC (Montelukast and Levocetirizine combination) 0-0-1 (at evening 7 PM) for one month. This drug also causes sleepiness.If wheezing comes again, the inhaler is enough. The inhaler is completely safe and does not cause addiction. She will get well soon. Exacerbation due to dust, mist, cold climate, pollution and rain. COPD - Chronic Obstructive Pulmonary Disease Exacerbation of bronchial asthma She has to wear a woolen cap which will cover her mouth, nose and ears while going outdoors. She should always have the inhaler in hand and use it anytime if needed." } ]

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

[ { "from": "human", "value": "Hello doctor, My mother, is 76 years old, currently suffering from low, blurry vision (both near sight and far sight). Her BP, sugar, and thyroid are normal. A year before, she was critically suffered from urosepsis with AKI, DM II, pleural effusion, etc. but recovered. Though she has the first stage of renal failure and ventricular ectopic in ECG now. Recently she visited an eye hospital where she was told that her eye problem is mainly due to gradual damage of optical nerve, which is irreversible and the doctor cannot do much. In this respect, she was tested with digital fundus photography and OCT (Retina -Tessellated fundus in the right eye, FR dull in left eye). As per doctor's mention, I come to know that she has some cataract in the right eye (nuclear sclerosis grade II diagnosed in both eye) which need to operate soon for better vision, but I am not sure about it as it is not written in prescription as a diagnosis. She is advised to take a drop of Bimatoprost 0.01 % in both eyes every day to control optical damage. Now, I like to know is this medicine helpful if she complains with optical nerve damage without glaucoma or cataract. Is there any other solution to save her vision or further damage at least." }, { "from": "assistant", "value": "Hello. I understand your concerns, and I am very sorry to hear about your mother's eye changes. I am afraid that the changes in the optic nerve are indeed irreversible and according to the reports is near total. This is known by the part of the reports that say CDR 0.9 in both eyes. To explain it in a very simple manner, the eye is like a camera, both have lenses, and just like the camera has a film, the eye has the retina. If there is a problem in both the lens and the film, simply changing the lens would not improve the quality of the picture as the film (retina) is also compromised. But in few cases may improve to a limited, yet unknown extent. The problem also gets compounded with her poor general condition with heart problems along with the recent sepsis. So operating on her cataract is quite risky. Regarding the eye drops, Brimonidine eye drops have been known to help in neuroprotection and may help in the preservation of whatever optic nerve function is left, theoretically. So this would be the thought process behind this plan of management given to the overall condition. As far as the next step in managing, it depends on the daily activities of your mother and if at all she feels her current vision is not enough for her to carry out the daily routine activities. In case you need more information, please let me know." } ]

[ { "from": "human", "value": "Hello doctor, I am a 54 year old female. I was taking Raciper plus for 15 days. After stopping, I have upper abdominal discomfort and hunger feeling. The abdomen is gurgling. Is this normal?" }, { "from": "assistant", "value": "Hello. First of all, I need to know what symptoms were you prescribed Raciper plus for. Did you have the same symptoms before starting the medication? I am providing you a free follow up to answer these questions. Revert with the asked details for a better help. For more information consult a medical gastroenterologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 25 year old male. I am scared of turning into a gay or homosexual. In the past, I had senseless and intrusive images popping in my head that I am kissing a guy whenever I used to be with my male friends. I never felt an attraction towards any guy. It happened six years before, but never thought about the reason. This thing stopped when I asked about this issue to a doctor and he said it as OCD. Everything was fine for over six to seven months. But, when I over think about why I am getting those images in my mind then the thing gets worse. I check every time when I see a guy whether I am attracted to him or not. Indeed, it sounds like I have gone mad. In my office there is a guy who is very attractive. But, when I fantasize him just to check whether I am normal or turning into a gay, I feel weird. But, I cannot stop myself looking at him. I envy him too, because I always wanted personality, health and voice like him. Whenever I see him I feel something different as if I am looking a girl. I am scared now. Please help." }, { "from": "assistant", "value": "Hello. After analyzing your current complaint and taking into consideration your previous history, I am of the opinion that your current symptom is also a symptom of Obsessive compulsive disorder (OCD). An obsession is an automatic, repetitive, intrusive and senseless thought or image which pops into a person's mind. Your previous symptom of seeing images of kissing a guy was an obsession. A compulsion is an action that you cannot resist doing despite knowing that it is senseless and should not be done. Your current symptom is a compulsion. Obsessive compulsive disorder. 1. Cognitive behavior therapy. 2. Anti-OCD medications like Fluvoxamine or Clomipramine. For further details consult a psychiatrist online.--->" } ]

[ { "from": "human", "value": "Hello doctor, I have had acne since three months. I cannot get it to stop. I am a 45-year-old female and have not had issues since I was a teenager. I do not know what is going on. It is mostly on my chin. Occasionally, it will be on my forehead and nose They are very painful with clear drainage. It leaves terrible scars. Everything I have tried makes the acne worse. I have very sensitive skin. I am not sure what to do. What are your suggestions? Currently, I am on Ativan, Ambien, Lamictal, Effexor, and L-methyl folate." }, { "from": "assistant", "value": "Hello, Welcome to icliniq.com. Are you a diabetic? Are you using any hormonal supplements? Since when your taking tablet Lamictal or Effexor? Lamictal in few cases may cause drug-induced eruption and acne. Effexor also cause rash. I saw your images not clear (attachment removed to protect patient identity), but it shows the pustular and nodular type of leisons followed by healing with pigmentation. You may use Clindamycin gel local application twice a day after face wash. Apply only the area that pustular acne are. Do not apply near the eye. You may take capsule Doxycycline 100 mg twice a day for one week. Check your hormonal status like serum estrogen and testosterone levels. Check your blood sugar levels. Avoid chemicals (new soap or creams) application on the face. If you developed any allergy to the above drugs please stop it immediately and consult with your physician." } ]

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

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

[ { "from": "human", "value": "Hi doctor, I had a c-section with my first pregnancy 19 years ago. I have fallen in love with a wonderful man who does not have kids. I and my fiance have been discussing and are planning to have a baby. I am concerned if I am able to have a VBAC delivery with my second pregnancy since my first pregnancy resulted in an emergency C-section. Also, I am 48. What are the risks of pregnancy in women over 40?" }, { "from": "assistant", "value": "Hello. Pregnancy at the age of 48 years definitely come with certain risks like an increased risk of chromosomal abnormalities due to the defective ovum being released. Also there may be a difficulty in the conception itself. VBAC (vaginal birth after cesarean) delivery has to take into a lot of factors into consideration like the cause for previous LSCS (lower segment cesarean section), the gestational age at which you had cesarean, the present baby weight, and if there is a spontaneous onset of labor or not and many other factors. I would suggest you go for an opinion from your gynaecologist before planning for a conception and take a pre-conceptional counselling so as to avoid any complications possible during pregnancy." } ]

[ { "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.--->" } ]