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[ { "from": "human", "value": "Hello doctor, I am a 22-year-old female. I have had irregular periods since the beginning. I was sexually active, and I had protected intercourse before six months and had my period on second of very next month after having sex. I had sonography done, and the reports said only slightly enlarged ovary. I have not had my periods till date. Its been three months now. Please advise what could have gone wrong. I recently had unprotected intercourse on last month and had an I-pill within 12 hours. Its been 10 days I have not got any withdrawal bleeding. I took a pregnancy test yesterday and it is negative. I started having Primolut N to induce my periods. What are the chances of pregnancy? And what should I do to regularize my periods?" }, { "from": "assistant", "value": "Hello. The chances of pregnancy are close to zero. Primolut N for period induction is good, but it is unlikely to work for you if I-pill did not give you a withdrawal bleeding. You may be suffering from PCOD. Please get your blood tested for LH, FSH, TSH, free testosterone, prolactin, DHEAS. Also, do your insulin fasting and transvaginal ultrasound. If the diagnosis of PCOD is confirmed you will have to take oral combined hormone pills with a prescription. That will regularize your periods and give contraceptive protection too. Also, your weight is towards the higher side. Try to lose weight that will help too." } ]

[ { "from": "human", "value": "Hello doctor, I am an 18-year-old girl. I have had thyroid problems since I was around 11. It used to be just considered hypothyroidism but now we have figured out that it is Hashimoto’s disease. I rotate daily between 88 mcg and 100 mcg of my Levothyroxine to keep my TSH in check because that is the only thing that works. I get my blood drawn every six months but my doctor has not checked these antibodies lately even though last time, the number was around 5,000 when it was supposed to be 0 to 59. Some days I can barely move, and I am really limited to the activities that I am physically able to participate in. I am just scared. I do not know what is going to happen to me. If someone who is older could help or tell me what happens, I would really appreciate it." }, { "from": "assistant", "value": "Hi. Hashimoto disease also causes hypothyroidism and you are already taking medication for hypothyroidism. So do not worry. It is a type of autoimmune disease. So kindly go for detecting which autoimmune problem causes your Hashimoto disease means along with Levothyroxine you have to take some medication also for autoimmune diseases like a steroid or immunosuppressive drugs or Iodine, etc." } ]

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

[ { "from": "human", "value": "Hi doctor, I have been using birth control pill (Crisanta LS) from last 2.5 years.This month I started on 13, and I doubt I missed 1 or 2. After 13 days of starting the pill, had safe sex with a condom, but we doubt that it broke. To be safe, I took two dosages of Unwanted 72 the next day and stopped regular birth control. After eight days, I got bleeding, and it lasted for five days (same number of days as my regular period after stopping pills every month). What was that bleeding? Was that my normal bleeding or withdrawal? I am confused as this was near to expected period. Then, I did HPT, and it came to be negative. What are my chances of pregnancy? Does this bleeding confirm that I am not pregnant? Somebody suggested that I can start my regular birth control pills and I started. After 10 days, I got my full abdomen ultrasound done. It indicates that no focal lesion was seen and endometrial thickness is 4 mm. Uterus size is 88 mm - 43 mm - 42 mm. Do the thickness and report confirm that I am not pregnant? What is the normal thickness at this stage if I am pregnant? Also, the doctor suggested me to stop birth control pill until I get my regular period. Is that correct? When should I expect my next period? As I had regular birth control pill for 10 days, will it affect my next period?" }, { "from": "assistant", "value": "Hello. What you experienced was a withdrawal bleed following Unwanted 72 (emergency contraceptive pill), which occurs in 7 to 10 days post emergency pill intake. So, it is normal. There is no pregnancy at all, as is confirmed in the ultrasound pelvis with ET being 4 mm. ET would have been more than 16 mm with decidual reaction if you had been pregnant. Latest bleeding becomes your LMP now (last menstrual period). For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have back pain on the left side and cannot move on that side. The pain was between my belly and back, but now it is only on my back at the end of the spinal cord. While sitting, standing, or even sleeping, I can feel the pain in this area and it lasts for one week. I am currently taking Ibubrufen." }, { "from": "assistant", "value": "Hi. You are very young to actually have persistent back pains. There are many causes of pain in the lower back region. It can be due to faulty posture, related to weak muscles, issues with disc, narrowing of spinal canal, or any bony instability besides many others. So accurate diagnosis is the key to proper management of the condition. You will have to elaborate on your problem of back pain which means the duration of pain and mode of onset. I would also like to ask you if it is associated with any leg pain or any other neurological symptoms like numbness, paraesthesias (electrical shock like abnormal sensations) or any weakness in limbs? Please also tell me about any associated symptoms like fever, weight loss, etc. What medications you generally take for your existing problem? If you have localized back pain with no other symptoms like radiating leg pain, neurological symptoms like numbness, weakness, paresthesias, etc, then you can start with following recommendations for an initial period of two to three weeks. 1. Maintain proper posture of your back while working and sleeping. 2. If pain is more then you can take a short course of anti-inflammatory medication like tab Etoricoxib or Paracetamol or one which suits you. 3. Physical therapy initially under the supervision of a trained physiotherapist and then to continue at home. 4. Adequate calcium and vitamin D intake if levels are low in the body. 5. Ice packs can be applied if your pain is acute, then hot fomentation can be done at home. 6. Analgesic spray for local application can be used and is easily available. 7. Avoid lifting heavyweight or acute forward bending in the mornings, etc. We will observe you for the next two to three weeks on how you respond to this conservative management protocol. If you are not feeling better, then we will have to get some investigations like, dynamic x-rays of lower back and few blood tests for evaluation." } ]

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

[ { "from": "human", "value": "Hello doctor, 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 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, When I had my third ultrasound, I was 24 weeks pregnant and it appeared like two faces in the ultrasound. I keep asking my obstetrician regarding my weight gain. I am gaining so much weight when I barely eat and my stomach so huge. I found that at 14 weeks on my first ultrasound I was having a boy and that was pretty early for me to find out a gender. I eat like two meals at once a day. I am now 34 weeks and 5 days pregnant. My obstetrician does not check my pelvis and not advised for another ultrasound. Can I send a picture of my third ultrasound to get a second opinion whether I am having twins?" }, { "from": "assistant", "value": "Hi. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor,My son is 3 years old. He eats too much chocolates and sweets. His health is down and having anus itching. He has worms. What to do? I am very sad and upset about his health." }, { "from": "assistant", "value": "Hi. For further information consult a paediatrician online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have hypertension. 138 mmHg systolic, 80 mmHg diastolic, 82 heart rate. Spasmodic foods (like yogurt) make higher hypertension. Antispasmodic foods (alkali, basic foods) do not cause higher hypertension. Which drug can I take? 57 years old, 72-kilogram weight." }, { "from": "assistant", "value": "Hi. BP of 138/80 is considered as high normal BP. You did not mention any other cardiovascular risk factors which put you in the low-risk category. In the first instance, I recommend lifestyle changes with regular exercise such as 40 minutes brisk walk on daily basis, reduce salt and caffeine, and smoking cessation (if you smoke). If after three months of lifestyle changes your BP remains above 130/85 then we can consider adding tablets at this stage, you do not need any tablets." } ]

[ { "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": "Good day, please i was diagnose with hep b positive 18months ago, my consulting tild me my condition iş inactive and need no medication. some month back i was feeling hurt at my chest i was later diagnose with ulcer. some some weeks now have been having pains around my chest and most especially middle of my check. please what is happening to me?" }, { "from": "assistant", "value": "Hello, Welcome to i cliniq You have been diagnosed with inactive hepatitis B, for that I will request you to send me all your laboratory work so that a decision about the treatment can be taken. you now having central chest pain which looks like to due to esophageal ulcer called esophagitis and you may be also having some retrosternal burning with it. For this I am prescribing some medications it will help out in this pain. You need to take Cap.Esomeprazole 40mg 1 before breakfast and Syp.Sucralfate 10ml TID. Both of these should be taken for 2 weeks and let me know incase you have no improvement. EGD if no improvement with medications. Esophagitis Chronic HBV Esophagitis Cap.Esomeprazole 40mg 1 before breakfast Syp.Sucralfate 10ml TID before meals Avoid spicy foods Needs follow up for HBV" } ]

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

[ { "from": "human", "value": "Hi, I am a 31year old male. I was recently diagnosed with minor gastritis after EGD. I was having stomach problems but have recovered at present. Last two weeks I have been having some chest discomfort. ECG and other tests show normal heart function. Since two days, the chest sensations are more prominent mostly while moving. Please help." }, { "from": "assistant", "value": "Hi,  Welcome to icliniq.com. Since you have mentioned that ECG and other tests came out to be normal, it is not associated with any cardiac abnormality. As you have a history of gastritis confirmed through EGD (Esophagogastroduodenoscopy), there is more possibility of association with acid reflux. Acid causes irritation of esophagus and leads to inhibition of vagal tone (vagus nerve supply to the heart) resulting in increased heart rate. This in turn leads to palpitation, chest discomfort, burning sensation etc.  I advise you to follow these: Another possibility is that you could have some muscle spasm/pull if this sensation is pain. If there is pain during movement of chest then you can take some muscle relaxant like Chlorzoxazone in combination with some pain killer. The word chest discomfort indicates that it could be palpitation (feeling of one's own heart beat which usually occurs when the heart rate increases), tightness in the chest, burning sensation or chest pain. If the discomfort persists, revert back with details like dietary habits, blood pressure and medical reports to a cardiologist online -->" } ]

[ { "from": "human", "value": "Hi doctor,My daughter is 9 years old. She gets nose bleeding once in few months and also gum bleeding. She complains about occasional back pain, stomach burning, and hip pain too. My family physician has written down a series of tests and asked me to get opinions from a hematologist, gastroenterologist, and an orthopedic doctor respectively." }, { "from": "assistant", "value": "Hi. From the medical history of your child, I can understand that she is having bleeding manifestations with normal CBC (complete blood count) and coagulation workup. I would like to know about the below-mentioned questions, The most common bleeding disorder is a condition known as Von Willebrand disease. I think she needs to be checked for it and the other condition which needs to be evaluated is platelet dysfunction. Investigations suggested are," } ]

[ { "from": "human", "value": "Hello doctor,I have been using Minoxidil for about a year now and continue to shed. I now have balding patches where it was not an issue before. Ironically the thinning I had started using it for filled in. Wondering if I need to stop the use or if it is normal to experience shedding still? I use it consistently twice a day." }, { "from": "assistant", "value": "Hello. Can you please upload a few pictures if possible, to advice proper treatment." } ]

[ { "from": "human", "value": "Hello doctor, I had a normal delivery five months back, but I can still see one stitch, which has not healed properly. The skin is still raw near the vagina. It does not hurt, but only when I pee or when water touches there, it stings. Please help. I do not want to get restitched, as it has been a long time. I am applying T bact and Drez S ointment." }, { "from": "assistant", "value": "Hi. How are you doing? Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have hypogonadotropic hypogonadism. My FSH, LH, and testosterone levels are low. My sperm count is zero. I am taking HCG 5000 and HMG 150 twice a week for the past three months. After taking it, my testis size got increased from 1.79 cm to 1.83 cm. Now after three months of treatment, my testosterone is 1.1 ng/dL. After three months of treatment, my sperm count remains zero. Please suggest. Please say whether I have primary or secondary hypogonadotropic hypogonadism." }, { "from": "assistant", "value": "Hi. There is no primary or secondary hypogonadotropic hypogonadism. But hypogonadism can be primary or secondary. In the primary, the defect is in testis with high levels of FSH (follicle stimulating hormone), LH (luteinizing hormone) and there is low testosterone. In secondary, there is a low level of FSH, LH, and testosterone. So you have secondary hypogonadism also called hypogonadotropic hypogonadism. Do a serum prolactin test. You are taking HMG (Menotropin) and HCG (Human chorionic gonadotrophin). It will gradually increase the testosterone level and testes size, which is small. Since you have zero sperm count, you must wait for at least six months as the testes size is small and the spermatogenic tubules will take time to develop." } ]

[ { "from": "human", "value": "Hi doctor,I am a 29 year old male. When I urinate standing up, I notice foamy bubbles. If I do it sitting, there are no bubbles. I read in the internet sources, that it might be due to a high protein content in the urine, which may be due to a kidney problem. I got really worried and opted for a check up. All the reports came back good, but uric acid levels were high at 8.69. Since I was in doubt, I tested at two different labs. But, the readings were almost the same. From the last few days, I observed frequent urination, due to which I stopped drinking water. Now, it is causing a slight burning sensation after urination. Please tell me if something is wrong with me or is it due to my anxiety? Should I undergo any tests?" }, { "from": "assistant", "value": "Hello. I hope it helps you. If you have any further query please ask me. For further queries consult a criticalcare physician 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, Is fever an immune response of the body to act as defense mechanism against infection, why is Paracetamol prescribed to reduce temperature?What will be happen, if not used?" }, { "from": "assistant", "value": "Hi. Very much impressed by your query. Yes as you said, fever is an immune response of the body to act as defense mechanism against infection. Most of the time Paracetamol is not needed if body temperature is not crossing >102 degree F. But any temperature >102 degree F causes many biochemical and physiological damages to the body, such as: Because of all this Paracetamol is used. But definitely not required for a low grade fever. For further queries, consult a general medicine physician online -->" } ]

[ { "from": "human", "value": "Hello Doctor, I am a 33 year old unmarried, healthy male. I have a steady girlfriend with whom I have sex regularly, as well as casual one night stands with other girls. I always practise safe sex, i.e, a) always use a condom b) never have uncovered oral sex (c) never have anal sex (d) always keep my penis covered with my undergarments till I put on the condom (e) always ensure that I pull out with one hand on the condom so that it does not slip out. I wanted to know what else can I do to prevent myself from any STD. 1. What are the chances of kissing my partner causing STD and should I avoid this? 2. I heard that a person can get herpes just through skin contact. Is this true and if so, what precautions can be taken for this? 3. Is there any vaccine I should take for herpes, hepatitis A and hepatitis B? 4. I do not use a lubricant, but use lubricated condoms. Is this the correct thing to do? 5. Can I try anal sex with my girlfriend. Is it safe? 6. Is it better to wash the penis immediately after intercourse to reduce the risk of STDs or should I just wipe the penis with a dry cloth after taking out the condom?" }, { "from": "assistant", "value": "Hi. I appreciate that you are very much conscious and alert while having sex and take all preventive measures. 1. Kissing can spread some diseases only if the other partner is infected .These diseases spread through saliva . There are so many diseases which spread through kissing like mononucleosis, certain kind of viral infections and sore throat and some other. I guess you are much concerned about STDs (Sexually Transmitted Diseases). HIV is present in saliva but till now no HIV case had been reported through kissing. But hepatitis B cases are reported and well documented and hepatitis A & C as well, so here I will advise you not to kiss women about whom you are not aware of their health status. 2. Herpes viruses are of many types and can spread through skin contact also. Here I think you are concerned with genital herpes virus which causes STD. This usually spreads via sexual intercourse but can also spread through body fluids like blood, saliva, oral sex (without a condom) if your partner is infected. 3. No, there is no vaccine available for herpes. But you must get hepatitis B vaccination done as it is a fatal disease. 4. If you are using lubricated condoms then no need to use a lubricant unless your partner is not comfortable without a lubricant. 5. Anal sex is usually not advisable as it can cause intense pain and injury inside your partner's anus and not safe for her. But if you insist and want to do, then apply a lubricating gel and can do at your own risk. 6. Washing genital organs after having sex is advisable. For further queries, consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have a small size of a cyst. The doctor told I have PCOD. I am taking Kalarchikkai with pepper and honey making small balls for the past 28 days. The first time I got period after 28 days second time I got after 13 days. Is it normal? Can I continue the medicine for 48 days? Or shall I stop? Please suggest ideas." }, { "from": "assistant", "value": "Hi. Nowadays, period anomalies mostly occur due to PCOD. PCOD may lead to menstrual cycle changes, a cyst in the ovary, trouble getting pregnant and other health issues. PCOD is linked to changes in the level of certain female hormones like estrogen and progesterone. USG abdomen, estrogen, LH, FSH, lipid profile, blood sugar. Hypothyroidism, inflammatory pelvic disorder. As per your description, you are already taking Kalachikai powder with honey. Kalachikai helps to manage cyst issues naturally. You should continue this powder 3 gm twice a day with honey after meals for 90 days. Along with this, you can also take Hyponidd charak Pharmacy two tablets twice a day after meals and Ashokaristam 15 ml twice a day with an equal amount of water after meals. Avoid spicy and fried junk foods. Do regular Kapalbhati and Mandukasana as well as pranayama like anuloma vilom nadi sodhan and bhramari." } ]

[ { "from": "human", "value": "Hello doctor, I am suffering from right side chest pain and right arm and also have fever and vomiting. What should I do? Is it symptoms of something big?" }, { "from": "assistant", "value": "Hello. You have mentioned that you have diabetes. Patients with diabetes need not always be present with typical chest pain in case of any sudden cardiac event; symptoms like right sided pain, and persistent vomiting should not be taken lightly. And also you did not mention about history of any 1) cough, 2) abdominal pain, and 3) burning urination In addition to a coronary cardiac event, your symptoms also suggest the possibility of any lung infection as it can lead to fever chest pain and even vomitings sometimes.And as people with diabetes have a predisposition to infections, patients with fever and vomitings should be evaluated for urinary infection also if other symptoms are present. You need to get 1) ECG. 2) Chest X-ray. 3) Complete blood picture. 4) Complete urine examination is done. Without any delay and also chest and abdomen needs to be examined for any infection. You can contact me any further queries." } ]

[ { "from": "human", "value": "Hello doctor,I have a lump under my skin on my arm, and it is slight my raised. It is not painful, and it is 5 mm in diameter. It has got a dark center that looks like a bruise. It has not grown in size either. What could it be?" }, { "from": "assistant", "value": "Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." } ]

[ { "from": "human", "value": "Hello doctor, My lower right side impacted wisdom tooth has been extracted a week back. Till now my half tongue and jawline of the right side are numb or I am not feeling hot or cold at that side. I am so much worried. Is that normal or is it a concern of worrying? I am panicking for getting sense in my tongue back. Please advice." }, { "from": "assistant", "value": "Hello. If the tongue feels numb even after a day, then you may have a condition called paresthesia. It occurs when the injection injures the nerves. and such numbness can remain for a week or two, sometimes even for a month. But it will go away as the nerves heal slowly. Take capsule Becosules (Vitamin B1 and B2) once daily for 15 days. But it is better if you go back to your dentist to show him first." } ]

[ { "from": "human", "value": "Hi doctor,After taking Unwanted 72, my wife got down within five days. But, her menses started again after five days though her actual time of menses not yet come. Why?" }, { "from": "assistant", "value": "Hi. Unwanted 72 is an emergency contraceptive pill containing high amount of progesterone. These medicines have a severe side effect of heavy or irregular bleeding. Your wife had the same side effect. Please check her hemoglobin levels; she might turn anemic if she bleeds much. Continue taking iron pills. It might take one or two cycles to get her periods to get regular again. So, preferably maintain a regular regime with condoms or oral contraceptive pills like Novelon, Ovral L, etc., rather than an emergency contraceptive. They are way safer." } ]

[ { "from": "human", "value": "Hello doctor,I have got red rashes on my corona. I have done unprotected sex 15 days before and my girlfriend is saying that she is still a virgin because we have not done intercourse properly. I just inserted and took out my penis." }, { "from": "assistant", "value": "Hello. I have seen the images (attachment removed to protect patient identity). It is herpes genitalis which is an STD (sexually transmitted disease).You need to take oral antiviral medications. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Tablet Acyclovir 400 mg three times a day after (breakfast- lunch- dinner) for seven days.Tablet Rantac (Ranitidine) 150 mg twice daily before meal for seven days. Apply T-Bact cream (Mupirocin Topical) twice daily. Avoid sexual contact. If your partner has similar complaints, then her treatment is also important. Get blood test for HIV (human immunodeficiency virus). For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I just recently had an RCT and crown placed on the upper front tooth. Now, there is a gap between my two front teeth. Can the crown be adjusted now?" }, { "from": "assistant", "value": "Hello. After capping, it is very difficult to adjust the crown because it may lead to misalignment of the crown with respect to occlusion. There is another method by which you can close the gap between tooth like composite filling between tooth leaving the cervical area or another method is to repeat the capping procedure. Please share your pictures of the front tooth which will help me guide you more. Treatment failure. The composite filling between tooth leaving the cervical area or another method is to repeat the capping procedure." } ]

[ { "from": "human", "value": "Hello doctor, I think I have hidradenitis. I get these boils under my armpits that often turns into open lesions and smells sometimes. It is embarrassing and it is taking control over my life. I need help." }, { "from": "assistant", "value": "Hi. Yes, it is hidradenitis suppurativa. I can understand it is a very difficult time for you. This condition requires both medical and surgical treatment. It is the problem with hair follicles and sebaceous glands. Once the glands are out, one can have relief. Right now you have active infection over the area so please start taking antibiotics. Hidradenitis suppurativa. Tablet Augmentin (Amoxiclav) 1 gm BD for two weeks, tablet Rifampicin 450 mg BD for two weeks. Apply Clindamycin lotion over the area. Maintain hygiene of the area, wash with soap and water, avoid irritants and Dettol." } ]

[ { "from": "human", "value": "Hello doctor, I have a wheezing problem. It is like asthma. Can I have a quick remedy as I am in office?" }, { "from": "assistant", "value": "Hi. The presence of wheezing suggestive of bronchoconstriction induced by asthma or bronchitis. For immediate relief, you can take Salbutamol inhaler two puffs readily. If nebulizer is available then Levosalbutamol and Budesonide Respule can be taken through nebulization. You can consult a pulmonologist for chest examination and accordingly your further management plan." } ]

[ { "from": "human", "value": "Hello doctor, Does (Inozith-250) Azithromycin work the same as (Clavu-nova 625) Amoxicillin and Clavulanate Potassium Tablet USP? I am using to treat a back/chest problem I had two years back which the doctor prescribed Inozith-250 for me. I used the same drug when I had a similar problem and I am well." }, { "from": "assistant", "value": "Hello. No, Azithromycin and Amoxicillin plus Clavulanate potassium work via different mechanisms. Azithromycin is an antibiotic useful for the treatment of a number of bacterial infections. Azithromycin is a type of macrolide antibiotic. It works by decreasing the production of protein, thus stopping bacterial growth. That is, it is bacteriostatic. Amoxicillin attaches to the cell wall of susceptible bacteria and results in their death thus it is a bactericidal compound while Clavulanic acid is a β-lactam drug that functions as a mechanism-based β-Lactamase inhibitor (an enzyme secreted by many bacteria for their defense against Amoxicillin). While not effective by itself as an antibiotic, when combined with penicillin-group antibiotics, it can overcome antibiotic resistance in bacteria that secrete β-lactamase, which otherwise inactivates most Penicillins. The doctor may have prescribed Azithromycin 250 mg twice a day earlier to you for maybe congestion or cold or some other problem but I would advise you to visit a physician in person and then take the medication. Then it would be of much benefit to you. For more information consult a pharmacologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am 22 years old, and I am a mother of four months old baby. Recently, I have got infected with chicken pox. Does breast milk transfer chicken pox to the baby? Do I need to take special care of my baby? Can I do breastfeeding now? Does it affect my child? Please help." }, { "from": "assistant", "value": "Hi. A mother who contracts chickenpox can do breastfeeding. Any vesicles present on the breast should be covered to minimize the risk of transmission. There is no evidence shown the presence of the varicella-zoster virus (Chickenpox) in breastmilk. Hence breastfeeding is safe. Breast milk does not transfer chickenpox to the baby. The doctor may prescribe Acyclovir 800 mg five times a day if you are seen within 24 hours of rash onset. It reduces the time to have full crusting of lesions and reduces the number of lesions. Acyclovir can be taken during breastfeeding. It is safe to take. Keep your nails short to minimize the damage from scratching." } ]

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

[ { "from": "human", "value": "Hi doctor, I ovulated on day-14 and the follicle size was 24 on day-13. I had intercourse with my hubby during the fertile days. From day-15, I have very loose stools. I took one Eldoper tablet on day-15, and was alright, but it started again on the next day. I feel really tired and have no interest in doing work. My appetite is also poor. Are these early signs of pregnancy? I am really confused. I never experienced this before. I request you to help me and suggest which tablet can be used for loose stools while trying to conceive." }, { "from": "assistant", "value": "Hello. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have a problem with the tooth that was decayed. A few days back it was cleaned and had permanent fillings on the first upper molar. However, on the same night, felt a slight pain when I touched the tooth or ate, which became more prominent the next day, and woke up with severe pain on third day morning. This is not normal at all. My cheek and ear was hurting as well and the lower teeth are aching. There is a constant sharp pain. Shoots for a little with painkillers but comes back quick." }, { "from": "assistant", "value": "Hello. You need a professional assistance as soon as possible. There may be two possibilities. The first one is carries present in deep part of tooth and create problem, in this condition you need root canal treatment. The second one may be the height of filled material is excess and it needs some trimming to maintain balanced height of the tooth. So, I suggest you to please see your dentist for a clinical examination." } ]

[ { "from": "human", "value": "Hello doctor, I have an abscessed tooth. The tooth is almost gone. I will have to get surgically removed and do not have the money for it right now. I was wondering. Can I die from the infection? I have been on antibiotics from penicillin to amoxicillin to sulfur meth 800-160 mg. At about 1 AM, I felt the same pain I had before. But, it was just the one tooth and not my whole left side. It felt like it was trying to come out on its own again, then felt like a needle touched on what is left of the tooth. I yelled ouch. It tasted funny and weird. I touched the tooth and it was bleeding. I looked in the mirror and saw blood. I got really scared and asked my mom what I could do. She asked me to rinse my mouth with warm water. I did but I still taste that funny stuff. Should I go to the emergency room?" }, { "from": "assistant", "value": "Hello. We are here to help you. Hopefully, this helps. Regards. For more information consult a dentist online -->" } ]

[ { "from": "human", "value": "Hello doctor, One year back, I took five i-pill tablets within 6 months, and two of them were taken within a week. I am now trying to conceive. Will the previous intake of i-pill affect me getting pregnant now. What should I do to get pregnant now? Please help me." }, { "from": "assistant", "value": "Hi. Taking I-pill is not really good for your health. You cannot change what has happened in the past, so let us not speak about it, but avoid taking I-pill in the future. Do not worry too much about it, because mental stress can cause specific hormonal changes that will reduce your chances of getting pregnant. If your menstrual cycle is regular, try to have sex during the mid-cycle. Ensure that you have sex at least once in 72 hours during the mid-cycle. Eat good food, and indulge in moderate physical exercise to keep your body healthy." } ]

[ { "from": "human", "value": "Hello doctor, My upper stomach area is pulsing suddenly from yesterday after eating. What does that mean?" }, { "from": "assistant", "value": "Hello, Welcome to icliniq.com. I want to know when did you last have Albuterol. It is is used in asthma for air pipe spasm. It has common side effects such as tachycardia (increased heart rate more than 90 minutes when the person is at rest) where people feel there heartbeat. I also notice your heart rate is 90, which seems to be secondary to Albuterol. Pounding of stomach however, is an unusual phenomenon, but can occur due to certain drugs and sometimes without any cause. The condition is called tachygastria. You can simply decrease the dose of Albuterol to see if it works in your case. I hope this helps. Tachycardia. GI motility disorder. Drug side effects and tachycardia. Reduce the dose of Albuterol." } ]

[ { "from": "human", "value": "Hello doctor, I am a 59-year-old male. I have dark spots on my cheeks close to eyes on both sides identical. I would like to have medical advice on this problem which I am having for more than three years. I am currently taking Obimet SR 500, Glimisave M1, Pivasta 2 mg, Pinom 40 mg, and Clopilet 75 mg." }, { "from": "assistant", "value": "Hello. Please send two to three clear pictures of the affected area for better evaluation and guidance. Do you have any symptoms (itching / burning) over this area?" } ]

[ { "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, Can I take two Amoxicillin 500 tablets for my first dose of medicines for a tooth infection? Is there anything at home that will take the pain away?" }, { "from": "assistant", "value": "Hello. If you are taking Amoxicillin for your toothache, then let me educate you it is an antibiotic and not a painkiller. So, if you want to kill the pain, I suggest taking a tablet with acombination of Ibuprofen and Paracetamol after meals. The pain will be gone in just 10 minutes. In case the pain is still there, buy Lignocaine jelly and pour some jelly on a cotton roll and put it on the infected tooth. You will get relief within minutes. If none of these are available nearby, you can take simple Paracetamol 500 mg. Taking two Amoxicillin tablets will reduce your infection and not your pain. For pain, you have to go for an analgesic (the above-mentioned medication). For more information consult a dentist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 23 year old obese guy. I am suffering with high BP for five to six months. Earlier, I had 140/90 mmHg and then 150/90 mmHg. Now, It is 160/90 mmHg. I am taking Cilaheart 10 mg in the morning and Concor Cor 2.5 mg in the afternoon. I am doing exercise also to control weight gain and also following a diet. I want to get rid of the high BP. Please help." }, { "from": "assistant", "value": "Hi. We are here to help you. At the age of 23 to 24 years, if you have high blood pressure, then we need to first of all evaluate you for secondary hypertension. My strong recommendations would be to go for, Getting blood pressure normal on medicines is not at all an issue, but we should make sure that there is no other cause that is causing the high blood pressure. So, first of all get these investigations done and write back to me with the reports. Revert back with the reports to a cardiologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My sperm count is 64 M/mL, motility 60 %, rapid linear progressive 15 %, sluggish linear progressive 15 %, forward progressive 30 %, morphology normal 35 % and abnormal 65 %. Are these values normal?" }, { "from": "assistant", "value": "Hello. Are there any pus cells or WBC's (white blood cells) in the sample report? Also, is the fructose test positive? Please share the complete report as an attachment." } ]

[ { "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,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,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,Please advice ayurvedic treatment for a pimple or cyst under frenulum." }, { "from": "assistant", "value": "Hello. I just read your query. See, pimple and cyst are two different things. Pimple is a kind of comedo having bumpy appearance. It is usually painful and pus may or may not be present. A cyst is an encapsulated growth which can be filled with water or fluid. It can grow slowly and usually non-cancerous. Pain is sometimes present. There are fewer chances of a pimple under frenulum in the mouth. More chances of cyst are there. Cyst usually requires surgical management. It can be ruled out with the help of clinical examination only. So ideally you should visit a nearby physician so that he can examine you and treat you properly. But if you are sure that it is a pimple you can take the following treatment: Take it for 10 days and consult me after ten days regarding improvement and for further management or you can consult a nearby physician. But, I still recommend you to visit a physician to make sure whether it is a cyst or a pimple. For more information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hello doctor, Unsure of diagnosis (could be a combination). My questions are as follows: 1. What is my diagnosis (they say schizophrenia and autism high spectrum) memorized 200 digits of pi in one day? 2. Could I not have mental illness and Marijuana was a one-time incidence? 3. If I do need medicines and stay on Lithium, how do I get off of Olanzapine after taking it for 20 days 5 mg and 10 days 10 mg? So not to go manic from the stop. Took a lot of medical Marijuana with them and went crazy, they took me to the psych ward. Put me on medicines for the first time. Risperidone and Luvox and did great, so good I stopped taking it which I relapsed (did it too fast I believe) but the doctor will not put me back on. Then I went on Invega Sustena monthly shot and cut my self out of anger, did not really want to live, they took me off. Put me on Lithium 900, did great for six months, then I missed a few doses and mania started coming to play. They added Olanzapine and that is where my problems started. Slammed the refrigerator door 10 times, broke it. Felt the need to listen to a message of jumping out a window (I did it on the ground floor), then broke a second story window due to a message in a song. I feel Olanzapine is increasing the message and I read that it can increase hallucinations. Can I just stop Olanzapine cold turkey? Still getting messages at 10 mg but never had messages before the Olanzapine (except during medical Marijuana)." }, { "from": "assistant", "value": "Hi. I read your query and understand your concerns about the diagnosis and problems encountered by you. Although the provided information is not sufficient to make a diagnosis of a case, but from the available description, it appears to me that you are suffering from cannabis-induced psychosis, a variant of schizophrenia which often starts with the use of cannabis. Although this has a cause, elimination of cause itself never sufficient to cure the problem. I must acknowledge that before making a diagnosis I need to have access to all your records or at least 30 minutes interaction with you. As stated above I do not think your mental illness and Marijuana can be separated from each other. Although the literature is scarce I have seen multiple numbers of patients with cannabis-induced psychosis. Since the problem is already there I think there is a need to treat. Since you have responded well to Risperidone or Invega, I see more merit with Risperidone use in your case in compare to Olanzapine. Although Olanzapine can be discontinued cold turkey, there is a need to manage those voices with the use of any other medication, preferably Risperidone as stated above. So I mean to say that it is fine to discontinue Olanzapine but simultaneously talk to your psychiatrist to prescribe Risperidone to manage those hallucinations. Having said this, I would like to inform you that we need to have a one to one discussion for making a proper diagnosis and designing the best strategy for the cure of your problem. This can be done through online consultation provided you are comfortable with the idea of online consultation." } ]

[ { "from": "human", "value": "Hello doctor, I am a 52-year-old male that has suffered from anxiety and anxiety attacks for years. About a year ago during a stressful time, it got worse. It seemed I was nervous all the time, apprehensive, basically felt terrible. This only made anxiety worse, etc. I take a low dose of Klonopin and really do not like to take that. My doctor prescribed SSRI which seemed to make things worse. All the time affecting my functioning with my job and whole life. Recently, I was diagnosed with subclinical hyperthyroid. Scans and uptake all appear normal. She wants to put me on a low-dose of anti-thyroid medicine. I am so confused because I do not like taking medications but want to feel better. Will this help and can you ease my anxiety over taking the medicines?" }, { "from": "assistant", "value": "Hi. I have read your query. Anxiety requires a two-way approach for its management- psychotherapy, and medication. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy: This involves talking about your anxiety to a therapist so that you do not keep your fears to yourself. Not just a therapist, I feel you should talk about it with anyone you are comfortable with. You can make some lifestyle modifications too to help you. Be physically active. Develop a routine so that you are physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. Quit smoking, cut down alcohol and drinking coffee. Both nicotine and caffeine can worsen anxiety. Use relaxation techniques like meditations. Keep calm and breathe. Self-talk helps too. Make sleep a priority. Eight hours of sleep is considered adequate. Eat healthy. Medications: This requires trial and error to choose a medicine that you can tolerate well. I feel SSRI's are a good choice. Please take the medicines for at least a month to see if you have adapted to it before switching to another one. And if you feel better with Klonopin, you can choose to take it. Subclinical hyperthyroid: It is caused when the thyroid startshyperfunctioning but it is not detected clinically. Symptoms include palpitations, tremor, heat intolerance, sweating, nervousness, anxiety, reduced feeling of well-being, fear, hostility, and inability to concentrate. I feel your symptoms of anxiety are aggravated because of subclinical hyperthyroidism. So I would advise you to start taking antithyroid medicines as they would control the level of thyroid in the body and hence help in reducing the symptom." } ]

[ { "from": "human", "value": "Hi doctor, I have been having resonance in the ear and nose since three months now. It all started with a bad sinus attack. I got my IgE test done and the result shows level 1000. Also, I had an MRI. It showed some polyps in the maxillary sinus. I had also got an NCV test, which showed slight palsy in the right ear and that is the same ear with the resonance. I hear myself loudly. While talking through the nose, it seems to be reaching the ear. What could be causing this? I have attached all the reports." }, { "from": "assistant", "value": "Hi. I understand your concern. Due to prolong and severe sinusitis, your eustachian tube got edematous. This in turn had developed negative pressure in the middle ear. This stage is named as eustachian catarrh. In your case, this had progressed to secretary otitis media and you are getting echoes of spoken words and blocked ear. For you, the treatment is as follows: Probably, you will feel better with the above treatment. If not, then please consult your ENT specialist and ask for grommet insertion on your ear drum. For further information consult an ENT otolaryngologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 39 years old, severely obese. I have been experiencing dizzy spells and pulsations in the back of my head. The pulsations are severe when I am sleeping. There are shocks in the head occasionally but more while sleeping." }, { "from": "assistant", "value": "Hi. We need to do an MRI brain with MRS (spectroscopy), MRA (angiography), MRV (venography), MRI cervical spine with MRA neck vessels with whole spine screening for evaluation of dizzy spells, pulsations in the back of the head. Obesity or overweight can be due to four main causes: 1. Primary genetic insulin resistance. 2. Not doing physical work and being the so-called couch potato (sedentary lifestyle). 3. Diseases related to fat metabolism (dyslipidaemias). 4. Eating too much (also called gluttony). Of these, if your obesity and overweight are due to a sedentary lifestyle, you can reduce your weight and waist circumference by walking, jogging, running, swimming, cardio, lifting weights, etc. If your obesity and overweight are due to eating too much, you can reduce your weight and excess fat by eating less. If your obesity and overweight are due to dyslipidemias, you can reduce your weight and excess fat by appropriate treatment. But, if your obesity and overweight are due to primary genetic insulin resistance, the only way you can reduce weight is by taking a low carbohydrate diet. Running miles on treadmill or starvation will not solve your problem. Before you start low carbohydrate high fat diet, we need to know what all you can take and what all you have to avoid. For this, a series of blood tests are needed. These are available as a package called metabolic profile A. If you have already done this, please send us the reports. If you have not done this, please do it. The technician will come, collect blood and you will get the report the next day by mail." } ]

[ { "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 son is 4 years and 10 months old. His weight is 16.3 kg, and height is 3'6\". He had blood in stool six months ago and was treated with antibiotics. Now he has gas in belly, constipation. He was tested for occult blood in stool was found negative. Deworming was done the previous week. Now he does not want to take food as earlier." }, { "from": "assistant", "value": "Hello. 1. Please increase water consumption for the child and reduce the amount of bread and bread products that may or may not be consumed. 2. As of now, you can start the child on some laxative like syrup Duphalac (Lactulose) which will help the child to pass stool. Please give syrup Duphalac 7 ml twice a day with plenty of water for 10 days and observe. 3. SOS if the child still needs help in passing stools, you may give a Dulcolax pediatric suppository (Bisacodyl)." } ]

[ { "from": "human", "value": "Hello doctor, I have left-sided pain in waist and groin region. I was already consulting a urologist and was told that I have an inguinal hernia. But, symptoms of groin pain are due to pancreatic irritation. I have noticed that pain sometimes occurs in different regions and there is bloating in my lower abdomen past few days. All other tests are normal and the urologist tells that there is no other problem but prostate irritation. I have a problem sitting properly and it pains in the groin. Also, bloating is very uncomfortable. Should I again consult a urologist? I feel there are gastric problems and there is also a pain in the groin during bowel movements. I am currently on Alfoo. Please help." }, { "from": "assistant", "value": "Hello. Your symptoms of groin pain while sitting or during bowel movements is likely due to an inguinal hernia. The pancreatic irritation is unlikely to cause such a pain. It causes periumbilical pain and also there is no cause for it. Now, next is there a hernia or not is unsure. If it is present then you need to visit a general surgeon, confirm it and get operated as it can cause complications. In patients with hernia, they have groin swelling, sometimes only seen on standing and coughing. Just check if it is present for you or not. For your bloating problem, you should avoid fatty, oily and spicy diet. You need to have some walk after having food instead of taking rest. You need to have regular sleep habits and avoid stress. Have lots of green leafy vegetables, fruits and avoid smoking and alcohol if any. Try to achieve some weight loss through diet and regular exercise. I suggest you take tablet Pantodac DSR (Domperidone and Pantoprazole) 40 mg before breakfast once a day for two weeks. Also, you should get dewormed yourself with tablet Bandy-Plus (Albendazole and Ivermectin) at bedtime once and another dose should be repeated after two weeks. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. For more information consult an internal medicine physician online -->" } ]

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

[ { "from": "human", "value": "Hi doctor,Recently I have been prescribed Tretinoin 0.25 cream and Benzaclin gel for my mild acne but ever since I started I have been getting dry and flaky skin around my eyes and mouth and burns on my cheek. Which cream is causing this? And how do I continue using them, if so?" }, { "from": "assistant", "value": "Hi. I have gone through your case. Actually, it is a very common side effect of Tretinoin cream and sometimes Bezclin (Clindamycin and Benzoyl peroxide) also cause it. My opinion is to stop both medicines for a week. If you have severe burning use Hydrocortisone cream only on burning areas for seven days only and then stop it. Also, use Vaseline lotion. First, apply on your hand and then tap your face with very little lotion in order to make your skin soft. If you apply more lotion then it will make your skin oily. After one week when your redness settles down then start with Bezclin gel only and apply only on lesions. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 28 years old. I have checked my pregnancy through Prega news in home after 48 days of my last periods. It shows two lines one dark pink and second light pink. I have checked two times but same results. I have done an ultrasound, but it does not show pregnancy in the report. Please suggest." }, { "from": "assistant", "value": "Hello. I have read the description of your problem. There can be three explanations for this. 1. Either it is an evaporation line (if have you have checked it very late than the time mentioned to check on the kit which is a false positive result). 2. Or this could be a very early stage of pregnancy where the levels are not sufficient enough to be detected in urine so gives a faint positive test, obviously at this stage usually the pregnancy may or may not be detected on USG (ultrasound). 3. Or the third possibility is that this is a very early pregnancy which is failing. If you could give a little bit more details about your previous menstrual cycles, the date of your last periods, and when the scan is done, it could have helped to narrow down the possibility. You can check for your blood levels of Beta hCG (human chorionic gonadotropin) hormone to check if you were pregnant or not. I hope this helps. Serum beta hCG level." } ]

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

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

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

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

[ { "from": "human", "value": "Hi doctor, I have been experiencing a patch of hair loss and it is getting bigger. I had two but the one is gone now. I am very proud of my hair and this makes me emotional." }, { "from": "assistant", "value": "Hi. This is alopecia areata, and the patch on your backside of the scalp is ophiasis, a subtype of alopecia areata. It is thought to be an autoimmune disease in which hair loss is in the form of patches but comes back itself as you have told. Meanwhile, you can apply topical steroids over it like Fluticasone propionate ointment or lotion. Another option is a mixture of topical Canthradine plus topical Capsicum and Methylated spirit in equal proportion and apply for five minutes twice per week as they have an irritant effect. Topical steroids will be beneficial for you. Follow up at one month. Alopecia areata. Apply Fluticasone propionate ointment or lotion over the area, take Multivitamins." } ]

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

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

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

[ { "from": "human", "value": "Hi doctor, I am a 70 year old female. My height is 165 cm (5'5\") and weight is 70.3 kg (155 lbs). My current medications are Quinapril-HCTZ 20-25 mg and Diltiazem 24HR ER 120 mg. I am experiencing discomfort in the right buttock for the past one year. I had a total body nuclear scan done recently and the narrative is attached. I am being sent for a CT scan. My doubts are, I got a total hip replacement in 2008. Would it be helpful to the CT scan radiologist to see the attached x-ray of the prosthesis since it shows a screw going into soft tissue? As this screw incidentally has been in the same position since 2008 and it has not caused any problem. Would it be helpful to the CT scan radiologist to see the narration of the nuclear scan? Is the CT scan capable of showing a possible bursitis inflammation?" }, { "from": "assistant", "value": "Hi. I have read through your query and reports (attachment removed to protect patient identity) in detail. Please find my observations below. The x-ray is always useful when reporting a CT scan. It provides a two-dimensional picture of the screw which is seen to be partly in the region of soft tissues. As a radiologist, I will always be happy to see an x-ray if available. The nuclear scan shows that there is no infection around the prosthesis. There is a small amount of suspected infection in the bowel or fallopian tube on the right side of the pelvis. This might help the radiologist to specifically look for bowel infection or fallopian tube pathology on the right side of the pelvis. The narration is beneficial to the radiologist to have a detailed look through your CT scan pelvis. CT scan will show bursitis if it is severe. Recent studies have shown an MRI scan to be the investigation of choice for inflammatory bursitis. In your case, bursitis is less likely because the nuclear scan does not show any abnormality in the region." } ]

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

[ { "from": "human", "value": "Hello doctor, My husband is not available whenever I ask him. Whenever his family treats me bad, he never asks anything. If we fight suddenly he is asking me to take care of myself alone. He is not helping me in my work. I am really stressed. I need someone badly to talk." }, { "from": "assistant", "value": "Hello. You are reporting relationship problems which is quite common. Almost all couples go through difficult phases early on in their relationships. Remember there are no perfect couples and no perfect marriages. Everyone has to work proactively to maintain a healthy relationship. Try talking to your husband when things are calm. Discuss with him in a calm manner about situations you find difficult. He may have a different perspective. Both try to approach the problem without accusing each other and follow a problem solving approach. Speak to trusted family members or elders who can discuss with you both in a neutral fashion. Relationship difficulties can be very stressful for both of you. Try to do relaxing activities like walking, exercise regularly, meditation, etc. If things are really difficult, marital counselling can help. You can contact again if further advice is needed." } ]

[ { "from": "human", "value": "Hello doctor, Are nightshades vegetables harmful? Please comment on nightshade vegetables. Do they cause inflammation? And if so, do we have to avoid them?" }, { "from": "assistant", "value": "Hello. Except for tobacco, all other nightshade vegetables can be taken in the recommended amount. Though they contain some chemicals, they are mostly in a very minute amount and are beneficial for health. The side-effect documented is a personal account and no research has concluded any harmful effects of these vegetables." } ]

[ { "from": "human", "value": "Hi doctor, I am quite allergic to dogs, cats, and pretty much anything with fur, which exacerbated my asthma, sneezing, and itchy eyes. I am hoping to get a job at home health, but many people have dogs and cats. Is there anything that could be done for me to enable to work in home health? Furthermore, my kids would love a little doggy at some point, if possible." }, { "from": "assistant", "value": "Hi. Is your allergy based on your assessment or has any allergy testing been done? The best way to prevent allergy is to avoid the requisite allergens altogether. We even suggest a change of profession and change of place to our patients. In that case, I feel you should not be wanting that job or the dog in your house. But before that, we can check for allergies either by skin prick testing or blood immunocap testing. Skin prick testing is more authentic and specific than blood testing." } ]

[ { "from": "human", "value": "Hello doctor, I have a 2 year old daughter. She is breaking out with red dots all over her body. They do not look like measles or chicken pox. She weighs 30 pounds and has no other symptoms. I have tried giving her a child allergy medication because I thought she might have developed an allergy to dog hair. Please help." }, { "from": "assistant", "value": "Hi. I need more information for a quality answer. It could be ITP (Idiopathic Thrombocytopenic Purpura)/other hematological disorders/allergy/infection/HSP (Henoch-Schonlein Purpura) and many other disorders can present like this. We need to investigate these.Advice: Try to revert back with answers for the above-mentioned queries to a child health specialist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, My father and my grandmother died within 3 months. After they expired, I started to face many issues like LIC claim and others. Due to too much stress, I am unable to sleep at night properly and feel sleepy in the morning. Because of this reason, I am unable to concentrate on my work. I am working in software industry. Due to the issue I am facing, I am not able to complete the tasks on time and going through a lot of problems. I am also suffering from body pain. Presently, I am on Zincovit multivitamin tablet. Thank you." }, { "from": "assistant", "value": "Hello. I feel sorry for your loss. Your problems are stress, unable to sleep at night and body pain. So, basically it is your stress that is leading to other problems. Stress can be managed both by medication as well as by lifestyle modifications (behavior therapy). First, try lifestyle modifications which include: Also, proper sleep hygiene needs to be practiced daily, so as to help you to maintain good sleep in the long run. Sleep hygiene entails following important points. These lifestyle modifications will help in improvement of symptoms and you will feel better. If symptoms persist even after lifestyle changes, then visit a psychiatrist. Drugs like Modafinil or Armodafinil will help to maintain daytime alertness and will reduce fatigue. Visit a psychiatrist for proper prescription of this drug." } ]

[ { "from": "human", "value": "Hi, I am diagnosed of Psychosis (NOS). The first episode was in 2010 and it lasted for three-four months before I was taken to a psychiatrist. I had been thinking that people are tracking me through email, internet. My mobile phone is tapped and all that. I did not get any auditory or visual hallucinations. I was prescribed Risperidone 2 mg and I took it for about 10 months before I discontinued it following a medical practitioner's advice. But the disease relapsed after 10 months of discontinuing the medication. This time with in one month of the start of the disease I was taken to a psychiatrist and he prescribed me Amisulpride 400 mg and another medication which I do not remember the name. This time also there were only delusions and no hallucinations. I was not able to tolerate the side effects of the medication and I decided to stop the medication after one month of using it. Within one month I was able to come out of the diseased state and stopped the medication by myself not taking advice from doctor. After three months of stopping the medication, the disease relapsed again a bit more severely this time but again only delusions and no hallucinations. My doctor told the relapse is because I stopped the medication abruptly. And presently I am under treatment of the same doctor and am on Aripiprazole 20 mg and Amisulpride 200 mg. His plan is to reduce and stop amisulpride slowly and continue aripiprazole for some more time. Totally I should be having the medication for 1 to 1 and half years. I am tolerating this medication better than Risperidone but still would like to find out if there are any alternatives.The Psychosis has responded well to the medication. And I am totally symptom free for the past six or more months. These are the questions I have? I read on internet there is a possibility of withdrawal Psychosis when antipsychotics are discontinued (attributed to increased number and sensitivity of dopamine receptors). Was it that what I got 10 months after discontinuation of the medication? Are there further chances of getting such withdrawal Psychosis, if I continue antipsychotics for a period of one and a half years? How much reliable is homeopathy in treating this?" }, { "from": "assistant", "value": "Hi. Consult a psychiatrist online for further folow up -->" } ]

[ { "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 took an I-pill after 48 hours of intercourse. Now I am experiencing brown spotting a week before my periods. Is it a sign of pregnancy?" }, { "from": "assistant", "value": "Hi. As you took an emergency contraceptive pill within 48 hours of intercourse, you can expect around 75 % protection towards pregnancy. The protection rate decreases with a delay in the intake of pill from intercourse. The spotting you had could be due to withdrawal effect of the pill or rarely may be because of implantation bleeding. So, to be sure, if you miss regular bleeding during your expected date of periods, please go for urine pregnancy test once. For more information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had a CT scan of the chest and abdomen. What is odd about this scan is that the technician did three scout scans before the final helical scan, which made me uncomfortable because I do not know how much radiation I received in those scans. When I got the CD, I looked at the dose report and it only reported the radiation dosage for the helical scan. The data for the scout scan is just dashed. So, I called the clinic and asked them for the radiation dose of the scout scans, and I was promised that someone will return my call with the requested information. But, I never got any callback. Is the radiation dose for the scout scans actually on the CD the clinic gave me and if so, can you help me extract that information? I have attached the reports." }, { "from": "assistant", "value": "Hello. Hope your query is answered. Please do write back if you have any doubts. For further queries consult a radiologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I am not able to get an erection since yesterday, all of a sudden. Also for the past two days, I do not have sexual urges. I am 21, male. I had not faced erection problems before and till 3 to 4 days ago, I was able to masturbate with no problem." }, { "from": "assistant", "value": "Hi. Erection problem in young people is usually due to anxiety and stress. Masturbation and feeling guilty also cause this. Do you have diabetes mellitus, do you smoke, is there any history of trauma to the lower back, is there any pain in testes? If the answer to all is a no, then causes are anxiety, guilt, etc. Do you have morning erections? If yes, then you are all fine. Anxiety causes a release of stress hormones in the blood which may suddenly cause erectile dysfunction. Just refrain from masturbation, do not try to forcibly masturbate, remain calm, do not think about erection problem for seven days at least. Do not forcibly divert your mind to erotic thoughts. Meanwhile, do the following exercises: 1. Deep breathing: Sit on the floor in a calm room alone, close your eyes, slowly inspire through the nose in five seconds, hold breath for five seconds and then release air from the mouth in five seconds. Then hold breath for five seconds and again repeat this cycle for 15 cycles. Do this daily in morning and evening. 2. Kegel: Tighten your pelvic floor muscles like you do while you strongly hold your urine when you have a strong urge to pass urine. Tighten muscles for five seconds and release, again repeat the cycle. Repeat for 20 cycles in one session and do 4 to 5 cycles in 24 hours. You can do this anytime anywhere while standing in a bus, walking on a road, sitting on a chair, lying on the bed, etc. 3. Do jogging preferably in the early morning, for 30 minutes daily. Eat lots of dry fruits, drink plenty of water, reduce salt intake, avoid fatty meals. Follow-up after seven days with details about your condition, so that you can further be guided, if required. Anxiety, guilt, stress. Not at this time. As described above. Avoid smoking, alcohol, masturbation, erotic thoughts, and avoid concern about the erectile problem." } ]

[ { "from": "human", "value": "Hello doctor, I have shortness of breath on exertion and episodic mild muscle weakness for about one year. It worsens with fatigue and particularly ptosis. Kindly help." }, { "from": "assistant", "value": "Hello I saw the chest x-ray posteroanterior and lateral views (attachment removed to protect patient identity). The findings are, 1. There are mildly prominent lung markings in the bilateral mid and lower zones. The upper zones are clear bilaterally. 2. There is no pleural effusion. 3. The cardiac size is normal. 4. The retrosternal space is normal. 5. The posterior costophrenic recess is free. The above findings can be due to mildly hyperactive airways. HRCT chest scan may be done if there are abnormalities in lung function tests. Please avoid any pollution area or dust exposure. For muscle weakness and ptosis, please get tested to know if you are having myasthenia gravis, the most common cause for ptosis and muscle weakness." } ]

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

[ { "from": "human", "value": "Hello doctor, I am 35 years old and I started dieting early last year. But it seems like my weight plateaued. I have been eating a low carb diet during weekdays and on Sundays, I eat the carbs that I want to eat. I work out 3 to 4 times a week. I sometimes sleep late. I have been on this schedule for the past 10 months. So for now, I am frustrated and worried why am I not losing weight." }, { "from": "assistant", "value": "Hello. Well, eating only low carbohydrate will not help. Follow a protein-rich, low carbohydrate, a fiber-rich diet that will fulfill the purpose. Have three small meals per day with lots of water. You can cheat sometimes with healthy junks. Exercise regularly with walk in the morning, at least for 30 minutes. Have low fat or skimmed milk in the morning, with brown bread. Avoid spices. Can have vegetable soup in the evening. Chicken and vegetable salad can work. Can start pilates, which works wonder for shaping up the body. Meditation before going to bed to bring positivity in mind and calmness. Warm lemon water early in the morning is also beneficial." } ]

[ { "from": "human", "value": "Hi doctor, I am 20 years old. My hair is getting thin. As my father is bald,  I fear that I will also get bald. Also, I want to improve my skin texture. Please help." }, { "from": "assistant", "value": "Hi. For further information consult an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Lower back pain unable to put pressure on legs to walk. 3 weeks ago I was lifting my dog into the car. I got a sharp pain in my lower back..went away in about two days. Today I was lifting my two year old into an inflatable tube, While setting her down I had the same pain but on the mid right side of my back. This pain continued all day. Then while bending down to get a dish out of the dishwasher I got a horrible pain in my lower back. The pain knocked me to the ground. My husband had to help me off the ground to the bed . Since then I have not been able to put pressure on my legs to walk without horrible pain." }, { "from": "assistant", "value": "Hello, You need to be examined to determine if this is a back strain or a sciatica from a pinched nerve. Is there any numbness in the leg, does the leg feel weak apart from the pain you feel while trying to walk, can you control your bladder well ,does the pain worsen upon straining ? If the answer to the questions is yes then you have a disc prolapse and you will need to see a doctor and perhaps a MRI too. In three mentioned to need to take anti-inflammatory tablets and muscle relaxant top help with the muscle spasm and apply Ice to the sore area on the back, rest in bed but not absolute such that you walk as much as to feel comfortable" } ]

[ { "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, If prescribed Percoset (5/325) and reversion back to regular Acetaminophen, is there even a slight chance that the oxy component of the Percoset could be triggered since Percoset side effects can be permanent even with one use?" }, { "from": "assistant", "value": "Hi. Acetaminophen is safe compared to Percoset. Single use of Percoset never causes permanent side effects. The side effect caused by a single dose (such as loss of appetite and difficulty in emptying bladder) will be for one day only. Once the amount of drug gets excreted from the body (now drug within the body becomes less gradually), automatically the effect or side effect (mentioned above) must disappear. Only for the usage more than 3 to 5 days, may lead to more side effects. If used for more than 10 days, the permanent side effects may come. Nothing to worry about vocal card swelling. This should appear as early as possible after the drug intake as it is the drug hypersensitivity reaction. If not occurred, it is not going to happen in the future. Do not worry about Percoset side effects." } ]

[ { "from": "human", "value": "Hello doctor, I am 24 years old. I do not know what is wrong with me. I feel depressed all the time. I left home two years back because of my parent's behavior. They always use to make me feel I am worthless and not important for them, they also beat me several times and I was facing emotional trauma on a daily basis. Now I stay away from family alone but seems like things will never change. I am all alone here and people I trusted have backfired on me. My office situation is very pathetic my manager harasses me emotionally or I do not know if I overreact. I just do not know what is wrong? I do not have any friends to talk. I gave a lot of importance to one person in my life and that person did not understand me at all. I cry all day in my room and do not even step outside. I get super angry or emotional on little things. I always stay alone in the office or at home. I feel like there is nothing left for me in this life and I am worthless no one really needs me in there life. For whom am I alive. I do not know if I am depressed or not? I am just done with this life. (Just to add I am a PCOS patient for the past one year)." }, { "from": "assistant", "value": "Hi. The symptoms you have mentioned are symptoms of depression. You left home because of the behavior of your parents and then you are continuously feeling low because of ongoing things at office and at personal space. All these things are aggravating the depression in you. The feeling of worthlessness, emotional trauma, crying spells, emotional lability, anger outbursts, lack of interest in anything, etc are part of depression. But if these symptoms are persistent and are hampering your personal life and you have negative thoughts then yes, we can think that you have a depressive disorder. If the symptoms are not persistent then no need to get worried. You just have to change your lifestyle, try to not to expect anything from others. Just focus on your life and your things. If anyone hurts you then try to ignore the thoughts. This is difficult but in some days you will learn to suppress the thoughts and with the time you will be able to ignore any emotional trauma. No need to get worried. If you are not able to function properly then you can visit a psychiatrist in person and antidepressants can be started. Escitalopram is a good option in your case. The drug is safe and has great efficacy. This will help to make your mood better. Do you have any thoughts like killing or harming yourself? Any ongoing stress that is bothering you? Any relationship issue? PCOS (polycystic ovary syndrome) too is an independent factor that aggravated depression because of hormonal changes. Control of PCOS also helps in improving mood symptoms." } ]

[ { "from": "human", "value": "Hi doctor, I am a 16-year-old male. I want to gain weight. Please suggest." }, { "from": "assistant", "value": "Hi. You can take four to five soaked almonds daily in the early morning and take a banana shake in the midmorning. Try to include a whole milk curd in your lunch. Do regular exercise to build your muscle." } ]

[ { "from": "human", "value": "Hi doctor,I have Fordyce spots on my private parts, could you please recommend some treatment for it? Tried Vitamin A but did not help." }, { "from": "assistant", "value": "Hi. Kindly send good quality image and revert back so that first diagnosis can be made. Fordyce spots are basically prominent sebaceous glands. There is no treatment required for same because they are natural glands. Few people have prominent glands others do not. But if one does not like its appearance then it can be treated with the help of procedure like electrocauterization. No topical medications would help. For more information consult a cosmetologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am an 18-year-old girl. Two weeks before I had an intercourse. From that day I started feeling pain when I urinate. I felt it is normal due to friction. But now the problem is getting worse. Now I realize I do not urinate as before. I felt my bladder getting full. I have an urge to pee. But when I urinate urine does not come out fully. I am feeling stomach pain due to that. I have to go to washroom frequently because drop by drop urine comes out and I feel severe pain. Can you mention what disease I have and possible treatment for that?" }, { "from": "assistant", "value": "Hi. Seems like you have some vaginal or urinary infection which is causing the problem. Please get yourself checked by a gynecologist internally and get a vaginal swab test and complete urine examination. Avoid having sex till then. Wear cotton panties and loose lowers. Maintain personal hygiene and take plenty of fluids. Wash your private parts with normal tap water every time you use the washroom. Avoid using vaginal douches and creams. Do get back to me with reports so that I can guide you further. Take care." } ]

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

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

[ { "from": "human", "value": "Hello doctor, I cannot concentrate on anything. My mind is not stable. I have my exams in next eight days but I am feelling like I do not want to give it because due procastination, I have not prepared well and it is because I was not able to study but now my parents are forcing me to give that exam and due to which we have an argument and always during that argument, I just want to leave the house. I do want to study but I am not able to concentrate and focus on it. Also, I am suffering from PCOD. Is it the reason for my unstable mind?" }, { "from": "assistant", "value": "Hi. PCOD does lead to some hormonal disturbance, do you have any symptoms of PMS? Premenstrual syndrome? Because that might be an explanation of your mood swings and irritability. As for the lack of concentration issue, start small with some breathing exercises and relaxation techniques, try guided meditation. For procrastination, it is often a reaction to stress, because we know the the work is stressful, to avoid it, brain goes on procrastination mode.Start with breaking the task in smaller chunks and do it like if you have to finish two chapters in a day, divide the number of pages per hour, then divide in 30 minute slot. Then just put an alarm for 30 minutes and read. Try this out and let me know if you need anything else." } ]

[ { "from": "human", "value": "Hello doctor,I am a 44-year-old male with 5ft 4\" in height and 69 kgs weight. My TSH (9.83) value is high, but T3 total (104.6) and T4 total (8.5) are normal. No medications are other than Uprise-D3 60 K capsule, which I take weekly. I have no particular symptoms but no weight loss in spite of very active sports and workouts daily and cholesterol borderline high in spite of a very balanced low-fat diet. My report says, Cholesterol 201, LDL Cholesterol 135, HDL Cholesterol 42, Non-HDL Cholesterol 159.00, and Triglycerides 118." }, { "from": "assistant", "value": "Hello. I can understand your concern. I have gone through the reports you have attached. In my opinion, you should get done repeat test after a month.No need to start thyroid medicines. Do regular aerobic exercise like running, cycling, swimming, or walking. I hope I have solved your query. I will be happy to help you further." } ]

[ { "from": "human", "value": "Hello doctor, I had an extraction and an implant placed for tooth ​13 about six weeks ago, and I am supposed to get a crown placed on the implant in about six more weeks. Sadly, apparently due to the change in my bite caused by having number 13 tooth, a bottom tooth broke through an old filling in the 14 tooth and cracked the tooth, and I was experiencing constant low-level pain in that tooth. My dentist drilled out the old filling and filled the tooth eight days ago, and he said I still have a crack he could see, but does not know how deep it goes. He wants to try to wait for six weeks and do the crown for the 13 implant and 14 at the same time. He said I may need a root canal for 14 or possibly extraction, and he would know more when he drills it for the crown, and he said I should contact him if the pain gets bad. I had a lot of pain for three days after he drilled and refilled the tooth, and then the pain got much better, but yesterday, day seven after he drilled and refilled, I had very intense pain, and it still hurts a lot today. Does the pain mean I need a root canal (or extraction). Or is there a good chance the tooth will still be fine with just a crown? Also, if the crack in 14 is really deep and extraction is recommended, can I add a second crown for 14 to the implant I already had placed for 13? I have read that you definitely can put two crowns on one implant, but I was not sure if that requires the implant to be centered between the crowns. In this case, the implant would be off center, directly under the 13 crown." }, { "from": "assistant", "value": "Hi. Thanks for giving all appropriate history. Tooth 14 that is having intense pain is indicating for root canal treatment (attachment removed to protect patient identity). If it would be a crack deep down to root you would be having sharp pain when you bite from it, otherwise pain would be mild. But in root canal case, you would be experiencing sharp lancenating pain and throbbing pain in continuous manner that increases when you lay down straight at bed. Moreover, your dentist will check clinically after opening the chamber of tooth that it is going for root canal or extraction. Again I would say from your given history I am suspecting it to be root canal case. Now, if it would be root canal of 14, then everything would be good as 13 will have cap on implant and 14 will have cap on root canal treated tooth. But ,in case of extraction you can surely have two crowns on support of 13. As a single implant is able to support atleast three crown in anterior segment of jaw and two definitely in posterior segment. Be easy with it. Hopefully, there will be no need of involving any third tooth in bridge cover. It would be best if you can provide me with clinical picture of both teeth and radiograph of the quadrant that is under procedure, so that I can suggest you more accurately." } ]