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sajilperfects

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llama_medical_dataset_7k_qa

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[ { "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, My dentist told me I have a tooth infection, but did not seem too worried and said I could wait until next month to extract it as that is when I will have insurance. This was a week ago. Since then I have been having moderate sinus headaches. Is this something that I should be worried about? There is a gross taste in my mouth from the tooth as well." }, { "from": "assistant", "value": "Hi. I had gone through your question, I can understand your concern. The taste may be because of the pus discharge from the draining sinus into the mouth. In case there are such symptoms, you need to take a course of antibiotics and you can wait till next month and if the symptoms are not so much you can wait as you do. In case you need any medication or treatment for any particular symptoms, mention it in next query. You can also use mouthwash Chlorhexidine." } ]

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

[ { "from": "human", "value": "Hello doctor, I am passing the worst time of my life for more than 1.5 years. Because my husband is getting frustrated and depressed day by day. I love him more than anything in the world, so I am too much worried about him. He works at home since he is a freelancer. We got married four years back and his problem started a year back. He became almost detached from all of his friends and family. So can you imagine his regular life? He wakes up at 12 PM. After that, he starts working on laptop till midnight. This lifestyle continued for almost one year. In the meantime, my mother-in-law and father-in-law both passed away suddenly within two months. My husband could not take this shock and he was going absolutely abnormal. Now he cannot feel any happiness, any rhythm or any charm. He acts just like a robot. As a wife, I am trying my best to make him normal and happy. But nothing can change him. Here is another difficult problem in our life. I tried to do freelancing job so that we can synch our life together. But I failed badly. Now I have no income and I am totally unemployed. This thing also a big reason of his disturbance. I am trying my best to do something, but what can I do in this sector? Except this one thing, I think I fulfill every responsibility to my husband as a wife, as a best friend. In this situation, I am also becoming frustrated. I am really afraid of our current situation. We love each other for more than 11 years and struggled so much to get together. We were a very happy couple and want to live some more time happily. Will you please help us to recover this situation?" }, { "from": "assistant", "value": "Hello. From what you have described, your husband has not been his usual self for more than a year. Did his problems start after his parents passed away or was he feeling low and detached even before this? It looks like he has some features of depression which have been perpetuated by adverse life events. Do not worry, it will gradually get better with some support. It is highly positive that you are understanding his situation and taking steps to get better. It is quite natural to get frustrated but try to remember that this tough period will not last forever. Try following these self-help measures: 1. Encourage your husband to open up and talk about his difficult feelings. Do not get into arguments, just try to listen and look for constructive solutions. When someone is depressed, they can be more irritable and easily frustrated. So do not try not to take critical comments personally. 2. Encourage him to do some exercise daily. It will help to lift his mood. 3. Make sure he eats healthily and sleeps well. 4. Try to make him reconnect with his close friends and family. Avoid getting isolated. But do not force it too much, needs to be done gently. 5. Try to distract by going for cinemas once in a while. If the problems persist, it may be helpful to consult your doctor locally and have some counselling to manage the difficult life situation. Take care." } ]

[ { "from": "human", "value": "Hi doctor, I have noticed something different on the tip of the nails. At the tip of all nails a band of half white color has formed and it is going around the circumference of the nail horizontally. They are not an exact horizontal line, but a circular band around the tip of the nail. I am also attaching the picture of my nails for your better understanding. I am not sure whether they were always there or have developed recently. But, I noticed them recently. Please tell me what is the cause of this. I also have some unusual taste in my mouth or tongue. I do not know whether they are related with the nails. But, I have not had this before. Please help." }, { "from": "assistant", "value": "Hi. For further information consult a dermatologist online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I 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, After 15 months of unprotected sex, I went for HIV test called Comb AIDS test but, the result came back negative for both HIV-1 and 2. Again after three months, I redid the test, but even this time, the result was negative. I was not satisfied, so I went for ELISA test, and again the results came back negative. I consulted two general physicians, who told me that I do not have HIV. But, I am still worried because of the symptoms that I have. I am a male, who weighs 62 kg, and I am 6 feet tall. The symptoms i'm having are: severe weakness, ulcers in mouth and tongue, fatigue, pain in legs while sleeping, itching in the private part, occasional sore throat, occasional itching and pain in ears, and black spots on my back. I remember having loose motions after a week of unprotected sex. At that time, the doctor told me that I have food poisoning, and I was alright after taking medicines. Are these HIV tests done by me reliable? Was the loose motion caused due to HIV? Is it possible that my immune system was so weak to detect antibodies during my HIV test? Should I go for another test such as PCR RNA test? Please help me, I am worried. Your kind response will be appreciated. Thank you." }, { "from": "assistant", "value": "Hi. The test kits used to diagnose HIV are highly sensitive and specific and gives accurate results. The majority of the people who are infected with HIV (human immunodeficiency virus) develop antibodies by three months, and even in the rare instances of late seroconversions, they develop HIV antibodies by six months. You can rely on your HIV screening test results. If there had been no other exposure other than that, you do not require any further test. The symptoms which you mentioned could be due to various reasons and cannot be attributed to HIV. In fact, there are no specific symptoms or signs which can lead to the diagnosis of HIV. As per the above information, you are HIV negative. Just relax. Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime. Best wishes. For more information consult an HIV AIDS specialist 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, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help." }, { "from": "assistant", "value": "Hi. For further doubts consult a sexologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, My 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 suffering from depression. It has been four years. I am always demotivated. I was average student but then I became a failure. I cannot concentrate on studies. I feel like god is talking to me and orders me certain things which I must do. I always feel like third person is ordering me and I get tired answering them. I feel like I have become a small child of second grade." }, { "from": "assistant", "value": "Hi. The symptoms like someone is talking to you, talking to God or hearing voices which others cannot hear could be occurring due to some psychotic issue. Such kind of symptoms are not generally seen in depression. Since such symptoms have resulted in loss of performance in studies, poor concentration in studies, so please visit a psychiatrist for help and evaluation. Drugs like Amisulpride, Olanzapine, Quetiapine, etc., can help you in coming out of depression and psychosis." } ]

[ { "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 wife is pregnant. Her hb level is 8.7 and delivery due date is 4th may. The doctor suggested blood transfusion. Is it necessary?" }, { "from": "assistant", "value": "Hello. Yes, it is extremely necessary to transfuse her blood otherwise you may pur her life on risk during delivery. Kindly do not delay in making this decision as delivery may occur any time now because she has already completed her term. Low Hb may cause heavy bleeding during childbirth which if become uncontrolled may even lead to death." } ]

[ { "from": "human", "value": "Hello doctor, I had accidentally pressed the soft spot in the head of my 40 days old baby while taking him out of the crib. He was crying before and after, and he had not made any special responses. Is there anything to worry? Please help. I am so tensed." }, { "from": "assistant", "value": "Hi. Thank you and have a nice day. For further queries consult a paediatrician online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a mother of a 16 year old boy, who is 5.9 feet tall. He has white spots on the back of his throat along with swollen tonsils. He does not have a fever but finds it hard to swallow. Is this strep infection or what is it? He had the same before, and it was told as thrush." }, { "from": "assistant", "value": "Hello. For further information consult an internal medicine 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": "Hi doctor, What health implications have been observed with a unilateral paralysis of the diaphragm? I have had a plication performed, but it failed and is back to the original issue. Currently, I am suffering from shortness of breath, chest pain with dizzy spells and increased heart rate. I am on Propranolol for the heart rate issue. Please help." }, { "from": "assistant", "value": "Hi. Traumatic or some cancer causing nerve compression. MRI Scan and spirometry. Unilateral diaphragmatic paralysis. For further information consult a pulmonologist online.--->" } ]

[ { "from": "human", "value": "Dear doctor, I had intercourse with my husband last month, after my regular periods. My last period date was 9th August and it is two months now. Till now, I did not get my periods. Suggest me what should I do." }, { "from": "assistant", "value": "Hi. The first step is to check for pregnancy. If the pregnancy test is negative then, we can give you tablets to induce periods. Also, we need to check your thyroid and prolactin hormone levels andscan abdomen to find out the reason for delayed periods. In case the pregnancy test is positive, please meet a gynecologist and follow them. Please do not hesitate to ask further queries to an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "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 did my ICL surgery six months back. Now my right eye is burning. What can be the cause of that?" }, { "from": "assistant", "value": "Hello. A burning sensation is the chief complaint of patients with dry eyes. The causes of dry eye are several in number and ICL surgery by itself rarely causes dry eye. Although there are innumerable causes of dry eyes, the treatment is purely based on the severity of symptoms and usually starts with carboxymethylcellulose acetate 0.5 % eye drops. In case you do want to find out the exact cause of your dry eyes, you would need to get a thorough eye exam with or without eye or blood tests. In case you have any further questions, kindly send me a scanned copy of your doctors report, test reports. I will do my best to help you." } ]

[ { "from": "human", "value": "Hello doctor, I am 24 years old. My weight is 100 kg and height is 158 cm. I have attached my laboratory reports. I am presently taking Metformin 500 mg twice a day and Eltroxin 1000 mcg tablets. I stopped taking the tablets two days before the test was done. Can I conceive with this weight?" }, { "from": "assistant", "value": "Hello. Considering you are obese, hypothyroid and still on supplementation, it indicates that serum insulin levels are high (attachment removed to protect patient identity). Hypothyroidism and anovulation could be a concern and you may be experiencing irregular menses. You need to get a follicular study done for a cycle to check if your ovaries are producing quality follicles and if they are ovulating by midcycle or not. This can be achieved by transvaginal ultrasound. I hope PCOD has already been ruled out, which can further deter your chances of fertility. You should reduce your weight and aim at 70 kg, else you may always try assisted techniques of ovulation induction if there is any problem with ovulation. For further information consult a family physician online -->" } ]

[ { "from": "human", "value": "Hi doctor, My father, who is 57 years old, was suggested to go for AVR (valve replacement). His weight is 74 kg. What are the procedures followed for valve replacement? Is there any consequence after the surgery? Can he lead a normal life after surgery? Which valve do we need to choose irrespective of cost? How many days does he need bed rest? My father has high BP, and always it ranges around 170/80." }, { "from": "assistant", "value": "Hi. Thanks for writing in to us. I have read through your query in detail. Please find my observations below. The valve replacement surgery is usually done using open heart surgery technique, and the surgeon connects the blood vessels to a heart-lung machine and then stops the heart. After this step, an incision is made into the aorta and using careful precision the aortic valve will get replaced. This operation is 98 percent successful. For people less than 65 years, the valve implanted is a mechanical valve, and this is because a mechanical valve will work for many years. In patients older than 65 years, a biological valve is used. He can lead a near normal healthy life. He has to follow up with his doctor regularly and be on medications for a long time. He will be in the hospital for a week and should not be on bed rest. Only thing is he must avoid physical exertion after surgery and take strict precautions for three months after surgery. The blood pressure will get controlled with medicines and doctors make it a point that operation is not risky due to that. Regular medication has to be taken and should get echocardiography as instructed by the surgeon and cardiologist." } ]

[ { "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, The patient is a 59-year-old male with whose weight is 52.3 kg and height is 166 cm. His PSA was 247.5. He had a TRUS guided biopsy, and the report is as follows. 1. Moderately differentiated adenocarcinoma.2. Gleason grade 4+4.3. Perineural invasion present. What does the biopsy report say? What will be the next step? What medicine should the patient take at the initial stage before any surgery? The patient is on Tamdura for the prostate issue and Diamicron MR 30 for diabetes." }, { "from": "assistant", "value": "Hi. I am sorry to know about the problem. The biopsy report says that prostate has a cancer disease. Since PSA is very high, it means that there is a chance that it has spread outside the prostate. The next step will be PSMA PET scan to find out the areas in the body affected by prostate cancer. If this scan is not available, you can get an MRI scan of the abdomen to check local involvement or lymph node involvement along with bone scan to find out bone metastasis. The treatment depends on the stage of disease. If it has spread to bones, then bilateral orchidectomy (removal of testes) is the standard treatment. If the patient does not want orchidectomy, then can get regular injections (once in 3 months) to suppress the testicular function. The patient should also take injection Zoledronic acid once in every 3-4 weeks to control bone spread. Other than these, there is a need for calcium supplements and iron supplements. Please consult the Urologist for regular follow up, since the treatment needs to be modified according to the response of PSA and clinical factors. PSMA PET scan or MRI abdomen with bone scan. Metastatic carcinoma prostate." } ]

[ { "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,Is Cymbalta good for depersonalization? I want some tips to overcome this. Also, how to get rid of apathy?" }, { "from": "assistant", "value": "Hi. I read your query and understand your concerns. For further information consult a psychiatrist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I have experienced a problem in erection since last three months. I am a smoker. The testosterone level in my last routine medical checkup was 134. Please help." }, { "from": "assistant", "value": "Hello. Revert back with the answers to the above questions to a sexologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I had a blood work on my liver. The results came back saying that my ALT and AST are very high and out of range. So, I would like to know what that exactly means. When I received my laboratory test report they said that I should seek medical advice. My AST is 75 and ALT is 35. My MCV 116 and MCH 39.2. Also, I am a heavy drinker. Please explain the report." }, { "from": "assistant", "value": "Hi. Based on your query, my opinion is as follows: Alcohol induced liver damage has caused increased enzyme levels. Possibly early stages, as no jaundice is seen. MCV high (mean corpuscular volume) is due to associated vitamin B12 and folic acid deficiency. Malnutrition due to alcohol abuse has caused this. Need to abstain from alcohol on an immediate basis as liver would take another six months to possibly recover. Repeat the test after three months. Also start Vitamin B12 and Folic acid supplements. Nothing major for now. If it progresses then may require liver transplant in next few years. For further information consult a hematologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, My son is 9 years 1 month old. His height is 119.5 cm and weight is 25.5 kg. He is a very normal and healthy boy. My height is 5 feet 5 inches and my wife's height is 5 feet. I am worried about his height? Please explain me." }, { "from": "assistant", "value": "Hello. Genetic and nutritional. Thyroid profile and x-ray both wrist joints for bone age estimation. Constitutional or genetic short stature. For further information consult a paediatrician online.--->" } ]

[ { "from": "human", "value": "Hi doctor, I have eczema. There is redness in my cheeks. I have used Corticosteroid cream for six days. Are there any side effects in using it?" }, { "from": "assistant", "value": "Hi. Corticosteroids should never be applied without a doctor's advise. Also, there are certain steroids which should never be applied on the face. If you could send me photos and details, I will be able to give you proper suggestions. Till then, do not use anything on your own. It does more harm than good. Consult a dermatologist online for further treatment -->" } ]

[ { "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, Is that fine to bring peanut butter (PB) on an airplane? I would like to know the ways that bringing PB on a plane might or might not pose a threat to others? What should you do if you are bringing PB and if you have an allergy and want to keep safe in case someone else brings some on the plane? Thanks." }, { "from": "assistant", "value": "Hi. You have asked an interesting question. Peanut allergy is one of the most severe food allergies. It can cause itchiness, urticaria, swelling, eczema, sneezing, asthma, abdominal pain, drop in blood pressure and cardiac arrest. It may even result in anaphylactic death if not controlled at the right time. The routes of exposure of the allergen are mostly the accidental ingestion of peanuts or PB by the concerned person (who is hypersensitive to peanuts). Air-borne particles in a farm or factory or crushing environment may cause respiratory symptoms in allergic individuals. However, the odor of peanut butter or its mere proximity has not produced any allergic symptoms in various studies conducted. Hence answering your questions." } ]

[ { "from": "human", "value": "Hello doctor, I am getting blood after my toilet and from last night I have to go to the toilet every 10 minutes. I am a 25-year-old female with a weight of 55 kg and height 5'2\"." }, { "from": "assistant", "value": "Hello. You are having blood in stool complaint as per history. Hereby, I am giving you my opinion on your case. It can be an acute infective condition like gastroenteritis or colitis. Your local rectal examination should be done and stool routine microscopic examination should be done for primary work up. You can be given an antibiotic course after stool report like Ofloxacin plus Ornidazole combination for five days. Drink more water. Avoid excess spicy foods. The probiotic tablet can be prescribed along with maintaining hydration with lots of water. Take Vital Z powder (Dextrose and Potassium chloride) with water to maintain electrolyte balance. Take care. Consult a physician for examination and discuss all these. For more information consult a family physician online -->" } ]

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

[ { "from": "human", "value": "Hello doctor, I am 18 years old. Nowadays I observe that I am losing my hair on the head and getting ball head. Is there any precaution to be followed? Kindly help." }, { "from": "assistant", "value": "Hello. 1. There are a lot of causes for hair loss including stress, lack of proper nutrition, scalp infection including dandruff, hormonal and genetic and seasonal and many more. 2. For routine, you should wash your scalp daily. 3. Do not apply hair oil as it can increase dandruff. 4. Take a diet rich in protein and vitamins which includes eggs, paneer, green vegetables, and fruits. As most of the time, it is dietary to take the tablet I am prescribing below for six weeks. Telogen effluvium. 1. Follihair 1 tablet daily for six weeks after meals." } ]

[ { "from": "human", "value": "Hello doctor, I have had excruciating lower back pain for over two weeks. I am a 38-year-old slightly overweight male. Got this while wrestling with brother. I am fine when sitting down but cannot put any weight on left leg and have sciatic to left knee. Ibuprofen, muscle relaxants, and steroids have not touched the pain. I have not slept for a few days because of constant pain while laying down. I was told that there may possibilities of SI joint injury. Do you know how long this typically lasts? what can I do to help with the pain?" }, { "from": "assistant", "value": "Hello. I would like to know some further details about your pain: 1. Do you also have any paresthesias (pins and needle sensations or tingling in left foot or leg)? 2. Do you have any difficulty in holding slippers in left foot or weakness in the left leg? 3. Does your pain also increase while coughing or sneezing or defecating? What medications and in what doses you tried already? Have you any other medical illness? Or taking medications of some other problem? Radicular pain. MRI lumbosacral spine, serum vitamin B12. PIVD. Tablet Pregabalin 75mg HS, Tablet Duloxetine 20 mg BD, Tablet Tolperisone 150mg TDS, Use Lumbar belt or corset in daytime. Avoid weight lifting, Avoid forward bending, Sleep in hard bed or mattress. Review with further details (as asked above) and MRI results." } ]

[ { "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 son is 6 years old and weighs 24.4 kg. He develops common cold quite often. I am also worried as dengue is spreading around my community and I would like to give him some medication which is preventive in nature. I would like to know what is the best medicine regime for my son to prevent dengue." }, { "from": "assistant", "value": "Hello. Eupatorium mother tincture is definitely a good choice of preventive remedy for dengue. You may give him 5 to 7 drops of this remedy mixed in half a cup of water once a day as a preventive medicine. If he has milder symptoms of fever or body ache then it can be taken twice a day. Gelsemium 200cc is another good remedy for dengue if he gets dull and drowsy during the fever. This remedy can be given twice a day for five days or until feels better. Kindly consider a general preventive measure for dengue like immediately consult a doctor for milder symptoms like fever. Take plenty of water, fluids and rest, rest under the bed net while you have a fever. Eat healthy and nutritious food. I am sure if you follow above steps he will less likely contract dengue. Just give him Eupatorium mother tincture as a preventive remedy for a week. Kindly let me know if you have any questions." } ]

[ { "from": "human", "value": "Hello doctor, I am a female, 27 years old, 50 kg, 162 cm. Just before sleeping at 11:30 AM, I took two Panadol advance pills and one Muscerol 3 pill altogether. I have not eaten for the last five hours earlier. Later that night, I woke up around 2 AM feeling nausea which lasted for a few minutes. Since then, it has been three days feeling upper stomach pain, especially in the morning. This pain vanishes once I am eating but returns mildly afterward. Other important information. It was the first time I am taking Muscerol 3. I am not a person who takes heavy medication regularly. I take Panadol pills when I am feeling very sick only. I do not have a previous diagnosis of ulcers." }, { "from": "assistant", "value": "Hello. The drugs that you mentioned all contain NSAIDs. These drugs are known to damage stomach mucosal lining and cause gastritis. I would suggest to minimise these drugs. You can use some over-the-counter antacids like Pantoprazole or Ranitidine available at stores along with syrup Gaviscon for a couple of days. If symptoms persist, you should get yourself examined by a gastroenterologist locally." } ]

[ { "from": "human", "value": "Hi doctor, I am 36 years old female, who is 6 weeks and 4 days pregnant. I take Gestofit 300 once daily and Fertigyn 5000 twice a week. I am on complete bed rest. I get a slight amount of brown discharge occasionally. Should I panic about miscarriage? I am afraid because I had two miscarriages, one at 7 weeks and the other at 11 weeks last year. Please help." }, { "from": "assistant", "value": "Hi. At 6 weeks 4 days, you can have a scan, if it is still not done, to confirm the fetal heartbeat, as the baby's heartbeat only can confirm the health of the baby and to see the decidual reaction. Brown discharge only means that it is old blood and implantation bleeding. When the embryo bores into the decidual lining of the uterus, it causes few drops of blood to come out. This blood comes out of uterus a few days later as brown discharge. It is normal and nothing to worry. Do not worry about the history of miscarriages, the chances of repeated miscarriages are only 3 %, which means 97 % chances of healthy pregnancy. For your information, bed rest is not needed. No matter what history you had, the baby does not get attached to uterus mechanically, rather by chemical attachment. So, whatever you do, the baby will stay attached to the uterus. Pregnancy is not an illness, so enjoy every moment of pregnancy with good health and lots of prayers. Baby will do fine. Medicines are fine, Gestofit (Progesterone) makes the uterus relaxed and reduces the likelihood of bleeding from the decidual layer. The best method would be to insert the capsule Gestofit 200 mg or 300 mg vaginally twice a day, as the dose reaching the uterus will be the highest with no side effects of the hormone. Injection Fertigyn (Human chorionic gonadotropin) improves the decidual implantation of the embryo. If you already had a scan and health of pregnancy has been confirmed, I suggest you try Proluton depot (Hydroxyprogesterone caproate) 500 mg injection, intramuscularly once in every two weeks until 12 weeks of gestation. It will not allow any further bleeding from the uterus. Consult your specialist doctor, discuss with him or her and take medicine with their consent. Hope I have clarified your doubt, do write back if you have any more queries. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, I have been suffering from heavy menstrual flow for the past 1.5 years. Around six months, I had heavy flow with clots. Now, I have been menstruating for the past 20 days continuously with heavy flow and clots. My current medication includes capsule Gynae CVP, tablet Augmentin and capsule Zevit. I am also having a urine infection now. For this, I am drinking plenty of water and other fluid. Please help." }, { "from": "assistant", "value": "Hi. You are losing blood heavily. Kindly upload your reports as well. Since you are bleeding for the last 20 days continuously, first we should try to stop this. I suggest tablet Meftaris (combination of Tranexamic acid and Mefenamic acid) one tablet thrice a day for three days and also tablet Regestrone (Norethindrone) 5 mg thrice a day for 5 days. This will certainly control the bleeding. Also, start some Iron preparation if it suits you. By that time send your ultrasound report. It can be a fibroid uterus or abnormal uterine bleeding due to endometrial hyperplasia and need to be followed further. Also get your CBC - complete blood count, coagulation profile and thyroid function tests done. For UTI (urinary tract infection), you are already taking antibiotics. After finishing its course, get a routine urine examination again to see if pus cells are present or not. Revert back with the reports to 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, My sonomammography report showed fibroadenomas in the left breast in 2-1 and 3-4 clock positions measuring 8 x 2 mm and 6 x 3 mm. My USG reports showed polycystic ovaries, a cyst adjacent to left ovary, a hypoechoic lesion is seen between the uterus and the right ovary is found with broad ligament fibroid. Recently, I have increased hair fall, and I have gray hairs. Please advise." }, { "from": "assistant", "value": "Hi. For fibroadenomas, it is better to discuss with a breast specialist. Many things happen due to genetics or due to use of any specific product. Check your family history regarding gray hairs. Use natural products to color hairs like henna (Indian herbal product). For PCOD, have a strict healthy diet with less salt, sugar, oil, and spice. Do a walk daily to have a healthy BMI (body mass index) and weight. Try to have regular menstrual cycles, or you can take a cyclic combined oral contraceptive pill for three months. Please send your scan report to guide you further. If you have any fertility issue, try to remove the fibroid as it is large and then decide for conception. If you have heavy periods due to fibroids, then you can do a myomectomy. Use natural products to the hairs. Avoid using conditioners regularly. If you have irregular cycles, try to consult a gynecologist for a further examination. Try to do serum progesterone, serum testosterone, serum insulin, serum prolactin, follicle stimulating hormone and luteinizing hormone, and thyroid function test. Discuss the laboratory results and the scan reports with your gynecologist. Have a complete checking and complete treatment of the health issues you have. If you are trying for conception, have folic acid daily and have sex in a fertile period of your cycle." } ]

[ { "from": "human", "value": "Hello doctor, I am a male who was diagnosed with generalized anxiety disorder (GAD) and social anxiety, eight years back. Initially, I was prescribed Paxil 20 mg, which helped treat my anxiety and depression but I started having side effects of weight gain, fatigue, and sexual dysfunction. When I stopped taking medicine, I started having anxiety and depression again. So my doctor prescribed Zoloft 50 mg and Wellbutrin XL 150 mg. After taking these pills, I started having side effects like extreme weight gain, fatigue, decrease libido, erectile dysfunction and slight hand tremors. I am worried to take a combination of two tablets for my illness because I read that taking one medicine is better than taking two. Is it true that Wellbutrin XL, when combined with SSRI, causes weight loss? And if I stop taking SSRI completely, will my anxiety relapse? I am looking for a medicine which helps my illness without causing any side effects as mentioned above. Please note that the following medications are not available in my country Valdoxan, Edronax, Desyrel, Pristiq and Viibryd." }, { "from": "assistant", "value": "Hi. Paroxetine acts on multiple receptors, and it is known for its withdrawal effects of weight gain due to its antihistaminic and anticholinergic action. SSRI (selective serotonin reuptake inhibitors) can cause significant sexual dysfunction. Usually, Bupropion along with SSRI is prescribed to reduce its sexual side effect. In your case, you are using Sertraline with Bupropion, and you are reporting no improvement in weight gain or sexual function, it is not that common to gain weight with Sertraline, but it can happen. Buproprion traditionally is an activating drug, and it is useful for reducing weight and improving sexual functions. I suggest you try taking Escitalopram 10 mg and Buspirone 15 mg (7.5 mg twice daily). Escitalopram is a classic SSRI, which has a minimal side effect of weight gain and sexual dysfunction. I know you do not want to take multiple medicines, but it is a much better approach to handling your illness. I would suggest you start this combination of drugs immediately after consulting your specialist, as some people are more sensitive to the adverse effects of the drug, so we may have to explore multiple options before we find the right combination for you. Continue doing daily exercises, meditation and relaxation exercises. Revert with further information to a psychiatrist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I am a 33 year old male. Recently, I went for a master checkup. To my horror, I found my liver reports abnormal. I have attached my reports for your reference. The ultrasound of abdomen revealed grade-I fatty changes in liver. Apart from this, my triglycerides levels are also elevated. My cholesterol levels are well within the limits. I am very much concerned. When I consulted a gastroenterologist, he recommended to abstain from meat, egg yellow and sweets for three months and suggested an active life and healthy food. The doctor did not prescribe any medicines. Please suggest me what to do. From the day of results till date, I have abstained from meat and have been doing exercise regularly. Moreover the doctor said that I suffer from non-alcoholic fatty liver disease. I have never touched alcohol and cigarette. I do not have any bad habits. Please suggest me a way to improve my health. Why is my alkaline phosphatase elevated abnormally? Do I have jaundice? When can I recheck my levels again? I do not have any symptoms like yellowing of eyes, skin and stomach pain, etc. Is there anything serious?" }, { "from": "assistant", "value": "Hi. It is good to get routine checkup (attachment removed to protect patient identity) and you got your problem identified earlier. 1. Complete blood count (CBC). 2. Reticulocyte count. Advice from gastroenterologist is absolutely recommended for you; also avoid fatty meal and alcohol. Continue exercise. We need to avoid some medications, which we will discuss after reports. Revert back with reports to a medical gastroenterologist online.--->" } ]

[ { "from": "human", "value": "Hello doctor, How can I improve my immunity for pneumonia since I already had it five times? Once when I was a kid, thrice in high school and currently at college. Please help." }, { "from": "assistant", "value": "Hello. For further doubts consult a pulmonologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I had severe cough and mucus formation which was in yellow. The doctor had prescribed antibiotics, Salbutamol tablet and allergy tablets. Now that cough has reduced but I feel some heaviness at the back right hand side and when waking up in the morning. While I had visited the doctor they had adviced me to take an X-ray. Later they said there is slight pneumonia and to continue antibiotics (Azithromycin) for five days. Also, I have completed my antibiotics dose for four days, still left with one more day. Cough is not there currently and better. I am attaching X-ray that was taken for your advice. Would like to have a second opinion on the X-ray report." }, { "from": "assistant", "value": "Hello. In attached X-ray report (attachment removed to protect patient identity), there is presence of slight consolidation in right side. So, it is suggestive of pneumonia like infection. For that, you need to complete antibiotic course. If clinically improved well, then no need for further work up." } ]

[ { "from": "human", "value": "Hello doctor, I have got blood clotting since the past two days in my right eye, in the part of the sclera. I have no idea whether it is an infection or not. I am currently using Moxicip eye drop to see whether I get any relief. I have used other home remedies like washing my eyes with cold water. Please suggest me what has to be done." }, { "from": "assistant", "value": "Hi. By going through your query, I understand that you are suffering from a subconjunctival hemorrhage. It is a self-limiting condition although cosmetically disfiguring, it causes no pain or any watering. I advise tablet Limcee (Vitamin C) to help in faster recovery and cold compresses at night. If you have discharge from eyes or watering and difficulty in seeing bright light and pain, let me know." } ]

[ { "from": "human", "value": "Hi doctor, I am a 31 year old female diagnosed with osteoporosis. Is Teriparatide treatment recommended? Or vitamin D supplements and Calcium tablets sufficient?" }, { "from": "assistant", "value": "Hi. Teriparatide is an extreme treatment for osteoporosis and is always based on your DEXA scan (dual energy x-ray absorptiometry) report. Have you got your DEXA scan done? How have you been diagnosed with osteoporosis? Please specify. If DEXA scan has not been done, then just take Calcium and vitamin D supplement, it will suffice. If done then revert back to me with the blood reports and scan report so that I can advise accurately." } ]

[ { "from": "human", "value": "Hello doctor, My fiance got sickle cell SD. He is 27 and does not suffer from anything else. He takes medication and changes blood every 4 to 6 months. My question is does it affect his life expectancy?" }, { "from": "assistant", "value": "Hello. Usually, in sickle cell anemia, blood transfusion is not needed. The prognosis depends on the severity of sickle cell. Dehydration, infection is a usual precipitant for sickle cell anemia. So it is better to avoid them and whenever having such incident, consult a doctor immediately. Sickle cell anemia patient's median age can be considered between 50 to 60 years but still, the exact specific prognosis cannot be predicted." } ]

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

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

[ { "from": "human", "value": "Hi doctor, I am a 27 year old male. From the last 3 to 4 years, I am having a troublesome gas problem. If I did not have food, then immediately my stomach is getting filled with gas. And so, I am unable to eat after that. I have a few other problems too. I have been getting sex thoughts in mind from my 15 years of age. So, I ejaculate very quickly, but only a few drops like jelly. Also, after complete urination, I am finding a few drops of urine in my pant. Whenever I am getting tension or fear or anger, I feel like someone is pushing some heat into my body from head to back and hands. After some time, the feeling will get weak with a bit of hungry. What to do?" }, { "from": "assistant", "value": "Hello. Lifestyle related. Revert after a month to an ayurveda specialist online.--->" } ]

[ { "from": "human", "value": "Hi, My wife has regular periods. All tests are normal. Her follicle develops into a big cyst every month. Doctor says it is because of subserosal fibroid. Is this correct?" }, { "from": "assistant", "value": "Hi. You should consult a gynaecologist and get her hormonal profile done to rule out other causes if any. Follicular cyst may be because of PCOD (Polycystic Ovarian Disease) or it may be because of subserosal fibroid and also it can be because of hormonal changes. Subserosal fibroid is nothing but a uterine fibroid. Hope I have answered your query. If you have further questions, consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I have eye allergy from the past 15 years due to vernal conjunctivitis. I am under Cromolyn 0.4 % for it. Kindly advice." }, { "from": "assistant", "value": "Hello. Along with Cromolyn, start Moxifloxacin plus Loteprednol eye drop four times a day for three days. Taper it to two times a day for the next five days. Then taper to once at bedtime for the next five days. Also, start Refresh tears eye drop every two hours continuously for a month" } ]

[ { "from": "human", "value": "Hi doctor, I have been trying to conceive for a few months, but every time the test comes back negative. My last periods was on the 25th of last month, and I started ovulating on the third of this month, and it ended on the 12th. My husband and I had sex on the fifth. Despite my history of irregular periods, I was expecting them to come this time around the same date as I was put on Cabergoline to control my high prolactin (22 on the last report) for regularity of periods. I did not get periods on 25th, but I did not worry too much, as I could have been late in general. However, I checked pregnancy on 20th of this month, which was negative, but I kept the kit. I checked the pregnancy again on 28th and found it negative again, and kept the kit again. After a few hours, I went back to throw the kits, and I found a very faint line on the 28th one, and checked the other one also and found a very faint line on that also. The one on 20th was more fade than the one on 28th. I thought it is urine or evaporation line, and did not take it seriously. I went to the hospital, and the doctors did not find any gestational sac or ectopic pregnancy in ultrasounds also. Nothing at all. But as I had a faint line, they asked me to come back after 10 days. Yesterday morning, I again did a home pregnancy test. Within 2 to 3 minutes, I got another faint T line. This time it was a bit darker as compared to the previous one. I do not understand what is going on. The doctors said that there is nothing called as false positive if the test is checked within prescribed time frame, and a T line appears only when there is some hCG hormone, however, nothing on the ultrasounds. My all four I-can strips show faint lines, but the Prega news kit does not show anything at all. Complete negative. My ultrasound shows nothing. What could be happening with me? My medications since last month are Cabergoline, Metformin, and Folic acid. The doctors say that it could be too early to say something, or it could be ectopic, which could not be verified in the ultrasounds. Could you please give me some opinion on this, as to what could have been the reasons for faint T line appearing within 2 to 3 minutes, while ultrasounds say I am not pregnant?" }, { "from": "assistant", "value": "Hello. For more information consult an infertility specialist online -->" } ]

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

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

[ { "from": "human", "value": "Hi doctor, My baby is now 1 year old. I got copper T inserted after 3 months of my delivery. I still have prolonged and heavy periods followed by spotting lasting for up to 10-15 days. There is no other issue that I face. Is it because of copper T insertion or can there be some other reason too? Will the copper T removal solve the problem? How will the removal regularize my periods? What are the other birth control methods which are safe (I am not much inclined towards hormonal methods since they lead to weight gain etc)?" }, { "from": "assistant", "value": "Hi. I have read and understood your problem. How was the bleeding before pregnancy and for 3 months after delivery? Was your delivery a normal or C-section? Whether the copper-T is properly placed or not or to see some other cause for heavy bleeding you need to take a transvaginal ultrasound -TVS. Sometimes if the bleeding continues then removal is the treatment, the period will regularize if it is due to copper T. If the cause is something else and the spotting continues, you will have to get treatment. There are medicines which can reduce the amount of bleeding. You need a clinical check-up." } ]

[ { "from": "human", "value": "Hello doctor,A spot appeared on the skin of my penis. Seven months later, this stain spread and my skin began to become more sensitive. Then I used a cream with corticoid (Lotrimin) and it got worse because now my skin has shrunk and lost elasticity. What should I do? Is the corticosteroid effect reversible?" }, { "from": "assistant", "value": "Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). Regards. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hi doctor,I am 51 years being treated for coronary ectasia and hypertension. I am taking the following medicines now. Tablet Clopilet 75 mg, Warf 2.5 mg and Nebicard H. Can I take Viagra for erectile dysfunction?" }, { "from": "assistant", "value": "Hi. The drug Viagra (Sildenafil) can cause potential side effects alone and certainly in combination with the above drugs. It can cause hypertension and even the heart attack also. So it is not safe in the asked context." } ]

[ { "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 am a 55 year old male. I am 5'8\" tall and my weight is 69 kg. I am suffering from piles over three years but there is no bleeding. I constantly have some sensation in anus which troubles me while walking. I am noticing my right wrist and feet with swelling almost daily morning. My BP was high around 160-200 over three to four years but now it is normal. My blood sugar is normal. In urine test, sugar and albumin are absent, pus cells 1/2 hpf and epithelial cell occ. Serum glucose was 110 mg. Currently, I am using Pilorute cream and capsule Hamdoroid. But, it is not so beneficial. My doctor suggested surgery but I am not ready for it. Please suggest a remedy." }, { "from": "assistant", "value": "Hi. Revert back with the answers for the above questions to an ayurveda specialist online -->" } ]

[ { "from": "human", "value": "Hi doctor, I want to ask about the condition of my ear because I have pain in one ear and I had some fungi in addition to the tinnitus. I recently went to a doctor, so he gave me some drops to eliminate these fungi, but after getting rid of those few fungi, I do not hear as well as the other ear. Some blood started flowing, and the pain is more. I think that there are infections and something more dangerous because the blood has not stopped. Please help." }, { "from": "assistant", "value": "Hi. As you have rightly put it, there is a possibility of recurrent fungal infection what we call as otomycosis. This condition is very notorious for its recurrence even after treatment. Usually, usage of earbuds i.e. q-tip initiate the entire problem as often the cotton tip is not sterilized in a proper manner thereby introducing infection. The entire fungal blob can obstruct your ear canal, and you will have fullness along with itching and associated pain. It is very essential that the fungal blob be suctioned out completely not leaving backtraces of fungal hyphae as they can form another colony in no time. I recommend you to see an ENT to get this entire blob suctioned out. Continue to use the antifungal ear drops (I usually recommended a combination containing Clotrimazole as it is the most effective in treating such conditions). It will take a while before your ear gets back to normal and there is nothing you need to get stressed about as it is a very common entity we encounter in the outpatient department. I hope this helps." } ]

[ { "from": "human", "value": "Hi doctor, I am 25 years old. I had unprotected intercourse with my fiance 20 days back. He withdrew before ejaculation, still, I took Unwanted 72 after three hours to prevent pregnancy meanwhile. Next day, I got a vaginal fungal infection for which I took Candid V6 for six days (symptoms are relieved now, still I get ocassional vaginal itching). Now after nine days, my breasts feel tender and areola portion is little swollen. I feel a little bit fatigued and breathless also. What can be this due to? Is this PMS? Are there any chances of pregnancy? Can antifungal tablet reduce the efficacy of the pill? What can be done meanwhile? I do not want to get pregnant at this time as we are not ready yet." }, { "from": "assistant", "value": "Hi. As your cycle length is 27 days, and you had unprotected intercourse on day 8 or 9 of your cycle and that was the most fertile period of your cycle. So, do not worry, wait till your next periods. If they occur in time, then no pregnancy but in your case, the chances of pregnancy are more. If pregnancy occurs, then after an ultasound, if it is in the uterus, then medicines are there for an abortion." } ]

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

[ { "from": "human", "value": "Hello Doctor, I eat well, but I am very weak and I look slim. Please suggest me treatment for a healthy and muscular body." }, { "from": "assistant", "value": "Hi Most of the people will be skinny till the age of 22-24 years and will gain weight after that without any exercise or supplement. So do not worry. Weight gain is a gradual phenomenon. It takes time. Do not expect immediate results." } ]

[ { "from": "human", "value": "Hello doctor, I cannot get to sleep due to a racking cough and have stuffy nose and headache as I take Apixaban blood thinner. I do not know what medication to take to treat this. Currently taking Apixaban, Bisoprolol, and Amlodipine." }, { "from": "assistant", "value": "Hello. This is likely a result of upper respiratory infection or allergic manifestations. Firstly, it is better to get examined by a local practitioner for throat and nose examination for signs of infection. You will need and should get prescribed antibiotic like capsule Augmentin 625 mg thrice a day along with some antacid like tablet Pantoprazole 40 mg once a day before breakfast for five days. For symptomatic relief, antiallergic medicine like tablet Allegra 120 mg once a day preferably bedtime till this resolves. Also, for cough syrup like Alex 2 teaspoon SOS will be helpful. For a stuffy nose, you may use Xylometazoline nasal drops, a drop in each nostril SOS. Also, avoid using over-the-counter other than Paracetamol like Ibuprofen, Diclofenac. Paracetamol may be used 650 mg three times a day accordingly." } ]

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

[ { "from": "human", "value": "Hello doctor, I am a 34 year old female. I am suffering from severe hair loss. Almost three-quarters of my hair I lost in 15 days. I have severe itchiness on the scalp with a sensation of something crawling on my scalp and body. But, my mother says nothing can be found on the head, except some traces of dandruff. Every now and then, I suffer from a skin problem of red bumps on the body. Please help me." }, { "from": "assistant", "value": "Hello. I have gone through your case. Take care. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hello doctor, I am 26 years old. I did not get my period for the past five weeks and yesterday I checked for my pregnancy and it turned out to be positive. I called my gynecologist and she suggested me to take Gestafine 200 one at night. And Folvite one in the afternoon. And also, she suggested taking one injection LUPI hCG HP 5000 that I will take it today evening. Is that the correct medication given by my doctor? What other precautions and other things that I have to do now? Please suggest me. And also about the food." }, { "from": "assistant", "value": "Hello. In an uncomplicated pregnancy, except tablet Folvite (Vitamin B9), nothing else is required in early pregnancy. The rest can be taken, and safe in pregnancy, but I would not say they are necessary. Secondly, continue tablet Folvite until three months. Then do a dating ultrasound now. Do a nuchal translucency, nasal bone ultrasound at 11 to 14 weeks. You can also do a dual marker testing for Downs syndrome. Then you must continue Iron and Calcium till the end of pregnancy from the third month onwards. At five months, that is between 18 to 20 weeks do an anomaly scan. At 24 to 28 weeks do a glucose tolerance test with 75 gm glucose. You should also take two doses of tetanus anytime after the third month. Take plenty of fruits vegetables and fluids. Take protein rich diet." } ]

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

[ { "from": "human", "value": "Hello doctor, I am suffering from insomnia from the past three weeks. Please help." }, { "from": "assistant", "value": "Hello. Is this the first time you are experiencing insomnia or there has been a previous history? Sleep problems can happen if you are stressed, anxious or have a mood problem. Is there anything stressful going on in your life ? Do you do shift work? Try to address the root cause and learn relaxation strategies. I see that you are talking Zolfresh 10 mg (attachment removed to protect patient identity). It is fie to take it for a few days but not recommended to continue for a longer period. Try these self-help interventions: 1. Relax atleast an hour before bedtime. You can listen to music, or take a bath. 2. Go to bed at the same time. 3. Have a comfortable bed, keep the room dark. 4. Avoid drinking tea, coffee in the evenings. 5. Avoid watching TV or looking at bright screens in the evenings. It can affect your natural sleep inducing hormone secretion. 6. Avoid day time naps. 7. Do regular exercises. 8. Avoid eating heavy meals before sleeping. Take care." } ]

[ { "from": "human", "value": "Hello doctor, I am sweating too much I guess. I am not sure if it is because of the heat here but I sweat. Pleae sugget me something which I can apply to my body. So it does not sweat much and I look fresh and I do not smell." }, { "from": "assistant", "value": "Hello. It is likely because of weather only and body sweats in order to keep body temperature down. So naturally if you try to stay in cold environment as much as possible this will automatically reduce. However, for reducing perspiration, you should ask for Aluminum chloride hexahydrate containing powder 6.25 percent to be applied over heavily sweating area like axilla, groin and back. You should use this powder in the morning. So you may request chemist for this. This should help you." } ]

[ { "from": "human", "value": "Hello doctor, I have a sore at the middle of my penile shaft. I believe this was due to excessive masturbation and having sex when it was sore and hurting, to begin with. It seems like it is healing up, but I want to make sure. There has not been pus, discharge or pain from peeing. Just the irritated spot has been sore. The skin has turned dark there as it is healing I presume? I have been having sex with the same person for over two years so I do not think it is anything she gave to me as she is clean. I am just hoping this is not some sort of STI." }, { "from": "assistant", "value": "Hello Welcome to icliniq.com. Usually, whenever soreness is present over the penis we have to rule out herpes or syphilis. But I have seen attached image (attachment removed to protect patient identity). It does not look like any sexually transmitted illness. For a few days, it is advisable to stop masturbation and you can apply topical antibiotic cream over that. If no improvement, then you have to consult a dermatologist for detailed evaluation." } ]

[ { "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 want your opinion on who is the best person (or where to start) for diagnosing and treating ADD in a 12-year-old child. The information and opinions are mind-numbing and confusing. I have the choice of taking my daughter to a pediatrician or a psychiatrist, after having her tested by a psychologist for school performance related issues. The resulted report indicates that she has serious trouble in concentrating (we knew that) and that she is exhibiting anxiousness (we knew that too). She is currently taking 20 mg Ritalin LA, and we need to re-evaluate the medication.In your professional opinion, where should one start? Will it be sufficient taking her to a pediatrician to re-evaluate the medication, or should I take her to a child psychiatrist for a full evaluation?" }, { "from": "assistant", "value": "Hello. You have asked a very pertinent question. I am not sure about the medical system in your area. Usually, young children in primary school are seen by pediatricians. Once they move to secondary school and if they have any co-morbid conditions like depression or anxiety, they are usually seen by child psychiatrists. But this arrangement is not universal, and there are huge variations. Both developmental pediatricians and child psychiatrists have the training and expertise to assess and manage ADD or ADHD (attention-deficit hyperactivity disorder). So if you are comfortable with your current pediatrician, discuss your concerns with him or her about your daughter's anxiety. If appropriate, they can refer your daughter to a child psychiatrist. Perhaps your daughter's response to Ritalin LA (Methylphenidate) and tolerability needs to be reviewed, and dose has to be titrated accordingly. If there are any emotional difficulties, she will benefit from pastoral support at school or some counseling. If emotional problems are severe, getting a child psychiatrist opinion may be sensible. Also, we have to remind ourselves that the management of ADD or ADHD is not medication alone. Your daughter will benefit from individualized support to help with her school performance. Her self-esteem should not be affected by ADD. Let her enjoy doing activities which can provide positive experiences. If she likes sports or drama or any other similar field, let her have regular time for pursuing her interests." } ]

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

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

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

[ { "from": "human", "value": "Hello doctor, I am a 46-year-old female who is dealing with perimenopause symptoms. My Ob-gyn has recommended taking low dose of birth control pills to relieve my symptoms. However, I am at a higher risk for breast cancer because my late mother (who died in an auto accident) was a breast cancer survivor and am not crazy about a course of treatment will fiddle with my hormones. Are there any treatments that do not involve hormones?" }, { "from": "assistant", "value": "Hello. That is really sad to hear about your mother but I would like to add into your information that evidence suggests that HRT does not significantly increase the risk of breast cancer. It is only contraindicated if the person taking HRT has breast cancer already. Secondly, yes other options (SSRI, SNRI, Clonidine, Primrose oil, Black cohosh, Red clover, etc.) are available for menopausal symptoms. But the choice of the treatment option depends on your symptoms. Many over-the-counter drugs like evening Primrose oil, etc., are available which are helpful to many women in relieving their symptoms. Another way is the choice of route of administration of hormones like pills, skin patches, vaginal rings, etc. These again depend on your symptoms and your overall medical fitness. Hope this information has given you a brief idea regarding options for your query." } ]

[ { "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": "Hello doctor,In the left side of my face right in front of the ear and around the lower back of my ear is swollen. I had a sore throat a few days before, and I have been coughing hard with lots of mucus. I had also swollen a teary, red, and slightly painful left eye, which started, a week before. What is this? Shall I go to the ER or doctor for my swollen face? I already consulted a doctor two days before the swelling and under antibiotics." }, { "from": "assistant", "value": "Hello. There are multiple reasons for what you suffer from, and your case could be one of them. First, that could be part of the illness, which is acute upper respiratory tract Infection (viral or bacterial, usually viral comes with such symptoms). The swelling could be as part of the disease as well which is swollen lymph nodes located around the ear and nothing to worry about as it is part of the infection that can be confirmed by neck ultrasound scan in all circumstances. I suggest you move to the emergency room for further evaluation and clinical examination. Acute URTI (urinary tract infection), reactionary lymphadenitis. Consult the emergency room for further evaluation." } ]

[ { "from": "human", "value": "Hello doctor, I have headache, cramps, nausea, bad morning sickness, back pain, hunger, feel light headed. I am taking Olanzapine and Zyprexa." }, { "from": "assistant", "value": "Hi. The symptoms that you mentioned are common side-effects of Olanzapine (Zyprexa). Please, do your best to tolerate the side-effects especially in the beginning of therapy (if you just started taking the medicines) as in some situations the side effects decrease in intensity by time. I strongly advise you not to stop this medicine or skip doses as it is extremely important to stick to its dosage and continue to follow up with your doctor." } ]

[ { "from": "human", "value": "Hi doctor, I recently had a car accident. I was passenger. How can my arm feel very still and tender? The doctor at the urgent care gave me Naproxen but my muscle is still tender and I have not been able to sleep at all. The doctor gave me Hydroxyzine which did not work." }, { "from": "assistant", "value": "Hi. If it is just a bruise, then you just need to give it time and pain control with some NSAID like Naproxen, and need no intervention but only if your swelling start getting worse. But in any accident we should consider ruling out underlying bone fracture as bone fractures need to be fixed surgically. I am not sure how bad your accident was, and how your bruises look like but if it is bad enough then might need X-rays to rule out underlying fracture. I believe that urgent care doctor have ruled out or did not think of fracture after examination. So just keep taking Naproxen, cold compresses with ice (wrapped in plastic bag or cloth) might help. Contact doctor if swelling or tenderness do not start getting better in 2 to 3 days or start getting worse." } ]

[ { "from": "human", "value": "Hello doctor, My penis top is red with a white pimple. I used Mupirocin ointment four months back. Then again the doctor gave Betnovate RD a month back and I used it three times. Now, my skin looks very dry and ugly. The redness has reduced but the skin looks abnormal." }, { "from": "assistant", "value": "Hi. I have gone through your complaints and it could be yeast infection. I would recommend you to upload the pictures of the affected areas so that I can have a clear picture of the condition and can guide you accordingly. For more information consult a dermatologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, My daughter is 15 months old. Her weight is 8.2 kg and height is 80 cm. One of the Pediatricians suggested me to give two supplements to her as follows. Osteocalcium 5 mL per day, which contains Vitamin D3, Vitamin B12 and Calcium phosphate and JusDee 60K granules one sachet per month, 1 sachet = 60000 IU. Is it fine to give? Instead of Jusdee 60K sachet can I give JusDee 400 drops per day? If yes, how much can I give per day? Also, recently, I have noticed that my daughter's first four upper teeth having some white discoloration of enamel during demineralization. Could you please provide your valuable suggestions on it? Thank you." }, { "from": "assistant", "value": "Hello. Undernutrition. JusDee drops, 1 mL once a day for a month. Continue the other as prescribed. For further information consult a paediatrician online.--->" } ]

[ { "from": "human", "value": "Hello doctor, Yesterday, I and my wife had unprotected intercourse and we are not planning for a child. I made sure not to ejaculate inside her and I pulled out in time but we are worried about the effects of pre-ejaculation if that might cause pregnancy. Her period this month completed a few days ago and waiting for a month seems too long. I-pill was my choice but after learning about the side effects am wondering if there is another way to find out if she is pregnant or should we just go for the pill?" }, { "from": "assistant", "value": "Hi. From day 1 to 10 of the period, it is a safe period. There is no chance of pregnancy as there is no ovulation happening during this period. So if you had intercourse during your safe period, there is no chance of pregnancy. Also, you say that you have followed a withdrawal method. So relax and do not worry. However, if you have a doubt then take an emergency contraceptive pill within 72 hours of intercourse. There is no chance of pregnancy. The side effects of the pills are minimal and temporary. However, if you have a doubt then get back to me. Take care." } ]

[ { "from": "human", "value": "Hi doctor, I have fatigue issues. Can you suggest a health supplement. I was thinking of using Amway Nutrilite Siberian Ginseng With Ginkgo Biloba. Further I am currently having vitamin B12 and Vitamin D deficiency for which I am using specific supplement as suggested by my physician which includes Mecobalamin 1500 mcg and Cholecalciferol granules in addition to spending some time in sun. I further wanted to know whether Amway Nutrilite Siberian Ginseng With Ginkgo Biloba will react with any of the current medication. Also, I have attached my latest blood test reports." }, { "from": "assistant", "value": "Hi. I appreciate your efforts for uploading the laboratory reports (attachment removed to protect patient identity). 1. You are suffering from fatigue syndrome and the reason for that is you have low vitamin and nutrient levels, deranged liver functions (although little one), high cholesterol and deranged lipid profile. 2. Yes, you may use the Amway product. It is a good brand for dermatological and dietary supplements. But there is little to no research available from third party or independent unbiased researchers. So, the safety of dietary products and other drug interactions with your other medications are not much documented. 3. Your supplements are good for vitamins. 4. You have to lower your weight, increase physical activity and have to keep a check on your cholesterol levels to keep in normal range. 5. Try diet modifications too. If these things do not work I will suggest then to start some lipid lowering medicine like statin. 6. Avoid alcohol and smoking if you do. It is hazardous for your liver which already is not working good. 1. HbSAg (hepatitis B surface antigen) and Anti-HCV (human papillomavirus) both by ELISA (enzyme-linked immunosorbent assay). 2. Ultrasound abdomen complete. 1. Take capsule SeaMega for fatigue and your cholesterol. 2. Take Salmon fish in food. Revert back with the laboratory reports to an internal medicine physician online.--->" } ]

[ { "from": "human", "value": "Hello Doctor, I am 60 year old healthy female with medically controlled hypertension. I have Behcet’s disease, though mostly under control. I have had various tropical diseases. I also had hepatitis A at childhood, and TB meningitis. I also have scoliosis. I have been diagnosed BCC (Basal Cell Carcinoma) half way down and in the middle of my back. It is about 2cm in diameter and raised about 1cm high. Having had many skin cancers removed previously I expected the same procedure i.e, administration of local anesthesia and excision. However, the general surgeon at the local hospital wants me to have general anesthesia for the surgical removal of BCC. I cannot understand the necessity for a general anesthesia for removal of a BCC (I have had many removed previously without any problem). As I have had adverse reactions to anesthesia before,I am very nervous about this. Once I had respiratory depression during moderate sedation. Of five previous surgeries, I have had blood transfusions with two. My recent blood work showed low PTT. Is it necessary that I should undergo surgery under general anesthesia?" }, { "from": "assistant", "value": "Hi, Welcome to icliniq.com. You should ask your surgeon the reason behind giving general anaesthesia in your case. Basal cell carcinoma is a locally invasive tumour with very rare chances of malignancy. The need for general anesthesia can arise when on clinical examination it was found that the tumour also involves underlying subcutaneous tissue, nerves and surrounding structures. In such cases we cannot rely upon the local anesthesia as we may have to extend the surgery. During surgery we have to remove one extra centimetre of the healthy margin to prevent recurrence of the tumour. This margin will be sent for histopathological examination later, to determine whether margins are free from tumour. If margins are involved resurgery has to be done. The size of your tumour is 2cm and may be your surgeon on examination found it to be a deep tumour. Hence to prevent resurgery, he might have advised surgery under general anesthesia. As in case of local anesthesia, sometimes it is difficult to extend the surgery especially when underlying nerves are involved. Do not worry about the general anesthesia as there are few anesthetic compounds which do not cause respiratory depression. So, inform your surgeon regarding the previous respiratory depression and get treated accordingly. For further follow up, consult a surgical oncologist online -->" } ]

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

[ { "from": "human", "value": "Hi doctor, I went to the allergist a week back and he said my nasal passages were swollen up. He prescribed QNASL. I am going to meet an ENT doctor in a day or so. I cannot breathe well or smell. What can an ENT doctor do for me?" }, { "from": "assistant", "value": "Hi. The steroid nasal spray you are using has local steroid which helps in reducing the swelling. This spray you will have to use for around six weeks. Secondly, to treat nose block you may use local decongestant nose drops for five days. If you have excessive sneezing you should use antihistamines also. If your problem is chronic that is from a long time I would advise you to get CT scan of paranasal sinuses done to rule out sinusitis." } ]