conversations
listlengths 2
2
|
|---|
[
{
"from": "human",
"value": "Hello doctor, I am 51 years old. I am having sweaty palms and feet every morning. I also feel nausea and headaches. What is the cause of this?"
},
{
"from": "gpt",
"value": "Hello. As per your presenting complaint, the diagnosis is migraine. Migraine headaches are a common cause of combined headache and nausea. Migraines can cause a variety of symptoms, including nausea, dizziness, sensitivity to light, and severe headache. You can make small changes to your lifestyle so that you prevent future migraine attacks. Here are a few steps to take to relieve migraine pain. You should drink a lot of water throughout the day so that you stay hydrated at all times. You should avoid eating less and should eat enough so you are getting all the nutrition that your body needs. Eating proper and healthy food is key to ensure your body is healthy. You should try and eat at the same time daily. Sleeping deficiency can trigger migraines, which is why adequate sleep (eight hours) is important. You should maintain a steady sleep cycle by sleeping at the same time every night and wake up at the same time. I hope this helps."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Recently I came to know that my ward has a germ cell tumor. He is undergoing surgery for the removal of right testes today. It is unknown whether he is affected with cancer if so, what is the type and whether it is curable or not? How long will this take and what are the steps should be considered for the treatment? Please help me because I am depressed."
},
{
"from": "gpt",
"value": "Hello. This is a high-grade testicular germ cell tumor (attachment removed to protect patient identity). The molecular markers such as hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase) are high. Also its spread to the liver and adjacent lymph nodes. Ideally, the primary tumor in testis has to be removed and then treated with a chemotherapy called BEP (bleomycin, etoposide, and cisplatin) regimen for the rest of the metastatic disease. If after surgery, his markers fall, and if he responds very well to chemotherapy, we can expect a cure where we could do a stem cell transplant in the future. But for now, his plan would be a surgery followed by chemotherapy. Also, consider semen preservation before surgery and chemotherapy."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a habit of eating fennel seeds a lot. Could this be the reason for not getting pregnant even after trying for two years?"
},
{
"from": "gpt",
"value": "Hi. Fennel seeds can normalize your gastrointestinal tract and nervous system. It balances excess pitham. It helps in balancing heat within the uterus, that is very much essential for getting pregnant. So, daily consumption of fennel seed life long will never affect the pregnancy. You may continue consuming it. Please check gynecologist or Siddha or Ayurveda doctor to evaluate why there is a delay in conception. Please check for your husband too. The reason may be identified for specific treatment."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am thinking about getting a kitten, my father and brother are allergic to it. So, it will be kept in the upper room. I want to know if I have the same allergies. During my college days, I have spent six years with cats, never touched them but you could see them walking around, some even came close and hid under my tables."
},
{
"from": "gpt",
"value": "Hi. Allergy can run in families, you have a chance of being allergic as your father and brother are allergic to cats but not a must. Being close to cats in the past for many years is a good indicator that you might not be allergic to cats but still allergy can develop at any age. You can do a skin allergy test by a dermatologist (skin doctor) to know if you are allergic to cats or not. Skin allergy test. ?Allergy. Avoid contact with cats, if proved to be allergic."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My kid is 4 years old (baby girl) and weighs around 14 kg. She has fever of 101 from last evening followed by vomitings and motions. She is vomiting green color fluid and passing stool of same color, we have given her Calpol 250 mg 4 ml doses twice from yestday for every six hours. Should we give her Vomita medicine? Or continue with Calpol?"
},
{
"from": "gpt",
"value": "Hello. Based on your history, I can suggest please go to pediatrician urgently. May be need to do abdominal sonogram because green color vomiting is unsual in 4 years old children, sometimes there may be lying some intestine problem like obstruction. I am not making you scared but informing you regarding possible urgency. You can give Calpol every six hourly. For vomiting, you can give syrup Ondansetron 5 ml three times a day for three days. Give ORS to prevent dehydration. I am not giving you full prescription because I want you to visit pediatrician and get herself checked first. Ultrasound abdominal."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My lab tests are as follows: Seven months ago: blood glucose of 105 mg/dl, GTT one hour 160 mg/dl, two hours 118 mg/dl, morning insulin 6.2 μU/ml, HbA1c 5.2 %, A1 6.1 %. This month: BG 110 mg/dl, GTT one hour 184 mg/dl, two hours 115 mg/dl, morning insulin 5.3 μU/ml. Every other blood test within normal ranges. I am male 32 years old 1.86 cm 93 kg 13 to 14 % body fat athletic with healthy nutrition habits. No history of diabetes in the family. Could I be having cancer in pancreas judging from the insulin values you are seeing? I have had many years to do a blood test and with this random one seven months ago. I was told by my doctor that I had to keep monitoring my blood glucose since I could develop diabetes later on, and since I have never had a problem with blood sugar as a kid and no family history of diabetes, I was wondering what might be going on cause insulin levels dropped from my last test and since my diet was pretty much same with healthy choices why is this happening. My doctor for the last seven months kept telling me to calm down and that I do not have anything cause stressing is bad for my blood glucose too. Should I be telling him to get a pancreas MRI done?"
},
{
"from": "gpt",
"value": "Hello. I just read your query and from what you have mentioned I would like to say that the reason that your insulin levels are dropping is because of your beta cells of the pancreas are getting exhausted and are not gradually decreasing the production of insulin. Pancreatic cancer does not have these manifestations at all. So testing for cancer without any strong family history or clinical manifestations is just not recommended. Continue with your healthy lifestyle and try to workout more as they reduce insulin resistance and thereby decrease fatigue of your pancreatic cells. For more information consult a diabetologist 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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "i have pain while passing stool and also blood with it sum time spots and some time much more, and i have physical exam to a doctor, who said it is not piles, it is anal fissure then i ask whtat is this he said in simple words its a cut. he suggest me gtn 0.2% and brixin tab if there is no relief in 10 days there will be need of operate please suggest me"
},
{
"from": "gpt",
"value": "hello I will definitely help u regarding your problem anal fissure is a cut in the anal pessage due to hard stools it may present with pain and bleeding in 99 percent cases surgery not required but proper medicines and prevention is necessary here I will advise you complete treatment only one gel and tablet will not help follow my treatment, you will get better in 5 days follow me after 5 days so I will modify your treatment anal fissure Sitz bath with betadine 2 times for 15 minutes Syp Duphalac 4 tsp HS ointment Diltigesic locally 3 times Ointment Smuth locally 3 times Tab Enzoflam 2 times daily Tab Pantop DSR OD plenty of water avoid spicy and fatty foods high fibre diet 5 days"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I was diagnosed last week with a dysfunctional pancreas but further tests are needed. Yesterday, I had a couple of beers and I woke up today with pain in my pancreas (I am quite sure). In the pain scale, it is about where I should take a Paracetamol, but I am afraid to put something down in my stomach. It is not severe. What should I do? Eat lean food and drink water till it goes away or is another treatment needed? I have been on Nexium, Ranitidine for four years and my pancreas gets worse when I take that medication. I stopped Ranitidine one week ago. I had endoscopy last week and esophagus and stomach looked fine. Could it be gallstones blocking pancreas? Hope you can help me here."
},
{
"from": "gpt",
"value": "Hi. I have reviewed your query and can well understand your worries. I would recommend combatting this situation without medications as these medications will also affect your stomach. Try not to take pain medications as much as possible. In severe and unbearable pain you can take though. You already had fundoplication and taking pain medications can cause gastroesophageal reflux disease (GERD) or gastric ulcers along with hyperacidity in the stomach. Without having a look at gallbladder it is difficult to say anything about the origin of issue that may have caused pancreatic insufficiency. For diagnosing gallbladder issues (sludge accumulation inside or gallstones) we need to go for an empty stomach ultrasound study of the abdomen. It can show most of the gallbladder issues along with any correlation between the gallbladder and pancreatic issues like gallstones and pancreatic insufficiency. Alcohol is not good for the pancreas. It is the single most dangerous threat to the pancreatic normal functions. It may also lead to pancreatic cancer along with smoking, age, and infection of the pancreas. It is not severe. Yes, you should deal it like this conservatively, as aforementioned in detail. Hope it helps. Please go ahead for further pancreatic studies as advised by your physician and avoid smoking and alcohol as these are like a poison to the pancreas in this scenario."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had an ear infection but my ear infection has gone now but very low pitched ringing in my right ear is not stopping."
},
{
"from": "gpt",
"value": "Hello. The symptom you are experiencing is called tinnitus. Tinnitus is not always due to a sinister cause. Simple conditions of the ear like wax or ear infections both of external ear canal and middle ear can cause it. First and foremost you must know that tinnitus may be aggravated by apprehension and anxiety. You have to make a conscious effort to ignore it. Most of the times, it does not need any treatment. So be assured most likely to be a benign condition. I would like to know the duration of symptoms and whether it is unilateral or bilateral. Are there any symptoms of hearing loss and giddiness? Did you have any earache and prior history of upper respiratory tract infection? you may do a hearing test which will give us further insights. For now, you may just wait and ignore it. It might resolve in a few days."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am continuously hearing a metallic scratching sound for the past one month. Best described as like the sound of cricket insects as heard in the dead of night. I am taking medication, namely, Syndopa plus, Rasalect, Pramipex ER3, Rozucor, and Amantrel for Parkinson for last seven years."
},
{
"from": "gpt",
"value": "Hello. I understand that you have tinnitus. Has it been there only for a month? Is it associated with any decreased hearing? Is it there in both ears? Is the tinnitus accompanied by vertigo or vomiting sensation or fullness in ears? Have you done any testing for the same? When a patient comes to us with symptoms like yours we ask for all these details in history to rule out any neuroma in the nerve or age-related hearing loss or Meniere's disease. A basic investigation that we ask is pure tone audiogram. Additionally, I would suggest you get a SISI (short increment sensitivity index) test done. These two should give us a fair idea and help us rule out the above conditions and check for the cause of tinnitus. If the tinnitus does not have any cause we can help you tolerate it using tinnitus matching and masking. Some centers also provide tinnitus retraining therapy. These are useful. Certain medications like Caroverine and Nicotinic acid also are helpful in improving the condition. For more information consult an ENT otolaryngologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a 44 year old female, mother of 2, 165 cm tall and 75 kg weight. Two months ago, I fell ill with a bad flu (may have been also an acute viral infection) with high temp (39 degrees), probable inflammation in the sinuses, nose, and throat and sinuses pain. The first antibiotic (Klacid) did not help much and low temp of 37.3 to 37.5 persisted for weeks. Then a throat swab analysis showed the presence of streptococcal pneumonia. However, X-rays of sinuses and lungs did not show any problems.In the meantime, a month ago, the nose cleared, and the pain in sinuses subsided. However, the right ear got clogged for a week, and as it unclogged, the left one got clogged. In the meantime, local doctors gave the diagnosis of post-viral infection-caused inflammation of the eustachian tubes. A second antibiotic was prescribed and taken two weeks ago - Augmentin. After the second antibiotic, temperature normalized. However, the left ear clogging persisted.Additionally, three weeks ago, shortly after the clogging of the left ear, a high-pitched noise in the left ear appeared (tinnitus ?), which is particularly audible at night and has caused me sleeplessness, stress, and depression. Audio tests performed by local doctors have proved that the hearing and hearing nerves are intact for both ears.I have taken for two weeks now Flixonase spray (corticosteroid like Nasonex), spraying once per nostril every morning. However, as a result, I developed an extreme dryness in my mouth and throat, and after three days, I stopped that. Now, my left ear feels better but is still clogged and ringing. What would you advise us to do?"
},
{
"from": "gpt",
"value": "Hello. The clogging of ears and ringing sensation (tinnitus) are probably due to accumulation of fluid in your middle ear post eustachian tube blockage, as a result of the upper respiratory tract infection you had had previously, a condition known as serous otitis media. I suggest doing tympanometry (if not already done) to confirm the diagnosis. If tympanometry confirms the diagnosis, then I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an ENT otolaryngologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have developed tinnitus after using a nasal spray Sudafed, please assist. Not on any medication, hearing is fine. I was suffering slightly with dizziness prior to the tinnitus four months back which had cleared by then."
},
{
"from": "gpt",
"value": "Hi. I just went through the complaints that you been having. This sounds like peripheral vertigo and this is how people usually present with. The treatment management part, take a tablet called Betahistine 16 milligrams twice daily for three days followed by once a day for three days and stop. Drink plenty of water just to prevent dehydration as dehydration sometimes worsen this tinnitus and giddiness. If you still continue to have the symptoms or the symptoms persist, I want you to consult with an ENT specialist and if you still have any queries please feel free to contact me."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 21 and suffering from tinnitus from last four months. The sound in the ears is not constant. It is changing. Sometimes, it is loud enough that I can hear it even in a crowded place and sometimes so low I cannot detect in a normal environment and the most important of all with a loud noise like train horn it is taking a peak and when the sound goes off it comes back to normal. My doctor told me this is due to cold and prescribed some antibiotics. But it did not work. So he told me to visit an ENT specialist. After visiting an ENT specialist, he told me my ears are fine but I should do an audiogram. And also given me some antibiotics. There was no hearing loss in the audiogram. And the medicines also did not work. Then I again visited the doctor. This time he told me there is nothing to worry about and sent me back home. What I want to ask is, if there are any other tests that could detect why this is happening and how this could be treated?"
},
{
"from": "gpt",
"value": "Hello. You are suffering from fluctuating tinnitus for four months as you have said. Tinnitus (ringing sensation in the ear) may be due to problems of the ear or problems not related to the ear. Ear problems causing tinnitus are generally associated with hearing loss. But that is ruled out in your case as your audiogram is normal. Some investigations need to be carried out: I would suggest you go for the investigations as suggested. If no cause is found, you should go for tinnitus retraining therapy. An audiologist may help. Avoid loud sounds, have a diet comprising of green vegetables and fruits containing beta-carotene (mango, papaya, etc.). For more information consult an ENT otolaryngologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have constant tinnitus and sensorineural hearing loss for about five months. I am sending you reports of my PTA and otoscopy. Now I have ear fullness, tinnitus, and hearing loss in my left ear. My right ear is normal. Tinnitus is continuous for past four months. I do not have any vertigo or dizziness episodes. Please tell me is my symptoms of Meniere's disease. Please tell me the cure for ear fullness."
},
{
"from": "gpt",
"value": "Hi. I have seen the reports (attachment removed to protect patient identity). There is minimal loss in the left ear. The symptoms do not seem to be due to Meniere's disease. The tinnitus is due to the hearing loss. Take tablet Cinnarizine 75 mg once daily for 15 days and tablet Vitamin B12 1500 micrograms once daily for 15 days. You will definitely be benefited. Consult with your doctor before taking them. Avoid any excess mobile usage or earphones use. Take care. For more information consult an ENT otolaryngologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,This is regarding a male aged 48 with high blood pressure, diabetes, sleep apnea, and overweight. He has muscle spasms or shakes, drops things because of this, cannot stay awake during the day. It affects his driving and family life. He can nap for a few hours and when he gets up falls asleep on the chair, dozes off during a conversation, eating, and sometimes while standing."
},
{
"from": "gpt",
"value": "Hello. It is clear that he has obstructive sleep apnea which causes interrupted sleep during the night due to obstruction of the nasopharyngeal air flow. As a consequence, he becomes sleepy in the daytime. Confirmation of the diagnosis requires: Has he done any of these tests? CPAP (continuous positive airway pressure) is helpful in relieving the symptoms. Also, reducing the weight is very helpful. For more information consult a general medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 16-year-old female. My weight is 85 kilograms, and I have a height of 5 feet 3 inch. I have excessive daytime sleepiness for the past three years. It got started in me before three years, and my parents took me to the local GP immediately. They did blood tests and told that I have iron and folic deficiency. But I am still suffering even after the deficiency is gone. I always get sleep during the daytime. I try myself to stay awake for daily activities. I struggle extremely. It is interfering me in my day to day life. When I go to GP, they keep recommending me blood tests. I need a solution for my problem. Please help."
},
{
"from": "gpt",
"value": "Hi. You have obstructive sleep apnea. Please say about other symptoms whether you had snoring, interrupted sleep, unrefreshed sleep, and morning headaches. If you had these symptoms, it supports the diagnosis. It is a condition characterized by obstruction of upper airway especially during sleep due to narrowing of airway due to obesity. Obstruction of upper airway leads to temporary stoppage of respiration, increased sympathetic drive, and increased pulse rate. Also, another reason for pulse rate rise is deconditioning as you are not accustomed to activities. You can do ENT examination if you have nasal stiffness, and recurrent tonsillitis to rule out the nasal causes of obstruction. You can also do a thyroid function test, lipid profile, sugar, Hba1c, vitamin D, and polysomnography. Polysomnography is a sleep study used to confirm the diagnosis and to know the extent of the disease. CPAP (continuous positive airway pressure) is needed. You have to reduce weight. It is the first line of treatment. You need to have low fat, and a low-calorie diet to lose weight. Secondly, CPAP is a mask and device, and the pressure during inspiration and expiration during sleep keeps your airways patent and avoid this from happening. Also, regular exercise is essential. Chest physiotherapy and yoga will be helpful. So you can follow these steps, or you can visit a nearby sleep specialist or pulmonologist."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am wondering about the connection seen between my excessive fatigue or sleeping issue with cardiac insufficiency. I have excessive sleepiness due to mild sleep apnea. But I have a strange disconnect regarding exertion. Even, a slight anaerobic activity reduces my breath and it takes time to have a standard respiration rate. When I use an elliptical machine, I have trouble in getting my heart rate up to 110 beats per minute. However, when I take Vyvanse, I can easily hit a heart rate of 125 beats per minute. I recover immediately after stopping it. I have a blood pressure of 130 by 88 mmHg. Currently, I am taking Enalapril, HCTZ, Amlodipine, Levothyroxine, and Prozac. These problems preceded my daily alcohol intake and minor cannabis use. Please suggest."
},
{
"from": "gpt",
"value": "Hi. Yes, daytime sleepiness occurs due to sleep apnea. If it is present in its severe obstructive form, it can cause a host of cardiac diseases like atrial fibrillation, coronary artery disease, and heart failure. The exercise intolerance initially develops the consequence of early heart failure. Also at your age, you may be suffering from chronotropic incompetence, that is, the inability to increase heart rate with exercise, and regular graded exercise will help you. Stay off from alcohol and cannabis."
}
] |
[
{
"from": "human",
"value": "Hello, I'm looking and would like to discuss my treatment options for my conditions. I've bipolar disorder II, social and generalised anxiety disorders, panic attacks and agoraphobia due to it. In past, I used escitalopram, venlafaxine, fluoxetine, sertraline, lithium, depakote, quetiapine, risperidone, anxiolytics. Venlafaxine was effective but had to discontinue it due to high blood pressure it caused. Other treatments mentioned didn't work for me. Anxiolytics worked, but now i don't have such options to continue this treatment because I'm getting used to Tranxene. Currently I'm taking Lamictal 200 mg and 10 mg olanzapine. I am afraid to go out from my flat, I am constantly alarmed, nervous, anxious, can't eat because of constant lump in my throat. Anxiety is debilitating, I can't work outside my home. At work I get so anxious that I have to take some free days from work, if I don't do that, I vomit from this anxiety. 1) Can duloxetine be effective? Is it common that it can increase pulse and blood pressure as Venlafaxine did? 2) How long does it take for escitalopram to take effect? 3) Can prozac decrease anxiety? 4) Is paroxetine an good option for me?"
},
{
"from": "gpt",
"value": "thank you for taking help from psychiatrist. you should continue medications on which you are stable at present. 1)duloxetine may be good option for you. it does not increases blood pressure. 2)tablet escitalopram takes around 4 weeks for full effect after starting medications. 3) yup,prozac can decrease anxiety but it belongs to same group as tablet escitalopram. 4) yup,paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine. you should follow below advice which can help your anxiety. hope you get your answer. thank you"
}
] |
[
{
"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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am feeling tired for a couple of weeks. I do not have the feel of sleeping. I cannot completely open my eyes in the morning. I have a headache and neck stiffness. I went to a urgent care as I had chest pain, they did an ECG and blood test and told me that there is nothing to worry about heart and they told, I may have GERD and gave me some acidity medication. I had a follow up with an ENT as I was having a headache. The ENT doctor told me that I have a sinus infection. I took antibiotics given by the doctor for seven days to get some relief but, still, there is tiredness, feeling of sleepy and some discomfort in my throat and neck. Three years back, I used to have acid reflexes and I used to cough a lot so I developed tonsils. I am not sure what is causing headache and tiredness? Is this anything to do with brain stroke or gastro problems? This is causing a lot of anxiety and stress for me. Currently, I am taking Amoxicillin, Fluticasone, Prednisone, Ranitidine tablets."
},
{
"from": "gpt",
"value": "Hi. It may be due to sleep apnea or obstructive sleep apnea. Frequent awakening while sleeping that is unidentifiable to the individual himself causes all the discomfort. It is a disease where we cannot sleep well and we will feel uncomfortable and lazy, you will have no energy and daytime sleepiness is very common. GERD can be a chronic issue. It also adds to the symptoms especially as you have head and neck issues. I can see you are already taking some medications for this. If there is no benefit, consult a Gastroenterologist soon. For evaluation and assessment, consult a sleep apnea doctor who would run a lot of tests after careful examination. For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have obstructive sleep apnea and using CPAP for a year. I feel chest pain in the mornings. The same kind of pain is felt whenever I sleep without the mask. My BP, sugar and ECGs were tested before six months back and they were normal. What is the cause and remedy?"
},
{
"from": "gpt",
"value": "Hello. For further information consult a pulmonologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, The patient underwent extensive routine physical examination including MR/CT imaging and laboratory analysis earlier this month. The MR Brain shows evidence of lacunar stroke and ischemic brain changes. Please advise if these might be connected to untreated obstructive sleep apnea (more than five years). If so, some recent research indicates that these cerebral changes might be partially reversible with CPAP treatment. Please let me know your professional opinion and suggested investigations and/or treatment."
},
{
"from": "gpt",
"value": "Hello. I carefully went through your question and the patient's medical history. I reviewed her medical report and the uploaded brain MRI study (attachment removed to protect patient identity) and would explain that those changes are indicative of small vessel disease, which means chronic gradual blockage of small vessels inside the brain. I agree with you that untreated sleep apnea, for such a long time, can lead to these brain changes. On the other hand, you should know that other risk factors such as uncontrolled high blood pressure, dyslipidemia, diabetes, age, migraine if present, smoking contacts, obesity, sedentary life, etc., also contribute to these changes, besides sleep apnea. Unfortunately, these brain changes are irreversible. This means that adequate treatment of sleep apnea and a better control of blood pressure values or blood lipid profile, will not make them vanish. But, all these measures will help stop the progression of this disorder and prevent further changes to the brain. You should know that sleep apnea is a known cardiovascular risk factor, which means that it contributes to uncontrolled hypertension and atherosclerosis process (generalized narrowing of blood vessels in the brain, heart and other organs). So, I am sure the CPAP (continuous positive airway pressure) device will help stop the progression of these changes. These brain changes in later stages can lead to dementia and depression or gait disturbances. That is why, it is necessary to keep under control all the above-mentioned risk factors (including sleep apnea), in order to stop the progression of this disorder. I would also recommend checking fasting glucose and blood lipid profile every six months, to be sure that she does not suffer from dyslipidemia or diabetes. It is also advisable to take daily Aspirin of 80 to 100 mg (if there are no contraindications to this drug), in order to prevent the progression and further small strokes in the future. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope you will find this answer helpful. For more information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 53 year old army veteran, served for 33 years, who was diagnosed while serving in the army with chronic granulomatous disease and sleep apnea. When I filed a Veterans Administration (VA) claim, the VA rated me for compensation but combined the ratings into one rating. This means that the VA is saying that granulomatous disease caused the sleep apnea. All of my research indicates these two medical diagnoses are completely independent of each other and have no impacts on each other. I am looking for a medical opinion to support my research so that I may submit it to the VA so I am rated separately for each diagnosis."
},
{
"from": "gpt",
"value": "Hello. Chronic granulomatous disease (CGD) is an immunodeficiency condition where the white blood cells cannot fight the pathogens effectively which cause different types of infections. As for sleep apnea, it is caused by narrowing of the air passages mostly in the nasopharynx area which cause interrupted night sleep, usually the cause is obesity in short-necked persons or hypertrophied uvula. There is no relation between both except in very rare conditions (Kimura's disease) where CGD causes hypertrophy of the larynx. Please provide me with some photos of your neck and inside your mouth to see if there is hypertrophied uvula. Sleep apnea is usually associated with hypertension and severe headaches. Do you have any of them? Revert with more information to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have white itchy spots on my penis and on its skin inside. Kindly help."
},
{
"from": "gpt",
"value": "Hello. I understand your concern but there is no attached photograph in your message. I need to see the picture of the affected area to make appropriate diagnosis and to suggest you the appropriate treatment. Kindly send the same."
}
] |
[
{
"from": "human",
"value": "hi. I am a male aged 52yrs weight 80kg diabitic my doctor has recently advised me gabapentin nt 400 for neuropathy earlier i was on pregab150 so while checking about the reviews from the patients on net i found that 99% were against gabapentin which confused me and thought to have a 2nd opinion kindly advise"
},
{
"from": "gpt",
"value": "Hi. Welcome to icliniq. I am Dr Anshul Varshney for your help. It's an excellent drug. Infact it's an elder sister of Pregabalin only. Gabapentin is little more potent then Pregabalin. Only possible side effect of that drug is dizziness but since your mother has been on Pregabalin 150 mg then Gabapentin should suit her. Gabapin NT also contains Nortryptilline, which helps further in neuropathic pain. Dear, if you will check side effects / reviews of any drugs you would get for all. If in doubt, discuss with your doctor once again being empathetic. I use this drug very often and most of the Diabetologists use it. So, I would suggest you to start it and see if she gets any adverse effects, we can go for other options. Though to be very honest we don't have much options other then Pregabalin or Gabapentin in Diabetic Neuropathy. I hope it helps you. If you have any further questions please ask me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, A 23-year-old male patient hit with bike accident, fell on back side of head, CT scan reports reveals mild cerebral edema, with some facial fractures, currently patient is having blood clots discharge as post-nasal drip, and not associated with headache, dizziness, seizures, fainting, etc. Please let me know the cause for blood clots discharge as post-nasal drip and is mild cerebral edema complicated?"
},
{
"from": "gpt",
"value": "Hello. I have read your concern. You might be worried of the cerebral edema if this will cause any harm. A repeat 48 hour CT scan if with any signs of wakefulness deterioration is warranted if that ever happens. The blood clots is a sequelae of the trauma to the face. Most commonly this is part of the superficial veins near the nostrils called keisselbachs plexus. This will heal. Give it 2 to 3 days until it gets crusted by itself with the help of the antibiotics to lessen chances of infection. If the CT scan is normal other than the mild cerebral edema is seen, then no further medical and neurosurgical procedure is needed. The zygoma fracture and orbital fracture is also not worrisome if does not cause any deformity (like a protruding bone), and does not need any procedure for it if it does not obstruct your visual field or puncture the globe of the eye. I agree with antibiotics and saline spray three times a day. It would also help taking some Ibuprofen to lessen the inflammation and swelling, if taken every eight hours."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I daily take Pristiq antidepressant tablet 50 mg, which doctor had prescribed since a year. Now I am tapering the tablet gradually as per doctor's instruction. The first week every other day and second week every two days and the third week every three days. And now this is my fourth week, and I am off completely. So my question is, can I use 5-HTP supplement tablet? So that my withdrawal symptoms will be less. And when I can take 5-HTP? Withdrawal symptoms are scary to me, and I want to completely stop this Pristiq because I tried many times to get it off, but unfortunately, I cannot. I had withdrawal symptoms, brain zaps, nausea, and diarrhea. I have some supplements like fish oil, b12, and 5-HTP but still waiting for a doctor advises."
},
{
"from": "gpt",
"value": "Hello. As you are tapering your Pristiq (Desvenlafaxine), there will be no withdrawal at all. You need to restart because of anxiety or depression disorder, not because of withdrawal. 5-HTP (Hydroxytryptophan) is not FDA approved and no guideline for it to how to use and when to use. It is a supplement product, but not a medication to treat. You should follow depression and nonpharmacological management. Do exercises daily for 30 to 45 minutes like walking and practice meditation for 20 minutes daily. Eat healthy home cooked foods, avoid junk foods. Spend quality time with friends and family every day. Spend time for creative hobbies like reading good books, writing journals, painting, drawings, and learning new skills or language or musical instruments. Have enough of 7 to 8 hours of sleep daily. Avoid tobacco or alcohol or any substance abuse. Live your life, do not just spend it. Be bold and confident."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My son who is 11 years old now has a undescended right testicle. Ultrasound determined that it was in the inguinal canal when he was 8 years old. We have been waiting for it to come down, but it has not. Does the surgery to correct the testicle improve fertility? Or does it lessen the chance of malignancy? I would like to monitor through ultrasound. I am wondering what your thoughts are on this course of action."
},
{
"from": "gpt",
"value": "Hi. I suggest that surgical correction should be done to bring it down as low as possible. Reason being, it permits self palpation of testis for early detection of any tumor. Frequent ultrasound is not feasible or practical to think of. Self palpation can be done every day. Ultrasound cannot be done every day. Surgery is a minor one. If it is already shrunken, in my opinion the surgeon may suggest removal of it. Do not be afraid and go ahead."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My son is 20 months old. In polio campaign he was given 3 drops of OPV instead of 2 drops. I am worried about the extra drop given. I could not find any recommendation of WHO or UNICEF for minimum and maximum dose of OPV drop in the internet. Please help me in this matter. Thank you."
},
{
"from": "gpt",
"value": "Hi. An extra drop of OPV (oral polio vaccine) should not cause him any problem. These are live attenuated vaccine and thus virus does not cause any illness. Case report of them are very rare and usually with faulty vaccine preparation. Also, this was his booster dose. It would only help in giving immunity to polio."
}
] |
[
{
"from": "human",
"value": "Hi doctor, Just recently I have noticed some weird breakouts around my chin area. I am not sure when they started. While I do from time to time experience acne, I do not think what I am experiencing on my chin is not an acne breakout. Because there is no white head or black head present. They are not popable. The only change in my diet is I have been enjoying an occassional glasses of wine after dinner. I have also started eating mozzarella cheese, which I have not eaten before. Thinking that it was perhaps linked to hormones. I have restarted birth control three days ago after a 4 month hiatus. Please help."
},
{
"from": "gpt",
"value": "Hi Welcome to icliniq.com. I have reviewed the attached photographs (attachment removed to protect patient identity) and according to me they are papular lesions of acne. They are not blackheads or whiteheads. I would recommend you to continue with the birth control pill besides applying Benzoyl peroxide 5 percent gel on the pimples twice daily. Follow some tips to avoid pimples such as keep your face dry, avoid applying oily creams and moisturizers, avoid oiling of scalp, use cosmetics labelled as non-comedogenic and reduce the intake of sugary foods. 1. Hormonal disturbances. 2. Seborrhea. Acne vulgaris."
}
] |
[
{
"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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "i have blood in my stool but no pain . I m suffering from externally piles. But there is no itching nd pain in that.. Almost from a week blood is regularly going through out stool..."
},
{
"from": "gpt",
"value": "Hello. I welcome you to icliniq. The external hemorrhoids can cause bleeing and pain when they are enlarged or secondrary to constipation which produces an abnormal pressure over anus causing swelling of piles. The definite therapy is surgery, however if certain lifestyle modification are employed the anal hemorrhoids can reasonably be controlled. These life style modifcations are I hope this will solve your problem. anal hemorrhoids as above can follow up after 7 days of treatment"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I recently went off my medicine Celexa, that I was taking on for over 10 years. I went through a lot of trauma in the past 4 years. I was just starting to do better and was using natural supplements. 5 months after going off medicines, I moved to a different town where I had to look for a new job and stress from all that and being triggered by previous events from past put me in a lot of stress. I suffer from PTSD, anxiety and depression. I went back on Celexa few weeks ago and had severe reaction. I even lowered the dosage and still had bad reaction. So, GP switched me to different medicine. I am now on Effexor 75 mg. My doctor does not feel comfortable dealing with my psychiatric medicines herself. Hence, I have been on 5 week wait list to see a psychiatrist and been on 75 mg of Effexor for just over 2 weeks. Anxiety has subsided slightly and I am no longer vomiting due to anxiety or having any chest pains. But, I am scared all the time and have worried anxious thoughts all the time because of which I cry, and my appetite has decreased. I feel very hopeless and lack energy. I do not know how I can deal with all this. I am feeling isolated from my friends and supports where I used to live. Hence, having hard time finding a place to live where I was before. I am not having any idea if these medicines are working and no one to properly monitor them. I am feeling very desperate and scared. Please help."
},
{
"from": "gpt",
"value": "Hello. I have gone through your query in detail. I can understand what you are going through and you have my sympathies for the same. Though your mental health is quite disturbed right now, you have many reasons to be optimistic as far as your anxiety, depression and post-traumatic stress disorder is concerned. First thing being, that you were doing good on high dose Celexa (Citalopram), which means that your illness responds, once you have attained sufficient dose of a suitable drug. Secondly, currently your anxiety symptoms have reduced to some degree, but there are remaining symptoms which are because of depression (anxiety itself could be a symptom of depression to some extent). You might experience some anxiety initially when increasing the dose. For which you can take tablet Ativan (Lorazepam) when necessary. Once your depression improves, you will find a lot of your problems disappear on their own as they are directly or indirectly related to depression. Take care. Life stressors and changes. Major depressive disorder or PTSD or generalised anxiety disorder (GAD). Optimization of the dose of current medications."
}
] |
[
{
"from": "human",
"value": "Hi doctor, Three years back, I had headache and head numbness for few days. I consulted a doctor and got a thyroid test done. That time my TSH was 3.7 and he prescribed me Thyronorm 25 mcg. He told me to discontinue it when my TSH level comes back to 1.5. Now, for around 11 months I am having body pain, hand numbness, dry and itchy skin, hair fall, rashes on neck and hands and bowel movement issues. TSH - 4.58, total T4 - 7.50 and total T3 - 0.91. This is my recent thyroid result. Apart from these all the blood and scan reports are normal. I have left side back pain also. But, still the doctor says that the thyroid results are normal. Please help me."
},
{
"from": "gpt",
"value": "Hi. Your symptoms fit into thyroid disease but your thyroid report is absolutely fine. A normal thyroid report rules out thyroid disease, unless you are presently on Thyronorm. So, we need to find other cause for your symptoms. Body pain and numbness could be due to nerve problems, vitamin B12 or D deficiency and diabetes. Your reports say that you are not having diabetes. But, I do not see any tests done for vitamin B12. So, kindly get the vitamin D tests done and revert back with report. Hair fall could be due to hormonal imbalance or due to stress. Is there any kind of stress in your life? I recommend you to get serum testosterone and serum DHEA (Dehydroepiandrosterone sulphate) levels tested and revert back with report. Regarding rashes kindly upload the picture so that I can give better opinion on that. You mentioned about bowel movement issue. What exact problem you have with bowels? Constipation or loose motions? Kindly revert back with the details asked."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My father, aged 70 years, lost five kg of weight in two to three months. Usg and CECT confirms a right renal mid-lower polar well defined large 11.3*10.6*12.0 cm soft tissue density homogeneously enhancing mass with internal regions of non-enhancement is observed with no obvious calcification or fat content. The lesion appears to be containing renal fascia with increased peripheral vessels likely mitotic mass lesion of the right kidney (RCC). The right renal vein and IVC is patent. The mass is seen to indent the right psoas muscle, but a flat plane with the adjacent structures is nearly maintained. The urine test and renal functions are normal, and there is no evidence of metastasis. Kindly tell me if it is benign or malignant, and what are the possible line of treatment? Please help."
},
{
"from": "gpt",
"value": "Hello. As per the report, it is renal cell carcinoma (RCC) and it requires further evaluation. In the treatment of RCC, first of all, surgery is needed to remove the tumor and if required the kidney too. Then after confirming the diagnosis on histopathology, chemotherapy, or radiation is required. Please consult an oncosurgeon immediately. I hope it helps you. If you have any further queries, please ask me."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My son is 5 months old. He can hold his head during tummy time and turn his head in both directions. But when we make him sit, he usually looks in one direction. He has a flat head on one side. Does this mean he has torticollis?"
},
{
"from": "gpt",
"value": "Hello. A child with torticollis will not be able to make much neck movements at all, in any direction or position. The very fact that the child can look in both directions during tummy time is suggestive of the child not having torticollis. As regards to the flat head, some kids have it but do not worry. Also, with regards to the child looking in one direction only while sitting means that the child requires a little bit more strength to turn his neck (which should develop with time)."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 22 years old and I have blurred vision in my left eye. It started when I was 17-years-old. I also have an allergy in my eyes. I consulted with the doctors, and they suggested lasik surgery for me."
},
{
"from": "gpt",
"value": "Hello. If you have allergy problems, then you are not an ideal case for any refractive surgery procedure like Lasik (laser-assisted in situ keratomileuses). First of all, the actual cause of blurred vision is needed to be diagnosed, whether it is a refractive error or you need glasses. Then to get rid of glasses Lasik is one option. But if your cornea is affected due to allergy (allergy can affect cornea) and the clarity is changed, then Lasik might not help. So you need to get an eye examination from a specialist and then get diagnosed for the exact cause of blurred vision. You can send your prescription if you already have consulted to an eye specialist. Then we can discuss the appropriate treatment option for that cause. You are welcome for any queries."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had a miscarriage at 5th weeks before a month. I did a pelvic ultrasound, and the doctor said everything was fine. I would like to know the possible cause and how to avoid them? As I am ready to try for a baby again."
},
{
"from": "gpt",
"value": "Hello. First trimester miscarriages are very common, and mostly they are due to underlying abnormalities in the baby which are not diagnosed on ultrasound, and the most common cause is chromosomal abnormalities. So nothing to worry about and you can try for your next baby and keep taking folic acid meanwhile. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have several questions. Please clear my doubts and tell whether they are myth or fact. Is masturbation harmful? Is hair fall associated with masturbation in any way? How frequent can one have sex? I am having sex with my partner daily and even twice a day sometime. Is it harmful? When I do fast, I ejaculate in some 3 to 4 minutes and I am not able to satisfy my partner. Am I suffering from PE? If yes, then what should I do? Is it necessary to pull the foreskin back before inserting my organ? I have only one partner and she is also loyal. Is there any issue with unprotected oral sex? We have been doing unprotected oral sex for the last 8 months and there is no problem so far. Is it harmful if we do anal sex? Thanks a lot in advance."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 29 years old. I am suffering from itching genitalia for over 5-6 years and the severity would range from low to medium. It is mostly due to sweating in that area. I used to apply itch guard for a few days and it used to get fine. Now, over four to five months I have severe itching on my genitals that is in the penis, testicles and also the area below. I am using Candiderma powder frequently. But, when the problem increases I apply Quadriderm ointment at night for 2-3 days. There is also a lot of flaking and cracking of skin. I have attached the pictures of it. I usually end up itching while sleeping too. What can be the problem? What medication and precaution should I take?"
},
{
"from": "gpt",
"value": "Hi. Your problem seems to have lingered on to become a chronic hyperkeratotic scrotal eczema. This is a result of your hyperallergic tendency, constant scratching, sweat induced maceration and intermittent but incomplete treatments with suboptimal medicines. Till you revert with the answers, I advice you to do the following: 1. Sweating. 2. Tight undergarments. 3. Constant scratching. 4. Application of inappropriate creams intermittently. 1. Blood sugar levels fasting and postprandial. 2. Serum levels of IgE antibodies. Follow up in two weeks with pictures to a dermatologist online.--->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I did an abortion seven years before, and I have not got any complications since then. But I was reading about the perforated uterus, and now I am worried. I do not have any medical issues, and my concern is that I am getting scared I might not be able to conceive again."
},
{
"from": "gpt",
"value": "Hello. Thanks for sharing your concern, and it is quite understandable. Uterine perforation usually occurs if abortion is being performed by the use of sharp instruments and vigorous curettage. If the abortion was undertaken with medicines only then, there is no such chance of perforation. Secondly, if perforation was being there, it might have caused your symptoms like pain, fever, bleeding, etc., if it was of considerable size. So if there was not any problem after the abortion at that time, it means that there were no complications associated with it. So you need to relax now as there is nothing to worry about your fertility. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had a cold sore arising on the border of my top lip and tried to stop it with alcohol and tea tree oil. The sore did not form, but I was left with a burn from the oil, and I pulled off the burned skin, leaving a small circular open wound. After healing, it started pink, but now it is whitish and sunken. It is hard to cover with makeup. This happened about three weeks ago. Will this heal back to normal skin color? If so, what can I use on it to even it out and speed up the process? The hole is tiny, like the size of a pimple."
},
{
"from": "gpt",
"value": "Hello. I have gone through your case. First, you need to understand that it is normal skin response to heal with either hyperpigmentation or hypopigmentation (white color as in your case) whenever it gets trauma (burn or insect bite). Most of the time, lesion heals within four to six weeks. But if the wound is depressed as you have described then it means the scar is formed and unfortunately such injuries are sometimes permanent, but still, some do show response to the laser treatments. Please always try to send a picture for opinion. My advice is according to your description."
}
] |
[
{
"from": "human",
"value": "Hello doctor I have history of Thyroid and PCOS, i am taking 50mg of eltroxin. my period is delayed by 6 days .when I tested preganacy test after 4 days of period days two lines are showing but not clearly. please suggest me can I go to doctor for a checkup or wait for 1 week for clear result. or what type of precaution I should take during pregnancy?"
},
{
"from": "gpt",
"value": "Hello, Welcome to Icliniq. I see than you haven't mentioned the date of your last menstrual period. Ideally, if you have had a regular 28days cycles, the urine pregnancy test is usually positive by the time you skip your periods. Delayed ovulation can be common in PCOS, So, I would suggest you to recheck your home pregancy test with an early morning urine sample tomorrow, and exactly at the time interval at which the result has to be read as mentioned on the kit. Sometimes if seen very late , the evaporation line also may seem as faintly positive which is actually a false positive. Early morning urine sample is supposed to be having concentrated levels of the Beta HCG hormone which is detected on the pregnancy kit. So recheck again tomorrow with a morning sample of urine. If you donot have any pain or spotting, you can visit your Gynaecologist at ease, may be in a week, and get an ultrasound done for pregnancy viability and localisation. Meanwhile continue taking folic acid & Eltroxin Medications & recheck your thyroid levels as during the pregnancy the dose may have to be changed due to increased requirements in pregnancy. Hope this helps. Please feel free to revert back anytime for any further queries or Information. - Continue Tablet Folic acid 5mg daily once till 14weeks. - Continue Tablet Eltroxin 50mcg daily once. - Avoid sexual intercourse in the first 4months of pregnancy."
}
] |
[
{
"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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Having painful sex six weeks postpartum and five weeks after my obgyn had to suction blood out of my uterus because my cervix closed too soon. Wondering if this is normal or if I should set up an appointment to be checked out. I am female, 23 years old. I am 5 feet 9 inches tall and weigh 300 lbs."
},
{
"from": "gpt",
"value": "Hello. Yes, it is normal, sometimes body takes a little longer time to heal especially if there was instrumentation being done with the uterus. If you do not have any pain otherwise or any never, discharge or excessive bleeding then you do not have to worry. It is just that your body is not ready yet to bear sex. I would suggest you to wait for one more week or so and see how the condition stays and even then it is the same then please do not forget to book an appointment with your local doctor."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Last one week, I am having issue with my erection at bed time. I am 35 years old. Please suggest me some medicines to be taken at bed time to make a relation with my wife without any problem. I am feeling very bad at bed. I have used an oil one week ago. Since then, I am having erection problem. Please suggest me some curable medicines right now."
},
{
"from": "gpt",
"value": "Hello. Eerectile dysfunction has many causes and I would suggest you to get yourself fully assessed by some local expert before proceeding to further management and avoid self-medication. Now coming towards your problem, erectile dysfunction can be caused by diabetes, hypertension, anxiety and high cholesterol even and with increasing age and heavy smoking. So if any of these is the case with you? If yes, then you have to first eliminate those factors first. Maintaining a good diet and exercise may help resolving the issue. Thirdly, a product known as Natural Viagara is available in market. Its safety has been approved so that can be used as well but it will not relieve the actual underlying cause which is utmost important to consider."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I think I have ADHD. I am a teen and cannot go to a psychiatrist as my family does not believe me when I tell them and even claim I pretend to have the symptoms. I think there is something wrong with me and want to know."
},
{
"from": "gpt",
"value": "Hi. To answer your question regarding ADHD: Most people with ADHD will have displayed signs and symptoms of the disorder from a young age, usually before 12 years old. In this case your ADHD will usually have been noticeable and picked up by teachers or parents at a younger age. However, many cases can be missed and only picked up later. In this case I recommend referral to a general practitioner who can more reliably assess the situation. A referral to a psychiatrist can always be made, if necessary. This is also bearing in mind that there can be multiple reasons why you might find difficulties concentrating. Therefore, it is better to proceed slowly and start with a GP consultation before jumping into any treatment of ADHD which can involve powerful medications that can have serious side effects. A screening test for ADHD like the Conner’s test filled in by both the child’s teacher and parents. To be seen for a thorough examination by a family practitioner. If there is evidence of potential ADHD, then referral to a psychiatrist or child and a dole scent psychiatrist would be the next step. As per the findings of the GP or psychiatrist. The young patients symptoms should not be completely ignored and a proper thorough investigation should be done in order that something potentially serious is not missed."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am writing a fiction novel about scientific abnormalities. I think there is no better professional than a doctor to ask this. What would happen if a tumor is left untouched in a human? What happens after the tumor takes over their life? Would it eventually conquer all of the victim's body? What would be the end result? Would it count as a separate organism once it overtakes the body? This question is not meant to disturb your work, it is only for the development of ideas. If you find this question unethical or offensive please ignore it."
},
{
"from": "gpt",
"value": "Hello. Tumor basically consists of cells with unregulated capacity to multiply and spread. So, if tumor is not removed, then its size keep on increasing. Also, it spreads to different organs through blood and other tissues, and occupies other organ as well. So, normal tissues or organ throughout the body is invaded by tumor cells which cannot carry out the normal function of the organ, so organ failure ensues. So, one organ failure leads to other and eventually heart stops and person dies. So, human body is invaded by cells which causes dysfunction in the body and eventually body stop working (means death) before going ahead. But, we cannot consider it as separate or new organism because new cells are not functional and cannot form organs to make a new organism. For imaginary purpose, you can think in a way you mentioned of transforming or replacing one individual with other or person who has acquired some new characteristics due to tumor cells, etc., but does not occur in reality."
}
] |
[
{
"from": "human",
"value": "Hi doctor, This is really nerve racking but I noticed these growth on my shaft (fold area) that are very small and round. They tend to itch quite often especially when touched. I have attached a picture. I am afraid it could be genital warts. I last had sexual encounter with a female escort earlier this month. We kissed, rimmed her anus and I used condom for vaginal sex."
},
{
"from": "gpt",
"value": "Hi. The last picture shows a genital wart-like lesion (attachment removed to protect patient identity). They are treatable too, they would require a physical ablative therapy like cryotherapy or radiofrequency removal, which can be done in a skin clinic. Warts are not usually itchy. If you have itchy, scaly lesions, better to complete an antifungal treatment and then go for wart removal."
}
] |
[
{
"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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have hard erections for a long time, and I have to take Viagra to have sex. After having Viagra, the problem is that I have a mild headache. I have been searching for some herbal supplements for long and do not know whether they are safe or not. Could you please suggest a more sustained therapy. I am not having any other medical issues other than once I have had a kidney stone."
},
{
"from": "gpt",
"value": "Hello. According to your complaints, you may have erectile dysfunction (ED). Reason for erectile dysfunction includes, 1. Decrease sensation of the penis that can be due to infection, diabetes, spinal injury, and recent masturbation. 2. Stress due to work or family related and night duties. 3. Depression, varicocele, homosexuality, and religious constraints. 4. Fear of failure - having one episode of ED once may make you feel you will end up with ED. 5. Low self-esteem (chronic masturbation). 6. Long term illness like cardiac disease, thyroid disease, kidney disease, and any other disease with long term medication. 7. Negative attitude towards your partner. .8. Hormonal issues like a thyroid issue, low testosterone. 9. Long term drug usage. 10. Diabetes and hypertension. You have to check doppler penis, USG pelvis and scrotum, blood pressure, RBS (random blood sugar), Free T3, T4, and TSH (thyroid stimulating hormone). Share more details regarding the above reasons, after which we can work on diagnosis and treatment. Yes, Viagra (Sildenafil) can cause headache, but regular use will not have that effect. It can be used for temporary purposes. Identifying the cause and treating it will help you. Regarding herbal medicines, it depends on the company that makes it."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have been suffering from alternate loose stool and constipation, with the feeling of incomplete evacuation of bowel with abdominal pain for the past five to six months. I feel it is IBS. Kindly guide."
},
{
"from": "gpt",
"value": "Hello. Indeed, your symptoms seems to be IBS (irritable bowel syndrome). However, further consultation with a gastroenterologist, running colonoscopy, and abdominal ultrasound are highly recommended to rule out organic problems first. Stool analysis, culture, and sensitivity testing are recommended to rule out candida overgrowth or other infectious diseases. With regards to treatment strategy, until you get the tests reports, I can only suggest to,"
}
] |
[
{
"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": "gpt",
"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 suffering from depression. I am having feelings of mild depression, but I do not know if I am actually depressed, but here is a bit of my life since I was a boy. I lost my mother when I was very young and did not have any memories of her. I grew up with my dad and my siblings, but I have always felt different, alone, cursed, and forgotten as nothing seems to work for me. Never felt loved, my dad was addicted to alcohol and, and most of my family members abandoned me till date. I struggled with the feelings of worthlessness daily as I grew up. I have little or no friends as I grew up, I had a lot of suicidal thoughts. My self-esteem was too low, had a dislike for myself, not able to express myself. I am short-tempered and a little caring same time. When I was 20, my feelings got worst, and I cried every day at night. I have extreme mood swings because when I am around people, it seems I am happy, but when I leave, I return to my hole. Kindly help."
},
{
"from": "gpt",
"value": "Hello. You have described facing several adverse childhood experiences like losing your mother, and indifferent father addicted to alcohol and lack of loving support while growing up. These adverse life events could have potentially affected your feelings like, making you feel low, affect your self-esteem, and cause suicidal thoughts. Anyone in your situation would have probably felt the same. It is good to know that you had some support from a friend before. It is important not to isolate yourself when you are feeling like this. Try to meet supportive people regularly. If you are in education or doing a job, try to speak to a senior person and see whether they can be a mentor to support and guide you. If you are spiritual, try visiting holy places regularly if you find it helpful. You have said that you feel happy when you are around the people and low again when lonely, this is understandable. People feel better in practical social situations. You will also benefit by consulting a doctor who can do a full assessment of the nature and severity of your symptoms, and it will clarify whether you have clinical depression. Try to speak to your friend and family and make sure you get help. You may need some counseling support or therapy to help you move forward in life. Equally important is self-help measures like eating healthily, sleeping well, exercise regularly, keeping yourself gainfully occupied, and having positive social relationships."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Five months old baby suffered from loose motion and fewer doctors gave Ofloxacin 50 mg and Flagyl 200 mg syrup. They told to give 3 ml three times a day, each syrup for 5 months old. Is this dosage correct?"
},
{
"from": "gpt",
"value": "Hi. The dose specified above is too much and unnecessary for a child so small as 6.8 kg. It is advisable instead to just give the child Enterogermina 1 capsule twice a day for five days along with ORS with the passage of each loose stool. As for the fever, you can give syrup Crocin (125 mg/5 ml) 3.5 ml (six hourly) if temperature is above 100 F. Also, give ORS 70 ml with passage of each loose stool. Watch for dehydration. If worsening, please show to a pediatrician."
}
] |
[
{
"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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Four months back, I had protected sex with a massage girl. She gave me body to body massage, and then performed oral sex and vaginal sex while I was wearing a condom. I was wearing a condom throughout the whole time.There really was no kissing. Maybe one or two kisses on her neck. Some skin to skin contact. 1. What are my risks for contracting a STD (specifically which ones)? 2. What are my risks for contracting other STDs? I am tested HIV after 4 and 12 weeks with fourth generation test CMIA method, it is negative. 3. A small bean size cyst or lipoma is existing from three months onwards and still exists. Is it related to any STD?"
},
{
"from": "gpt",
"value": "Hello. Skin to skin contact can lead to genital warts and genital molluscum contagiosum in the area of direct contact, which are viral infections. I cannot quantify the risk exactly but can tell that you will get these only if she had these active lesions at that time. No chances of HIV, syphilis, hepatitis, if no mucosal contact or blood contact. You need to send me the photograph of any skin lesion to comment on that. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have been depressed since a few months and I want it to end. I am really tired of it and I feel like I am a failure. How can I get through depression?"
},
{
"from": "gpt",
"value": "Hello. Do not worry, treatment is possible. Daily excercise and a balanced diet rich in antioxidants and omega fatty acids is known to help. Share your feelings with family and close friends as sharing helps a lot. Meditation daily for at least half an hour in the morning helps you relax and eases your anxiety. Consult a psychiatrist in person for detailed evaluation and treatment."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 34 years old, male and I am suffering from high BP and my creatinine level is 1.57. I am daily walking, my ankles are swelling once I get up from bed. So, now I have stopped. If I have to walk, up to how many kilometers can I walk, what kind of food I should take, whether this disease is curable? Please give me suggestion."
},
{
"from": "gpt",
"value": "Hi. I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). Your weight is also slightly high. So you also need weight reduction. So avoid oily and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Take more fruits and salads. Strict salt restriction in diet. Daily walk for 2 km. With proper blood pressure monitoring, weight management, your creatinine can be reduced."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am aged 46 years. I am having a HbA1c of 7 (recently tested a few days back) and has a problem of tearing my frenulum during intercourse with my partner. I have consulted two urology doctors. The first one says I need a circumcision as there are frequent infections in glans due to sugar levels. Whereas second doctor recommends a frenuloplasty. I am confused. The first doctor says since I have frequent infections due to frequent raised sugar levels, I get smegma quite often in my glans. Please advise me if I need to go for the frenuloplasty or circumcision."
},
{
"from": "gpt",
"value": "Hi. First of all, I appreciate you for providing elaborate history which will help in making diagnosis and advising treatment plan. Now, coming to your health query, I can understand your concern and will try to help you. Your diabetes is quite well controlled as per your HbA1c. However, the cause of tear in frenulum occurs due to short frenulum and not always due to infection. Though chances of infection are high in diabetes, usually it causes balanoposthitis and difficulty in retraction of foreskin, which is not the case with you. Smegma is normal secretion under the foreskin and is not a cause for concern, as long as you keep cleaning it. As far as proposed surgery is concerned, though frenuloplasty is sufficient surgery for short frenulum, circumcision can get rid of both short frenulum as well as smegmatic collection under foreskin. Hence, my advise is circumcision."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had sex with a sex worker a day before yesterday. But I told her not to remove her dress because I did not have a condom. Then I had a hug and allowed her to suck my penis for five minutes. While doing, she told me that my liquid is coming in her mouth, and so I stopped. After that, I sucked her breast some time. I do not know either milk is coming or not. Then finally I told her to do hands blow job after which I ejaculated. My question is the next day I got a red pimple in my inner thigh on both sides and is getting irritated. Why is it coming suddenly? I feel it may be an indication of HIV. It happened only after the incident. I was thinking in two ways. Could it be due to my liquid which went inside her mouth, if she has an infection? Or maybe due to that, I have sucked her breast I felt I might have drunk her milk. Is this an initial infection of HIV? Kindly look at my attachment. Please advice."
},
{
"from": "gpt",
"value": "Hello. As per your exposure, you seem to be safe from HIV. The thigh lesions are not due to HIV (attachment removed to protect patient identity). It could be due to other causes. Do you have any symptoms like pain, itching, etc.?"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have tingling left arm. Thumb and index finger are somewhat numb. Skin lesions infect arm. I was told that they are not shingles. Bone at base where skull and spine meet is stiff and sore. On no medication. Taking Ibuprofen for pain."
},
{
"from": "gpt",
"value": "Hi. Tingling sensation in the left arm can be due to nerve compression in the neck or in the arm. You will need a thorough physical exam followed by electroneuromyography study of the arms and legs and if possible, MRI of the cervical spine. Meanwhile, do not lift heavy weight and bend forward."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My fiancee and I had an unprotected sex two months back, and after 3 to 4 hours, she took an emergency contraceptive. Her last period started three months back, and she took the pill (Unwanted 72) on the sam day after sex in 3 to 4 hours. I did ejaculated outside. After 7 to 8 days of taking the pill, she had cramps and bleeding like periods, and after 10 to 12 days, again cramps and bleeding like periods happened and today, her period has not come. Is that a sign of pregnancy? Is there any possibility of delay in periods? Please help."
},
{
"from": "gpt",
"value": "Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. There is nothing to worry about. However, if you have a doubt, then get back to me. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 17-year-old male. I have been masturbating for three to four years. I am too much addicted to this habit and porn. I cannot remember how many times I do it a day. It has ruined my life. I was a topper in studies, with good physical and mental fitness three years ago. But now my whole health and study are destroyed because of this habit. I am suffering from fatigue, depression, hypersomnia, mental stress, etc. I forget things very quickly. I cannot concentrate on anything, and I usually spend my day alone, staring at my mobile. I am very worried and stressed. I want to leave this habit forever and be physically and mentally fit again. My confidence level is very low. Please help me."
},
{
"from": "gpt",
"value": "Hello. This is not an issue that you can feel comfortable by sharing with someone else. For porn addiction, or any other addiction, please work cyclically. If we want to come out of it, then we need to break the cycle. For example, have a count of how many hours in a day, and at what time do you watch porn? If it is for 4 hours, try adding one thing in your life which you can do for 30 minutes, like exercise or playing with friends. From tomorrow for the next seven days, do that for 30 minutes. Then next week increase the time off the screen and slowly build other habits which can use your time and keep you distracted. It will take some time, but you will come out of it if you work hard. You can always share your progress or concerns."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have a spot on my cheek and I am diagnosed with adult acne and mild eczema. Is it anything to be concerned about?"
},
{
"from": "gpt",
"value": "Hello. I understand your concern. You have both eczema and acne it seems. But medicines for both are different. Use the following medicines for eczema. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Mometasone 0.1 % cream local application twice a day. 2. Cetaphil moisturizer for body twice a day. 3. Tablet Desloratadine 5 mg twice a day. For acne use the following medicines. 1. Fixed combination of Adapalene 0.1 % and Benzoyl peroxide 2.5 % gel for local application at night. The gel needs to be applied very gently as spots on acne and a thin layer over the acne-prone site, and it is not to be rubbed. It can cause mild irritation upon initial use, which can subside with continued usage. It is nothing to worry about. Use the medicines given above. It should decrease in two to three weeks after which you can follow up again. It does not look like anything that should raise your concern. The spot appears to be an excoriated lesion of acne. Is there anything specific you wish to ask that is bothering you? I would be glad to clarify your doubt."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My father is having enlarged prostate and has to undergo prostatectomy surgery. But, it is getting delayed due to ITP (idiopathic thrombocytopenic purpura). Right now he is under urine catheter. From past 12 days he is using Silodal-D 8 mg. Doctor said that after 20 days the prostate gland will reduce. Through ultrasound test we came to know the size of prostate enlarged is 54.6 cc. My doubt is, if it is enlarged to 54, is it possible that it can reduce through tablets? Or is it a must to undergo surgery? Right now the platelet count is 40,000. Please suggest a solution for this."
},
{
"from": "gpt",
"value": "Hi. Your father was on medication and has history of urine retention in the past. Currently, he is on catheter. Chances of medical management will not be successful. He needs surgery of either TURP (transurethral resection of the prostate) or HoLEP (Holmium laser enucleation of the prostate) for prostate. Size is never a criteria for surgery. Enlarged prostate can shrink by 30% if Dutasteride is given. But, this does not guarantee that the patient will become catheter free. However, it reduces blood vessels in prostate and helps decrease blood loss in surgery. Dutas-T (Dutasteride and Tamsulosin) also contains similar medicines as Silodal D (combination of Dutasteride and Silodosin). His ITP needs to be tackled and with all due precautions and keeping platelet concentrates on standby. He can undergo endoscopic surgery with due risks. Laser surgery - HoLEP will be better for him if available."
}
] |
[
{
"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": "gpt",
"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,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": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist 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": "gpt",
"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 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": "gpt",
"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": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 48 year married male suffering from quick ejaculation. I do not have diabetes or BP issue. Please help."
},
{
"from": "gpt",
"value": "Hello. Premature ejaculation is defined as ejaculation with minimal sexual stimulation, before the patient desires and before or within one minute of penetration. Frequently, performance anxiety could be a cause of premature ejaculation. In that case, you can take deep breathing for two minutes before sex. It will relax you enough. If you still feel anxious, you can take tablet Alprazolam 0.5mg half an hour before sexual activity. Remind yourself that you are having sex for mutual pleasure and relaxation. It is not an ordeal or duty where you are supposed to be the performer. There are many ways to treat premature ejaculation if it is not possibly due to anxiety. 1) The first technique is known as squeeze technique. In it, when you reach close to orgasm, you or your partner should squeeze on the ridge between the glans and the shaft of penis till the erection subsides. Then begin with your sexual activity once again. Repeat this a few times before you finally ejaculate. This will increase your time of ejaculation and also give you some voluntary control. 2) The second option is you can use Lignocaine spray (Shotmax spray). Spray once on the glans penis 15 minutes before sexual activity. It will reduce the extra sensitivity of the glans to normal level. You can also use 2% Lignox jelly (Lignocaine) instead of spray. 3) The third option is you can take tablet Dapoxetine 30 mg one hour before sexual activity. These techniques are sufficient to treat majority cases of premature ejaculation. 1. Anxiety. 2. Sensitive glans. Premature ejaculation. 1. Treat performance anxiety. 2. Squeeze technique. 3. Lignocaine spray. 4. Tablet Dapoxetine."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My wife aged 27 years is going through her 5th month of motherhood. Before delivery she was looking good and also her skin was fair as well as good. But now her skin got darker, there are some spotting on her face and also dark circles around both the eyes. Kindly help to improve her appearance. Thank you."
},
{
"from": "gpt",
"value": "Hello. These changes are all due to hormonal changes which occur during pregnancy. So, it is very difficult to treat. It is better to avoid any treatment during this period. Many drugs cannot be given during pregnancy as it can affect child. Moreover, these changes many times subside after pregnancy or lactation period. So, counseling her is the best choice. Use a safe soap or cleanser like Cetaphil to wash face. She can use sunscreens like Shade lotion 2-3 times a day. It helps to prevent darkening of skin. Ask her to take nutritious diet as recommended during pregnancy. Do not strain or rub the eyes and give rest to the eyes. Check if there are any refractive errors of eye."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 25 year old man. It is about 4 years that I am experiencing chronic sputum production which I feel is originated from my nasopharyngeal or oropharyngeal region. It does not pain or itch and the quantity too is less. In the first year of its development it was mostly white in color but sometimes yellow and difficult to remove. Many of my doctors did not take it serious and just adviced me to wash regularly with normal saline. It gets a little bothering sometimes especially in morning after waking up or late at night or after eating some special meals or juices like orange juice which are sweet, but I think it should not be an allergy. It does not go inside my stomach by swallowing my mouth secretions and are very difficult to get out. All my other hematology, biochemistry and hormone profiles have been normal during these 5 years. I am having issue only with the sputum. It was cultured once, but no bacteria was grown. Please help to get rid of that. Thanks for your advice in advance."
},
{
"from": "gpt",
"value": "Hello. This is post nasal drip. It has a multitude reasons for its evolution and for disturbing all over this long period. Nasal septal defects like deviated nasal septum (DNS), stones in nose and polyps in nose are some of the reasons. Long-standing Inflammation of sinus mucosa around nose also causes such issues. Chronic tonsil infection, pharynx infection or stones on tonsils may be other causes. 1. Radiologic investigation for anatomy of nose and paranasal sinuses. 2. CT scan is mandatory. 1. You need to consult an otorhinolaryngologist for thorough evaluation. He may need to go for urgent sputum culture and sensitivity testing and an antibiotic accordingly if bacterial infection is the cause. If fungal infection, antifungals are needed then. Viral does not remain so long usually. 2. If anatomic defect is found he may go for a surgical repair. 3. Medication may be decided according to ENT evaluation because in such chronic cases hit and trial method is not acceptable for treatment."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had unprotected sex approximately 18 hours ago. I am worried if I should take I-pill. I am already taking medication for PCOD since one year. There has been some improvement and my period is due in a day or two. The medication that I am taking is Calcarea phosphorica 200 and Jonosia Ashoka. I am a 22 year old female and my weight is 63 kg and height is 4'11\". Should I take I-pill? Does it have any serious long-term effects? Also tell me if taking I-pill would worsen my PCOD problem? Please suggest few other safe contraceptive methods other than the general contraceptives. I had done lower abdomen ultrasound about four months back and the doctor observed small cysts. Thanks."
},
{
"from": "gpt",
"value": "Hello. As you are a known case of polycystic ovary syndrome (PCOS) there are chances that you may have delayed ovulation ad hence delayed menses. So, you must take an emergency contraceptive pill within 72 hours of last intercourse. Again you are on homeopathic medication which would have its effect for long-term and will not offer you any immediate protection.After the I-pill you should expect your menses in the next 7 days. If it does not occur, then you should rule out pregnancy with a serum beta-hCG test. Besides oral contraceptive pills (OCP) the best contraception for you would be a depot injection or a Norplant (Levonorgestrel) hormonal contraceptive. But, as you are a case of PCOS, hormones should be avoided and condoms should be used as barrier contraceptives."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am 24 years old. I have over imagination problems since when I was a child. I imagine that I am a winner and what I want and where I want to go. Still, I am facing these problems in my job, education, and personal relations. I imagine all my favorite, but in realities, it is not, what I am doing. I felt guilty about what I thought. Please help. How could I stop this over imagination problems?"
},
{
"from": "gpt",
"value": "Hello. The problem of excessive imagination occurs because imagination is one of the defenses used by the brain to overcome day to day stresses. Also, it prepares you for the future and motivates you. But if it is excessive and causing problem, then you may use some behavioral measures to overcome this. 1) Make a schedule. 2) Involve yourself in positive distractions. 3) Tie a rubber band on your wrist and pull it whenever you are going into the imagination too much. You may seek the help of local psychiatrist if it does not work."
}
] |
[
{
"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": "gpt",
"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."
}
] |
Subsets and Splits