conversations
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[
{
"from": "human",
"value": "Hello doctor,My brother has thalassemia intermedia. His Hb is between 7.8 to 9. Please suggest how soon he can recover from this."
},
{
"from": "gpt",
"value": "Hello, Welcome to the icliniq.com. Thalassemia intermedia is severe as compare to thalassemia minor. In this condition, episodic blood transfusion is needed, especially during childhood. Your brother can be prescribed iron tablets if there is no improvement then blood transfusion might be required. I hope I have answered your question. Let me know if I can assist you further."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 35 years old. I have migraine problem from last one year. I took Sibelium 10 mg. But I noticed after taking these medicine that my memory has become weak. Before, I had good memory."
},
{
"from": "gpt",
"value": "Hi. Sibelium (Flunarizine) 10 mg is a good medicine for migraine but probably has not been quite helpful for you. You can consider taking tablet Betacap Plus (40+10) once in the morning regularly for a month. At times of severe, unbearable pain, you can have tablet Naxdom 500 mg SOS after food. Also, since you have migraine, it is necessary for you to know your triggers and avoid them. For example, some people have migraine when they go out in the sun, some due to loud sound or flashing lights and some due to spicy food. Understand what triggers migraine attacks for you and avoid that. Regular exercises, yoga and meditation will also help reduce frequency of your migraine. Take care."
}
] |
[
{
"from": "human",
"value": "Dear doctor, I had a small stiff boil in the middle of my eyelid for months. Then it disappeared and another one appeared in the outer corner of the same eye (right eye) and kept getting bigger and smaller and still has not disappeared. Then, about six months later, when I blinked it hurt, and I felt another boil under my eyelid and when I looked it was full of pus and I did not disturb it. The next day when I woke up, my whole eyelid was swollen and hurt really bad. But the pain went down in three hours or so. I then realized that another boil was inside my eyelid. The boil burst by itself though and now I have three boils in my eyelid and the third one is in the inner corner of my eye. Is this serious?"
},
{
"from": "gpt",
"value": "Hi. Your history indicates recurrent inflammatory swellings of the glands of the eyelids in the form of hordeolum/stye (focal infection of the glands of the eyelid). Since these swellings are recurrent and multiple, you require evaluation to treat the underlying predisposing factors. However, no need to worry as this is not a serious condition. The treatment for hordeolum is the use of antibiotic eye drops or eye ointments and anti-inflammatory drugs. Applying hot compression provides symptomatic relief. The common problems that need to be ruled out are refractive errors, blepharitis (chronic inflammation of the eyelid) and systemic conditions like diabetes. Consult an eye care ophthalmologist online regarding further investigations -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My question is that if one has sex with a partner who has never had sex before, not using a condom, can he or she still get HIV/HPV or any STDS."
},
{
"from": "gpt",
"value": "Hello. No, if you had sex with someone who has never had sex with anyone else before you then you cannot get an STD. STDs are only transmitted from an infected sexual partner. So, if it is the first time sex for someone then obviously that person has never been exposed to STDs. For more information consult a HIV AIDS specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, About two years back, I had an arthroscopic surgery (OCD MTD) for my ankle because of a previous injury. At first, my ankle got better, but now it is starting to get worse. As I am experiencing a lot of pain and difficulty in walking, I got an MRI done. Please see the results. Can you tell me what they mean?"
},
{
"from": "gpt",
"value": "Hi. Previous injury. 1. MRI images. 2. X-rays and clinical pictures. Revert back with the details to an orthopaedician and traumatologist 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 13-year-old male and I have had semen leakage for about three months. I think it is from weak nerves because last year, I would masturbate a lot but then I stopped because it was becoming painful and I was embarrassed. Then about three months ago, I watched something inappropriate and I ejaculated without doing anything. Then a week later, I started to have semen leakage every day about three to four times a day. I am just very worried and I just want this to be cured and go away. Also, could this affect my eyes in any way? Please help."
},
{
"from": "gpt",
"value": "Hi. Let me tell you that the symptoms described by you suggest that you have a nightfall problem. The high quality way to deal with dusk is the use of herbal or selfmade remedies. There are no aspect outcomes for such remedy methods. You ought to have yogurt at least two or three bowls a day. Avoid looking at porn as plenty of porn arouses you sexually. So it is recommended now not to watch porn. Sage tea – having two cups of sage tea a day will limit the probabilities of nocturnal emission. Gooseberry – popularly recognized as amla acts as an anti-oxidant and helps in lowering the nightfall. Gradually the moist goals trouble will be solved. Bathing – it is a recommendation to take bathtub earlier than you go to bed. It helps you have a sound sleep. A sound sleep is very vital for averting nightfall. I hope this helps."
}
] |
[
{
"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, 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, We had an unprotected sex on 13th day of her period. She took Ipill 19 to 20 hours after sex. Now on period due date she got light bleeding for two days. According to her, she always gets her bleeding only for two days. 28 days cycle. Before sex she got periods on 21st and after sex she got it on 19th of next month. Any chance of pregnancy?"
},
{
"from": "gpt",
"value": "Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The bleeding could be because of hormonal changes due to the pill you have taken, it is withdrawal bleeding. So relax and do not worry. However, if you have a doubt then get back to me. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor, If the stroke has occurred in the left side of the brain, we know the patient's right side of the body would be weak and numb. But when the patient's right side of the face is also numb, is this also because of the stroke on the left side of the brain?"
},
{
"from": "gpt",
"value": "Hello. Please let me know if you have any other questions. For more information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am spending sleepless nights. I am struggling to fall asleep and often get disturbed by dreams. I feel restless legs throughout the night. The next morning when I wake up I feel fatigue. I am addicted to Benadryl to get sleep. But, I am trying to avoid it now. Please guide me for a sound sleep."
},
{
"from": "gpt",
"value": "Hello. As per your complaints, it seems that you might have developed dependence on Benadryl. And it is quite possible that due to this dependence you might be having these symptoms. Benadryl is basically a Codeine-based cough syrup, which is an antitussive agent OTC (over the counter) drug used to suppress dry cough. Codeine is a psychotropic substance which belongs to opioid group which is known for its dependence producing properties. Hence, due to long-term self-medication codeine cough syrup produces physical dependence. In the absence of it, body will crave for it and will produce withdrawal symptoms in the form of body aches, restlessness, palpitations, sweating, rhinorrhea, lacrimation, agitation, perspiration, vomiting, shivering, yawning and rarely fever with visual disturbances. Hence, in your case there is a strong possibility that you might be having withdrawal symptoms. But to confirm that, you have to tell few more details, We can conclude whether it is of opioid dependence or not from the answers given by you to the above questions. If it comes out to be opioid dependence, then we have to start with substitute treatment for opioid in the form of either Buprenorphine or Naltrexone, along with symptomatic management. Revert back with the answers for the above questions to a sleep medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have a boil on my inner thigh, which keeps recurring. I have had a boil in the same spot before. When I popped it went away, but now it has come back. It is also very painful. Please help."
},
{
"from": "gpt",
"value": "Hi. I have read your query. It seems that you are having furunculosis. Boils (also called furuncles) are a deep bacterial infection of hair follicles. The cause of recurrence may be Staphylococcus aureus, which is most commonly carried in the nostrils, armpits, between the legs and in the cleft between the buttocks. It may be transferred to other sites from the nostrils through the finger nails. General measures to avoid the recurrence are as follows. Regarding treatment, I suggest oral antibiotics like tablet Augmentin 625 mg (combination of Amoxicillin and Clavulanate potassium) if you are not allergic to penicillin group. Take one tablet thrice daily for five days. Also, my suggestion is to apply Mupirocin twice daily for five days. Consult your doctor, discuss with him or her and take the medicine with consent. For further information consult a dermatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,Yesterday I had to have a frenuloplasty. I had to have a general anaesthetic. I woke up and never got any advice off the urologist because I never saw him after the procedure. The nurse who discharged me told me to take off the dressing in the morning and wash the wound and the foreskin twice daily. My concern is today I noticed my foreskin has become swollen and looks similar to a balloon. The stitches are preventing me from pulling my foreskin back over the glans. So, it has been retracted all this time. Is the swelling normal and due to the incision or is it not normal? Also, am I suppose to keep it pulled back or do I try to push it back over the glans? My glans is very sensitive. So, it feels like an electric shock every time I move."
},
{
"from": "gpt",
"value": "Hello. You have very likely developed a paraphimosis. It would be more clear if you share a picture of the penis. You are supposed to keep the skin in front of glans. If it is painful to roll the skin over the glans, I suggest using Lignocaine gel and pull it front. After that, the swelling will slowly subside. If red discoloration also is present, then it can be a hematoma. Please share a picture. Revert with more information to a urologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had my first heart palpitations two years ago. One doctor prescribed me Ciplar LA 20 and Ecospirin 75 for three months. The doctor also suggested Dilzem or Flecarite on SOS basis. I got palpitation even after having the above medicines. Dilzem worked on as needed basis but since it was a strong medicine, I stopped taking it. After one year, I got all the tests done again and irregular heartbeat got detected in Holter monitoring. I have attached the reports. Currently, I am on Concor 5 for two weeks starting two months ago. There are around two episodes per week but with this medication, duration and maximum heart rate have been controlled. Attached is the latest Holter monitoring test before 48 hours and 2D eco test reports. I need an opinion on: Can food allergies cause arrhythmia? I noticed palpitations just after having food items with cheese. Any test recommended to find out food allergies causing palpitation? What are the long-term side effects of medicines? What is the success rate of cardiac ablation? If required, should we go for burn or freeze ablation?"
},
{
"from": "gpt",
"value": "Hello. You are suffering from paroxysmal atrial fibrillation and intermittent ectopic. Food allergies will not cause this problem but if you take spicy food, have lack of sleep, mental or physical stress can aggravate the problem. Usually, these medicines have no or little side effects. But at the same time, you need to take medicine. Radiofrequency ablation is safe and effective. The success rate is 60 to 70 percent. You need to discuss this with a specialist cardiologist and with an electrophysiologist. You need to continue the medicines on a long-term basis. Concor (Bisoprolol) is a good drug and Ecosprin ( Atorvastatin and Aspirin) after food is good enough. I hope you don’t have thyroid problem. For more information consult a cardiologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, Last week, I had a sexual encounter with a girl. I did not have any penetrative sex, but I rubbed my penis against her vagina for two to three times. There was no vaginal fluid contact also. I did not have penetrative sex, so I did not use a condom. So, I am worried whether I am exposed to HIV, and I am thinking of getting tested. But on the internet, I read that the tests are accurate after three moths only. I came to know about HIV RNA test, and I am thinking of getting tested for it. Can I go for that test now? Is a doctor's prescription required? I want to get tested after 10 days. Please tell me if it is reliable or not? If reliable, where should I get it tested?"
},
{
"from": "gpt",
"value": "Hello. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor,I have a quick question. I have fatigue, some soreness in my throat. I might have a high temperature and some dry lips (dehydration). I also am worried because I had a handjob from a stripper about two weeks ago. We did not have sex but she did spit saliva on my penis. There was some rubbing from her ass on my penis but we did not have anal sex. I am not sure if I should be worried about HIV. I am not sure if I really have a fever and if I have something from the flu season."
},
{
"from": "gpt",
"value": "Hello. I have noted your concern. A handjob is not a risk. Saliva is not infectious unless it has blood contaminated from bleeding gums or open sores in her mouth. Anal rubbing without actual penetration is not a risk unless she had open weeping sores in the perianal area or anal rim. Otherwise contact with outer perianal skin is not a risk for HIV (human immunodeficiency virus). Regards. For more information consult an HIV AIDS specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a 27-year-old male with no history of joint issues. Can stress and anxiety cause joints to pop? I was okay last month but this month it has been really stressful for me and I know my hands feel stiff and all my joints pop. When I raise my arms, one can hear the tendons stretching like rubber bands. When I rotate my legs, my hips pop. They make pretty loud pop with no pain at all. My elbows sometimes pop, not often. I have no disease that I know of. Can this be caused by stress and depression? Please help."
},
{
"from": "gpt",
"value": "Hello. Random clicking and popping joints is a common occurrence and as long as there is no associated pain or swelling, there is nothing to worry about at a young age such as yours. Excessive stress and anxiety can make your muscles taut. This can happen during periods of depression too. When you move any synovial joint around, the taut muscles around these joints cause the popping and cracking. You can try gentle stretching exercises every morning. This will help relax your muscles and subsequently relax your joints. For more information consult a family physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a mother of a 16 year old boy, who is 5.9 feet tall. He has white spots on the back of his throat along with swollen tonsils. He does not have a fever but finds it hard to swallow. Is this strep infection or what is it? He had the same before, and it was told as thrush."
},
{
"from": "gpt",
"value": "Hello. For further information consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, It has been weeks since I have been feeling acid reflux with symptoms of heartburn and back pain. I have been taking Kremil-S and Omeprazole. Lately, I am experiencing diarrhea. I hope you can help me."
},
{
"from": "gpt",
"value": "Hello. I have reviewed your history as well as the medication profile you just shared. (attachment removed to protect patient identity). So the part of the problem is secondary to the medicine you are taking such as diarrhea which tends to occur secondary to Kremil-S since this medicine contains aluminum and magnesium both could cause diarrhea. I want you to stop it now. In addition, Senokot also causes diarrhea. I am afraid that your initial physician has given you both these medicines for constipation or for stomach pain? You should stop it as well until your diarrhea gets better. Omepron (Omeprazole) is a generic medication but there are many which are now available with good effect. I recommend you to switch to capsule Esomeprazole 40 mg. Take similarly as you were taking Omepron before breakfast in the morning. If this dose does not help increase the dose to twice daily before the meals. Let me know in a few days if symptoms persist, I may consider adding other medicines for you if it does not work in your case. Gastroesophageal reflux disease. Dyspepsia Follow up in three to five days."
}
] |
[
{
"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 30 years old. I am in my first trimester of pregnancy. My 10 weeks 4 days ultrasound showed a very healthy baby of 36 mm with movements and strong heart beat. It is great news. It also mentioned that anterior placenta extending on the lower end. My gynecologist did not seem concerned at all and even never mentioned it. But, what does it mean? Is too early to judge? Or is there some precaution I must take? Thanks in advance."
},
{
"from": "gpt",
"value": "Hi. It is too early to judge about placental position. Secondly with growth of baby, placenta normally moves up. So, there is nothing of concern right now. Regarding precautions, low lying placenta which is also known as placenta previa may sometimes bleed (manifests as vaginal bleeding) with sexual intercourse. You have to keep this fact in mind if you experience bleeding. You can avoid intercourse to avoid bleeding, though it is not a must. Sexual abstinence not compulsory, as the placenta is just extending on the lower end and not of serious type which covers internal opening of the cervix. For further information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 25 year old male. I am 91 kg, and my height is 5 feet and 2 inches. My cholesterol levels are high, and I am over weight. I have hypertension, and I am taking tablets for cholesterol. I need a Paleo diet chart. Please help me. I am attaching my recent reports."
},
{
"from": "gpt",
"value": "Hello Welcome to icliniq.com. I went through your reports (attachment removed to protect patient identity) and saw a marked elevation of cholesterol levels with low vitamin D levels. So, it is very much necessary to take up a strict diet so that you get all your vitals to a near normal range. For more information consult a nutritionist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have anxiety and panic attacks from last six years. My doctor prescribed Nexito Forte 10 mg. My doctor tapered the tablet to Nexito Plus 5 mg three years back. My questions are: Is the relapse due to decreasing the dosage? Should I increase it again?"
},
{
"from": "gpt",
"value": "Hello. The dose of the particular drug depends upon many reasons. So, it is difficult to tell that this dose is effective or not for the particular person. Now coming back to your questions, first Nexito Plus (Escitalopram and Clonazepam) has only half of the dose compared to Nexito Forte (Escitalopram and Clonazepam). So, when tapering the dose, few persons may relapse. If you develop the symptoms of anxiety, you need to increase the dose again. And it is quite difficult to predict who is going to relapse. Secondly, as the Nexito Plus has a lower dose of the drug, it is quite prudent that it may not be effective in all persons. So, increasing the dose is a good option. Similarly, when one is tapering the dose, some symptoms may reoccur. Then one has to slow down the pace of tapering as to avoid the relapse. So, if you are stable on Nexito Plus, then no need to increase the dose, but if you have symptoms then you need to increase it. The dose is basically changed according to the response and side effects, one is tolerating. It is individually designed to meet the requirements of that particular person. Thanks and regards. For more information consult a psychiatrist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My blood reports show high monocytes and eosinophils for over two years of span. I feel there is no energy, muscle spasms, splenomegaly, muscle pain, and malaise. I am seropositive RA. But, my CRP and ESR are normal most of the time."
},
{
"from": "gpt",
"value": "Hi. Rheumatoid arthritis is one of the causes for high monocyte count and multisystemic involvement. Hence, treatment for that is nonsteroidal anti-inflammatory drugs and disease modifying drugs like Leflunomide, etc. The high eosinophil count causes include allergy, parasitic infection, skin conditions and pulmonary eosinophilia, etc. According to the cause, the specific treatment can be given. For allergy, antiallergic medication like Fexofenadine is useful. For further information consult a hematologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My 64 years old mom was recently diagnosed with ovarian cysts and is undergoing a hysterectomy plus oophorectomy two days later. During the same routine health checkup when her cysts were diagnosed, her urine report showed RBC of 6 to 8/hpf. Is this a possible UTI? And if it is, why should not our surgeon correct it before the operation? I asked him about it, and he said it would be taken care of when she gets admitted. I wonder why? I am particularly more worried about it because she also has a left artificial hip from the past two years which should not catch any infection. I remember her orthopedician asking for a urine culture a few days before her hip replacement and giving her antibiotics for the UTI immediately after that surgery. So, why is this surgeon not bothered to correct the UTI pre-operatively?"
},
{
"from": "gpt",
"value": "Hello. RBC (red blood cells) in urine does not mean UTI (urinary tract infection). Pus cell in urine indicates UTI. Up to five pus cells per HPF are normal. 2 to 4 is in your case. So, it is not UTI. There are many causes of RBC in urine. Is she on any blood thinners, like Ecosprin (Aspirin) or Clopidogrel which can cause mild RBC in urine. So, that might be the cause and not UTI. For more information consult a urologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 33 weeks pregnant. In my previous pregnancy, I had a c section at 33 weeks as my water broke. Presently, I am taking Aspirin tablets daily. My doctor prescribed it. But I have a doubt that will it cause excessive bleeding in my delivery? As I am near to delivery is it safe to take these tablets? I am currently taking Ecospirin 150 mg, Diamet Metformin 500 mg, Orotate 3D, Folsafe D, Wysolone 5 mg, and Iron tablets."
},
{
"from": "gpt",
"value": "Hello. I totally understand your concern, but please do not be stressed. All you need right now is to relax, keep calm, and take some rest. Yes, Ecosporin is totally safe during pregnancy, and mostly your gynecologist will continue it until 36 weeks at least. But I would like to know the reason for starting Ecosporin and also the steroids ( Wysolone) because you have not mentioned it (could be related to previous pregnancy events which need to be known in detail). And also if you go into labor you can stop it then, the effect usually does not last more than a day, and the dose that is given in pregnancy is very low. So definitely there is not much risk of bleeding. I hope this helps."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am allergic to pollen and I am suffering from hay fever. I have been sneezing because of it. In the mornings I see a bit of phlegm with a little bit of red blood in it. Also, it is seen only in the morning. Is it related to allergy or something to worry about? I am reasonably healthy and my CBP is normal, which I got it done a month or two ago. I am low in vitamin D and vitamin B12 and taking some vitamin pills for it. Other than this I do not have any health issues. Please suggest me."
},
{
"from": "gpt",
"value": "Hi. Yes, it is related to your allergy. Sometimes, with excessive sneezing you may have this capillary bleeding. Nothing to worry as it is coming only in the morning associated with sneezing. Try to avoid contact with pollen. I suggest you to use antihistamines and leukotriene inhibitors, tablet Allegra 180 mg (Fexofenadine) once a day and tablet Montelukast once a day. Sometimes you may need to use steroids if symptoms are severe to evaluate. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. Do you have any cough or throat pain? Get a chest x-ray posteroanterior (PA). Check blood for bleeding and clotting time. Get a detailed check of your nose and throat by your medical practitioner to see any nasal polyp and other things. Revert back with the answer to the above question to an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had a CT scan done yesterday for something else (nothing serious). They did say there was a 0.3 cm superior right lower lobe pulmonary nodule. Minimal bibasilar atelectasis. No focal consolidative opacities and no acute abnormality in the lungs. The doctor said since I am not at high risk due to size. I have never been a smoker, and because of the tiny size he did not think I need a follow-up, just with PCP. I wanted a second opinion on this."
},
{
"from": "gpt",
"value": "Hello. Any past history of pnuemonia, bronchitis, or any history of tuberculosis? Connect me with details for full evaluation and management."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a loose vagina and I am 20 years old, female and I am sexually active. I used to have sex always with toys so it became loose. Please help me. I need to tighten my vagina again. Once I used Everteen vaginal tightening gel for a month and I stopped its use as I was afraid of its use."
},
{
"from": "gpt",
"value": "Hi. The Everteen vaginal gel is an herbal product used for the same purpose but the efficacy of this is not well established. This may help some but not all. Kegel exercise are a good option for you. You can do this exercise daily and will see good results. As of now stop using toys or atleast stop bigger toys so that the benefits of Kegel exercise are maintained. If the hymen is torn then there is a procedure called hymenoplasty, which can restore the hymen. This is a surgical procedure. For more information consult a psychologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 36 year old male. I have been having knee buckling problem for some time. The problem started in the right knee about four years back and since then I have stopped sports. However, at times during some movement or jerk, I get this buckling problem and pain for two to three days. About two weeks back, I had a similar problem in my left knee as well while trying to jump and take a photograph. It is paining since last two weeks. I have attached the MRI and CT scan reports. Do I have to go for a surgery? Or can it be cured with exercise and physiotherapy? My weight is 97 kg and height is 5'9\"."
},
{
"from": "gpt",
"value": "Hi. I have gone through your history and the reports attached here (attachment removed to protect patient identity). For further information consult an orthopaedician and traumatologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,My Hb is 15.8 but HCT is 49.2 and total RBC count is 5.63. What is the reason? I fear about polycythemia. Is it possible to reduce HCT?"
},
{
"from": "gpt",
"value": "Hello. If you are a smoker, then stop smoking. At this stage, secondary polycythemia is more common than primary and smoking is the most common reason for secondary. For further queries consult a hematologist 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": "Hello doctor, I am a 22-year-old male. I have been getting hips, legs, knees, and back pain issues when masturbating. I usually masturbate four to five times a week, sometimes I can go two to three days without masturbating. I have cracking noises in my hips and knees and my quad muscles feel over stretched and tight. This problem has affected me and I am very limited in performing any activities such as sports. I am not physically active anymore, I used to play sports regularly but since I started having so many problems from the waist down, I stopped. Also, I get pain even when I am standing, sitting, or driving and get pain in the morning after waking up. I live abroad and to get any medical attention requires months of waiting. I currently have an MRI booked in five months but my symptoms are getting worse day by day and I do not have the patience to wait until then. Is masturbation the reason for my problems? How can I fix these issues and get my life back to normal? Is MRI necessary? If not, what do I need instead? Please help."
},
{
"from": "gpt",
"value": "Hello. Sorry about your health condition. Masturbation usually may not cause weakness or muscle problems. So do not worry, the possible causes for your problem is 1. Panic attacks or anxiety which lead to increased tension in muscles. 2. Hypocalcemia. 3. Fibromyalgia. 4. Hypothyroidism. 5. Vitamin D deficiency. 6. Rheumatoid arthritis. 7. Myositis. Still, many possibilities are there. So use vitamin E capsule like Evion 400 mg twice a day for two weeks. Use tablet Aceclofenac 100 + Thiocolchicoside 4 mg twice a day for five days. Avoid excessive masturbation as it may lead to penile mucosal injuries, lack of sex drive, etc. Eat more green leafy vegetables and fruits. Do yoga and meditation regularly to release your muscle tension. Get done hemoglobin level, thyroid profile, serum calcium, and vitamin D levels. Also, do RA (rheumatoid factor) factor, ANA (antinuclear antibody), ASO (antistreptolysin) are also useful. If symptoms are not improved please consult with your physician or rheumatologist, he will examine and treat you accordingly."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I had sexual intercourse last night with protection. Immediately after, I went to take a shower and I see that my left labia majora is swollen but painless. It is kind of weird to walk lie down or sit. It was only my second time having sex. What should I do? Is this a dangerous situation?"
},
{
"from": "gpt",
"value": "Hello. How are you doing? I do not see any reason for you to worry. Hope I have clarified your query. Do write back if you have any more queries. All the best. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had very dark complexion in the past. But after consuming antioxidants like Vitamin C, E, Glutathione and Alpha Lipoic Acid my skin has lightened up about two to three shades. It has been very helpful but I still need to get lighter. Is it safe for me to get IV Glutathione? I have heard it absorbs quickly and gives results within one or two sessions. Other than that what can I do to lighten my skin?"
},
{
"from": "gpt",
"value": "Hello. Injectable Glutathione is not FDA approved. Still, it is used by many people to reduce the skin tone by two to three shades. It is a once-a-week injection for four weeks, then once in two weeks for four weeks. If there is no response after three to four sessions then further treatment should not be taken. I personally would not advise taking IV Glutathione as the results are not permanent. Skin color changes back to the normal tone after three to six months of stopping treatment. For more information consult a cosmetologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 18 year old female, who is suffering from coughing fits and severe tonsillitis. The coughing fits only come when I am lying down, and I bring up mucus which kills my throat."
},
{
"from": "gpt",
"value": "Hi. Sorry to hear that you are not feeling well. For further queries consult an internal medicine physician online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 22 year old female, and I am getting married this month, and I am going for my honeymoon. So, I want to delay my periods without any side effect. I am still a virgin, so I do not want to ruin my honeymoon. So, please suggest the best medicine. When to start taking it, in what dose, and when to stop it?"
},
{
"from": "gpt",
"value": "Hi. Let me start by congratulating you in advance for your wedding. There are many methods, all using hormones, to either prepone or postpone the period. I would like to suggest the simplest and the best method. I would not confuse you with too many dates, as these hormones have to be taken on time without fail, any failure can cause bleeding in between. Try taking oral birth control pills or contraceptive pills, like tablet Duoluton-L or Dear 21 or Novelon or Ovral G or Intimacy plus 3. Have one tablet at night now onwards for 21 days, and without giving a break, start the next packet. Take it until the date you want to postpone the periods, and you will get your period 4 to 7 days after stopping the pill. It is also the best contraceptive method for a newlywed couple. You will have 100 % protection and no trouble with sex. In such a case, you will have to take it cyclically from the first day of bleeding."
}
] |
[
{
"from": "human",
"value": "Hello Doctor, I am 19 years old. My teeth are yellow from childhood (from 10 years of age). A black layer is formed at the backside of teeth. When I see my teeth it seems very dirty and too much of creamy layer is formed on my teeth especially in lower canines and lower incisors. In the lower teeth, yellowness is 'V' shaped and in upper incisors the creamy layer is much lesser than the lower ones. The creamy layer gets removed by using my nails on that, but toothpowder is not able to remove that yellownees. I am feeling very sad while seeing my dirty teeth. My molar and premolar teeth have a black spot on them and people told me it is eaten by tooth worm. Is it true that tooth worm damages the teeth? When I contacted a local doctor he did scaling procedure. Just after scaling procedure, all the yellowness was clear (almost 80%) and black layer at the backside was also clear. I became very happy by seeing this. But about a month after scaling, my teeth again turned much yellowish and looks very bad and black layer at the backside of teeth also started appearing. Is scaling only a temporary process and is it complete wastage of money? For clean teeth, is there any permanent thing which will make our teeth very much white and glowing?"
},
{
"from": "gpt",
"value": "Hello. Yellowing of teeth is mainly due to one of the following or a combination of these: You have given an excellent description of the clinical condition of your oral cavity. From your history it is very clear that, the yellowness of your teeth is due to plaque and calculus deposits. Plaque as you have mentioned is yellowish and creamy. This gets partially removed with brushing. Calculi are hard deposits either yellowish, greenish or sometimes blackish in color. They are firmly attached to the teeth and do not go off with brushing or tooth powder. Even the abrasiveness of the tooth powder cannot remove the calculi. During childhood due to improper brushing there are chances of plaque and calculus formation over the teeth. Because children at this age tend to be playful and do not concentrate on oral hygiene. \"Tooth worms\" as people say are nothing but bacteria that affect the teeth. These bacteria act on the teeth and cause demineralization of the teeth and lead to tooth decay and cavities. The lower incisors and canines are more prone to plaque and calculus deposition (v shaped deposition in accordance with the tooth morphology) due to inability of us to reach the inner sides of these teeth while brushing. At this age of yours, these deposits may be due to: Dental scaling is the procedure that removes plaque and calculi. But it does not mean that these deposits will not come back again. Continuous oral hygiene maintenance after scaling is mandatory to prevent recurrence of plaque and calculi. Hence, scaling is not a wastage of money, it is an investment to prevent one's teeth and gums from infections and thereby increase the life of the teeth. So, a permanent solution for your problem is to follow these steps to maintain oral hygiene: And finally, pearl white color of the teeth indicate that they are unhealthy. Teeth which are slightly yellow, without any deposits on them are said to be healthy. Hope this answer helps you. Consult a dentist online for further follow up -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 32 year old female with asthma. I have cervical disc herniation for 10 years. Over the past 5 months, symptoms were back with tingling, weakness and shooting pain in arms. I tried medications like Celebrex, Lyrica and also massage, physiotherapy, chiropractor and acupuncture, but the symptoms are getting worse. I did an MRI neck around 3 weeks ago which showed straightening of cervical spine due to muscle spasm. MRI indicates cervical spondylosisdeformans C5-C6 - broad-based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT]. Posterior osteophytes were also mentioned. Now, for the past 2 weeks, I have increasing twitching in the thumb especially left which is becoming almost continuous. Is that a sign that the disc is worsening?"
},
{
"from": "gpt",
"value": "Hi. A herniated disc in the neck can cause three potential problems: As long as you do not have spinal cord dysfunction or significant weakness due to nerve compression, then you can try nonsurgical treatments like physical therapy, pain medication, or steroid injections. If you continue to have significant arm pain or neurological symptoms for more than 6 weeks or develop weakness then you may need surgery. An EMG/NCS (Electromyogram/Nerve Conduction Studies) test looks at the function of your nerves in the arm. It might be helpful if you get this test done to confirm that the MRI findings and pain you have correlate, before deciding whether to undergo surgery."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have had sores on the back of my tongue for weeks now. I have a pain in both ears that comes and goes. I also occasionally have a feeling of something in my throat that will not clear by swallowing. What could possibly be going on and who should I see for this?"
},
{
"from": "gpt",
"value": "Hello. A chronic throat irritation with an enlargement of lingual tonsils that feel like sores in the back of your tongue, foreign body sensation in the lower part of the throat and recurrent ear pain are usually symptoms of reflux laryngopharyngitis, which is a type of acidity related disorder. Usually, it occurs because of untimely eating habits, stress. lack of sleep, etc. The treatment includes anti-reflux medications and lifestyle modifications. Have your food at proper timings. You should not sleep immediately after dinner. Wait for at least two hours before you go to bed. For more information consult an ENT otolaryngologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have a lower wisdom tooth that has been infected chronically for well over a year. I also have an upper molar that is broken decayed and has been like this for years. The wisdom tooth oozes green pus if you apply pressure with a cotton swab. The decayed tooth is mildly painful. I saw my dentist a few days ago, who did not seem overly concerned. She slightly cleaned the gums around the wisdom tooth and prescribed me Cephalexin and sent me on my way. I have been taking Cephalexin for a few days, and yet the tooth is still oozing. My throat is red and irritated, the gums inflamed and there is no swelling in the mouth. Also, my nostril on that side is tender and painful. I am severely worried about the infection spreading to either my heart or my brain. In fact, I read an article a few days ago about a 26 year old who died from a tooth infection spreading. I do not have a fever. I have mild nausea. It is tender on that side of my jaw. The dentist had said the next thing she could give me was Clindamycin, but I have a fear of the side effects of that medicine. I already have heart problems and mild stomach issues. I have read that Clindamycin can cause severe gastrointestinal problems and arrhythmias. She also suggested Zithromax, but I have had heart palpitations while on that medication as well. I am having the teeth removed by an oral surgeon in two weeks, but am afraid of dying from infection before then. What are my options? What is the best course of action? Are there other antibiotics for this? Am I dying from the infection already? Any of your advice or help is appreciated. My other possibly relevant health history is as follows: I have high blood pressure, tachycardia, high cholesterol and mild PVC's. I had a MRSA infection in my arm 10 years ago. I have many strep throat infections every year and frequent sinus issues. Also, I would like to mention that when I took smoothed Cephalexin capsule with a sip of water, I got a random salty taste in my mouth."
},
{
"from": "gpt",
"value": "Hi. I have read your complaint and the relevant details. Please do not panic relating this to death. Maintain good oral hygiene for this two weeks. Revert after a week of extraction to a dentist online.--->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 49 year old female. I have been checking my PPBS at home. But, there is a bit ambiguity in my results. My PPBS after two hours shows around 210 and if I check after three hours my PPBS levels up to 140. So, kindly please let me know that which test result am I supposed to consider. My fasting blood sugar level is usually 120. I am not taking any regular medications. I have been noticing the variations since past one month. I am not prone to any diseases or surgery. My BP and cholesterol are also normal."
},
{
"from": "gpt",
"value": "Hi. We are here to help you. For further information consult a diabetologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, The last you gave me an answer for my query but somehow I could not send you pictures and I am sorry for that. I have a vein on the left side of my penis which is totally visible. It is not a painful one but its totally visible even in a flaccid state also. I need to correct it before marriage. Please help me. I am sending pictures for your reference."
},
{
"from": "gpt",
"value": "Hello. For more information consult a urologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, My last period was on 25th February 2020. I have done urine test twice at home and it is positive and I do have other symptoms of pregnancy. I am sure that I am pregnant. Due to Corona situation, I am afraid to get out and do other tests and see the doctor. I do have a dry cough for the last one month and some time with white mucus. Mostly when I eat rice, and spicy food my cough starts. I have called a gynecologist and she told me to have Adovas after lunch and Duvent (Rupatadine 10 mg) after dinner for seven days. After seven days, I called her and told her that I feel a little better but not stopped coughing and she advise me to take Adovas only three times a day. I did and it did not help me at all. I called her again and she advises Montelukast 10 mg after dinner and its also not working. It has been four days since I took Montelukast and I feel like I need to deep breath when I take it. I have only cough, no fever, no pain, no breathing problem, no headaches, and no running nose. As you know in this Corona situation I cannot go out with a cough to get other tests or see a doctor for my pregnancy advice and lab test. Would you please help me advising good medicine so my cough stops. Other than the above, I am taking Folic Acid 5 mg two times moring and evening as she told me do I need to take anything else for my pregnancy at this moment. Please help."
},
{
"from": "gpt",
"value": "Hi. Congratulations on your pregnancy. Let me tell you in the first three months of pregnancy vomiting sensation, gaseous state, mood swings, breast, and back pain are common. I understand it is not possible to have a consultation now. For cough, do stream inhalation three times a day, tablet Azithromycin 500 mg twice daily for five days, syrup Dextromethorphan / Guaiphenesin combination 5 ml twice daily for five days. (We get it as syrup Ascoril in India). You will be fine. Folic acid is a must once a day till your pregnancy, and tablet Doxinate (Doxylamine) twice daily before food will prevent nausea and vomiting."
}
] |
[
{
"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 have a problem with my throat. Can you check the bumps present above my tonsils in the throat? I have attached my complete blood count report. I also have lymph node raised in the neck on the right and left side shoulder, so my body is fighting with something. Current symptoms are sore, redness, inflamed throat, and tight feeling when I swallow. Is left tonsil lower than right? Also, I feel dry throat all the time. These strange bumps circled in the picture along with red throat are my concern."
},
{
"from": "gpt",
"value": "Hello. From the picture, I can see a slightly congested posterior pharyngeal wall along with tonsillar region (attachment removed to protect patient identity). The bumps you are referring to are small tonsillar cysts which do not carry any significance. They are benign and are not a cause to worry. The tonsils are only slightly enlarged and hence do not need any removal."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 35-year-old female. My weight is 91, and I have three children. I am not having my menstrual period for the past four years. After running some tests, doctors confirmed it is high prolactin, and gave me drugs, but it did not help. I want to find out if there going to be any damages to my health because of this? What can I do?"
},
{
"from": "gpt",
"value": "Hello. It points out that you had early menopause, which occurs in 5 to 10 percent of women at age less than 40 years of age. And yes it has adverse effects same just like menopause in another woman at the usual age. So you must consult your local doctor and get a prescription for HRT (hormonal replacement therapy) which will result in monthly cycles as well as protect you from developing early osteoporosis. You have to continue taking it until the natural age of menopause. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 28 years old. I had no periods for the past five years, after giving birth. I suspect hypothalamic amenorrhea. I had one round of Clomid during my ovulation period, but I had no pregnancy. During the last few months, I stopped my exercise, and so I gained weight. Can I try naturally and see if my body will ovulate on own or should I continue with the Clomid?"
},
{
"from": "gpt",
"value": "Hello. Just by using Clomid (Clomifene) or Letrozole, you may not have your periods. Did you have any significant bleeding post delivery? Your weight looks fine. No periods for five years is too long, and present hormone levels will be unknown. I suggest you have any of the birth control pills of 21 twice a day for 10 days. Throw away the 21st pill. No matter what the cause is, you will have periods within 7 to 10 days of the last medicine. On day three or four of your periods have serum FSH (follicle stimulating hormone), LH (luteinizing hormone) and AMH (anti-Mullerian hormone). This will give you an idea of follicle reserve and also if any central cause present. If both these are normal, you can start Clomid or Letrozole from day three or four and will have a much better result. I hope I have clarified your query, do write back if any more questions and for your feedback."
}
] |
[
{
"from": "human",
"value": "Hello doctor,How accurate is the HIV Ag/Ab test at 40th day after exposure? I know I should retest after three months, but could the symptoms show up, and the antibody is still hidden? Please give me an explanation."
},
{
"from": "gpt",
"value": "Hello. The window period of the Ag/Ab test varies from 18 to 45 days. Therefore a negative test at six weeks (42 days) would be considered conclusive in 98-99 % individuals. However, a negative test at 12 weeks is still considered the golden standard (conclusive in 99.9 % of individuals). CDC (centers for disease control) recommends that a negative Ag/Ab test at six weeks is good enough to rule out HIV. Take care."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had a positive urine ovulation predictor kit test before four days. I visited the clinic for a follicular scan on that day, and I believe there was a rupture of the follicle. I want to know if I have fertile days left after follicle ruptures or there is no chance? We did not have intercourse before follicle rupturing."
},
{
"from": "gpt",
"value": "Hello. Follicle rupture is the right time for planned intercourse. So please go ahead and plan for pregnancy. However, if you have a doubt, then get back to me. Take care"
}
] |
[
{
"from": "human",
"value": "Having pain in anus as well as difficulty while passing stools. huge anount of blood loss."
},
{
"from": "gpt",
"value": "Hello. I welcome you to icliniq. First of all try to reduce your weight. At most times, it is the obesity which has been causing problems. The bleeding while passing stools can be secondary to anal fissure, hemorrhoids, rectal ulcer due to difficult defecation. For better clarification and confirming the diagnosis I need to know more about your symptoms- such as how exactly the amount of blood it is? Does blood form a streak over the sides of poop? How painful it is while passing stools? and does it causes pain or burning even after 1 hour of opening your bowel? and Do you have constipation? No. of stools in a week? If you could answer me for above question, I would be in better position to tell you what it is exactly. Considering a possibility of anal fissure, I recommend you to apply Diltiazem gel 2 % over the bottom with a finger 3 times daily, and start taking ispagol husk 2 table spoon full in glass of water daily irrespective of constipation or not. Take at least 2 to 3 liters of water/fluid daily. Reduce weight by brisk walking 150 min/week and reduce caloric intake. As mentioned above Mentioned above As mentioned above"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am a female nearing 40. My partner and I are sexually very active. A year ago, I was diagnosed for PID, and pap smear revealed nothing else. We both got treated and were fine for a few months. I am very clean, often wash before and after the act. We are both into oral too. Since a few days, I am having excessive discharge (no smell or pus) which is almost white, burning at the tip of my left labia and pain in the lower abdomen.There is no burning sensation when I pass urine. After meeting the burn comes up. I do not use perfumed soaps, but I use a feminine wash. Is this PID again or something else? My partner is fine, and we use protection during this time. Can you suggest some medication? And what could this be?"
},
{
"from": "gpt",
"value": "Hello. Based on the symptoms you described, it appears you must be having yeast infection like candidiasis. I would suggest you take a tablet Fluconazole 150 mg by mouth single tablet for you and your husband. Clingen forte vaginal pessary to be kept vaginally every night for six nights. If there is still no improvement, you can consult your gynecologist for examination and do pap smear and ultrasound if abdominal pain persists."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I concern that I have angle-closure glaucoma. I took a strong sleeping pill called Trazodone one night and woke up with a decreased vision in the right eye. My left eye became bad three weeks later. It has now been three months with no improvement. Fundus and other clinical examinations are normal. However, an OCT showed nerve fiber thinning and ganglion cell thinning."
},
{
"from": "gpt",
"value": "Hello. I reviewed your reports with patience. OCT (optical coherence tomography) of optic nerve head is normal. Your vision, color vision, visual field, and intraocular pressure are normal. I do not think you have any glaucoma. Please feel free to ask your queries."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have inflammation of the penis head and small red bumps on the outer edge of the penis after sex and masturbation. The bumps occur and disappear after a few days. I have been using antifungal cream for about a month and also took antibiotics. It looks like it has vanished but occurs back very irritated after masturbation. I believe it could be balanitis, but that is a self-diagnosis."
},
{
"from": "gpt",
"value": "Hello. I understand your concern, but there are no attached photographs in your message. I need to see the picture of the affected area to make an appropriate diagnosis and to suggest the proper treatment. Kindly send the images."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have been having some chronic abdominal discomfort in my stomach, and occasionally in my chest for several weeks. Also irritable bowels. Before this, I took a six-week course of Ampicillin for what was perceived to be prostatitis. Had an abdomen CT scan with contrast because of testicular pain and right varicocele. My question is, would colon cancer be seen on pelvic CT scan?"
},
{
"from": "gpt",
"value": "Hello. I do not know why you are getting worried about colon cancer? These are not symptoms of colon cancer. As far as your query is concerned, colon cancer may or may not be detected on CT scan based on the stage of cancer. But in most cases, one can see abnormal growth over there. A colon cancer diagnosis is made on biopsy done by colonoscopy. I feel your symptoms are more related to irritable bowel syndrome. Try a good probiotic like cap VSL 3 (live freeze dried lactic acid bacteria and bifidobacteria) that would help you in regaining normal flora that might have been disturbed as a result of antibiotic intake. I need to know if you have any blood in stools, weight loss, or anemia?"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I got drunk and had one-night-stand with an escort. We used a condom, but I did not erect fully when inside her, but I still ejaculated. I am concerned that I could be at risk. I believe the head was covered at all times even though I went soft."
},
{
"from": "gpt",
"value": "Hello. I understand that you are concerned, but if the mucosal surface were not in contact and there were no open wounds in contact, then it is not possible to acquire STDs (sexually transmitted disease) like HIV, syphilis, herpes, etc. But the STDs like genital warts, or genital molluscum does not need to have mucosal contact as mere contact of the lesions on genital skin can lead to spreading of these STDs. But if you are sure of the fact that there were no visible bumps like wart or molluscum, then that too is unlikely."
}
] |
[
{
"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 24 yrs old female...my height is 156cm and I weigh 91kg... I had two abortions...and still no baby...yesterday night I had some blood on my stool...and earlier for few months I had gas problems... usually, gas comes for many times in a day...also, I feel like gas is stored in my abdominal area and feels like to visit toilet often... Feeling heavy in my lower abdominal area, for me It feels like gas... yesterday one time I got some blood on my stool and today I didn't get any blood... but my abdomen feels heavy...and it creates discomfort...what is my problem and what I need to do to get relief from this doctor? Will you please suggest me some opinion? Please doctor..."
},
{
"from": "gpt",
"value": "Hello. I welcome you to icliniq. Actually the chronic problem of gas you mention is common in some one with overweight to obese-as in your case may be. Since your weight appears to be way beyond normal and this has definitely health consequences if not controlled. The blood in stool you mention, is somewhat alarming, and requires a thorough in person examination of the bottom, and looking for the causes such as anal fissure, hemorrhoids, to some serious disorders like inflammatory bowel disease. To summarize I want you to go and meet a gastroenterologist in your local area and get yourself examined to determine the cause. For your and foresee physician's ease just discuss above mentioned causes with him or her. So to finalize, the gas problem is benign (non alarming), but the blood you mention is alarming and need to be investigated. I hope this will help Small intestinal bacterial overgrowth Follow up after getting examined by physician in person"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Two years ago, I suffered from a miscarriage and had undergone D and C. I am suffering from hypothyroidism and on Thyronorm 75 mg, and now the levels are normal. After six months of D and C, I got pregnant while on ovulation induction treatment, and unfortunately, that was an ectopic. My right tube is now blocked as I had undergone surgery. The tube is not removed, but the tube is blocked. It has been a year since I had surgery. I am trying to conceive, but I am not able to. My doctor put me on Letrozole, and it is my fourth cycle for it. During the first cycle, the ovulation was on left tube with ET 6.5 mm, and I did not conceive. Next two were on the right side, so no chance. Now again luckily it is on the left with ET 7.8 mm on day 16. What are my chances of conceiving, and is there a risk of ectopic again? My left tube is clear HSG test was done. Kindly explain to me."
},
{
"from": "gpt",
"value": "Hello. No matter which side the ovulation occurs, the egg will fall into the peritoneal cavity and moves into the available open tube through which it enters the uterus. Since you had one ectopic pregnancy, you have a higher chance of repeat tubal pregnancy. But since HSG (hysterosalpingography) shows a patent tube, you also have a high chance of normal uterine pregnancy. The only chance is to have a pregnancy and have an early scan to confirm pregnancy inside uterus. I hope I have clarified your query, do write back if you have any more questions, for feedback."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have a few questions about glaucoma. I recently had my yearly eye check-up, and my doctor told me that my eye pressure is slightly above average. I know that having a high eye pressure can cause glaucoma, and it leads to permanent blindness. I do not have any pain in the eye, and also there is no family history of glaucoma. So my question is, how do I know if I have glaucoma, and what are the chances of actually getting diagnosed with glaucoma?Is there any home treatments I can do to reduce my chances of getting glaucoma? Any eye drops I can use or any pills or vitamins I can take? My doctor said that just because my eye pressure is slightly above average, it does not mean I have glaucoma. My doctor also said there is nothing to worry about, but I need a second opinion."
},
{
"from": "gpt",
"value": "Hello. Over the years, glaucoma definition has changed. Glaucoma is damage to the optic nerve with visual field defects, and intraocular pressure (IOP) is one of the risk factors. Only with high IOP, we cannot label that someone has glaucoma. Because some people have IOP more elevated than normal but still that is not damaging (called ocular hypertension), and some people have normal IOP, and that is damaging for them, so that is labeled as normal tension glaucoma. So IOP only is not determining factor to label glaucoma other important factors are there. Glaucoma evaluation needs some tests like visual fields and OCT (optical coherence tomography) and optic disc. After seeing all test, diagnosis of glaucoma is labeled. Complete eye exam and analyses are needed for diagnosing. Pain is a feature of one type of glaucoma that is angle closure, and most of the patients of glaucoma would never have pain and will be diagnosed accidentally or through routine eye exam or with decreased vision. No medication is needed until the diagnosis of glaucoma is made. Risk of glaucoma is still there even if family history is negative. Especially after 40 years of age, people having glasses (myopes or hypermetropia) are at risk. So I would advise you not to worry and let your doctor decide. If he or she thinks you need some tests, they will advise you and then determine whether you have glaucoma or not. Otherwise, relax and enjoy. You are welcome for any queries."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I got married before a month, and we are unable to have sex because of my very hard hymen. Yesterday I got bleeding during sex, and we thought it broke, but it was like a small tear from the side. My husband's penis is above average, and it is very hard, so I get unbearable pain every time, and he is unable to penetrate as I force him to stop. Is there any medicine to tear the hymen or only surgery is the option? Please help us."
},
{
"from": "gpt",
"value": "Hello. I can understand your concern. Hymen will not be hard, and your partner needs to understand your vagina, proper foreplay will dilate the vaginal region for easy access. Ask your partner to masturbate for you and increase foreplay. The hymen does not generally break in the first penetrative sex. If your pain persists, it can be due to injury, wait for a week for the hymen to heal. If your pain persists, you can use a painkiller. Increase the foreplay time or masturbation will lubricate the vagina for less painful sex. Use K-Y gel (water based lunbricant), or painkillers if you have any doubts regarding masturbation and foreplay. If all these basic things are fine, we can think of other surgical causes."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 40-year-old male. For past five to six years my hairline has reduced drastically, a kind of pattern balding or thinning of hair. So, please suggest whether I should opt for ayurveda, homeopathy, or any other alternative medicine?"
},
{
"from": "gpt",
"value": "Hello. I understand that hair loss can be quite disconcerting. Please provide me with a few details so that I can prescribe you an appropriate medication. Do you have dandruff or any other kind of disease in the scalp? Do you have any other problem in your body, like anemia, thyroid issues and so on? Are you taking any oral medication for the same? Because there are a wide variety of diseases that can manifest as hair loss. Also, if you could please provide with a picture of the problem, taken in good light and in sharp focus so that I can prescribe you an appropriate medication."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have a history of recurrent early miscarriage (before seven weeks). Investigations pointed to high autoimmune antibodies and high NK cells. With medication, I conceived naturally and had a successful pregnancy. I am now pregnant again (unplanned) and am 7 weeks + 3. I had some spotting and cramping three days ago. The spotting was light and stopped within a few hours. The cramping continued for another day. Blood hCG levels are rising very well and are currently over 83,000. A transvaginal scan yesterday showed the heartbeat and we were told all is well. Today, I had some light spotting (dark brown) and discomfort and passed a brown clot. My query is whether this may have been the cause of the spotting the other day, or maybe this was caused by irritation from the TV scan yesterday. I am concerned anyway and any advice would be greatly appreciated. Current medications: Eltoxin, Prednisolone 5 mcg, Clexane. Sarting Intralipids next week to target NK cells."
},
{
"from": "gpt",
"value": "Hi. How are you doing? I understand your concern. From your history, I do not see any reason for you to worry. This spotting could be from mild erosion on surface of the cervix, which may bleed spontaneously or during sex or due to scan probe. In your history as you have not mentioned pain, I can say for sure that there is no intrauterine blood. Scan also did not pick any hemorrhages (attachment removed to protect patient identity). The medications you are having is absolutely the perfect ones. Most of the miscarriages before 12 weeks are due to genetic problems. But in the present scan as baby's growth has been adequate, you do not need to worry. This clot could be an implantation bleed. This is normal and nothing needs to be done."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 23 years old. I am really worried and fed up with my fat thighs and hips. As I am suffering from polycystic ovarian syndrome and I used to miss my menses. Now, my menstruation is regular. But, whenever I skip physical exercise I am sure that I will miss my menses. I think these all are the reasons for my fat thighs and hips. Sometimes, this problem makes me frustrated. Please suggest me some measure."
},
{
"from": "gpt",
"value": "Hi. Review with the report and for any information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I had a swollen lymph node in my groin and for which I took antibiotics for two weeks. But, there was no improvement. So two days back, I had a biopsy of the whole lymph node. I will get the results in five days from now. I am worried because, now I have another swollen lymph node in the groin, just below the one given for biopsy. When I called my doctor, he said that it is not a typical reaction to the operation. I have an appointment with him in two days. Can you please tell me why my lymph node is swollen again?"
},
{
"from": "gpt",
"value": "Hi. Revert with more information to a urologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I cannot concentrate on anything. My mind is not stable. I have my exams in next eight days but I am feelling like I do not want to give it because due procastination, I have not prepared well and it is because I was not able to study but now my parents are forcing me to give that exam and due to which we have an argument and always during that argument, I just want to leave the house. I do want to study but I am not able to concentrate and focus on it. Also, I am suffering from PCOD. Is it the reason for my unstable mind?"
},
{
"from": "gpt",
"value": "Hi. PCOD does lead to some hormonal disturbance, do you have any symptoms of PMS? Premenstrual syndrome? Because that might be an explanation of your mood swings and irritability. As for the lack of concentration issue, start small with some breathing exercises and relaxation techniques, try guided meditation. For procrastination, it is often a reaction to stress, because we know the the work is stressful, to avoid it, brain goes on procrastination mode.Start with breaking the task in smaller chunks and do it like if you have to finish two chapters in a day, divide the number of pages per hour, then divide in 30 minute slot. Then just put an alarm for 30 minutes and read. Try this out and let me know if you need anything else."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have got very painful rashes on my left thigh which seems to be going up to my spinal cord. Is it shingles? I do not know but I want a good diagnosis soon. Please help."
},
{
"from": "gpt",
"value": "Hello. Yes, this does look like shingles. Please visit a dermatologist on an urgent basis and start on antiviral like Acyclovir or Valacyclovir as soon as possible. Other possible causes for sudden occurrence of such lesions can be irritant contact dermatitis that you can rule out by thinking if you have come in contact with any chemicals or insects on these areas."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I seem to have high cholesterol for the first time and high insulin levels. Please go through my reports and advise. Thank you."
},
{
"from": "gpt",
"value": "Hi. I went through all your reports (attachments removed to protect patient identity). Only few abnormalities noted. Raised insulin levels indicate that your body is becoming resistant to Insulin. It means that you are at risk of becoming diabetic in near future. The solution for raised insulin level is daily aerobic exercise like brisk walking, jogging, running, cycling or swimming for at least 30 minutes every day. Elevated total cholesterol and LDL cholesterol are seen. Since the elevation is not much, also you are young (in report it was mentioned as 32 years) there is no need to start medication at present. Eat low calorie low cholesterol diet - avoid sweets, carbonated beverages, non-vegetarian food, junk food, cheese, butter and ghee. Eat more of fruits, vegetables and drink plenty of water. And do exercise as advised above. Elevated platelet count with slight reduction in mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) is probably due to iron deficiency. For this the solution is eat iron-rich foods like jaggery, green leafy vegetables, peanuts and dates."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have had ED for several years now. I am able to get an erection but I am unable to maintain it. I have been going to a men's clinic for seven months now and they have done the GAINSWave treatment and implanted a testosterone pellet last week. After all this, there has been no improvement. I have been using the ICI injections and that maintains the erection. Sildenafil is effective sometimes, but not consistently. I have also improved my diet and exercise. I also have delayed ejaculation during this, but in the last 10 days, I am unable to ejaculate at all either through sexual intercourse or masturbation. I have been on SSRIs (selective serotonin reuptake inhibitors) in the past but stopped taking them six days ago. At this point, I am at a loss and would like to get another opinion and some direction."
},
{
"from": "gpt",
"value": "Hello. Your lipid values and blood sugar values are absolutely normal (attachment removed to protect patient identity). I would like to say a few points here. Lisinopril HCTZ (Hydrochlorothiazide) is a combo of two drugs in which HCTZ has erectile dysfunction as one of its side effects. Hydrochlorothiazide need to be replaced with a different drug or removed. You are on three antihypertensives Lisinopril, HCTZ, and Amlodipine. Is your hypertension that severe? Testosterone implant may improve your libido but may not benefit ED (erectile dysfunction) always unless there is a gross hormonal dysfunction. SSRI group of medicines are prescribed to delay ejaculation. I do not know why were you prescribed one. That is the culprit which has stopped your ejaculation totally. Better to discontinue it. Instead of Sildenafil for erection, you can try tablet Tadalafil 10 mg (Cialis) after consulting your andrologist. The erectile effects of Sildenafil are short lasting whereas Tadalafil has prolonged effects and one pill on Friday will make you have a wholesome weekend. It may even stop the need to have intracavernosal injections. One investigation which I would suggest you is a penile doppler which gives an idea of blood flow to the penis. GAINSWave is an addon to cure you fast. Penile doppler study. ED."
}
] |
[
{
"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 25 years old. For the last one month my hair has been falling out a lot. My diet is vegan. I am eating a wide variety of foods, getting all my nutrients and not lagging in anything. I have got new hair growth on the top of my head and I am not losing it in patches. The loss is all over. Please help me."
},
{
"from": "gpt",
"value": "Hi. Please answer the following questions for more information. Is there any recent stress either mental or physical? Are hairs falling from whole scalp or sparing any area like only in occipital area? Please send the photographs of scalp. Are you on any medication?"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am 19 years old. I do not have any sexual desire or libido. I am not getting normal erection. I have done a hormonal test to see if something is wrong. Currently, I am on antidepressant. The clinic said that the results are normal. But, I have a feeling that something must be there. Kindly can you check the results and let me know if they are normal or not. Thank you."
},
{
"from": "gpt",
"value": "Hello. Your submitted blood work (attachment removed to protect patient identity) looks normal. I do have some questions for you though. Did you have normal puberty as compared to your peers such as height, shaving, pubic hair, etc? Did you have normal sexual desire and libido in the past? How long has it been since you lost interest? Have you had mumps? Or any other medical problems? Have your thyroid function and prolactin levels been tested? If not get them done. What kind of antidepressant are you taking? Talk to your doctor who is prescribing the antidepressant to see if the symptoms are related to depression or due to the medication you are on."
}
] |
[
{
"from": "human",
"value": "Hi doctor, A physiotherapist did some manipulation with my neck and since then when I fall asleep at night, my arms, hands, upper back (area just below the neck) and brain feels weird as if blood supply is cut. This happens several times during the night while I am sleeping and these symptoms go away when I sit for 5-10 minutes. Because of this, I am unable to sleep properly. I want to get Doppler ultrasound of arteries and veins. Please suggest which Doppler ultrasound I should get to rule out the possibility of any obstruction in arteries or veins caused by several jerks, trauma to my neck and rest of the spine that might be causing problem with blood circulation. My whole spine MRI screening shows disc protrusion at L4/5 and L5/S1. Cervical area does not show any significant change. Please help."
},
{
"from": "gpt",
"value": "Hello. You have mentioned pain and numbness in your upper limbs after manipulation was done by a physical therapist. You have also mentioned both upper limb involvement which is actually a surprise because normal spinal manipulations should not actually lead to this especially if your cervical spine MRI is fine. To actually find out a cause for both your upper limb symptoms, a detailed neurological examination of both your upper limbs including assessment of motor power, sensory examination and evaluation of deep tendon reflexes, nerve conduction studies and CT angiogram of carotid and vertebral vessels can be done. There is an entity called as thoracic outlet syndrome which can actually lead to your upper limb symptoms, but bilateral involvement is not very common. Can you kindly send me the above mentioned details along with the investigations done by you till now? I can see and advise you accordingly. Also send me your blood investigations done recently as well. Will be based upon the investigation and clinical details as provided."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My son is 4 years old. He was only on milk diet till three years. His eight teeth got brown color, when we went to the doctor he suggested for cleaning and filling for six teeth but for two teeth, he suggeested for RCT. My son never complained about pain or swelling. Do we really need to go for RCT?"
},
{
"from": "gpt",
"value": "Hello. Yes, it is called pulpectomy procedure, not proper root canal treatment as done in adults. Those milk molars have to stay till 10 years of age at least. So, if you want to prevent breakdown of teeth and pain in near future, it is necessary."
}
] |
[
{
"from": "human",
"value": "Hello doctor, MOG IgG positive, and NMO IgG negative. Sudden problem in vision of one eye. Age 9 years, female. Treatment IVMP for five days. Please suggest the best possible treatment and please explain about the condition."
},
{
"from": "gpt",
"value": "Hello. MOG-antibodies are common in children with acute demyelinating syndromes (like optic neuritis in your case) with both monophasic and relapsing disease courses. MOG is myelin oligodendrocytes glycoprotein normally present on oligodendrocytes of brain, spinal cord and optic nerve myelinated neurons. Many time during viral infection or due to some unknown reason, bodies immune cells falsely perceive it as a foreign particles and attack on it and it will damage the myelin sheeth. Mostly affects vision of eyes, spinal cord function and brain. Diagnosis is made by history and examinations, MRI brain and spine, CSF, NMO, MOG antibodies. Treatment of patients with MOG-Ab-associated demyelination includes management of acute relapses and chronic immunotherapy for those with relapsing disease. Acute phase treatment: Best possible treatment in your case is IV Steroid for five days, already given. But in case severe disease, IV immunoglobulin or plasma exchange for five days, both will reinstall immunity but not indicated in your case as she is improving with steroids. Maintenance with tablet Prednisolone 1 mg/kg/day for four to six weeks, then will slowly taper down and stop. But in case of relapse (further attacks) will have to continue for long time."
}
] |
Subsets and Splits