conversations
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[
{
"from": "human",
"value": "Hello doctor, I had forced gay sex before 17 days. I had an HIV rapid test after six days of having sex, and the result was negative. Am I prone to HIV and STD's? How long it takes to detect HIV and STD in urine test after exposure?"
},
{
"from": "gpt",
"value": "Hello. Good, you have done a rapid HIV test, and it is negative. But normal results are negative. This means that no antibodies were found and that you may not be infected with HIV. Most people who become infected with HIV will develop antibodies to the virus within two months. During this time, you may have an HIV test, but this test cannot detect it. You will have to repeat the test more than three months after your possible exposure if your results are negative. Better do ELISA (enzyme-linked immunosorbent assay) for HIV, and VDRL (venereal disease research laboratory), TPHA (Treponema pallidum hemagglutination assay), and HBsAg (surface antigen of hepatitis B virus) for STD. If possible, investigate your sex partner also."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 54-year-old woman. Around four to five months, I have been experiencing heavy hair fall in the frontal and lateral region. Since the past one year, I am also experiencing thyroid conditions (hypothyroid 6.40) along with stress and menopause (menopause onset was seven months before). I can notice new hair follicles but very less in number compared to hair fall (more than 100 at times). I have taken multivitamin tablets for a month. Now, I am taking menopause tablets. I have been applying onion, aloe vera, and ginger oil for the past two to three months. Also, I am consuming yogurt, milk, dry fruits. Kindly suggest some measures to arrest the hair fall and initiate hair growth. Also, suggest dietary restrictions and additions if any. I am a housewife and mainly do household chores, though nothing significant."
},
{
"from": "gpt",
"value": "Hello. I understand your concern. Thyroid issues and stress causes hair to fall. Please send me images of your scalp to assess your hair loss better and help you accordingly. Meanwhile, you can start using this. Kindly consult your doctor to discuss and take the treatment with consent. 1. Anaboom anti-hair fall serum on the scalp once a day. 2. Tablet Keraglo Eva once a day. 3. Keraglo-AD shampoo thrice a week apply on the hair for 10 mins and wash off. Also, get the following tests done 1. Hemoglobin. 2. Serum ferritin. 3. Vitamin D levels."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I am suffering from an epididymal cyst in my left testis. Large anechoic cystic lesion of size measuring 1.61*2.05*4.41 cm, vol 7.62 cc in the head of left epididymis. And my right epididymis is thickened and inflamed. Is it possible to cure both without surgery?"
},
{
"from": "gpt",
"value": "Hello. I can understand your concern. There is a possibility to remove anechoic cyst naturally. You can take the following medicines. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Vridhivadhika Vati 1tablet, Kanchanara Guggulu 1tablet, Gokshuradi Guggulu 1 tablet, and Chandraprabha Vati 1 tablet twice a day after meals. 2. Varanadi Kashayam 15 ml twice a with an equal amount of water before meals. Avoid spicy and fried junk foods. Drink plenty of water. Take these medicines regularly for one month."
}
] |
[
{
"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 positive UPT and my LMP is 31st March. I have an irregular period at 13th May and I found some blood spots. After that, I go for a TV ultrasound that shows no definite gestational sac, endometrial echo is central and normal in thickness and measures 0.6 cm. Before TV ultrasound, on 8th May, I checked my beta hCG and it is 178 and after 48 hours it is 247. Is this miscarriage or should I go for another ultrasound because after that I do not have bleeding or cramps or anything? Please guide."
},
{
"from": "gpt",
"value": "Hello. I have gone through the description you mentioned and understand your concern totally. But the details are a little confusing, it would have been good if you could give details with dates when beta hCG (human chorionic gonadotropin) was checked. I understand that scans were performed and the beta hCG test on 8th May is 178 and on 10th May it was 247. On 13th May you got the scan as you had a spotting, right? See, as your previous cycles have been irregular, it is difficult to predict when you would have ovulated exactly. So we cannot go by your dates to calculate the duration of the pregnancy. May I know when did the urine pregnancy test turn positive for the first time? It would be advisable to recheck your urine pregnancy test now again, as you had spotting, if the levels are falling then it would be suggestive of a miscarriage, and mostly this could be like a biochemical pregnancy, where pregnancy is detected only in the blood tests, but on the scan I cannot find the gestational sac development, which has ultimately got aborted. (As levels you mentioned last were pretty low). Another possibility to be ruled out, more importantly, is ectopic pregnancy or pregnancy at some unknown location. To rule out all these, doing a serum beta hCG will clear your doubts. Serum beta hCG level. Repeat ultrasound after checking the beta hCG value. Report to your gynecologist if you have any sharp pain."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have got my urine pregnancy test positive five days before. My last period was in the mid of last month. I have taken unwanted 72 after 11 days of my periods, but there may be some contraceptive failure. I consulted my medical friend, and she suggested me about medical abortion and prescribed Clear kit. So yesterday morning I have taken Mifepristone and today in the morning I have taken one tablet of Misoprostol as guided by her. But it is around four hours after taking medicine, but still, there is no bleeding. Now even three tablets are remaining. Please help me."
},
{
"from": "gpt",
"value": "Hello. Let me start by giving the right schedule for MTP kit. Mifepristone 200 mg orally single dose, will dislodge an embryo from the uterine lining. This will have some gastric problems but no bleeding. After 48 hours of this oral pill, place all four tabs of Misoprostol 200 mcg each at a time vaginal, after wetting it properly in water. Or you can have all four tablets orally at a time. This will soften the cervix and also make uterus to contract. Now you will have pain and bleeding. Complete expulsion will occur within four to five days of Misoprostol. Now you can keep those remaining three tablets vaginal after two days in the morning time. Do not worry, and it will not fail. I hope I have clarified your query, do write back for your question and feedback."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had unprotected sex with a girl, but a sperm has not come because I was inactive as I have drunk. This happened last month. After 23 days, I had RNA PCR, and ELISA both came negative. Then after 7th week, I had antigen, antibody test, which came back negative. In the 10th week, I went for Elisa test 0.4, and it was non-reactive. After completion of the 11th week, I went for Tri-Dot and that also came negative. Should I wait for one week, or is it sufficient for me? Please help me to come out of this situation."
},
{
"from": "gpt",
"value": "Hello. Guidelines says that you should repeat the test after 12 weeks of exposure, but because you have undergone test many times, you are almost sure that you do not have HIV. But it is better to repeat once after 12 weeks. You need not be anxious as most likely it turns to be negative as there is no hint of any symptoms and on previous test results."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My penis size is small. Please advise what can be done."
},
{
"from": "gpt",
"value": "Hello. The size of the penis has no roles in sexual intercourse. Even a person with a small penis but good erection can satisfy any girl. Only a few centimeters of the vaginal wall has sensitivity. What is the size of your penis? If your erection is normal, then stop worrying for that. Jelqing is a home-based exercise that can be utilized to improve the size. The exercise is done in the semi-erected penis and some good lubricant can be used during this. Milking like action is done from base to tip in semi erected penis and this is repeated for around five minutes. This should be done 2 to 3 times a day and if done properly this provides good results. You can learn about this from the internet too."
}
] |
[
{
"from": "human",
"value": "Hello doctor,One of my friends wants to use Dexona and Practin to gain weight. Can she use it for 10 days?"
},
{
"from": "gpt",
"value": "Hello. Using Dexona (Dexamethasone) and Practin is not a correct drug for weight gain. Dexona is a corticosteroid hormone (glucocorticoid) used for arthritis, blood, hormone, immune system disorders, allergic reactions, specific skin and eye conditions, breathing problems, certain bowel disorders, and certain cancers. Practin (Cyproheptadine) is an antihistamine used to relieve allergy symptoms such as watery eyes, runny nose, itching eyes and nose, sneezing, hives, and itching. So these are not for weight gain."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I got an impacted wisdom tooth removed a week ago, I am still in a bit of pain and cannot open my mouth wide without a lot of pain and today I keep getting like pinching feelings in my temple, ear and neck on the same side as the extraction and I have bad breath and a yellow tongue and spitting out yellow stuff when I rinse my mouth. It worries me."
},
{
"from": "gpt",
"value": "Hi. This is a case of post-extraction trismus which occurs either due to traumatic extraction or wrong injection techniques. First of all, I do not know how much you open mouth, it would have been better if you can send photograph with open mouth at highest. Coming to your problem, you need to take muscle relaxants for one week like Zerodol MR (Aceclofenac with muscle relaxant) twice daily. You are required to do some exercise like placing ice-cream sticks between teeth till gap is closed. It must be repeated two to three times daily for same period. However, if there is a very small mouth opening and you are not able to eat, then you need to consult oral medicine specialist for mechanical opening of the mouth."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I had a 4.4 PSA and had an MRI that was negative. Six months later my PSA is 5.7 and even though the MRI was negative it is suggested that I should have a prostate biopsy. I am a 73-year-old male. I am certainly not that excited to have a biopsy. Any thoughts?"
},
{
"from": "gpt",
"value": "Hi. I can understand your concern about undergoing an invasive investigation without any symptoms. Let me explain you what does PSA suggest. Basically, PSA is secreted by the prostate as well as some other body tissues. It does not reach circulation and hence remains low in blood as long as the barrier between prostatic tissue and blood vessel is kept intact. Rising PSA is a sign that there is some tissue alteration which has resulted in breach of this barrier. Hence, do not be under the impression that rising PSA always means malignancy. But it is better to confirm the absence of malignancy by biopsy as, at a PSA level as low as 5.7, even in a unlikely event of report being malignancy, the chances of organ confined lesion is very high, which is easy to treat and chances if cure are high. Hence, it is better to undergo biopsy and get your fears allayed. As such, the biopsy is a very small procedure and safe in experienced hands. Wish you a safe biopsy and I hope the results will be benign."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Recent health check (which I do it by myself routinely and I do not have any diabetes, BP or any other disorder), I found abnormal values of the following hematological parameters, Hb- just normal, RBC- low, MCHC- low, MCV- high (lab has marked all the last three items under bold). Liver , kidney and other blood parameters are normal. Cholesterol- normal, except TGL, which has slightly gone up. My age is 53, BMI- 23, active and fit. Kindly advice whether I need to worry. Even two years back also the parameters RBC/MCV/MCHC were marked as abnormal which now I have noticed."
},
{
"from": "gpt",
"value": "Hello. I have checked your attached reports (attachment removed to protect patient identity). Your hemoglobin level is within normal range. So you may need not to worry about that. You need not worry regarding slight low red blood cell count. For slight high MCV, you can investigate further with serum B12 estimation. Your triglyceride level is slight high. For that you can continue with prescribed medication that is Atorvastatin. So finally you need not worry regarding your all attached reports as per my opinion."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Is my throat swab wrong? Do I have MRSA? There is lymph node swelling and cobblestone appearance from 5 to 6 months. Tried different antibiotics but were not helpful."
},
{
"from": "gpt",
"value": "Hi. It is not MRSA at all. It is a staphylococcal infection (attachment removed to protect ptient identity)."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am suffering from chickenpox scars since childhood as it left so many marks and holes on my face. I need some suggestions to get rid of it. Please help."
},
{
"from": "gpt",
"value": "Hello. I understand that the chickenpox scars have been disconcerting to you. The treatment approach would depend on the depth of the wounds. Very deep scars would need a procedure like dermabrasion. For superficial scars, you can try Tretin 0.025 (Tretionin) cream daily night. Apply it in small amounts and very lightly over the scars, daily night for two months. It will not lead to a 100 % reduction in the scars, but it would gradually make the scars less visible by tightening the skin. If you are not satisfied with the results after two months, consult a local dermatologist for dermabrasion."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have had heart palpitations for two weeks. 3 to 6 times a day. Feeling of one hard heatbeat. I bought a holter monitor and catched it today. Seeking advice."
},
{
"from": "gpt",
"value": "Hello. This is an atrial ectopic or extra beat in other words. These occurs intermittently, so, ECG may be normal in between. These are not worrisome usually and most of the times without much significance. However, we need to rule out the possibility of structural heart disease before calling them benign. So, echo should be obtained to rule out possibility of structural heart disease. Also, thyroid problems can cause these, so thyroid profile should be obtained. Also, too much coffee, sleep deprivation, stress, alcohol and other addictions may cause those, so should be minimized, if any. If too frequent and symptomatic, then one can have beta-blockers medicine like Metoprolol which suppress these. Otherwise these settles with time."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have fever and leg pain since last night. I had preauricular sinus infection pus drainage three weeks back. I was on different antibiotics for the last 45 days. Taxim O, Centil, Augmentin, and Lizobact 600. I stopped taking them two days back."
},
{
"from": "gpt",
"value": "Hello. I have gone through your query. As per your query, you have taken multiple antibiotics for a long time which is not good. I need to know whether you have done a culture sensitivity test for the pus draining out of the sinus or not, because if you take antibiotics according to the culture then chances of recurrent sinus infection and fever are very less. Can you send me the photos of your infected area (preauricular sinus)? Mostly pus discharging sinuses are caused by tuberculosis infection in most of the cases. In my opinion, you should go for a detailed physical and systemic examination along with some blood tests and chest x-ray. Also, if discharging sinuses is still persisting then you need to do a pus culture sensitivity test both for bacterial culture and Acid fast bacilli (AFB) culture and other advanced tests for tuberculosis. Now you can take tablet Paracetamol 650 mg whenever you develop a fever. Please do not ignore your problem as it can lead to deterioration of your health. I suggest you to consult a physician and get a detailed physical and systemic examination done and detailed evaluation along with the above tests."
}
] |
[
{
"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, My younger daughter was diagnosed with pneumonia when she was 8 months old. She is better now (11.7 months now). Her birth weight was 3.5 kg. And by 7 months, she was 6.9 kg. But due to this pneumonia attack she lost her weight and is now weighing 6.9 kg. Is it okay? Or is she underweight? What can be done? I am worried that she is very tiny. Does pneumonia cause weight loss?"
},
{
"from": "gpt",
"value": "Hi. The weight is quite less for an approximately 12 months old child. Please start the child on Multivitamins like Calcimax P 5 ml twice a day and syrup Visyneral Z 5 ml once a day each for three months. Also, start the child on complementary feeds if not yet started. Get the child physically evaluated and probably basic blood tests have to be done to find out if currently there is any infection because of which she is loosing weight."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have been on my period for 15 days so far, and I just noticed today when I pee it stings first and then goes away. I am a virgin. I also missed my period for a month or two before this occurred due to stress with classes."
},
{
"from": "gpt",
"value": "Hello. There is nothing to get stressed. You might be having urinary tract infection, which is very common in girls. You take care of your hygiene, especially during periods and frequent change sanitary towels and wash the area with plain water as many times as possible. Secondly, increase the intake of water and also take cranberry juice three to four times a day. It will help relieve the pain. If this pain does not get relied on by these measures, then you might need antibiotics to cure the infection. But, hopefully, these simple measures would work out for you. Hope it has helped you."
}
] |
[
{
"from": "human",
"value": "Hello doctor,I have done PRK eye surgery about a month ago in both eyes. A few days later, my left eye had some weird blurred vision which turned out to be corneal ulcer that is in the center and relatively big. I got treated immediately with heavy antibiotics Ceftin or Vigamox. After two to three weeks there was some improvement in vision, redness and the loss of epithelial cells is about 1.2 mm, after which I started taking eye steroids, and vitamin C three times a day. Unfortunately, I found out today that there is another small epithelial defect that opened under the first one (both are still very small). I have bad light sensitivity, and I would like to know if there is anything to be done now apart from waiting to get better. I have been told to be patient at least three months since the scarring is still prominent and central, although it is getting slightly better every time I see the doctor. I am currently on, antibiotic eight times a day with steroids three times and Sythnomyine twice a day. Most of the scar is in the front stroma. But central, and it has been slightly getting brighter every time."
},
{
"from": "gpt",
"value": "Hello. Indeed a corneal ulcer requires patience, time, and continuous monitoring until it is fully healed or scar forms. Sometimes it might take up to a year and more. It is however mandatory that you add to the list of eye drops that you are using a lubricant (artificial tears) because dryness is inevitable after any refractive surgery and once you are using eye drops that contain preservatives. You can use the lubricant every hour if you need but except the last hour before going to sleep. That is also very important if your job includes intense visual activities at the PC and or use of mobile devices. I wish you a fast recovery."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am wondering if there is any specific thing to look for on an EKG to show bifascicular block? I am trying to learn EKG reading and was wondering if you can help me."
},
{
"from": "gpt",
"value": "Hi. Look for right bundle branch block and axis deviation. If left anterior or posterior hemi-block is also present, this makes it bifascicular block. If AV block also, this makes trifascicular block. If left anterior and posterior blocks combine, it is called left bundle branch block, if left and right both bundles block, this is called complete heart block and third degree AV block. If you are a medical personnel, it is easy to understand, if layman, then it may take some time to get used to EKG."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am wondering how serious is bifascicular block? Is it common among younger people? I am only 30 years old and this came up on EKG. I was very surprised as I live a pretty healthy life. Any ideas what caused this and what steps I should take next?"
},
{
"from": "gpt",
"value": "Hi. I can understand your worries. It is not common in general population. It occurs mostly in those who have heart attack, angina, have high blood pressure or some valvular disease, especially aortic valve. Other cause is fibrotic degeneration of conduction channels, but it occurs usually in old age as age-related degeneration. It may progress slowly and lead to trifascicular block or complete heart block. Treatment is not advised if heart rate is normal. If in future heart rate decreases or block progresses than cardiac pacemaker may be necessary to implant. Risk of this condition is that if it is due to fibrosis, then it may spontaneously progress which may take years. Other risk is that if anytime in future you have angina or heart attack, then there are more chances of further progression of block as compared to those who do not have this block. I advise you to repeat ECG, have an echocardiography done to see valvular disease, if present, monitor blood pressure."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My father is 86 years old. He is a hypertension patient and on Metosartan 25 mg, Ecospirin 75, and Nexpro. For prostrate, he is on Maxvoid 4 mg for the past 10 days. He is complaining that while passing urine there is an urge and sometimes he passes stool. On medical advice, he took Imodium four tablets for two days and Ofloxin 200 mg for five days but still the problem continues. Please advice."
},
{
"from": "gpt",
"value": "Hello, Welcome you to icliniq.com. I can understand you must be very concerned about your father's health. Well I have reviewed his medical history, which he has been taking for hypertension, prostate, and recent use of antibiotics and Imodium. So typical symptom you mention that whenever he urges to pass urine, stools passes by itself which is suggestive of stool incontinence-means loss of control stools. With his age, it is possible that he has weak anal sphincter. The anal sphincter is a muscle around the anus which contracts and control the stool output. In older age, it become weak and lack sustained contraction hence get loosened. With every attempt to pass urine, which increases abdominal pressure, would also lead to evacuation of stools. This stool incontinence because of loose sphincter at times perceived as diarrhea, however, it is not actual diarrhea. For diarrhea, once has to have stool volume more than 200 ml/24 hour, and significant change in consistency of stools like watery stools, or greenish unformed stools containing food particles. If none of these signs which are suggestive of diarrhea I suggest you to stop Ofloxacin if given for perceived diarrhea. The drug he has been taking for prostate also causes external anal sphincter and hence partly contribute to his stool incontinence. I want to know if he is feeling mucus (thick jelly like material) in stools, blood in stools or rectal pain, or repeated visits to toilet when nothing comes out? This information is important to rule out any inflammatory process beside loose anal sphincter. I suggest you few investigation for stool studies, which will tell if he has active infection of bowel and if present can be treated with antibiotics then. For treatment he can take Imodium, two tablets thrice daily for two more days. Excessive use of this medication would cause constipation and can worsen patient discomfort. I want you to help him learn pelvic muscle strengthening exercises. There are many youtube videos available to learn how to do pelvic floor strengthening exercises while sitting on a common chair. Lastly biofeedback therapy which is a computerized software which help him to control his anal sphincter while passing urine or otherwise. This treatment is offered at physiotherapy department of a hospital. Avoid excessive fibers and modify liquids (1 to 1.5 liter maximum) intake in a day. This would reduce the overall bulk of stools formation in the bowel and hence decreased stool output. Stop or reduce alcohol intake if taking. This also causes diarrhea and loose sphincter controls. I hope this helps. Stool incontinence secondary to age with loose sphincter, plus drug side effect. Digital rectal examination (performed by gastroenterologist in person). Norectal manometry (not usually required if digital rectal examination is suggestive of the diagnosis). Stool detail report. Stool fecal calprotecin and stool for occult blood. Stool for ova and parasites. Stool for fat globules and reducing substance. Complete blood count. Stool incontinence secondary to older age and drug-related. Follow up to disclose other parts of history as mentioned above. Otherwise follow above regimen and see me in one week time after investigation."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have white patch on my face. It was very pale but when I apply Fluticasone, it appears as white even my cheeks are rough and slightly depigmented."
},
{
"from": "gpt",
"value": "Hello. How long it has been there? What are the symptoms of it? Any other area affected? Any other family members affected? Any history of hypertension? Diabetes mellitus? Thyroid disorder? Any known drug reaction? Looking forward to your response in order to help you."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I got dog bite before 17 days, and the wounds are categorized as a category -II. Within an hour, I got a Rabipure vaccine and TT at the hip area. However, the next day morning, one more dose of Rabivax has been given in the shoulder and continued the schedule from the second day. My doubts are, 1) Will there be any side effect due to the extra dose given within 24 hours? 2) Will, it make any difference in giving, first-day Rabipure and subsequently Rabivax? 3) Is there any food restriction after a dog bite? 4) Do I require booster vaccination every year?"
},
{
"from": "gpt",
"value": "Hello. Yes, there is no problem in injecting two dosages within 24 hours. Usually, the first, two shots are given after one another. Apart from that Tetanus toxoid is must that you have taken. It is not the case that the vaccine is ineffective. This is the usual protocol that is followed for safety concerns. Overall, five shots are given within one month. You do not worry but follow your physician. There is no restriction on foods provided as you are fine with your stomach. However, you should avoid intoxicated drinks like alcohol and other things. Vaccination is recommended for high-risk cases. You can get vaccinated that is for safety after year, and it is recommended in case of risks. Rest do not worry as the majority of the times dogs are not rabid, and you might be aware of that."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My wife gave birth before nine days, and we did a blood test yesterday, and her RBC count was 3.54, hematocrit 33.3, and hemoglobin was 11.4. Is this a normal result considering she just had a C-section?"
},
{
"from": "gpt",
"value": "Hello, Welcome to the icliniq.com. Her hemoglobin level is borderline, and there is only mild anemia. There is no need to worry regarding these results. I suggest you give her a healthy diet like more green leafy vegetables, pumpkin seeds, dried beans, and more fruits. There is no need for any medication for anemia just now. I hope this will help you. Let me know if you have any questions."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am getting married three weeks from tomorrow. I am taking the Progestin only birth control pill as I cannot take the combination pill due to my migraines with aura. I talked to my gynecologist a couple of weeks ago to see if there is a way to adjust my period date so that I do not get it during my honeymoon. She told me to go off of my pill this week so that I will get it this week (which I did) and my period would not come for my honeymoon. However, I am certain that she told me the wrong dates as now I am right on schedule to get it again for my honeymoon. I am just wondering if there is anything I can do now. Would it work to go back in the pill for the next week and then go off again and get my period again so that I can push it back and I do not get it in my honeymoon? Or will that probably mess with my system too much?"
},
{
"from": "gpt",
"value": "Hi. How are you doing? As you have already stopped the pill, you should be getting the periods any day next week. In that case, it was a right advise. Once you get the periods start the same pills again, without any break, till the date you want to postpone the periods. This will be a good cycle controller and a contraception. But, if you feel the periods are going to be delayed to the end of this month, then better start the same pill till the date you want to postpone the periods. Do not forget any pill in between or you will have periods in between. Just for an information, migraine can be cured by clearing the cause. Noone has found the etiology of migraine. Predisposing factors are lack of good sleep, sleeping too late, using the screens with bright blue light at close distance for long (tab, mobile, laptops, TV, etc.), missing timely meals, sweating a lot, taking too much of physical or mental strain, etc. So trying to make few changes will relieve you of this migraine. You can even start on combined pills, which are more effective than these Progestin pills."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 17 weeks pregnant. In my USG report a blood collection is found of 52 mm x 20 mm at internal os. I am very worried. What is to be done with the problem?"
},
{
"from": "gpt",
"value": "Hi. How are you doing? After 12 weeks pregnancy, the risk of bleeding is low. Only a bleed from the margins of placenta is to be worried about. Cause of this collection could be: 1. Erosion and thereby minimal bleed from the raw surface of erosion. There may be mild discharge with or without some altered blood. You can have vaginal antifungal or antibiotics like Cansoft CL or Candid V or Clingen Forte once at night for 5 to 7 days. 2. If you have had sex recently. Above medications can be used. 3. I hope cervical length is greater than 2.5 cm and internal OS is closed. If not, you may need a cervical cerclage stitch. To be on a safer side, you can have: A. Injection Proluton depot 500 mg IM once in two weeks for 1 to 2 months. B. Capsule Susten or Dubagest or Naturogest or Vagestone 200 mg twice daily vaginally for 1 to 2 months. These both can be used simultaneously. They both are Progestrone hormone. They relax the uterus and if the blood has any chance to irritate the uterus, these two will stop it. So can prevent preterm labor pains. It is not easy to prevent pain once it starts, so better to use it before any risk factors. I do not think there is anything to worry, avoid any strenuous work, journey and sex."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Can you please tell me the difference between left and right bundle branch block? And why is left considered far more dangerous?"
},
{
"from": "gpt",
"value": "Hi. Heart needs current to beat. Current is generated in sino-atrial node. It is like electric generator. It travels via bundle branches, which are like wires. Current goes from SA node to AV node via atrial bundles. Then from AV node to a small bundle called HIS bundle. Then goes to right ventricle via right bundle branch and to left ventricle via left bundle branch. Then it further divides down. When there is interruption in right bundle, it is called rbbb and same for left bundle branch. Right bundle branch may not always be dangerous because right ventricle is a low pressure chamber, pumps blood to lungs which is also low pressure. Left ventricle has to pump blood to whole body, it has to force more. When lbbb occurs, left ventricle is contracted via current coming from right bundle branch and it takes some time to reach left side although only milliseconds of difference but that is significant. Thus, there is dys-synchrony between ventricle which may lead to ineffective output from left ventricle, because whole vascular circuit is interconnected and should work in rhythmic synchronized way. Moreover, lbbb usually occurs due to heart attack. But all this is not as simple as mentioned. It is more complicated. It needs much time to make you properly understand the whole working of heart and its connections. Hope you got a little idea about lbbb and rbbb."
}
] |
[
{
"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, How accurate are early ultrasounds at determining gestational age and conception? Based on my 6th-week scan I am 23 weeks today means I conceived around December 25th. Is it possible that I actually conceived around December 5th and baby is measuring small? (I have had six ultrasounds and the baby has never measured more than 2 days off from the date given at my 6-week scan) even though my last period last came on November 28th she has never measured on track for that."
},
{
"from": "gpt",
"value": "Hello, Welcome to icliniq.com. The first-trimester ultrasound scans done before 12 weeks are the most accurate ones in the assessment of gestational age with an error of only + /- 5 to 7 days in the assessment of gestational age. So they are used for obstetric dating and determination of expected date of delivery. Moreover, if you have done 6 ultrasounds and the date calculated from each of them corroborates and does not lag behind then probably your baby is growing well and it is not small as you apprehend. The date we calculate from the first day of last periods is accurate only if the periods were regular for the last 3 months and there was no history of miscarriage or ovulatory disorder like PCOS (polycystic ovary syndrome) or contraceptive pill intake. In case of any discrepancy the date from dating scan at 6 weeks are accurate and to be considered. It is a probability that you actually conceived in later part of the cycle which leads to this discrepancy between the date and USG."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am an asthmatic for 15 years. Right now I am using Foracort 400 mg since three years. I am also hypertensive and using Telma-AM. Since past six days I am facing uneasiness in breathing and because of that maybe my BP has raised. Last week before all this happened I got a master health checkup done and my uric acid level was 9.1 and traces of albumin were there. Just to mention, that was my sixth day of keto diet when I got the checkup done. Later, I stopped Keto. Kindly guide me."
},
{
"from": "gpt",
"value": "Hello. As you know, asthma is the chronic inflammatory airway disease with waxing and waning episodes. If you have asthma, your airways are always inflamed. They become more swollen, and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for the air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and chest tightness.There is no permanent cure for asthma, and current guidelines suggest to keep it under control with the inhaler medicines. Foracort 400 mg is the best inhaler, and you should continue using it two puffs twice daily. As far as the diet is concerned, diet can increase or decrease inflammation in the airways, depending on what you eat. But the ketogenic diet per se is not responsible for worsening underlying asthma. Rather in some cases, it seems beneficial for the patients. So, the ketogenic diet is not at blame for asthma worsening. Might be there is another reason for the change in asthma pattern that is causing uneasiness or difficulty in breathing. So, it is advisable to see your treating physician and get the necessary investigations done to find out exact control of your asthma. Also as you said, the master check up uric acid value is high and needs evaluation by the doctor. Environmental changes as high pollution, colds, drop in temperature might cause asthma flare-up, and you may need to take inhaler like Levolin (Levosalbutamol) for the time being. So overall, only after proper physical evaluation, we can decide the exact cause of your discomfort. For more information consult an allergy specialist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor,I started my paleo in the month of November wherein my HbA1c was almost 10, continued strictly for 100 days and in February HbA1c was 6.5 without taking medicines. Afterwards, cheating started and now it is 8.8. Also, there are some imbalances in the blood report. Now, I am assuring you that I shall stick to my paleo diet and follow your instructions. Kindly suggest me a plan. I can take eggs and chicken."
},
{
"from": "gpt",
"value": "Hello. Paleo or Keto diet is not sustainable, as it is elimination and crash diet, especially for morbidly obese people. It not only about bringing sugar levels down, also it should not cause any nutritional deficiency, which may happen with paleo. Having higher intake of animal foods means having higher and processed saturated fats. For diabetes, all carbs are not the culprit, only simple and processed form of carbs raise blood glucose levels. For sustainable lowering of blood glucose, one should have a large serving of fruits pre-breakfast (fruits do not increase blood glucose), a large serving of mixed salads before lunch and dinner. Reduce intake of rice and wheat based foods. Totally avoid market and packed foods, dairy in all forms, refined oils. With these changes, you can have sustained lower blood glucose. Please contact me for any further details. For more information consult a nutritionist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Does the keto diet positively affect and alleviate stomach issues such as IBS?"
},
{
"from": "gpt",
"value": "Hello. Keto diet is a crash diet, which means it can be done for a short period of two to three months or so. It can surely improve digestive issues such as IBS (irritable bowel syndrome) as it involves a very low intake of carbohydrates. But one must be careful in making the right food choices while consuming fats. Avoid eating fried stuff. Go for healthy fats and proteins like whole boiled eggs, steamed chicken, cottage cheese, raw olive oil, and avocados, etc. You can include vegetables like carrots, peas, broccoli, spinach, kale, and mushrooms, etc. Do it for one month, and if it shows good results, you can continue further."
}
] |
[
{
"from": "human",
"value": "Hello doctor, For three years, I have been taking 12.5 mg of Atenolol and 80 mg of Diovan to control blood pressure. Readings over the years have been good and average. 120/60 was the blood pressure 55 to 60 was the pulse rate. I have a good blood pressure monitor, and I take readings three to four times a day. Last month while taking a regular reading, we noticed a reading of 136/60 blood pressure and pulse 32. A few minutes later, the bp was 141/68 and pulse 32. We went to the emergency room at the local hospital during a trip that took about 25 minutes. The readings had gone up to 60 bpm, and the blood pressure readings were satisfactory. I was in the emergency room for about 12 hours, where they did several blood tests an ECG and a chest X-ray. I was discharged the next day because they said my condition was fine and they recommended dropping the 12.5 mg of Atenolol completely. (I am attaching a 24 hour Holter monitor report that was done two or three days later). I took 0.4 mg of Flomax for 18 days for BPH. The readings were normal from the last month till the mid of this month. Then suddenly on a fine day, the readings of pulse rate and blood pressure were high, so the family doctor recommended resuming the Atenolol at 12.5 mg. After four days, we then found that the pulse rate was going down into the 30 bpm again, so the family doctor recommended cutting the Atenolol in half to 6.25 mg after which the readings of the pulse rate were high 30’s and blood pressure going up to 191/85. So the family doctor recommended taking 6.25 Atenolol in needed basis if the pulse rate and blood pressure started to spike. So we monitor blood pressure and pulse rate each morning before we go out to see if it is necessary to take the Atenolol and it is very stressful."
},
{
"from": "gpt",
"value": "Hello. So the problem you mentioned are two 1. High blood pressure and 2. Heart rate 1. For BP, continue Diovan (Valsartan) 80 mg. Regarding Atenolol, it does not has many effects on BP, but has an effect of lowering heart rate. If your BP remains elevated, you may increase the dose of Diovan to 120 mg. 2. Take Atenolol 6.25 mg, if heart rate without it remains more than 80 to 90. If the heart rate is below 90, no need to take Atenolol. Moreover, count heart rate manually by counting beats or pulse. Do not rely on what the BP measuring device tells. Remember one thing, sudden stopping of Atenolol increases heart rate beyond normal for a few days, but later it settles to normal. So, be patient."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 23, and I have too much problem. I have depression, anxiety, and many sexual problems. I watch extreme pornography daily. I think I damage my penis by rough and abnormal masturbation. I am too much worried about it because I face too many complications. How to diagnose whether my penis is damaged or not? Please help me."
},
{
"from": "gpt",
"value": "Hello. Why do you think you have damaged your penis. Is there anything abnormal in the penis? Too much of thinking about it may lead you in depressive mood state. Masturbations is normal thing, maximum persons in your age practice it. If I talk about prevalence you will be shocked, nearly 100 % of male and 70 % female practice masturbation (standard psychiatric book). There is no harm in masturbation, semen is an ordinary fluid like saliva, and in male sperm, it is produced daily. If we do not perform sex or do not masturbate, semen will come spontaneously in the form of nightfall, but that is not again a problematic thing. It is a harmless practice until if you become an obsession, and start hampering your daily life. Thinking about near one in fantasy is also not uncommon, it happens. If you want to quit it first set in your mind that you have not committed any crime, you are going to leave a habit that was trying to conquer you. You can do it. Do not remain in guilt, move ahead and involve yourself in other activities. Try to be with friends and family. You can take help of religious thoughts. Do moderate exercise, reschedule yourself, be active. You can contact some psychiatrist nearby you. Take proper sleep and a healthy diet. Practice yoga and meditation that will help you."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am pregnant with my second child. According to my LMP, I am supposed to be about 10 weeks. However, I had a scan about 3 weeks ago which showed 6 weeks 5 days and another scan this week and it showed 6 weeks 3 days. Baby is also sitting on the uterus lining making the baby very easy to miss if the sonographer is not thorough. There is also a strong heartbeat. Is it possible that due to the baby's current position in the uterus we are not able to get the right measurements to see if the baby is growing well? I do not think it is possible for a baby to decrease in size with a strong heartbeat. Please help. I am emotionally stressed due to this. I have another follow-up scan in a week."
},
{
"from": "gpt",
"value": "Hi. Firstly, is your period regular or irregular? Were you breastfeeding or taking any pills? In these cases, LMP is not considered as accurate, and scan is the main thing to determine the gestational age. Secondly, the baby position does not play a role in hindering having measurements. The baby would sit on the lining because it gets nutrition from there, and that is what is called implantation. Thirdly, what concerning is that if measurements were the same three weeks ago why the baby has not progressed in these three weeks. Possibly one of these scans is not correct either this recent one or the last one. This thing is worrying for me, and it is good that you are having a follow-up scan, and if the baby's heartbeat is there, then you have nothing to fear. Hopefully, everything would be clear by next week. I am wishing you all the very best."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have been having these eruptions on my forearms since past two months. They are not painful and cannot be popped. But they take a long time to disappear and look prominent. What are these and can they be stopped from re-occurring? I had them last year too during summers and they disappeared after 4 to 5 months. I have severe keratosis pilaris on my forearms and back, can they also be keratosis pilaris?"
},
{
"from": "gpt",
"value": "Hi. From these two photos (attachment removed to protect patient identity), it is visible that lesions are little inflamed and red. It is indicating folliculitis. Non-bacterial folliculitis can be non painful. Specially pityrosporum folliculitis. Keratosis pilaris is a condition where you may have dry hard covering surrounding hair opening. Sometimes it may also get inflamed, so it can be related to this also. Arms are common site for such bumps. You need capsule Doxycycline 100 mg twice a day for 14 days, Clindamycin gel local application morning and evening, tablet Fluconazole 400 mg stat. For keratosis pilaris, you will need moisturizer. 14 days, it should subside."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My father is suffering from gas issue from the last 7 to 8 days. He does not feel like eating from 2 to 3 days. Have checked with local doctors, after a few tests they found nothing but his bloating has not gone down. He also feels pain in stomach. Please suggest."
},
{
"from": "gpt",
"value": "Hi, Welcome to iclinq.com. There are different conditions that can cause abdominal bloating that goes from non-urgent to serious conditions. If he is not passing bowel movements or gas and has remarkable abdominal pain, it can be a serious condition like bowel obstruction and needs to be taken to hospital emergency department. On the other hand, if he is passing gas and bowel movements, he needs to be checked for H. Pylori which is a stomach bacteria and has a specific treatment. If H.Pylori is negative then next step is to see a gastroenterologist for potential gastrointestinal endoscopy."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My dad is 78 years old and was diagosed with stage 4 transitional cell carcinoma of left kidney for which he underwent a neprourectomy. It is six months now and he took immunotherapy for the same. He had three doses of Ketruda but with third dose he developed pneumonitis and changes in lung. He had blood culture but no infection was present so they treated with steroids for 10 days, after stopping steroids he developed some tiredness and fever for which he was put on antibiotic Bactrim. But after he took that for a few days, he was better but just two days back he developed extreme drowsiness, slurring of speech and confusion. He was advised to rush to a nephrologist because his creatinine was 3.7 and his HB was 7. His potassium levels were high too and ESR was 120, lymphocytes were low. So, they took out all the drugs he is presently on to stabilise his creatinine and potassium levels and transfused blood. My question is he was on maintainance drugs for 40 years of which Sartel 40 for hypertension, Glyciphage for diabetes, Liofen and Gabantin for trigeminal neuralgia and Ativan for anxiety have been withheld. Do these drugs cause any interference with his kidneys? Please let me know because I want a second opinion and be double sure that this is the right thing to do."
},
{
"from": "gpt",
"value": "Hello. I have gone through the details about your history. Cause of deranged renal function is multifactorial. First of all, Ketruda that is Pembrulizumab can cause interstitial nephritis, that can cause damage to kidney and rise of creatinine. Sartel is for blood pressurebut it can cause rise in creatinine in acute setting such as after surgical stress, so stopping is a good decision. When there is a damage to kidney, drug such as Gabapentin get accumulated in body and can cause neurological symptoms as you told. It will subside gradually as kidney function improves. So, from current medicines, you stop Parozep until his kidney recover, for blood pressure take Amlodipine 5 mg (as the blood pressure is normal now) (attachment removed to protect patient identity). Get urine routine done and urine protein creatinine ratio and if creatinine continue to rise, a kidney biopsy may be needed. Otherwise, control of potassium and urine output as per regular protocol of treating nephrologist. Take care and would like to know further detail and progress, wishing him a speedy recovery."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 36-year-old woman with family history of heart disease. For a couple of days, I have been feeling discomfort in my chest, like my heart gets squeezed and I have chest discomfort on the left top part of my chest, like six fingers down my clavicle. I also have a lot of fatigue, specially from 10 AM to 1 PM. The discomfort gets worse when I am laying on my back and I can feel my heart moving in my chest in an unusual way and the squeezing feeling coming and going. I have had anxiety disorder for almost 20 years but this does not feel like my usual anxiety. I am worried and not knowing exactly what to do."
},
{
"from": "gpt",
"value": "Hello. Classical cardiac chest pain is a sensation as if an elephant is sitting on your chest. It lasts from a few seconds to minutes and could be provoked by exertion. What you are feeling is classified as atypical chest pain but you also have palpitations. Do you have a way to check your blood pressure and heart rate? Please let me know."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am a 36-year-old male. I previously had a chlamydia infection and was successfully treated. Will such previous infection interfere or affect my fertility? I recently had a scrotal examination and the results were normal."
},
{
"from": "gpt",
"value": "Hello. Chlamydia infection persistence or recurrence can definitely cause an apparent increase in the pus cell and WBC count in the seminal fluid which can easily decrease the total sperm count and its quality. If you have been treated it is good, but again it takes 90 days for new spermatids to form adults and become functionally mature for fertilization. It is always best to get a repeat semen analysis and culture done to be sure that there is no repeat or recurrence of chlamydia infection if you have been sexually active post your previous examination or if your partner was not treated along with you."
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?"
},
{
"from": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached."
},
{
"from": "gpt",
"value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well."
},
{
"from": "gpt",
"value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help."
}
] |
[
{
"from": "human",
"value": "Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help."
},
{
"from": "gpt",
"value": "Hi. For further doubts consult a sexologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, This is my CBC report and everything is normal except RBC. In it, RBC shows anisopoikilocytosis predominantly microcytic hypochromic cells along with normocytic hypochromic cells and few targets cells. WBC is within normal limits. Platelets: adequate. (MCV) mean corpuscular volume72.0 fL, normal range 80 to100 fL. (MCH) mean corpuscular Hb. 18.6 pg, normal range 30 to 36 pg. (MCHC) mean Corpuscular Hb. Concentration 30.0 g/dl, normal range 32 to 36 g/dl. I will attach the report. Please suggests cause and solution for this."
},
{
"from": "gpt",
"value": "Hello. Your report is suggestive of microcytic hypochromic anemia. Do not worry about that. It is a treatable condition. With the recovery of hemoglobin level by tablet, your PS (peripheral smear) will be reverted to normal. It is not an alarming condition. But I suggest the following work up for you. 1. Serum ferritin estimation. 2. Serum transferrin saturation. 3 Serum FEP. 4. Serum TIBC. These four investigations, help in rule out iron deficiency anemia. 5. HB electrophoresis. This fifth investigation will rule out any hemoglobinopathy if present. Kindly revert back with these reports so that I can guide you further. Hope I have answered your question."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I usually would get my period on placebo pills on the third day, and I skipped my period by not taking placebo pills for a couple of months. I started to take them again and had my period last month, and this month I am on the third day, but it has not come. Could my body just be changing? Is it normal to get my period farther into the placebo pills?"
},
{
"from": "gpt",
"value": "Hello. Yes, what you are experiencing is very common, especially if you have been on the pills for a while. The birth control pill will actually thin the lining of the uterus over time, and many women barely have any bleeding during the placebo week, we sometimes call these pill periods as it is often just some very light spotting or brown discharge. It is ok if you do not have bleeding during the placebo week, as long as you have been taking your pills every day and you are sure you are not pregnant."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have had a fishy odor down there since I was in elementary school. I was not sexually active at all either. Just a couple years ago I realized I might have something called bacterial vaginosis. I went to the doctor for it a couple years ago and got prescribed Metronidazole and it did nothing for me. Ever since then I have not really gone to the doctor about it again. I am worried because I have read that BV left untreated can make you infertile. How common is it that this could happen? And do you have any tips for me?"
},
{
"from": "gpt",
"value": "Hello. Yes, you have heard right that if vaginal infections are left untreated they may lead to PID and infertility. It is a serious issue which must be dealt with promptly and appropriately. Bacterial vaginosis leads to change in vaginal flora and pH which results in fishy odor and discharge. Metronidazole is the recommended treatment for it but as you say it has not affected you then I would suggest that you must not neglect it and get yourself fully checked by having vaginal swabs tested and getting exact diagnosis and treatment. Secondly, hygiene is of very much importance with regards to vaginal discharge. Some tips are as below: Keep the vaginal area clean and wash with plain water as much as possible. Avoid any cosmetic products over the vaginal area and wear cotton rich undergarments."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I tore off a mole or a freckle some weeks ago and now the surface, it is like this. Is it good or should I worry? What are those red spots?"
},
{
"from": "gpt",
"value": "Hi. I have gone through your case. Your lesion is active which means the area has not healed after removing your mole (attachment removed to protect patient identity). Keep applying Fucidin acid cream two times a day till red area disappears. It is not something to be worried for as such raw areas take some time to recover. But no opinion can be given for lesion or mole or freckle which you have removed yourself. It could be a simple mole or it could be a wart. Such raw areas are usually seen after wart scratching."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I have a kind of flap in my mouth since three weeks in the inner left cheek near the saliva hole. At the beginning, it was bright red with light pain when I put my tongue on it, and now, the flap is the same color than the rest of my mouth and painless. What should I do?"
},
{
"from": "gpt",
"value": "Hi. In the absence of pain, it seems to be a case of fibroma, a non-benign lesion and you need not worry about that. This can be due to trauma, bite or sharp tooth or broken tooth in the area. However, I need to rule out the possibility of stone in duct and tooth. Can you answer these questions: Do you feel any pain on chewing or during eating in any part of the mouth or gland? Is there any pain when you bite? Do you have any carious tooth in the region? Do you have any history of biting in that region? Any other problem for which you are taking medicines?"
}
] |
[
{
"from": "human",
"value": "I have a small pimple or swelling in anal area where stools are passing from last one week which is not painful and there is no problem with bowel movement. Its having an itching sometimes.. it is piles or any related disease. It just had a small itching sensation and had small pain while washing after bowel movement and no pain while passing stool."
},
{
"from": "gpt",
"value": "Hello Dear. I welcome you to icliniq. This seem to be a perianal boil. The boil is a pus containing hair follicle. Hair are the stalk and follicles are the trunk of the hair. The follicle can get infected and cause enlarged painful swelling called as boil. It is not communicating to your bowel thats why you dont have problem with your bowel. The best thing you can do is to keep this bottom are clean and hygienic. Wash it thoroughly with each bath and remove hairs timely.. You can apply fusidic cream three times daily over it. It shall heal in few days of application of this cream. I hope you will be fine. Good day. perianal boil/folliculitis none fusidin cream for local application follow up if symptom persist"
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am having knee problems for a while. It feels like my knee needs to be popped but it will not. I cannot bend my knee without having pain. Could someone please tell me, why is it? And what should I do to make it feel better?"
},
{
"from": "gpt",
"value": "Hello. Thanks for your query to this platform. You are actually quite young to be having persistent knee pains. Your knee pain could be due to certain reasons. But, common ones are chondromalacia, pain due to knee instability, inflammation, etc. If there is no history of any injury, and no signs and symptoms of inflammation or infection like swelling, skin redness or local warmth on touching, then I would like to advise you for conservative management initially in the form of."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My daughter has pleural infection in lungs. When she was 2 years, decortication was done by open surgery. Now she is four years old. 3 days back she got fever. Though after taking antibiotic her fever subsided, x-ray report showed mild cardiomegaly with bilateral perihilar congestion. Is there again a chance for fluid to get gathered inside her lungs? What should we do for the same? Please advice."
},
{
"from": "gpt",
"value": "Hi. I can understand your concerns. Pleural fluid collection occurs when infection persists for long time and is not responding to antibiotics. Pleural fluid collection in past does not increases the chances of collection at a later age. This time, x- ray (attachment removed to protect patient identity) shows mild cardiomegaly and perihilar congestion. This is not related in any way to lung infection and fluid collection. I suggest you to do an echocardiogram, to see what is the cause for cardiomegaly. Further treatment will depend on echocardiography report."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My father and my grandmother died within 3 months. After they expired, I started to face many issues like LIC claim and others. Due to too much stress, I am unable to sleep at night properly and feel sleepy in the morning. Because of this reason, I am unable to concentrate on my work. I am working in software industry. Due to the issue I am facing, I am not able to complete the tasks on time and going through a lot of problems. I am also suffering from body pain. Presently, I am on Zincovit multivitamin tablet. Thank you."
},
{
"from": "gpt",
"value": "Hello. I feel sorry for your loss. Your problems are stress, unable to sleep at night and body pain. So, basically it is your stress that is leading to other problems. Stress can be managed both by medication as well as by lifestyle modifications (behavior therapy). First, try lifestyle modifications which include: Also, proper sleep hygiene needs to be practiced daily, so as to help you to maintain good sleep in the long run. Sleep hygiene entails following important points. These lifestyle modifications will help in improvement of symptoms and you will feel better. If symptoms persist even after lifestyle changes, then visit a psychiatrist. Drugs like Modafinil or Armodafinil will help to maintain daytime alertness and will reduce fatigue. Visit a psychiatrist for proper prescription of this drug."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am a 40 year old woman. I had hysterectomy 4 years back. Now, I have no periods or blood loss of any measure. I am having balanced diet with plenty of meat and kale chips. Since 3 months, I have started taking raw food and prenatal vitamins because of cracks in mouth that would not heal and it seemed like hair was falling out. After over a year of severe insomnia, exhaustion, mouth sores, constant itchiness and RLS issues that made my husband wonder, I went to my doctor last week wondering if it could be hypothyroid. As I have not had periods since 4 years, I did not suspect any anemia. Doctor has done two CBC's. The second one had even lower hemoglobin and hemotocrit levels. My last CBC that was taken 4 years back showed a hb of 14.4 but vitamin B12 results were within normal range. I am attaching all my reports for your reference. Please guide."
},
{
"from": "gpt",
"value": "Hi. Based on your query and reports (attachments removed to protect patient identity), my opinion is as follows:The low hemoglobin at present is not due to blood loss, it is nutritional. If you look at the iron studies, the iron levels are very low, indicating inadequate iron in body. They can be possibly secondary to reduced intake and may be a cause of malabsorption. As the other vitamin levels are normal, it is more likely reduced iron intake or absorption. The reticulocyte count would increase in case of anemia, if the nutrition too improved. It is staying within the normal range. If you start iron supplements along with vitamin C (for better absorption of iron), you will find your reticulocyte count increasing within 2 weeks. There is no hemolysis or hemorrhage, as in both conditions, if nutrition was adequate, the reticulocyte count would have also increased. At present, all studies including red blood cell volume distribution (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) are iron studies that are pointing towards iron deficiency. Good to know your thyroid profile is good. Insomnia and exhaustion can be easily explained by anemia. Also improve the hydration (take at least 5-6 liters of water per day). Avoid coffee or tea along with food, as it inhibits iron absorption. Adding citrus fruits or vitamin C rich diet during food intake improves iron absorption. At present, nothing to worry except iron deficiency. Supplements of iron with iron fortified food and iron-rich diet should help. Also, take vitamin B-complex supplements, as early changes like ovalocytes are also seen in blood. Both iron and vitamin B-complex supplements to be taken, and within two months, you will return to your normal self. Repeat the reticulocyte count after 15 days to check if it is increasing. 1. Both iron and vitamin B-complex supplements to be taken. 2. Most importantly iron-rich foods to be taken along with vitamin C supplements. 1. Iron-rich diet, iron fortified foods. 2. Balanced diet and good hydration."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I got my dental checkup done recently. A small cavity was observed on the side of my tooth between 2 teeth. I am attaching a photo of x-ray. Please check second upper tooth from left in the x-ray. Also let me know, if this can be cured by filling?"
},
{
"from": "gpt",
"value": "Hi. I checked the x-ray (attachment removed to protect patient identity) Yes, this can be cured by restoration."
}
] |
[
{
"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, My mother has been on Holter heart monitor for the last 24 hours. If any abnormalities found on this, then what treatment can be suggested by doctors?"
},
{
"from": "gpt",
"value": "Hi. Thanks for the query. Holter monitoring is done to identify rhythm problems, to diagnose the type of arrhythmia, and its relation to daily activities, to detect heart blocks and to monitor treatment. Now depending upon sign and symptoms and rhythm identified, the treatment plan may be devised by a cardiologist. In general, for fast rhythms, medicines are given to slow down the heart rate and also reversion of rhythm to normal can be attempted via medicines or invasive intervention. For slower heart rates such as heart block and its symptoms such as loss of consciousness or dizziness, pacemaker (which is an electronic device than generates a pulse for the heart) may be implanted. Depending upon rhythm detected, further tests may be advised such as cardiac electrophysiology study. So, possibilities are many; if you provide some history of the patient, I can guide you properly. Just tell symptoms of the patient, any current illness and medicines she is taking, any previous ECG, echocardiography or other tests performed. If you can provide the above details, it will narrow down my answer and easy to understand for you. I am praying for your mother. Regards."
}
] |
[
{
"from": "human",
"value": "Hello doctor,My baby has developed redness around the perianal area. We have been traveling for the last two days, and hence, the usage of the diaper was more. My husband has developed a fungal infection, and he is on antifungal. He avoids touching the baby. Please help."
},
{
"from": "gpt",
"value": "Hello. If possible, please avoid diapers. Apply easy nappy or rash free ointment around the anal area in thick layer three to four times a day. Apply candid cream twice a day around the anal and groin area. Diaper rash. Diaper rash."
}
] |
[
{
"from": "human",
"value": "Hello doctor, Foot pain started 18 months ago after running. It has persisted, but the severity of pain depends on how active I am. Most recently, the pain has become more severe. Please review my X-ray."
},
{
"from": "gpt",
"value": "Hello. Please send me the full X-ray which you have sent (attachment removed to protect patient identity). I would like to see the whole joint, like of talocalcaneal joint."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My blood test shows platelets and monocytes above the normal range. Is this a sign of cancer?"
},
{
"from": "gpt",
"value": "Hello. There are two types of thrombocytosis, primary and secondary. Primary thrombocytosis is a disease in which abnormal cells in the bone marrow cause an increase in platelets. Secondary thrombocytosis is due to another condition the patient may be suffering from, Increase of monocytes indicates there is a chronic infection, an autoimmune or blood disorder, cancer, or other medical conditions."
}
] |
[
{
"from": "human",
"value": "Hello doctor,From the last six months, I am getting my periods either five days before my due date or two days later than the due date. I want to know, is it normal to experience this time interval in periods?"
},
{
"from": "gpt",
"value": "Hello. Yes, this is normal. Seven days plus or minus is considered as a normal menses cycle. It means any cycle length between 21 to 35 days is normal."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 51 years old. I had a severe allergic reaction when I was 7 years old, after eating a crab meat sandwich. It was made with canned crab meat, and I cannot be sure if it was real or artificial. I found large round red hives all over my body, which turned to rings before healing. I never ate crab or lobster since then. I have always eaten shrimp, scallops, clams, and many other types of seafood without issue. I continue to wonder if my allergy all those years ago was a crab meat allergy. I have been avoiding crab and lobster for no reason. Does all seafood belong to the the same family?"
},
{
"from": "gpt",
"value": "Hello. Allergy reaction is due to a specific particular protein or substance. Each group has a different type of protein. It varies from each. There are several types of shellfish, each containing different proteins like crustaceans include crabs, lobster, crayfish, shrimp, and prawn. Mollusks include squid, snails, clams, oysters, and scallops. Some people are allergic to only one type of shellfish but can eat others. Other people with shellfish allergy must avoid all seafood. So one may need not get an allergy to all group and family."
}
] |
[
{
"from": "human",
"value": "Hi doctor, My son is 11 months old. He is suffering from cough and cold, and his BCG spot has also turned red. He received his vaccination long back. Then why did it turn red now? He is currently on Levolin. Please help."
},
{
"from": "gpt",
"value": "Hi. There is no issue with the BCG spot turning red at 11 months of age. It is alright. As long as it is not swelling up and ulcerating completely, it is fine. Sometimes, some children may scratch it making it red. In this regard, I would advise you to get the BCG scar evaluated physically by a pediatrician. As regarding cough and cold, you can give syrup Levolin 2 ml twice a day along with syrup Montair LC 2.5 ml once a day for 5 to 7 days. SOS, you can use nebulization with Duolin if the cough is very severe."
}
] |
[
{
"from": "human",
"value": "Hi doctor, I am having red rashes on the glands of the penis. I used Candid Total and it disappeared completely. Again after seven days it again appeared and it seems red patches on right and left side of the penis. I continued using it and then got an advise form one of my friend for using Surfaz SN along with Doxt SL 100 which I am using it since last 15 days. It was improving slowly. I was using very hot water for cleaning the penis but suddenly day before yesterday, the color of the penis became red and the patches have also become red. I am having pain on the glands of the penis and seeing some white discharge. I do not know why it has happened suddenly, due to usage of hot water or for some other causes. I consulted local doctor and he advised to take LNZ 600 one tablet twice daily for five days and T-Bact ointment twice daily for 10 days. Please advise."
},
{
"from": "gpt",
"value": "Hi. You have erosions on the glans penis that is more consistent with candidal balanitis, other possibilities are chancroid, herpes. Please stop using Surfaz SN, it has steroid in it. Steroid helps to bring down the inflammation, itching will get better but it will not cure the fungal infection further makes the fungal infection worse. I believe that is what happened for you now. Can you please answer these questions so that I can rule out other possible conditions and suggest you appropriate medications. When did it start? Do you have similar red rash on foreskin as well? Any history of unprotected sexual intercourse? Any history of white discharge in the female partner? Did you have fluid filled blisters when it started? Is this the first time you are experiencing this kind of lesion? Do you have any allergies to medications? Do you have any other medical conditions? Diabetes? Do not use hot water for genitals. Always use lukewarm water."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My arms, neck and underarms are blackish compared to the rest of my body. Please look at my pictures and inform me the solution."
},
{
"from": "gpt",
"value": "Hello. I understand that you are concerned. Looking at your photographs, I can appreciate that you have two things (attachment removed to protect patient identity). 1. Acanthosis nigricans: The darkening of the neck and underarms is due to thickening of the skin, known as acanthosis nigricans. It is a manifestation of insulin resistance and is usually associated with diabetes mellitus, weight gain, obesity, thyroid disorders and certain drugs. Sometimes no cause can be identified. 2. The arms darkness seems simple tanning due to sunexposure as I can appreciate the sharp cut off at the arm, where sunexposure ends the skin is fairer. Use the following medications: 1. Kojic acid cream apply once at night for pigmentation. 2. Suncros sunscreen lotion apply three times every three hourly on sun exposed areas during day time. 3. Tablet Limcee (Vitamin C) one tablet once a day after breakfast. Get following investigations done 1. FBS. 2. T3,T4, TSH. 3. Fasting lipid profile. Please review with reports."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I am 31 years old, female. I had unprotected sex three days ago. What should I do now?"
},
{
"from": "gpt",
"value": "Hi. No need to worry. There are two options. 1. You can go for Levonorgestrol, taken 72 hours after sex. 2. You can go for Ulipristal Acetate 30 mg taken 120 hours after sex."
}
] |
[
{
"from": "human",
"value": "I have always had trouble with my tonsils. I get tonsil stones frequently and snore. For the past month I have had a mild sore/scratchy throat. I can tell my left tonsil is swollen, and it is causing some pain. Sometimes the pain reaches my ear, but not often. My doctor did a swab to check for infections but it came back clean. Could this be allergies? I have never had allergies before, except for asthma as a child. I have no other symptoms."
},
{
"from": "gpt",
"value": "Hi, I understand that you are worried about your long term tonsil problem.. Tonsil enlargement could be due to infection or as a part of some other disease If your swab is negative, we need to investigate for other possibilities also I would suggest you some investigations for the same Meanwhile also take the tablets as prescribed CBC, ESR, PERIPHERAL SMEAR CT NECK CHEST XRAY Tonsillar enlargement inder evaluation T. Cefuroxime 500mg 1tab twice daily for 1week after food T. Aceclofenac + Serratiopeptidase 1tab twice daily agter foof for 5day Betadine throat gargle thrice daily Review with investigations"
}
] |
[
{
"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, My wife had a cervical tumor or some kind of growth in her teenage years. Whatever it was, medication took care of it for her. Now she is 31, has had three kids, and for the last few months has spotted and cramped for one day right after her period ends. She has a pap smear appointment for next week, but I am extremely worried in the meantime. What are the chances that the symptoms are because of cancer? Are there other benign conditions that are more likely causing this?"
},
{
"from": "gpt",
"value": "Hello. Thanks for sharing this information here. First of all I would like to see her reports from the previous diagnosis and treatment and only then I would be convinced that it was a tumour. Secondly, from your point, it sounds that it was only a cervical polyp which is totally benign and after removal of it patient does not have any symptoms. And thirdly, pap smear does not detect cancer. It detects only early changes which Iead to cancer. So get relaxed now as nothing is wrong with your wife as she has given birth to three healthy kids. She must go for a pap smear without any hesitation and I hope it would be fine as well."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have problem in one cord and it is for about a month now. I was given Defcort and antibiotic for a week. Persisting for little over a month now."
},
{
"from": "gpt",
"value": "Hi. Since how long you have been having this problem? As per the picture, it has been there on only one cord. If it is early stages, conservative management can be tried. Did your doctor tell you about it? One month duration is a bit less to decide on surgery I feel. You should go for conservative treatment. Conservative treatment means antireflux and antacid measures along with control of allergy. Dietary precautions are to be taken. Absolute voice rest should be maintained. What is your job? Do you speak a lot or sing?"
}
] |
[
{
"from": "human",
"value": "Hello doctor, Can I start Unwanted 21 after my periods? Four days back was my last day of period. My period cycle is usually for five to six days. Please suggest as I want to start my oral contraceptive."
},
{
"from": "gpt",
"value": "Hello. Oral contraceptive pills are normally taken cyclically from day-5 of menses to day-24. I suggest taking tablet Norethisterone 10 mg twice daily similarly in every cycle. Oral contraceptives are ideally started from the start of a cycle, but if you want to start, start now from today and then stick to it regularly. Take the 21 tablets and then the placebos or choose the pill-free period for withdrawal bleed. The body takes some time to get used to it. Side effects could be headache, breast tenderness, high BP, clot formation, on long-term use irregular bleeding, carcinoma of the breast and endometrial hyperplasia that can lead to endometrial cancer. Hormonal contraceptives are better not used for many years. Better to change the method to prevent long-term side effects like after taking it for a year, you can have injection Medroxyprogesterone (three monthly) for few months, etc. For more information consult an obstetrician and gynaecologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, My wife is in the 14th week of her pregnancy. During a routine checkup, we came to know that she was infected from HEV. What will happen? Do we have to abort the child?"
},
{
"from": "gpt",
"value": "Hello. There is no need for the abortion as HEV (hepatitis E virus) does not cross the placenta, but you need to have a close follow up for the pregnancy. Also, you have to get in touch with fetomaternal doctors (baby-mother doctors) and get a regular check-up of your liver function test. You would need to be delivered in a hospital setting as HEV may infect the baby at the time of birth. HEV is not harmful to the baby during pregnancy but needs close monitoring, and vigilant care of mother as mother's condition may deteriorate if not addressed properly. I hope it has helped you. If you require any further queries, please do not hesitate to contact me."
}
] |
[
{
"from": "human",
"value": "Hello doctor, My 1-year-old son has not started saying any word like mama or dada yet and I am worried. It could be sign of autism, though he turns when his name is mentioned, plays with his siblings, etc."
},
{
"from": "gpt",
"value": "Hi. Even though the child turns when his name is mentioned I would advise you to first get a hearing screening done to rule out hearing issues. Next, about the autism. Generally autism cannot be diagnosed in children below the age of 3 years. So it would be very harsh to label this child as autistic. Not just that, an autistic child generally does not play well with others. If the hearing is normal and other developmental milestones are normal, you need to wait for another 3 to 6 months. Some children are slow. Also, another thing that needs to be evaluated is a tongue tie. Kids with a tongue tie (depending on the extent) have difficulty in creating speech."
}
] |
[
{
"from": "human",
"value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?"
},
{
"from": "gpt",
"value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->"
}
] |
[
{
"from": "human",
"value": "Hello doctor, I have a pea sized lump between my right buttock and thigh (groin area) that I just noticed a few weeks ago after accidentally shaving over it. It is not painful, but a little sore like a scrape would be. It appears to be solid in the middle and darker, but has almost an inner tube look around it that is pinkish. It does not look like it has fluid in it."
},
{
"from": "gpt",
"value": "Hi. What your photo shows is a skin ulcer (attachment removed to protect patient identity). There are many reasons for skin ulceration in the groin area. We have to rule out sexually transmitted diseases first of all. I would like to know if you are sexually active, whether your partner has any such problems. How about your general health? Do you have any kind of problems in your other body systems? For the ulcer, you can apply a topical antibiotic like T-Bact cream daily thrice. It will help it heal if it is a simple bacterial infection. I would suggest you apply it for two weeks, then approach a local dermatologist for a full checkup, in case it is not responding. Get well soon."
}
] |
[
{
"from": "human",
"value": "Hello doctor, A week back, I wore a G-string that was a little snug and I accidentally fell asleep in it. The next day, I noticed that my perineum and anal area were sore so that night I got a mirror and looked and noticed that there was a straight swollen line from my anus to my vagina opening right where the string sits. So I did a sitz bath and applied Neosporin and Destin and the pain stopped. This morning I checked on it and it is still swollen but no more pain unless I poke it with ny nail. Is it herpes?"
},
{
"from": "gpt",
"value": "Hi. I have seen your images (attachment removed to protect patient identity), looks like perianal area is swollen secondary to explained injury. It will take a little time to heal completely. Kindly follow the following instructions: 1. Lignocaine gel for local application over perianal area before and after defecation. 2. Continue sitz bath for 4 to 6 minutes a day. 3. Tablet Combiflam 400 mg BID for three days. 4. Drink plenty of water. 5. Keep hygiene over perianal area."
}
] |
[
{
"from": "human",
"value": "Hello doctor, I recently had my thyroid test done. I am attaching the reports of the same. The note reads that a physiological rise in total T3 and T4 levels are seen in pregnancy and patients on steroids. Does it mean that I am pregnant? I am worried."
},
{
"from": "gpt",
"value": "Hi. Your thyroid level is upto normal level. The preference range given in the reports is for pregnant female (attachment removed to protect patient identity), not for non-pregnant female. And Thyroid levelnever determines pregnancy. If you had unprotected intercourse and delayed menses, then you can go for UPT test for confirmation of pregnancy."
}
] |
Subsets and Splits