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qucklecrabik
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mc_dataset

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train · 257k rows

conversations listlengths 2 2
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I struggle to focus and I cannot concentrate on my studies. I just think about other things, not always bad things, but sometimes I think about throwing myself out the window. When I am asked a question or if there are some people around, I used to get panic and struggle to answer. My voice will be too low and can hear my heart racing. I have been self-harming myself for over a year now. I have got cuts and scars on my arm. I do not get along with my family and I barely do anything anymore, either I sleep or think simply lying in bed. I sometimes hear voices of people who are not present. I feel like tight chest and my breathing is difficult. I want to do well at college, but I am not happy. My mood changes within a few seconds. I am too shy to visit a doctor. Please help." }, { "from": "gpt", "value": "Hi. Personality issues. Psychotherapy (DBT - dialectical behavior therapy). For further information consult a psychiatrist online.--->" } ]
[ { "from": "human", "value": "Hello doctor, I get headaches very often. It is very sharp and painful. I feel tired if I workout a little bit. During workout I get headaches. I started losing my memory like I forget things too soon. Why is this happening? What might it be?" }, { "from": "gpt", "value": "Hello. While workout you are getting a headache. What kind of workout you are doing? Is the headache one side or mention the area whether front, back or sides? And you said after headache you are getting tiredness and memory loss. Some times in migraine headache you will have like this but usually one side. So I will suggest a few investigations. 1.CBC (complete blood count) and Hb (hemoglobin). 2.ENT (ear, nose, and throat checkup) and ophthalmologic check-up. 3.MRI brain. 4.Blood sugar levels. For the time being, take this medication with the consent of your treating doctor. 1.Tablet PAN-D (Domperidone and Pantoprazole) 1 bd (twice a day) before food. 2.Tablet Stemetil (Prochlorperazine) 5 mg thrice a day. 3.Tablet Paracetamol 650 thrice a day for five days." } ]
[ { "from": "human", "value": "Hello doctor, I am a 47-year-old male. I have chronic fatigue being on healthy diet. I am not on any medication. There is also low libido. In the blood test report, the levels of UIBC, DHEA, estradiol, vitamin D, progesterone, phosphorus, and platelets were low from the normal level and high B12 level. In the past, my blood test has shown low RBC. Can you tell me what is going on?" }, { "from": "gpt", "value": "Hello. Your chronic fatigue can be explained by low levels of vitamin D, low phosphorus, and low DHEA (dehydroepiandrosterone). I will explain why do you have these low levels. There are many causes of vitamin D deficiency, but most common is inadequate exposure to sunlight which I think is the cause in you. Other causes of vitamin D deficiency are malabsorption of vitamin D, kidney disease (not in your case). Vitamin D is essential in the absorption of phosphorus in the intestines. So, a low vitamin D will eventually lead to low phosphorus. And both low vitamin D and low phosphorus can cause chronic fatigue. Remedies are, increase your exposure to sunlight. There is no need for vitamin supplementation at present. Your LDL cholesterol and total cholesterol is on the higher side. I advise you to take tablet Rosuvastatin 5 mg at night after dinner for one year and repeat lipid profile after one year. Also, go on a low-fat diet. Now coming to your low DHEA and low estradiol levels, DHEA levels usually decreases with increasing age so that it could be an age-related issue in your case. It can also be reduced in conditions like adrenal insufficiency, diabetes, kidney disease, but there is nothing in your reports to suggest these diseases. Low DHEA can explain for low libido and chronic fatigue, but low libido can also be due to depression and even abnormalities in prolactin levels (which has been not tested in you). Also, get one serum prolactin level tested. My advice is to increase your physical activity and decrease your calorie intake, this will help in increasing DHEA levels. There is no need for taking DHEA supplements. Low estradiol is also due to low DHEA, but that is not significant. Increased vitamin B12 levels are usually seen in liver diseases or myeloproliferative disease (diseases of the bone marrow ), but one more common cause is if you were on multivitamin tablets it might have caused increased levels. But if you were not on multivitamins, then I advise you get one bone marrow biopsy done for the evaluation or detection of myeloproliferative diseases because even low platelets are seen in these diseases. Kindly revert for any further queries or clarification." } ]
[ { "from": "human", "value": "Hello doctor, I am a 31-year-old woman. My menstrual cycle usually lasts between 27 to 30 days. I usually ovulate on day 12 of my cycle. I usually track ovulation so I know I do ovulate. I recently took a blood test that shows my MCV is 77 and my MCH is 25 both below normal range. My HbA1c was 5.90 and my ALP levels were mildly elevated as well, at 134 (report said it had to be between 42 to 128). My TSH was fine and well within range. My problem is that my follicular phase seems fine but my luteal phase keeps changing. It lasts anywhere between 14 to 18 days. I wonder, is that normal? Do I need to test myself for PCOS? I never had acne problems. I have gained weight, but that is been over five years. I have never missed a period yet." }, { "from": "gpt", "value": "Hello. It is really good to know that you are very knowledgeable about your cycle routine. Let me add a few things further into it. The first thing is that the luteal phase is always fixed (14 days) while the follicular phase varies in women's cycle due to hormonal changes in the first half of the cycle. If you want to calculate your ovulation day, then we usually deduct 14 days from the total cycle length. So in your case, your ovulation day is around 14 to 16 depending on if your length is varying between 28 to 30 days in my view. Ovulation on the 12th day is possible in those women who have a cycle length of 26 days. I hope it might have cleared how to calculate ovulation day. Secondly, all your tests are normal, and you have nothing to worry for PCOS as you do not have that because the cycle length of 26 to 35 days is being considered normal for any woman and you are falling in this criteria. I hope this information has helped you. If you require any further queries, please do not hesitate to contact me." } ]
[ { "from": "human", "value": "Hello doctor, My son is 17 years old. He is doing odd things, such as calling the police for ear pain. He is under a lot of stress from national exams and high expectations. He does not sleep much, but his appetite is well. After calling the police and talking to them, he was back to his room studying. Late evening he told me that he is doing well and not to worry about him. Overall, he is distracted, and his grades are dropping. I am desperate as I am in the health field and I know that can mean severe pathology or simply a reaction to stress." }, { "from": "gpt", "value": "Hello. It seems he is not in touch with reality, like calling the police for ear pain. Can you tell since when he has ear pain and how it started? Since how long has has such odd behavior and sleep problem? Does he express any other odd behavior? Is there any history of substance abuse or truancy? He might be suffering from adult ADHD (attention-deficit hyperactive disorder), depression, anxiety and ATPD (acute and transient psychotic disorder). The management depends upon the disorder he is suffering from." } ]
[ { "from": "human", "value": "Hello doctor, I had sex with my fiance a month ago, and I did not use the condom. After 15 days the testicle pain started with abdominal pain, and then the small bubbles at penis glands. Now with the tiredness of the head, the headache is accompanied, and the sweat is high. I used to get testicle pain in only summer, three or four times per three months. The urine albumin present 1+ in the urine test, the urine epithelial cells 15 to 18 and the urine RBCs 10 to 12. What it could be?" }, { "from": "gpt", "value": "Hello. I have gone through your query. I would like to know a few more details to answer your question better. Have you have had any fever, rashes or joint pains in the last two weeks? Based on your symptoms, it is most likely that you either have a urine infection or some infection of the genitalia. The urine test reports also suggest the same. It would be necessary to have a complete physical examination to find out what is the exact infection and treat it with medication which should be able to get you back to normal. You may require a urine culture test or urethral swab test to pinpoint what the infection is. I would suggest you to visit your local urologist at the earliest to get the tests. I hope this helps, feel free to revert with any other questions or concerns." } ]
[ { "from": "human", "value": "Hello doctor, I am on a holiday. I wish to delay my period. Kindly advice." }, { "from": "gpt", "value": "Hello. Please mention your last menstrual period date. Ideally, menses can be delayed safely and effectively by starting progesterone only pills from day 21 of your cycle daily till as long as you wish to delay your menses but advisably not more than 15 days. Once the pills are stopped, one usually get her withdrawal bleed in the next three to five days. If started later, on just a few days before the expected date of menses, then there are high chances that complete cessation of bleeding may not occur and you may experience irregular spotting in between the course of medications. Hence it is important to learn about your last menstrual date. You can use tablet Medroxyprogesterone acetate 10 mg one tablet twice a day from day 21 daily for the next 10 to 15 days to delay your menses. The most common side effect faced are progesterone side effects like headache, constipation and often bloating sensation, but it can be controlled by increasing daily water intake up to three to four liters a day." } ]
[ { "from": "human", "value": "Hello doctor, I had an unprotected sex and noticed two issues on the shaft of my penis. The first thing I noticed was a dry, flaky area about the size of a dime. I have applied mosturizer to it thinking it was just dry skin, but it has not gone away over the past two weeks and that spot is still noticably lighter than the rest of the skin. I have also noticed a single, small white bump near the head of my penis. It is raised but only slightly. The white bump does not itch and is painless. Both I have noticed after unprotected sex about a month ago and did not change much. What should I do?" }, { "from": "gpt", "value": "Hello. If it is not sexually transmitted disease then it can be acne, Fordyce spots which develop when skin's pores are clogged with natural oil, called sebum, sweat, and dead skin, it can also cause infection. Pearly penile papules (PPP) is small, fleshy bumps that usually develop in gland penis in rows around the head of the penis. A skin tag is normal, and it happens as age advances. If it is lichen planus, it can lead to infection and needs medical management. If you have PPP, then it is normal, and there is no need for treatment. Regarding the white growth, if it is not painful, it can be syphilis. Swelling in the shaft, if not painful then think of syphilis. Please share more details regarding the issue, and we will work on treatment." } ]
[ { "from": "human", "value": "Hello doctor, A while ago, I started noticing milky discharge from my breast, the discharge continued for about three months. After two months I started to develop red burning rashes on my breast. The rash first appeared as a single ringworm like red rashes on my breast and no improvement for two days now and rashes have increased at the sides of my two breasts. What could cause this? And are these two occurrences related? I applied a triple effect cream (Bmn plus cream) on it, that is when it started to produce blisters. Please help." }, { "from": "gpt", "value": "Hello. I can understand your concern. Milk secretion in nonpregnant women is galactorrhea that can occur due to causes like increased prolactin levels in the body, prolactinomas, continuous usage of antacid like drugs, etc. Rubbing of clothes to the nipple can also lead to discharge. Tight innerwear, allergy to fabric material lead to skin rashes, etc. can aso be the cause for the discharge. So, you, please consult your gynecologist once, get examined and go for serum prolactin levels and if needed sonomammography. With this work up the possible cause of your problem can be identified and treated. I hope I have answered your query. Take care." } ]
[ { "from": "human", "value": "Hello doctor, I believe I have dissociative amnesia. I am unable to recall memories until the age of 13. Every now and then I remember a spotty memory but it is never concrete and when I do remember something, in my mind it seems like a dream instead of a clear memory. What could I do with this?" }, { "from": "gpt", "value": "Hello. Memory is the most surprising thing. You remember some events so vividly while others wash out as if they never happened. The retention of things depends on our concentration and attention at that particular time, and the wish to remember it. We all forget most of our childhood memories only a few remain fresh in our conscious. Again individual variations present, but one thing I can tell you this forgetfulness is unlikely to be dissociative amnesia. Dissociative amnesia is usually followed by a stressful, traumatic event in which our mind subconsciously want to avoid. In the absence of stressor, it often does not occur. So if you have some really bad childhood memories, you may have dissociative amnesia. A detailed assessment of yours would be required for dealing with it and appropriate treatment requires some therapy sessions." } ]
[ { "from": "human", "value": "Hello doctor, I have a question about hearing. Firstly, I am aware that hearing loss takes place when the tiny hair cells within the inner ear are damaged. My question is, once a particular hair has been damaged, will the same sound level that previously damaged it, hurt it again? For example, if you listened to a sound at 90 dB for nine hours and your hearing was damaged, would doing the same thing another day further damage your hearing? Or would it not change anything, as your ears would not be registering the same level of sound as the previous time?" }, { "from": "gpt", "value": "Hello. There is something called a temporary threshold shift and permanent hearing loss. Temporary loss is the loss which if a sudden burst of sound and you get hearing loss as hair cells are fatigued however hearing regains soon in some time. If it is a permanent loss that too at a severe level for all frequencies chances are the person will not notice the same loudness of the sound afterward however there are some pathologies where the sound amplifies itself, and it is called recruitment. So in that condition, the person may not even respond to a loud sound of 80 dB however they might complain abnormal loudness at 90 and feel the same discomfort as a person with normal hearing has. It all depends on the pathology and condition of the hearing loss." } ]
[ { "from": "human", "value": "Hi doctor, I am having a tough time with my skin infection. It is being around two months since I got affected by that. I am having the hives of dark reddish in color in specific areas like on the penis point and on the buttock. It is so itchy and the whole body is getting so itchy like on hands and legs too. There developed some red spots. Can you provide me the best cure? Till now, some dermatologist suggested HH Mite ointment and I forgot the name of the other tablet. He said to apply that ointment for the whole body from neck to legs. I did, but no improvement. Please help." }, { "from": "gpt", "value": "Hi. Revert back with the photographs to a dermatologist online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 32 years old PCOD patient with primary infertility. My LMP was 10 days before. I took tablet Letrozole 2.5 mg once a day for five days from the next day of my periods. Today is my eighth day. I had a USG today. Findings are, ET 3.6 mm, right ovary follicle is 11 mm, left ovary follicle is 1.8X1.2X1.8 cm. What am I supposed to do now? Shall I take tablet Progynova to build up endometrium. Is that follicle on left ovary a cyst? Please guide me in the further course of action. You can prescribe me medicines, I can take it, as I am a gynecologist and I need guidance from an infertility specialist." }, { "from": "gpt", "value": "Hello. As you are on day 8, ET (endometrial thickness) is low for the day of the cycle. You should be starting on Progynova (Estradiol) 2 mg one tablet twice a day for the next seven days. Your follicular scan days should be on day 11, 15 and 17. The follicles are appropriate for the age in the right ovary and are developing. The left ovary may be a simple cyst or late recruited follicle from the previous cycle but needs to follow-up with scan. At a follicular size of 20 mm, you should be opting for injection hCG 10000 IU intramuscularly for initiating ovulation. If this is a timed intercourse cycle and not an IUI cycle, then intercourse should be started daily from the day of hCG injection, else IUI to be done after 36 hours of injection hCG administration after a TVS scan (transvaginal ultrasound) to confirm rupture of follicle and also endometrial thickness (target 8 to 9 mm). Also progesterone-like tablet Susten (Natural Micronised Progesterone) 2000 mg one tablet twice a day can be started from day 16 for the next 10 days, to support pregnancy if fertilization occurs. On day 14 post ovulation, you may get a serum beta hCG test done to check for conclusive results with regards to pregnancy." } ]
[ { "from": "human", "value": "Hello doctor, I am 55 years old and had my left ovaries removed when I was 40. I have low estrogen and suffer from brain fog, hair loss, pain, and weight loss. Currently, I am taking Vitamin supplements. What should I take and how often should I take it?" }, { "from": "gpt", "value": "Hello. In this age group these symptoms are very common due to hormonal changes. These are menopausal symptoms. You can take the following medicines regularly. Kindly consult your doctor, discuss the suggestions and take the treatment with concern. You should take Ashwagandha and Shatavari powder 3 gm each and Prawal Bhasma 500 mg twice a day with warm milk after meals. Also take Ashwagandharishtam 15 ml twice a day with equal amount of water after meals. Take these medicines regularly for one month. You should take Ashwagandha and Shatavari powder 3 gm each and Prawal Bhasma 500 mg twice a day with warm milk after meals. Also take Ashwagandharistam 15 ml twice a day with equal amount of water after meals. Take these medicines regularly for one month. Avoid spicy and fried junk foods, Drink plenty of water, do regular kapalbhati and pranayama like anuloma vilom nadi sodhan and bhramari." } ]
[ { "from": "human", "value": "Hello doctor, I am a 53-year-old male with 6'2\" height and weight 220 lbs. My HbA1c is 8.5, high triglycerides, vertigo, and some gait issues. I had a massive pulmonary embolism two years ago, not on any blood thinners, and sometimes I have high blood pressure. Contrast MRI shows a small focus of T2 prolongation present within the medial right cerebellum just posterolateral to the fourth ventricle measuring 5 mm which is also T1 hypointense and nonenhancing. This could represent sequela of an old lacunar type infarction with surrounding gliotic changes. Should I get the GGT blood test done? What is the cause of this problem?" }, { "from": "gpt", "value": "Hello. MRI findings are compatible with an ischemic stroke in the brain. The stroke could be related to atherosclerosis and diabetes. HbA1c is high, indicative of diabetes. For this reason, I recommend physiotherapy and take daily baby Aspirin to help prevent a future stroke. It is also necessary performing a Doppler ultrasound of the carotid arteries or a carotid and vertebral artery angio CT scan. It is also essential to check your blood lipid profile. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need." } ]
[ { "from": "human", "value": "Hello doctor, I have brain fog like symptoms, chronic worry and stress issues for more than one year. What can be done?" }, { "from": "gpt", "value": "Hello. Fog like symptoms as you have mild cognitive impairments, cloudy thinking, and judgment impairment, these all are due to generalized anxiety disorder. Kindly consult your doctor, discuss the suggestion and take the treatment with concern. 1) Tablet Fluotexine 20 mg once daily. 2) Tablet Tryptomer (Amitriptyline) 25 mg once a day in the evening for two months. 3) Need behavior therapy with a local psychiatrist. If you have more queries, contact me." } ]
[ { "from": "human", "value": "Hello doctor, I am a 26-year-old female. I have been experiencing unusual vision problems. I have lost sharp clarity, and I had an OCT which showed thinning of ganglion cells in my maculas. Other clinical results looked normal. But I am scared that I have damaged my eyes because it seems things are starting to blur. I do not know what to do. Do I have macular degeneration? Currently, I am on Sertraline 100 mg and Diazepam. Kindly give me your opinion." }, { "from": "gpt", "value": "Hello. I am sorry to hear that you are experiencing these symptoms, but hopefully, we can get them resolved or attended to. Unfortunately, I cannot assess the OCT because you only attached the doctor's conclusion (attachment removed to protect patient identity) and not the scan itself, please upload it as soon as possible. What you are experiencing might be the common side effects of Zoloft (Sertraline) it can cause widened pupils and blurriness of vision. I would advise you to approach the doctor that prescribed it for an alternative. I would also recommend you start using lubricating eye drops to compensate for the acquired dryness of the eyes. Use any over the counter (OTC) artificial tears four times daily in both eyes during the day and not before going to sleep. Hopefully, that will reduce the blurriness. As for macular degeneration and the changes in the ganglion layers, you need not worry at the meantime because of many reasons like you are young, no significant changes on the OCT (optical coherence tomography) were detected. There are other reasons for the blurriness that need to be excluded. However, and to eliminate your suspicion, a yearly OCT is recommended to compare the changes and see if the process is stable." } ]
[ { "from": "human", "value": "Hi doctor, For controlling my hypertension, I was prescribed Benicar 40/12.5 mg once in the morning, Amlodipine 5 mg twice a day and Clonidine once in the evening. These were prescribed after ECG and blood work. Even, after taking the medication, my BP is usually 160/85 mmHg. What to do further. Please advise." }, { "from": "gpt", "value": "Hello. I want to highlight a few important points here: Amlodipine should be used once daily. Instead of taking 5 mg twice daily you should take 10 mg once daily, which is the maximum dose. Clonidine on the other side can actually cause rebound hypertension, which can explain your high blood pressure. It should be the last resort of the treatment of hypertension. It would be nice to know the dose that you are taking these days. I would like to know when did you take your blood pressure and if you follow a low salt diet. Benicar - Olmesartan is a good medication. Please consult your specialist doctor and discuss my opinion. I would like to know if you have any other medical conditions like diabetes, stroke, high cholesterol or a heart attack to determine your blood pressure goal according to the latest guidelines. Revert back with the answers to the above questions to an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hi doctor, My last period was on 11th of last month. Now, the pregnancy report is positive and blood test for hCG was done in which report showed 1176. 14 hCG level and 48 hours later showed 1342. 41. Is it normal pregnancy? My age is 36 years." }, { "from": "gpt", "value": "Hi. I can understand your concern. According to your description, the possibilities are: You are pregnant which is indicated by urine and blood tests. Now, we have to confirm whether the pregnancy is in uterus or not. Usually blood levels of beta hCG should double in 48 hours. But that did not happen in your case. Now, we have to rule out the possibilities like abortion or ectopic pregnancy. For this, please undergo ultrasound once which will help in ruling out ectopic pregnancy. Take Progesterone supplements to prevent abortion. And repeat beta hCG levels again after 48 hours, this will help in confirming the site and nature of pregnancy. Take care. Ultrasound, repeat beta hCG levels after 48 hours. Ectopic or abortion. Progesterone supplements." } ]
[ { "from": "human", "value": "Hello doctor, I am a 24-year-old male. I am afraid that I might be suffering from phimosis. My foreskin is too intact that it covers the whole penis, without retracting even during the time of erection. There is no problem while erection, masturbation or urinating. It is just that my foreskin is too intact that it covers my whole penis and I get to see no glans penis, as it is totally covered by my foreskin. My foreskin starts to retract from the middle of my penis. I am so afraid that this might affect my sex life. Please help." }, { "from": "gpt", "value": "Hello. You can try to retract foreskin daily during bathing, a little more every day. If this does not work or is painful, better get a circumcision done. This will ensure there is no problem during intercourse. It is a small surgery done by urologist or surgeon." } ]
[ { "from": "human", "value": "Hello doctor, How likely is it to re-tear (or re-separate) the acromioclavicular joint after surgery was performed on it with a cadaver tendon? It has been a year and a half post surgery. He was lifting 50 lbs overhead, wind pushed equipment back, causing loud popping in left shoulder (previously had surgery). Shoulder is now presenting with swelling, no mobility and pain.I want to know the likelihood of acromioclavicular joint getting separated again." }, { "from": "gpt", "value": "Hi. There is a high likely chance since you are symptomatic (pain and swelling). Subjecting to vigorous exercise and history of previous surgery adds to the suspicion. It is better you get evaluated and treated earlier. Though cadaver tendons are stronger and it is been 1.5 years. It can never equate your original strength. First get your pain and swelling down with analgesics and get an X-ray. If no bony injury and pain persisting, get an MRI done. X-ray followed by MRI shoulder if needed. Acromino-clavicular joint dislocation. Analgesics and anti-inflammatory followed by evaluation." } ]
[ { "from": "human", "value": "Hello doctor, I am concerned about this lesion on my son's foot. It has been there for a couple months and it is not going away. Can this be some type of melanoma (acral)?" }, { "from": "gpt", "value": "Hi. Single lesion or any other also present?" } ]
[ { "from": "human", "value": "Hello doctor, My daughter is 2 years old. Now, she is speaking only 3 to 4 words. She is not talking like other children. Please tell me if she has any kind of disorder. I have been to the doctor once and he told nothing to worry. After 2 years only they can speak. But my elder daughter spoke when she was 1.5 years old. I am so worried about her. Please tell me what to do. Her birth weight is 3.2 and now she is around 9 I think." }, { "from": "gpt", "value": "Hello. I got your concern. Based on the above history, my comments are: 1. I think she can listen and understand but there is a problem with expression. 2. Her weight is low according to age, so give her more energy rich food to gain weight. 3. Let her play with same age children, day care center or neighborhood children. 4. Do not confuse her with multiple language if you are speaking multiple language at home. 5. Sometimes, some children learn to speak late. So do not worry. Just be vigilant. Watch her behavior. Follow up after one month. Isolated speech delay." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am a 27 year old male. Doctor prescribed me Azithral and Fepanil for fever. But, the fever is on and off for the past seven days. My blood test showed normal no malaria or dengue or typhoid. First, I took Azithral and Fepanil and then the next day doctor added Cefuroxime axetil along with it. As the fever continues, I have got Amikacin intravenous. And now I have stopped all the medicines and still have a fever. What fever is it? I had four Fepanil capsules per day for every six hours for the past seven days. My blood report is normal and there is no pathogen for malaria, dengue or typhoid. But, the value of WBC is high with ESR of 50mm showing microcytic anemia with neutrophilia." }, { "from": "gpt", "value": "Hello. The possibilities for fever in your case are as follows: For further information consult a general medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am a 33-year-old male with no significant medical history aside from essential tremors treated with Inderal 120 mg, and anxiety treated with Venlafaxine 75 mg. Three months before, I consulted an ENT doctor because of an unilateral (right) tonsil enlargement. I am attaching a photo of what it looked like at that moment. Upon clinical examination, my doctor was not worried and suggested to monitor the volume of the tonsil in the upcoming year. I had underwent adenoidectomy during childhood. In the last few months, I have noticed that the same tonsil has gained in volume and now appears round, red and more swollen than before. It is not painful when I swallow, but I have the sensation that something is stuck in my throat (most probably a collateral effect of edema). I am attaching another photo of what it looks like today. I do not feel any lumps in my neck. I have an appointment to see my ENT again, but it is only in one month from now. Being a big fan of catching things early I am a bit worried about waiting another month. Could you please give me your opinion?" }, { "from": "gpt", "value": "Hello. The two tonsils are unevenly enlarged. Whereas it is usually not any abnormal growth, we can say conclusively only after biopsy. I suggest you discuss with the doctor about the option of tonsillectomy and histopathological examination of the sample. Meanwhile you should get some Benzydamine gargles and check if the symptoms resolve." } ]
[ { "from": "human", "value": "Hello doctor, I had sex with my partner before two days and that was my ovulation day. I started taking Krimson 35 from the next day. Am I safe?" }, { "from": "gpt", "value": "Hello. Actually Krimson 35 is not an emergency contraceptive pill. Hence, there a chances of pregnancy. I would suggest to do serum beta hCG (human chroionic gonadotropin) after 10 days of sex." } ]
[ { "from": "human", "value": "Hello doctor, I am 17 years old. In my right eye my pupil is barely visible in the centered, but it never dilates or constricts, most of the pupil seems to be covered by my iris. My left pupil is perfectly fine and dilates and constricts according to the amount of light. I can see out of the affected eye but it is not as clear as my other eye. I have this condition since birth, and it is not anisocoria. Kindly help." }, { "from": "gpt", "value": "Hello. I understand your concerns and have seen your photo attachment (attachment removed to protect patient identity). From the image you have attached, I can say that this may be a persistent pupillary membrane. It is a disorder of eye development that occurs during embryonic growth and development. A condition such as this is usually asymptomatic except for the appearance, but if thick can obstruct vision. There are various treatment options, including laser iridotomy which can be done as an outpatient procedure, which will change the appearance. In case you need further information, please let me know." } ]
[ { "from": "human", "value": "Hello doctor, My son is 8.11 years old. He had an eye injury one week before, which caused left eye corneal epithelial defect (3 mm, no infiltrate). He was adviced for constant use of single vision white glass. His reports are, Right eye (SPH=+0.00), (CYL=+0.75), (AXIS=95), (VISION=6/6). Left eye (SPH=+0.00), (CYL=+0.25), (AXIS=90), (VISION=6/6). Does he need to wear glasses? Or eating a carrot, beetroot will help him to be normal?" }, { "from": "gpt", "value": "Hello. I understand your concerns and have gone through your son's eye records. I can confirm that the power given cannot be reversed by eating carrots and vitamins. This type of power is called a cylindrical power, and if he does not wear the glasses, he can develop weakness of his optic nerve in the long run, along with short term effects like blurred vision and headache. A drug called Low-dose Atropine in a way can be used to control eye power in children and halt progression but it is only tested in minus powers and not in plus powers. My suggestion is to advise him to wear glasses regularly and follow-up with the ophthalmologist every six months. I hope this helps you." } ]
[ { "from": "human", "value": "Hello doctor, My lower front tooth broked in an accident. I visited the dentist here in my place and he suggested RCT. My first session of RCT has been done 11 days before, and the last session was two days back. I want your advice on steps after RCT. Is laser filling possible for such tooth break or crowning is the only option? Which type of crowning is most suitable for it? Please help me. I am waiting for your valuable advice." }, { "from": "gpt", "value": "Hello. Crowns are best after RCT. Best crowns are zirconia. They are metal free, and they have good strength than other crowns. Other than that is CADCAM crowns. They are 3D porcelain metal crowns and have good strength. They come with a warranty. Both look very good and have exact teeth color. Filling of teeth will be done on the last day of RCT. Ask for post and core if possible. But the crown is important in everything. I wish you good health and happiness. Keep me updated with the improvements." } ]
[ { "from": "human", "value": "Hello doctor, I am a 21-year-old male. I have OCD for past five years. I went to several doctors and used too many drugs such as Sertraline and Fluoxetine and Anafranil. The only drug that helped was Anafranil. I asked from my doctor to prescribe Anafranil but he denied and in every visit he prescribes SSRI, but it does not help me like Anafranil. What is the highest dose of Anafranil for OCD? Can I use only Anafranil 75 mg once a day? Please help me." }, { "from": "gpt", "value": "Hello. Anafranil (Clomipramine) is a type of older antidepressants, and it has some undesirable side effects like constipation dryness of mouth, at times effect on the heart. Because of the side effect for file usually, doctors refrain from going for higher doses. But if you are not facing any adverse impact, then we can increase the dose of drug top to 150 to 200 mg. The toxicity of this drug occurs easily as compared to SSRI (selective serotonin reuptake inhibitor) which is again a limiting factor for prescribing commonly. But always follow your treating doctors advice in increasing and decreasing the doses of drugs." } ]
[ { "from": "human", "value": "Hello doctor, I have a very blurred vision due to high eye grade and astigmatism. My left eye is 225, and the right eye is 675. I am planning to get a pair of contact lenses, but the special lenses are a bit pricey. Will it damage my eyesight if I am going to choose regular contact lenses?" }, { "from": "gpt", "value": "Hello. In general, contact lenses are only meant for occasional use and cannot be used every day. In case you meant the special lenses have higher oxygen permeability and help your cornea stay healthy, please go ahead with those. The best option to remain permanently free from glasses is refractive surgery. If your power has been stable for around a year, I will recommend that you see your ophthalmologist for SMILE (small incision lenticule extraction) or PRK (photorefractive keratectomy) than using contact lenses for a long term. In case you need further information, please let me know." } ]
[ { "from": "human", "value": "Hello doctor, Kindly suggest which mouthwash and paste is good to use on daily basis." }, { "from": "gpt", "value": "Hello. On daily basis, it is suggested that one should try tooth brushing with paste recommended by the American dental association (ADA) and Indian dental association (IDA). While buying a paste, you should look for whether it is ADA or IDA approved. Second is choose the paste containing ingredients like fluoride, sorbitol, glycerol, sodium lauryl sulfate, calcium carbonate, and saccharin. You can use them daily particularly before sleeping. However, if you have sensitivity in teeth and issue with cold things like ice cream, then you can try pastes containing high fluoride which strengthens teeth and prevents sensitivity and also prevents further progress of cavities. You should try usual toothpaste but after three months try this fluoride-rich paste for one month so that you will not develop future caries. Mouthwashes contains mostly Chlorohexidine, but it is not recommended for daily use. It is used in the case when there are gum inflammation and bad breath. Moreover, it is not recommended for more than 15 days as these cause staining of teeth sometimes. If you have gum infection or bad breathe, you can try it." } ]
[ { "from": "human", "value": "Hello doctor, I am 20 years old and I have myopia (-3,50 ). I always avoided smoking, lived a healthy lifestyle and ate a balanced diet but my vision just got worse. I just became worried about my vision. What else can I do to stop this progress?" }, { "from": "gpt", "value": "Hello. I understand your concerns. I want to assure you that such myopic progression is quite common at a young age such as in your case. This is mainly because of the exponential growth and development of all the parts of your body at this stage of life. I can confirm that this has nothing to do with the diet you eat. Over a period of time, this growth will cease, and your eye power will stabilize. One suggestion to reduce progression is to avoid excessive near work like reading books, using smartphones, fine near work like jewelry or watchmaking, etc. I hope this helps you." } ]
[ { "from": "human", "value": "Hello doctor, I had a bump on my arm. I thought it was a burn so I broke it and it became more prominent. It was there for almost two months. So I went to a skin doctor, and they said it is a wart from a germ. They gave me three options. Either apply a cream, liquid nitrogen, and laser (C02fl). I chose the third option because they said it is more effective. After I did it, there was a scab remained which looked like a burn. It has been four days now. I have been asked to apply Bactrocin twice a day for two weeks and Derma V10 rescue oil after that. From the third day, I am seeing like something spreading from the corners of the scab which looks like blood inside and it is red. Is this normal? Please advice." }, { "from": "gpt", "value": "Hello. I have gone through your case (attachment removed to protect patient identity). In my opinion, it is posted inflammatory scab or crust. You need not to worry about this lesion. Whenever wart is treated either with lotion or with cautery or with CO2 laser, in the end, it similarly forms scab or crust as you are having right now. This shows the germ or virus which was the causative factor has been killed or dead by now. The red area which is lying beneath it is a raw area of skin which will heal once this scab will fall off. Bacitracin ointment is fine. Apply this or apply Polyfax (Polymyxin B sulphate, Bacitracin zinc) ointment twice daily for days. Apply petroleum jelly on it at night. Your lesion is fine. Do not get worried about it. Human papillomavirus. Apply Petroleum Jelly or Polyfax ointment." } ]
[ { "from": "human", "value": "Hello doctor,I am a 28 year old male. For the past five years, I have few swellings on both underarms. Recently, my mother was diagnosed with breast cancer. While browsing on the internet, for her condition, I found out that my swelling may be of lymph nodes and may be cancerous. This urged me to get consulted. My swellings are a bit painful while touching. It at times gets sore and brings out smelly pus, which is yellow in color. I am anxious and would like to know what the best way to proceed here. Many thanks." }, { "from": "gpt", "value": "Hi. Revert back with the answers to the medical oncologist online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am a-32-years old male. Two days ago my wife and I had diabetes tests, and as of now, we do not have diabetes. Three to four months ago when we tested my result was 120, and my wife result was 140. But two days ago when we had tested, I have 122 before breakfast and 240 after two hours of breakfast. My wife had 142 at fasting and 242 after two hours of breakfast. We were shocked and worried. My mom and dad do not have diabetes and wife side her mom had diabetes, but her father does not have. My weight is 81 kg, and I am 5'5\" height. My wife is about 87 kg weight and 5'5\" height. Again we did a test at another place using glucometer after four hours after lunch, and surprisingly I got 102, and my wife had 170. The lady who did our test in front of us and confirmed that we do not have diabetes. Please help us. We do not know how to proceed. Awaiting for your response." }, { "from": "gpt", "value": "Hello. A glucometer is not the standard gold method it has a variability of 30 Plus or minus for conforming. Do HbA1c (glycated hemoglobin), FBS (fasting blood sugar), PPBS (postprandial blood sugar level) and urine complete. If these all reports turn to be normal, then there is nothing to worry. Maybe from tomorrow do regular exercise and take the test after seven days." } ]
[ { "from": "human", "value": "Hello doctor, I had a sudden weight gain. Are there any foods that should be avoided either at certain times of the day or all together while taking Levothyroxine to treat an underactive thyroid?" }, { "from": "gpt", "value": "Hello. Avoid raw cabbage, cauliflower, brocolli, soy and soy products like soy sauce, soy milk, tofu, strawberry, walnut, spinach, and brussel sprouts. Do not take any meals or drink except plain water for atleast 45 minutes after taking medication. Avoid taking acidity-causing foods, calcium and iron supplements with the medicine." } ]
[ { "from": "human", "value": "Hello doctor, I am a 34-year-old male with height 5'10\" and weight 170 lb. Last week, when I turned my head to the right, I started to blackout. I have been doing neck stretches, pinched nerve exercises, etc. Ever since with no improvement to the condition, this may be due to golf, or light weight lifting related, but I am not sure as I did not do anything abnormal and there was no pop or any pain afterward. One key piece of information may be that if someone else turns my neck to the right for me, there are no symptoms. It only occurs when I do it. I was hoping this piece of information narrows it down. It has been one week and a half with this issue. I try to avoid turning my head to the right. I can go 45 degrees without symptoms, but when I approach 90 degrees, the symptoms start. There is no pain and numbness." }, { "from": "gpt", "value": "Hello. Do you mean blackout as the sudden loss of consciousness? May I know what is the extent of the episode? If you feel blackout when looking up or turning your head, this may be due to pinching of the arteries that are present alongside the spine, called vertebral arteries. This can sometimes happen as a result of changes in the vertebrae. Pinching of these vertebral arteries can occasionally cause blackouts as the blood flow is temporarily reduced. One condition called cervical rib, here extra rib in the neck area may compress the artery. Some time any lesion in brain clot or ischemia may cause transient ischemic attack (TIA). Better go through investigations such as CT brain, x-ray cervical spine AP or lateral view, FBS (fasting blood sugar), PPBS (postprandial blood sugar test), lipid profile and CBC (complete blood count)." } ]
[ { "from": "human", "value": "Hello doctor, I have some rashes on and behind my ear. I have tried everything but it is still there for over one and a half month. I have been ignoring it because I get better quickly but does not entirely disappear, and right now is worst than ever. It is quite itchy and at night it is even worst. Sometimes I feel the itchiness inside my ear. I went to an Otolaryngologist, and he told me to use Clotrimazole, but it did not work and turned worst. Other doctor told me it looked like herpes because sometimes when it is horrible, you can see little red bumps in the ear. I took Acyclovir and at the beginning looked like getting better, but it has not got better. I have not consulted a skin specialist yet." }, { "from": "gpt", "value": "Hello. I understand your concern. This is not herpes (attachment removed to protect patient identity), and this is a superficial fungal infection known as tinea corporis. If it involves the face exclusively, then it is called tinea faciei. Kindly consult your doctor, discuss the suggestion and take the treatment with consent. A. Capsule Itraconazole 100 mg twice a day after meals. B. Tablet Levocetirizine 5 mg twice a day. C. Cream Terbinafine apply twice a day. Do this for 10 days, and you will feel better. Follow up after that." } ]
[ { "from": "human", "value": "Hello doctor, I have some questions regarding allergy. When I was a kid, I had eczema on my mid-arms. Then it went away. Some years ago, when I was around 22, it came back aggressively on my face, neck, and shoulders. Then I was referred to blood food allergy tests (IgE). A lot of allergens was detected (wheat, melons, peach, cucumber, potato, parsley, carrot, etc). I did avoid those foods. After seven years, I wanted to test it again, and unfortunately, the test showed the same results, more allergies (coconut, plum, chestnut, buckwheat - things I eat regularly.) I also did the FABER test and had a lot of red lines. The doctor told me that none of those tests are 100 % sure and I should test all foods. But I am very afraid of the anaphylaxis reaction. I am now afraid to eat coconut, chestnut, etc., which I did regularly eat before not to have the severe reaction (not had one earlier though). I wanted to ask if the most severe reaction can develop for any food? Even for meals that I do regularly eat and have no problems with. Please help me." }, { "from": "gpt", "value": "Hello. 1. Yes, some food can cause urticaria and rarely angioedema like peanut and seafood allergies. 2. But, there is no significance of the test you have mentioned, as that is a very nonspecific kind of test and most of the people who get themselves tested found themselves allergic to hundreds of things like that. Hence, it is not significant. 3. And you have been eating them all regularly before, so I do not see any reason to stop them now." } ]
[ { "from": "human", "value": "Hi doctor, I had unprotected sex with my girlfriend. She took Unwanted 72 and vomited within one hour. She was late in her period by six days now. So, we had a pregnancy test and it showed negative. It has been eight days and she still did not get her period. What may be the reason?" }, { "from": "gpt", "value": "Hi We are here to help you. For further information consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am taking my second-day pill of my Krimson 35 for PCOS. I had unprotected sex with my husband, and we are not planning for a baby now. Should I take I-pill also along with Krimson 35 to avoid pregnancy?" }, { "from": "gpt", "value": "Hello. Krimson 35 (Cyproterone, Ethinyl Estradiol) is used as an oral contraceptive pill as well. It should be started from day one of the periods. So if you are having periods and started Krimson as well from day one and had unprotected sex, then there are fewer chances of pregnancy or conception. There are fertile periods in each cycle and first five days of periods in which there is menstrual bleed are included in the infertile period of sequence, so fewer chances of pregnancy if you have started Krimson in periods. You can further clarify if Krimson not taken on the second day, then kindly mention which day you have started Krimson. Please have complete treatment of any health issues if you have, follow some recreational activities and quit recreational drugs. Have a balanced diet, weight, and BMI. Send scan and detailed sex hormonal markers reports as well. As above. With detailed history and reports." } ]
[ { "from": "human", "value": "Hello doctor, About three weeks ago, my wife noticed a blood stain on my underwear while she was doing the laundry. I was surprised because I did not feel pain or any burning sensation. A week later I noticed this but I thought it was the old underwear my wife found. Recently I noticed blood in my underwear, and on the tip of my penis, while changing dress after morning exercise. It probably happens during my daily 60 minutes walk on the treadmill. And I do not know if this has anything to do with it. Sometimes I noticed I have slight pain on my penis, and this morning during my drive I noticed a mild burning sensation. Kindly give your opinion about this." }, { "from": "gpt", "value": "Hello. I would like you to get urine routine test, urine cultures creat, RBS (random blood sugar), CBC (complete blood count), USG (ultrasound), KUB (kidney, ureter, and bladder) plus prostate done. Possibilities are, 1. Blood in the semen. 2. Blood in urine due to infection or stone disease etc. 3. Exercise-induced hematuria. Blood in semen may occur due to swelling or stones in semen tube, and this can be treated with a course of antibiotics and anti-inflammatory. Urine infection needs a course of antibiotics. Exercise-induced bleeding is usually benign and may not need any treatment. You can get the above tests done and get back with reports. Till then start, 1. Tablet Oflox 600 mg (Ofloxacin) once daily. 2. Tablet Enzoflam (Diclofenac, Paracetamol) twice daily after food. 3. Tablet Pantocid (Pantoprazole) 40 mg once daily before breakfast. All medicines for five days until the culture report comes. Take care." } ]
[ { "from": "human", "value": "Hello doctor, I have been really thin since my childhood. Though somewhere it is genetic now I do not feel comfortable. I am not able to gain weight no matter what I eat. My pelvic bones have started to show slightly. My weight is just 41 at 17. I have tried eating different foods but no positive result. When I choose exercise as an option, I lose additional weight rather than getting an increased appetite." }, { "from": "gpt", "value": "Hello. 1. Calorie dense food should be incorporated in your diet like dried fruits, potato, sweets, nuts, jam, jelly, banana or mango shake, porridge, badam kheer, etc. 2. Leafy vegetables should be restricted in your diet as they reduce appetite. 3. You should take three major meals a day and snacks in between. Also, butter and margarine should be considered. 4. An adequate amount of egg, meat, fish, milk should be taken as it helps you for tissue building in your body. 5. Try to eat one boiled egg every morning. 6. You should eat more food at each meal. 7. Before taking a meal, you can walk for some time as it help to you feel hunger. 8. You should take more water." } ]
[ { "from": "human", "value": "Hello doctor, I have a problem with unity. And for me, it is a big problem that threatens my future. When talking to my face, my mouth tends to cry like a child when I am afraid of something, and this causes me a significant inconvenience. Please help me to overcome this problem before I lose my job as a manager. I have met a doctor, and he prescribed me Cipralex 20 mg for two years, and the result was almost 60 % excellent, and I stopped because the problem still exists. Kindly help." }, { "from": "gpt", "value": "Hello. I understand you took Cipralex or Seroplex (Escitalopram) 20 mg for two years which is a good medication for managing anxiety disorder, depression, and other emotional disorders. Did your doctor prescribe it for anxiety? Did he also diagnosed any other problem? You report that result was 60 % and the problem still exists. Did you stop the medication on your own? Sometimes it is advisable to continue for a more extended period especially if the problem is persistent. Has there been any relapse in your symptoms since the medication was stopped? How long has anxiety been a problem? Is it something present since your early age or start only in recent years? Can you please clarify what you mean by problem of unity? You have described some symptoms suggestive of excessive anxiety in some situations. You need to develop strategies and techniques to manage anxiety. Did you receive any psychological therapy like CBT (cognitive behavior therapy) to manage your symptoms? Kindly explore the availability of CBT at your place. Along with medication, CBT is very helpful in managing excessive anxiety. Please also try these self-help measures at home to help manage stress and lower your anxiety. 1) Practice deep breathing techniques. 2) Do progressive muscle relaxation exercises daily. 3) Avoid too much coffee, tea, and fizzy drinks. Also, avoid alcoholic beverages. 4) Regular walking or exercise will help to improve your mood and lower your anxiety. Go for at least 20 minutes of brisk walking daily. 5) If possible, you can start some martial arts training (like karate, etc.) as it will help to improve your confidence and self-belief. 6) Do not isolate yourself and do not bottle up difficult emotions. Talk to trusted family member or friend regularly. You are welcome to contact again for any further advice." } ]
[ { "from": "human", "value": "Hello doctor, I had this acne situation for the past three months. I am not sure of the cause. It started from the side jawline till the cheeks, and it got worse. I tried Benzoyl peroxide and it only helps to control but does not get well, and the skin got dried. Is it a hormonal change? What can I do? I am depressed for a year. Kindly advice." }, { "from": "gpt", "value": "Hello. Acne along the jawline and lower face can indeed be an indicator of hormonal imbalance. Do you have any menstrual irregularities, or facial hair growth or recent weight gain? I would appreciate if you send me the photograph to assess the severity and nature of your acne. Use the following medications after consulting your treating doctor. 1. Tablet Azithromycin 500 mg three days per week, for three consecutive days. 2. Use Adapalene plus Clindamycin gel. Apply once at night on acne in little amount without rubbing it and wash after one hour. 3. Use Benzoyl peroxide face wash. Do this for three weeks." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I have recently noticed a lot of wrinkling of my skin on both my thenar muscles of the thumb. I just noticed it a month ago. I also have a dent or atrophy on the back of my right hand between the little and middle finger. I am not sure whether this is new as it seems to appear in a video of myself taken before three months. I am a 35 year old male. My grip strength seems good. I recently did a personal best hang test of 1 minute 20 seconds. Two years ago, my neurologist told me that I had cramp fasciculation syndrome as I had a lot of calf and feet twitchings. I am concerned now that I may have MND. Please help." }, { "from": "gpt", "value": "Hi. For further information consult a neurologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have some pain in my lower left leg. It is more focused behind and around the knee, in my upper calf, and in the arch of my foot. It is not discolored or swollen or warm or colder than the other side. It is just uncomfortable. I have been pretty stationery due to an infection, but I do get up quite often to use the bathroom, and I often stretch. This pain started before four days. It has not gotten worse but at the same time has not reached better. Does it sound like a pinched nerve maybe or DVT? Should I go to the ER or make an appointment to see my primary care doctor? I am currently under Macrobid. I have done blood tests, hormone levels, CBC, and electrolytes test many times and all seems to be normal." }, { "from": "gpt", "value": "Hello. Leg pain behind the knees which is localized, non radiating in nature with no swelling, no history of prolonged bed rest and no fracture of a limb. Hence, this is not deep vein thromboembolism. DVT occurs when there is a prolonged history of immobilization with sudden onset of swelling. This also does not look like cellulitis where is a superficial subcutaneous infection, which is most common cause of swelling and pain. If this is more on walking, then we have to rule out claudication first and second is knee joint pathology. Kindly tell me if there is any history of trauma or fall, or any associated disease." } ]
[ { "from": "human", "value": "Hello doctor, I have never achieved orgasm without a vibrator. For years, I have experimented with different pressures, methods, stuffs and followed the advice of hundreds of articles, but nothing worked. I always make sure that I have enough time and relaxation. I have tried so many methods involving fingers, my partner and more, but still, nothing worked unless I use a vibrator. I even went months without using it to see if I would desensitize, but nothing changed. Just wondering if anyone else has the same problem. What I can do about it?" }, { "from": "gpt", "value": "Hello. Female masturbation is a complicated one. Yes, I have few patients who were not satisfied with many methods. Male masturbation works only more physical, and few mental work but female masturbation works with more psychological and few physical tasks. Method, if anything needs to be changed. 1. Fingers are used gently and rhythmically over the clitoris, apply study pressure with one finger and can increase two to three finger according to demands. Do not double the pressure of your finger unless you need. Rhythm in moments of the finger should be maintained. Do not be eager to give climax early, female will take them as they like or enjoy. 50 % of the female will reach orgasm or peak within three minutes and, few may take four to five minutes, it also depends on how the vagina and other parts of the female body are manipulated. 2. Vaginal massage as massaging the clitoris with one finger, other finger or fingers moved between the labia. Sometimes labia strokes alone will give results as it is attached to the clitoris. Speed of the stroking depends on personal likes. Initially, it starts with mild strokes and increase the speed according to the needs. 3. Females do not reach climax by inserting fingers or vibrators inside the vagina, since walls of the vagina are practically without nerves, although few sensory nerves close to the entrance of the vagina. Inserting big objects inside the vagina will have no use, since no erotic nerve supply inside the vagina. Deep vaginal penetration in men is fantasy, and it is not a sexual need for women. Only occasional vaginal insertion that to just for a few females will cause an erotic feeling. Keep exploring as much as you can. I hope I have answered your query. If you have further doubts, I would be happy to help you." } ]
[ { "from": "human", "value": "Hello doctor, I saw red spots, and skin crack on my penis head. Sometimes, it become painful. Urine open area is also painful and open like a lip." }, { "from": "gpt", "value": "Hello. You may be suffering from balanitis or pearly penile papules or sexually transmitted disease. If you have any sexual contact with an unknown person, then we can think of HPV warts (human papilloma virus) which comes under sexually transmitted diseases where you need investigation and start you on antiviral and surgical removal of the wart. If you had sex with a known person, maybe you would have caught simple infection and that can be treated. If it is due to condom allergy, balanitis inflammation due to painful sex, simple antibiotics and anti-inflammatory will help you. Another condition is pearly penile papules where there is no need to worry about infection. Sometimes it will heal on its own, or you need to meet a dermatologist to confirm the diagnosis for its removal. I hope I have answered your query. If you have further doubts, I would be happy to help you." } ]
[ { "from": "human", "value": "Hello doctor, I have these eruptions randomly on my skin since the past few weeks. They are present mostly on thighs, forearms and lower back. They feel tight and are painful to touch. What are these? Do I need to get them treated or will they go away over time?" }, { "from": "gpt", "value": "Hello. These are furuncles, a bacterial infection of the hair follicles. Use the following medications for five days. Kindly visit your physician, discuss the suggestion and take treatment with consent. A. Tablet Cefadroxil 500 mg twice a day. B. Tablet Flexon 500 mg (Paracetamol, Ibuprofen) twice a day. C. Ointment T-Bact (Mupirocin) twice a day. You will get better with these medications. If you have these again and again, then you might need some other drugs but for now, use these for five days." } ]
[ { "from": "human", "value": "Hello doctor, What to do when we find blood in our semen? There was a blood clot in my semen when I ejaculated during unprotected sex, but I have had unprotected sex regularly. The next day I masturbated to see if I still have it and this time blood was mixed in the semen. Although, it does not hurt and when I urinate it does not burn. I sometimes forget to drink water, but I still drink enough. Should I take a hepatitis shot or urinalysis? Do I have STD? Should I be concerned or will it go away? This happened to me before two years ago but it subsided." }, { "from": "gpt", "value": "Hello. Blood in semen with no other symptoms is very likely idiopathic or no pathology. After a period of abstinence sometimes aggressive frequent sexual activity leads to hematospermia. Majority of times it is self-limiting. Unprotected sexual intercourse will not give rise to this (rather it causes urethritis). Seminal vesicle can occasionally be infected from the blood. Just once examination by surgeon or urologist to feel seminal vesicle per rectum is preferred. For the present episode, wait for some time that it will resolve on its own." } ]
[ { "from": "human", "value": "Hello doctor, I have depression, anxiety, lack of confidence, lack of energy, palpitation, and excess sweating for the past 18 years. I have consulted so many psychiatrists. My current doctor prescribes me Nexito Forte, Prothiaden 25 mg, and Toficalm 100 in morning and evening. But I feel some sleep issue and sweating. I have also consulted one of a top psychiatrist, and he prescribed me Nexito 10 and Clonazepam 0.5 mg in morning and evening and Mirtazapine 15 mg in night. But it causes me some stomach problem as I have IBS, diarrhea too. Unable to understand that which combination of medicine is better for long term use. Please suggest." }, { "from": "gpt", "value": "Hello. You should go with Escitalopram (Escitalopram Oxalate), Clonazepam and Mirtaz (Mirtazapine). These combinations have a minimal side effect. You take antacid with it. Please do not take the above medications in an empty stomach. You must lose your weight. Do the daily exercise for 30 to 45 minutes and practice meditation for 10 to 20 minutes daily. Avoid junk foods, eat healthy home-cooked meal. Stop alcohol, smoking tobacco or stay away from any type of substance abuse. Spend quality time with friends and family. Spend time for your creative hobbies like read good books, write journals, do paintings, learn new skills or music, etc. Take enough seven to eight hours of sleep. Take a cold shower. Drink three liters of water daily. Live your life, do not just spend. Go for a vacation, spend time with nature. Stay away from social media as much as you can. Prothiaden (Dosulepin) will cause constipation. And low energy can be due to depression or anemia or thyroid abnormalities. It is less likely due to medication. Toficalm (Tofisopam) and Prothiaden will cause you oversedation or make you drowsy the next day." } ]
[ { "from": "human", "value": "Hello doctor, I am a 23-year-old-female. I have been losing a lot of hair since last year. I do not see any bald patches but I do see my hair thinning over time. I do not understand why this is happening since I have always had a mane full of thick hair. Is there any way I could stop the shedding of my hair?" }, { "from": "gpt", "value": "Hello. There can be a lot of causes of sudden increased hair fall which can include sudden weight loss, stress, illness, dietary changes like crash dieting, drugs, childbirth, thyroid problems, anemia, etc. If you think you have any of these kindly mention it. Get the following investigations done. 1. T3, T4, TSH (thyroid stimulating hormone). 2. CBC (complete blood count). Take the following medicines after meals for 3 days meanwhile with the consent of your doctor. 1. Tablet Hairfollic woman one tablet a day. 2. Tablet Autrin 1 tablet once a day." } ]
[ { "from": "human", "value": "Hello doctor, I am a 25-year-old male. I am straight but yesterday I had anal sex with my friend. I feel I took wrong decision. It is remembering me a lot. I want to forget that. My mind is not concentrating now. Kindly help." }, { "from": "gpt", "value": "Hello. If it has been done against your wish, you can take legal help. Are you intoxicated that time, or under any threat? Is there any injury or pain? Have you used condom? If done with your consent, just driven by impulse, not need to get in guilt. Some time accident happens. Forget it like a nightmare or just an accident. In accordance with forgetting this try to involve in other pleasurable activity, be with a friend, take proper sleep and healthy diet, can take low dose anti-anxiety drug from your doctor." } ]
[ { "from": "human", "value": "Hello doctor, I am a 33-year-old male with height 180 cm, and weight 85 kg. I always been healthy. I do not have symptoms of depressions. I took Risperdal to treat minor vocal tics, and I have OCD. Now I have been off Risperdal for five months and still no libido, no sex drive. I searched for post-SSRI sexual dysfunction (PSSD). Why do no doctors recognize this? What is the solution now? I took Risperdal three times for three months each time for the past two and a half years (on and off). I took Risperdal three months before. Symptoms are no libido, no sex drive, and no feelings for sex. I am not taking any other medication (never took any). Why is everyone ignoring PSSD? What is the treatment?" }, { "from": "gpt", "value": "Hello. The drug you used Risperdal contains Risperidone an atypical antipsychotics and it has an effect on libido, but it will wear off when you stop taking medicine. So we need to find other reason causing low libido such as, 1. Decreased sensation in your penis. 2. Fear of failure. 3. Low self-esteem (chronic masturbation). 4. Homosexuality. 5. Religious constraints. 6. Long term illness. 7. Negative attitude towards your partner. 8. Hormonal issue. 9. Diabetes and hypertension. These are other issues causing low libido. If you can share details regarding the above reason, we can work on your cause." } ]
[ { "from": "human", "value": "Hello doctor, I think I have balanitis, due to itching I have got rashes on the penis foreskin. I am having difficulty on retracting the foreskin, and the foreskin has formed a rubber band like structure at the tip of the penis. There is also a little bit of redness on the tip of the penis and inflammation too. Lately, I have been feeling inflammation of the glans." }, { "from": "gpt", "value": "Hello. 1. Yes, it is balanoposthitis (balanitis), most probably candidal balanoposthitis. 2. Do you have a history of sexual exposure recently? And if yes, does your partner has genital itching or vaginal discharge issues? Take the following medications with your doctor's consent. 1. Tablet Fluconazole 150 mg. Take one tablet today and one after a week. Do it for your sexual partner also, if any. 2. Apply Candid cream twice a day. 3. Tablet Levocetirizine 5 mg once at night. Do it for 10 days." } ]
[ { "from": "human", "value": "Hello doctor, I have blood flowing from my left ear without pain. Please help." }, { "from": "gpt", "value": "Hi. Most common reason for bleeding from the ear is due to trauma. There is nothing that you need to worry about as this is extremely common. Make sure you do not use earbuds as they often traumatize the ear canal or eardrum and introduce infections. Please do not use headphones or earphones as well, until it heals. Make sure you keep the ear dry, make sure no water enters the ear at any cost. For now you can apply Ciplox (Ciprofloxacin) ear drops three drops thrice a day and take tablet LCZ (Levocetirizine) 10 mg one tablet at night after meals for the next one week (this will reduce any itching). Make sure that there is no pus like discharge from the ear because in such a situation, the infection of the eardrum is more likely and will require systemic oral antibiotics. I hope this helps." } ]
[ { "from": "human", "value": "Hi doctor, Last week, I was bitten by red ant. Within 5 minutes I was collapsed and immediately rushed to the hospital. My BP was low at 80/60 mmHg. It was detected as anaphylaxis. I hereby attaching the treatment sheet for your reference. Six months ago, my 2 year old son expired due to unknown insect bite. We did not know about anaphylaxis at that time. What type of treatment should I get further for anaphylaxis?" }, { "from": "gpt", "value": "Hello. For further information consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, Recently after watching a video of a young person dying of heart attack, I have developed a fear of death. Although I am young and have no heart problems, I tend to think about it all the time. Please help me to get rid of this." }, { "from": "gpt", "value": "Hello. Here are two kinds of fears or phobias. 1) Temporary. 2) Permanent. Temporary lasts for few days after you suffer or witness some traumatic thing. Permanent ones would slightly fall under some psychiatric issues worth paying attention. I would recommend you to wait for some time. Keep yourself busy with positive and productive things and try to be in the company of family or friends. Try deep breathing, meditation and running. Everything should be settled by two weeks. If it does not, then consult a psychiatrist for proper evaluation and treatment." } ]
[ { "from": "human", "value": "Hello doctor, I have pain at the right side near the penis for 20 days. MRI done on pelvic region showing infective etiology likely, there is thickening of right side epididymis, and vas deferens, right side seminal vesicle is thickened. Mild hydrocele on the right side. A thick-walled, 22.52134 mm complex cystic area seen in the right inguinal region just posterior to and abutting the spermatic cord adjacent to the root of the penis. Current medications are Naprosyn 500 mg, Omeprazole 20 mg, Chymoral forte tablet, Methylcobalamin, Alpha Lipoic Acid, Folic acid, Pyridoxine hydrochloride and Oxidation plus capsule." }, { "from": "gpt", "value": "Hello. It is the infection involving right testis, right sperm tube and both sides of groin lymph nodes. Please get a urine routine and culture test done. From the list of medications, I do not see any antibiotic. I suggest you start capsule Doxycycline 100 mg twice daily, to be taken for 14 days with the consent of your treating doctor. Is there any recent history of sexual exposure? You can contact me in about five to seven days after getting a sonography of right inguinal and KUB region (kidney, ureter, and urinary bladder). Take care." } ]
[ { "from": "human", "value": "Hello doctor, I had done first IVF last year, but it failed due to a bad quality egg. Embryos were not developed after two days. AMH level is 1.52, and the egg count was low. On consulting another doctor, she suggested to go with PRP injection to rejuvenate the ovary, so that egg count and quality will increase. I am afraid if PRP will cause any harm to the ovary? Are there any issues to try PRP?" }, { "from": "gpt", "value": "Hello. You have been wrongly guided by your doctor because there is no apparent need for PRP (platelet rich plasma) therapy and injection into ovaries to rejuvenate the ovaries to produce better quality eggs. The therapy modality is relatively new and not sufficient studies have been done yet on them. It is being done for women with really low antral follicular count and AMH (anti-mullerian hormone) less than one and failed two natural timed intercourse and six IUI (intrauterine insemination) and one IVF (in vitro fertilization) cycles. You were directly subjected to IVF cycle, which was wrong without treating the pathology. AMH can be increased with DHEAS (dehydroepiandrosterone) therapy which is oral supplementation along with low dose OC pill (oral contraceptive) therapy for two months. That improves the quality and also the chances of natural conception. Also, another concern is a bicornuate uterus, which has their own demerits for natural conception so that IUI can be offered for conception at least for six cycles, post-therapy. If succeeded, then the bicornuate uterus is unable to sustain the pregnancy for the complete term, and often preterm labor occurs giving birth to a preterm baby. So weigh this complication as well in your mind. You can either opt for Strassman's operation first to increase the size of the uterus by joining them together and then try after a year or take the risk of IUI or IVF and accept complications associated with bicornuate uterus itself. You have to think and make a decision. PRP is the last line of therapy, not primary, in my opinion." } ]
[ { "from": "human", "value": "Hello doctor, I want to ask is it possible for me to transmit HIV through hand cut, (I have attached a picture) because I had anxiety when shaking hands. I am almost certainly HIV negative according to tests, but still anxious. Kindly advice." }, { "from": "gpt", "value": "Hello. No, unless you put your hands in HIV positive blood." } ]
[ { "from": "human", "value": "Hello doctor, I am 43 year old. My weight is 83 kg, and I do not have blood pressure. My fasting sugar is 102 and post prandial is 87. Why is it so? It is happening for the last three years. I am not able to reduce weight inspite of all exercises, and I eat just regular home meals with calorie consciousness. I am currently on 10 mg statin alternate days for cholesterol. Kindly help." }, { "from": "gpt", "value": "Hello. There are a few reasons. 1. Pre-diabetes can have such results which means you are more prone to get diabetes. Increased PPBS (postprandial blood sugar) means your pancreas is working very hard to reduce your sugar. It is overworking where it will deplanes beta cells in pancreas soon (beta cells present in the pancreas secrete insulin to maintain blood sugar). 2. Wrong blood report, take the report in a NABL (national accreditation board for testing and calibration laboratories) lab. Regular exercise and diet will help you. Meet a nutritionist and get a diet chart. Get a personal fitness trainer. If these are not working to reduce your weight, then we can think of blood investigation and medical treatment. I hope I have answered your query. If you have further doubts, I would be happy to help 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 was hoping someone could help me determine what these newfound bumps on my penis are. I have not been sexually active for the past eight months. But recently I have seen three bumps appeared on my penis. They do not cause any discomfort or itching, but I am concerned. They are not in the form of clusters, and there is no discharge from it. But they appear to be red." }, { "from": "gpt", "value": "Hello. Please send a few more good quality photographs. It could be molluscum contagiosum." } ]
[ { "from": "human", "value": "Hello doctor, I am a 40-year-old female. I went to my doctor a year before because I had a little blood in my urine when I wiped. He did a urine analysis, and some blood work and everything came back fine. There were no problems until three days ago. I peed then a few minutes later it felt like it still had to go so I went back to the toilet but I just got only blood. There was a lot this time, and it was fresh blood and small clots. It is hurting while passing the blood but that is all that came out though I had just emptied my bladder a few minutes before that. The only other symptom I seem to be having is all of a sudden there will be an immediate need to pee out of the blue but then when I go it is not a full bladder of pee just like half but it the onset was very sudden, or I am going to pee my pants. These are my only symptoms. I do have a long history of stones, but I am confident this is not due to that, because I have had blood from stones but not this amount of blood. And every time I have ever had a stone, it hurts worse than childbearing, and I am not in that kind of pain. I feel whatever is going on is the same thing I went to the doctor last year, but he found nothing. What is likely to be wrong with me? I am currently on Coumadin, Lanoxin, Coreg, and Propylthiouracil. Laboratory tests performed are urinalysis, hemoglobin a1c, CBC (complete blood count), fasting lipid panel, and fasting glucose." }, { "from": "gpt", "value": "Hello. A bladder infection (cystitis), stones and overdose of Coumadin (Warfarin), all three can be the likely reason for your bleeding. In case of any such bleeding, an ultrasound is a must. I prefer to start with a short course of antibiotics (mostly Nitrofurantoin and Cipro or Levofloxacin are given) for five days depending on sensitivity patterns. Blood clotting parameters need to be checked to see if you are on the overdose of Coumadin. Ultrasound is a must to rule out any other serious causes of bleeding like a tumor. Since antibiotics are not available over-the-counter in your place, you need to get back to your general physician. Moreover, even for getting an ultrasound and clotting parameters to check the overdose of Coumadin, you need the help of your general physician. Please do at the earliest." } ]
[ { "from": "human", "value": "Hello doctor, I have been taking Zoloft 25 mg and Ativan 5 mg one or two tablets to one tablet prn which I rarely take for anxiety. I take Tapazol 2.5 mg for hyperthyroid, TUMS two or three a day, Pepcid AC, vitamin D, B12, and Ventolin inhaler. I have been taking Zoloft and Ativan for 24 years. Four Psychiatrists and three medical doctors approved Ativan when I was diagnosed with anxiety. I worked for a psychiatrist for years, and he said I was merely cyclothymic if anything and stress. What is bipolar affective?" }, { "from": "gpt", "value": "Hello. Tell me one thing, since how long you have these thyroid nodules? Because some times symptoms of anxiety and restlessness might be due to hyperthyroid state. Is there any family history of any such kind of illness? Is there any change in functioning, sleep or appetite habit? In cyclothymia, there is an alternative period of depression and mania, but none of them is in full symptomatology, which means your functioning is not affected, but you can have distinctive period of euphoria and depression. Take a healthy diet, avoid junk foods, have proper sleep, do moderate exercise, follow relaxation technique, yoga and meditation may help you." } ]
[ { "from": "human", "value": "Hello doctor, I think I got balanitis. Which cream should I buy? I had sex five weeks ago without protection. Painful peeing lasts for two years but not as strong as this time. Sores came out after having unprotected sex." }, { "from": "gpt", "value": "Hello. First of all, you need to get blood tests for sexually transmitted diseases like VDRL (venereal disease research laboratory), HIV and HSV (herpes simplex virus), as the act may cause herpes simplex or syphilis. I would start with a combination of antibiotics like Doxycycline and antiviral pills like Valacyclovir. However, in your place, you need to get in touch with your general physician to undergo the necessary tests. Ointments alone will not be sufficient for treatment. A combination of Acyclovir ointment and Fucidin H cream (Hydrocortisone and Fusidic acid) as a thin layer may be applied for three days. Meanwhile, get in touch with your general physician. Avoid sexual activity until the ulcer is treated. Syphilis and HIV test to be repeated after three months." } ]
[ { "from": "human", "value": "Hello doctor, How can I take care of toothbrush health? How often to change toothbrush heads or disposable toothbrushes and the negative effects of not changing them often?" }, { "from": "gpt", "value": "Hi. Dentists recommend a change of toothbrush every six months. But this toothbrush health depends on patient's brushing habits too. Like if a person does not follow proper brushing techniques and brush his teeth vigorously, or maybe he is suffering from any gum disease and he is brushing more often then he must change his toothbrush more often like at every 2 or 3 months. Usually, by six months the bristles of toothbrush start weakening, are not performing their function well, some bacterial flora may start growing at bottom of bristles or at back side of toothbrush head where tongue cleaner is given. If such yellow or brown stains start appearing at some surfaces of toothbrush then toothbrush needs to be changed immediately. At toothbrush replacement, Miswak is the best recommendation. It is like a small bamboo stick and you can easily cut off its bristles after brushing every 2 or 3 days later and it leaches out antibacterial ingredients and has many good affects for your health too. Like it is a cure for all gum diseases." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]

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