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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": "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 female of 32 years old. I have a chronic issue of throat irritation. A year ago, I had taken treatment from the ENT specialist. He told me that everything is fine, but some kind of air obstructs the throat. Unfortunately, I lost the prescription. I have been to doctors here, but I am not satisfied. One doctor gave me gastritis medicine and it does not work. As per report my throat is fine. I do not have tonsillitis or sinus problem. But, I am keep clearing my throat. My current medication includes Rabeprazole sandoz 20 mg and Motilium 10 mg. I am in a real trouble. Please help." }, { "from": "gpt", "value": "Hello. We are happy to help you. From the details you have provided regarding your symptoms and the previous consultations, I can conclude with reasonable surety that you are suffering from a condition called reflux laryngitis. This is a chronic condition characterized by symptoms like chronic throat irritation, feeling of something stuck down the throat, frequent clearing of the throat and excessive throat mucous. It is because of local production of acid. Acid is produced in the stomach to aid in digestion. The throat mucosa is not suitable to handle the acid. When such local acid production occurs or the gastric acid contents rise up the esophagus, they cause chronic irritation of mucosa and produce these symptoms. They are seen typically as inflammation of the posterior larynx in endoscopy. If you can search for your endoscopy report and share with us it will be helpful. The treatment for this condition is to take a proton pump inhibitor like Rabeprazole 40 mg or Pantoprazole 40 mg twice daily, half an hour before food for about a month. Also, I advise to take a teaspoon of Mucaine gel (Aluminium hydroxide) after each meal and before bedtime at night for a week. The proton pump inhibitor prevents acid production and the gel which is a combination of antacid and local anesthetic produces relief of symptoms. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Some additional care to be taken during this treatment are, With these measures your condition will improve. But, it will be a gradual recovery. If you do not recover, then I would like to do some blood investigations to check if there is any other factor that is causing the throat issue. Also a repeat endoscopy can be advised to recheck the larynx, hypopharynx and cervical esophagus for the throat irritation. For further information consult an ENT otolaryngologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am currently taking Tadalafil as we are trying to conceive a child. I used to take Sildenafil Citrate but switched to Tadalafil a few months back. There are certain days when besides taking Tadalafil or Sildenafil I am unable to maintain an erection. This could be either due to low sex drive as this has become a routine chore or anxiety to conceive during ovulation so as to not miss the cycle. Under such circumstances is it recommended to take Tadalafil and Bupropion together? If Bupropion is advisable then how many hours before sex should I take it? Can I just take this tablet on days of conceiving? Do you suggest any other alternative besides Bupropion? Taking Tadalafil is giving me side effects like dry mouth and dry eyes, especially while sleeping. The side effects reduce a bit after a few days but continue up to the next cycle. Is there anything I can do to reduce the side effects?" }, { "from": "gpt", "value": "Hi. First, I would like to know the frequency of intercourse and the days on which you are trying for pregnancy. I mean, do you have sex every day during those days? Once every other day?" } ]
[ { "from": "human", "value": "Hi doctor, I have some questions regarding what the dermatologist told me yesterday, when I was visited with dermoscopy to check my nevi. I asked the dermatologist to focus on an atypical blue nevus (on my right arm) which has increased in size during the last nine years. He told me that the nevus pigmentation does not allow the dermoscopy to provide a conclusive diagnosis of melanoma. He adviced me to remove the mole but with no priority Now, I have some questions. 1. The fact that I have no priority means that there is a low probability that my nevus is a melanoma? Or it is due to the limitation of the instrument? 2. Would the dermoscopy have allowed to classify my nevus as a melanoma, if the nevus effectively was a metastatic melanoma? I do not know what to think." }, { "from": "gpt", "value": "Hello. Dermoscope is of different types. Some are more good than others. Using this instrument requires a lot of practice and experience. Sometimes the person performing it cannot appreciate all the features of a particular disease. In your case, the conversion of blue nevus to melanoma is very rare. On the safe side, the doctor advised you to remove it so that no confusion left. If he or she has picked up melanoma, they would immediately treat it. You should go for excision of your nevus and histopathology will reveal the exact tissue diagnosis." } ]
[ { "from": "human", "value": "Hello doctor, For the last two weeks, my two wisdom teeth on the right side of my face have been coming in. The pain has been incredibly severe and is almost unbearable at this point. I have been experiencing headaches and tenderness pain in my neck, jaw, and gums. I have trouble moving my jaw and speaking at times due to the pain. My teeth have become extremely sensitive to hot or cold items, my teeth are so sore that I struggle to chew food since my molars cannot touch without resulting in an incredible amount of pain. I do not have any swelling in my jaw or neck aside from my gums. I have been taking as much Advil as is safe in a day and some CBD oil as well. However, nothing seems to be helping. I am really worried that I have an infection and how long I should wait before going to an emergency room." }, { "from": "gpt", "value": "Hi. I can understand this pain. It is like erupting pressure pain caused at every 2 to 3 months interval. Since you are done with Advil (Ibuprofen) and it is not going away. Please start taking the following antibiotic regime as soon as possible. Tablet Augmentin (Amoxicillin) 625 mg twice a day, tablet Metronidazole 400 mg twice a day, tablet Brufen 400 mg three times a day. Do a course of all these medicines for 5 to 7 days. An infection will subside through it and hopefully, you will be at peace for a month. You can repeat this course every two months if condition recurs. If the pain does not subside through this course then sure go to an emergency room. Moreover, do salt water mouth rinses. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses three times a day. Take mustard oil put a pinch of salt in it, make a paste and apply on swollen areas inside the mouth, at gum line before sleeping. This also helps in reducing swelling. Give me a followup after three days. Stay happy and blessed. Indeed, there comes ease after every difficulty or pain. Take care." } ]
[ { "from": "human", "value": "Hello doctor, My vaginal opening is white in color and it itches a lot around that area. It has been like this only for the past 4 to 5 days." }, { "from": "gpt", "value": "Hello. The presence of itching over the vaginal opening with white discoloration is a possible indication of vulval candidiasis or fungal infection which can be treated with local and oral antifungals, but before starting any medicines, please get it confirmed by a local examination by your gynecologist or you may send a picture of the lesion for diagnosis and further advise." } ]
[ { "from": "human", "value": "Hi doctor, I am having issues with sleeping. I am exhausted all day every day, sleep 6 to 9 hours every night and take 2 to 3 hours nap every day. I am unable to control falling asleep. I am not on any medications." }, { "from": "gpt", "value": "Hello. The reasons for sleepiness could be many. Firstly, could be related to the deficiency in vitamins in body or iron deficiency. This can be easily tested by blood tests. Secondly, hormonal changes can cause sleepiness, like low functioning thyroid gland, which can also be checked on the blood test. Thirdly, sleep issues like sleep apnea or insomnia can cause daytime sleepiness which will require clinical assessment and sleep study. Finally, low mood or depression commonly causes sleepiness and feeling of exhaustion." } ]
[ { "from": "human", "value": "Hello doctor, I have an abscess on my top left gum that is now spreading to my cheeks. I am 19. I had an abscess in the same place at 10 or other young age. Last time I went to the dentist they did not do the cleaning in the first appointment so I did not get one, but wisdom teeth removal was suggested. I have good teeth, bad gums. Also cracked my teeth when younger. So one of my two front teeth has a fake bottom (do not know if that is relevant). I do use a gel and just learned that it could be contributing." }, { "from": "gpt", "value": "Hi. Immediately start with these medicines. Tablet Augmentin 625 mg twice a day for five days, tablet Gramex 400 mg twice a day for five days, tablet Brufen 400 mg twice a day or thrice a day if the pain is severe for five days. Moreover, take some mustard oil or olive oil, put 1/4th teaspoon of salt in it. Make a paste and put it on gum line having the infection. Do it three times a day for three days. When swelling regress, put this paste on gums before sleeping. And start saline water mouth rinses. Take a 1/4th teaspoon of salt in lukewarm water and do its rinses 4 to 5 times a day for two weeks. And you must know this will only subside infection for some time but will go permanently after getting treatment from the dentist. Stay happy and blessed. Give me followup after three days." } ]
[ { "from": "human", "value": "Hello doctor, Sometimes, when I am doing stuff, my vision makes it seem like there is a white haze, like heaven, I guess. Like everything has a white haze light. It is pure not like fog or a dirty color. Sometimes it lasts a few minutes, other times a few seconds. Sometimes I see it, other times weeks pass without seeing it." }, { "from": "gpt", "value": "Hello. There are a number of causes which could lead to such a problem. In the eyes, macular degeneration can cause problems like a distortion of images, also called metamorphopsia and a drop in vision. Retinal detachment can cause flashes of light which come and go in an instant especially on eye movements. It also causes a drop in vision and floaters on your field of vision. The posterior vitreous detachment also causes flashes of light without a drop in vision. So, what I mean to say is eye related problems will have accompanying eye-related symptoms, other than just a white light. Coming to other causes, fortification spectra are seen in some cases of migraine and are usually described as multi-colored lights just before the patient experiences headaches. These are the most common causes which can lead to a feeling of seeing light. In case you feel like you fit into one of the above, there is no need to worry as most of these are treatable. In case you feel you do not have anything in common with the above, please let me know about your condition in further details, example what causes this light to come, is it accompanied by any physical symptoms, does it arise while you are in a certain place or while doing a specific action." } ]
[ { "from": "human", "value": "Hello doctor, My son is 5 years old. He has a wheezing problem from one and a half years. Recently, a pediatric pulmonologist diagnosed his condition as reactive airway disease. Currently, my son is taking Foracort 200 one puff in the morning and one puff at night. My husband and his brother both had a wheezing problem when they were children. However, wheezing disappeared after they reached eight years. The allergy test was done and the doctor said my son does not have an allergy. Primary complex test (Mantoux test) proved positive but the doctor also looked at the chest X-ray and enquired about family history (no smokers, vegetarians, non-alcoholic). So she asked us to wait. No medicines were given. Did my son inherit this from his dad side? Will his wheezing also subside after a particular age? He gets wheezing problem once a month or once in two months which settles only after nebulization even when he is on Foracort. As of now, I successfully identified one trigger that causes wheezing which is acid reflux that happens when he skips breakfast or eats late breakfast. Also, he does not pant for breath during wheeze but coughs a lot. Is this condition curable? He also gets wheezing whenever he has a throat infection. Why does he get frequent wheezing even when he has no allergy? Does he have asthma?" }, { "from": "gpt", "value": "Hi. Yes, your son may have inherited it from the father. Considering that the wheezing may have been inherited from the father, it should follow the same course and should go away by the age of 8 years. Even if it has not been inherited, usually this issue disappears by the age of 8 years to a maximum of 10 to 12 years. The issue and its frequency of occurrence goes on reducing with age and it eventually disappears. In a very few cases (1 % cases) the issue may persist into adulthood. The condition is not curable but it is controllable with medications till the time it goes away with age. I would advise you to use an Asthalin inhaler during such severe episodes along with the Foracort inhaler. Asthalin inhaler is to be used as Asthalin 100 mcg one puff four times a day for 3 to 5 days following a severe attack. After that you can continue the Foracort and stop the Asthalin. You can obviously use a nebulizer along with it on an SOS basis. As far as the reflux is concerned I would advise you to get it diagnosed by imaging and as per the grade, we can start medications like Lanzol 30 mg once a day before food to reduce such episodes. Please do not be depressed about this condition. It happens to 20 to 30 percent kids out there out of which most of them get rid of the condition by 5 to 6 years. So do not worry. Be happy." } ]
[ { "from": "human", "value": "Hello doctor, I had a crazy dog that scratched me 10 years ago. So, I want to know whether that can lead me to rabies because I have never taken any anti-virus booster." }, { "from": "gpt", "value": "Hi. 10 years is quite a long time. It is highly unlikely that you can get rabies by an exposure 10 years back. Usually with infection of rabies virus, (through a bite of rabid animal) shows symptoms in 20 to 90 days. The period can be as long as more than a year. But I have not come across a period more than that. Regarding immunization, rabies is one of the few diseases for which post-exposure prophylaxis is available. It is always preferred to get yourself immunized along with anti-rabies serum." } ]
[ { "from": "human", "value": "Hello doctor, The patient has glioblastoma cancer, undergone surgery but not operated correctly, taken radiotherapy and chemotherapy, the doctor said chemo tablets are not working, maybe the tumor has formed again so they stopped giving medicine. We are not going anywhere now." }, { "from": "gpt", "value": "Hi. As you have considered in history, surgery, radiation, and chemotherapy have been already given. The glioblastoma is a grade IV brain tumor so have overall poor outcomes even after best treatment. So if the disease is unresectable, consider for best supportive care at home. But if the patient's general condition is good, it is time to add a second line of chemotherapy. All these drugs are prescribed only after patient's clinical examination. So my humble request to please consider for local oncologist visit." } ]
[ { "from": "human", "value": "Hi doctor, I have a couple of moles that have changed recently. Should I get them checked by my GP? The larger round mole is on my back of about 5 mm in diameter. Now, it is a little over 1 cm. Also, it has changed over a course of a few months. The other mole that I noticed recently, is raised, while the rest is flat. I have uploaded the photos for your reference. Please help." }, { "from": "gpt", "value": "Hi. For further information consult 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, Hair loss. I want to increase my hair. In some areas, hair is not coming. Please suggest something." }, { "from": "gpt", "value": "Hi. How are you? I hope your health condition is good. I have read your problem and have seen attached picture carefully (attachment removed to protect patient identity) and you mentioned that you have tried 2 % Minoxidil. Now you want to know how to improve or grow more hair in some area (shown in picture). There are some options: PRP therapy, oral Finasteride, increase the strength. Your hair fall pattern seems to be like Androgenic pattern or male baldness. The strength of tropical Minoxidil should be increased. Besides this, you can take oral Finasteride. But there is some side effect such as deterioration of sexual function but this problem is reversible, that means when you stop the drug, the problem will be reversed. You can use tropical PRP therapy which is safe and no adverse event occurs. But the result may not be up to your satisfaction. The other and final option is a hair transplant. This option is expensive but the result is quite good. I hope the above-mentioned information may help you to solve your problem." } ]
[ { "from": "human", "value": "Hello doctor,I am having an acidity problem. From the past 10 days, it is being greater due to which I am having a headache from the past 10 days. What should I do to control it and what should be my diet and routine exercise?" }, { "from": "gpt", "value": "Hi. I have read your problem carefully. I need some information that is missing in your query. Your age, job, daily life and dietary habit, acidity increases after or before the meal, more details about the stomach problem, bowel habit. I am trying to give you some suggestion which may help though a lot of information is lacking. You may be suffering from PUD (peptic ulcer disease). Another possibility is IBS (irritable bowel disease). To confirm it, I need detailed information and some investigation also. Now I am suggesting some medication: tablet Sucrafil 1 g TDS (one hour before the meal). Do not take anything between this time, tablet Tryptomer 10 once daily. Start the above two medications. Take regular food, avoid spicy and oily food, try to maintain a regular lifestyle. If further assistance is needed, feel free to contact with information I needed." } ]
[ { "from": "human", "value": "Hi doctor,I am a 37-year-old female, 140 lbs 5’5\". I saw a new cardiologist yesterday and my EKG results. Results said left axis deviation, LAPB, RBBB. I asked her if I have a bundle branch block and she said no because only the two heartbeats show it and the rest of the EKG was normal. I am worried whether I need a pacemaker if I have blocks now. What is she trying to say?" }, { "from": "gpt", "value": "Hello. I guess you mean LAFB and not LAPB. According to you, you already have RBBB and this time the EKG strip read LAFB. Many times the EKG strips read the EKG strip wrongly. You should believe in your cardiologist as humans are needed to interpret the EKG with some specific criteria, to fit the EKG as normal or some pathology. While LAFB stands for left anterior fascicular block, there is no term such as LAPB in my knowledge. The other term is LPFB, which stands for the left posterior fascicular block. The LPFB is extremely rare and usually occurs in isolation. It would be nice if you could post the picture of your EKG so that I could give a second opinion. Also when RBBB is present in combination with the other two (either LAFB or LPFB) is called bifascicular block. If the bifascicular block is present chronically in a patient it has a relatively low risk of progression to a high degree block." } ]
[ { "from": "human", "value": "Hello doctor, My vaginal opening is too loose without any sex. I do not know what is the reason? Can you please tell me what is the reason?" }, { "from": "gpt", "value": "Hi, Welcome to ilciniq.com. How are you? Hope you are fine. I have read your problem carefully. There is some lack of information. Your age, profession, height, previous sexual history, etc. You should remember that a loose vagina is a myth. It is a misconception. The vagina is elastic. With your age, it may lose their elasticity. So opening may lose their elasticity. Vaginal opening may be loose. If the looseness is fixed and not progressive you can wait. If loosening is progressive you should consult with a medical specialist or gynecologist-obstetrician. There is some exercise of pelvic muscle which may help such as Kegel exercise, pelvic tilt exercise. Do not be panic. Lead your normal life and observe." } ]
[ { "from": "human", "value": "Hello doctor, What are the ways a neurosurgeon can get to someone's brain? Along those lines, what does a person typically experience after having their skull opened or a bone flap?" }, { "from": "gpt", "value": "Hello. Regarding your concern, I would explain that there are a lot of ways that a neurosurgeon can reach the brain: 1. Craniectomy: Trepanation and excision of the skull, which is called open surgery. 2. Endoscopy, through a device like a tube with a camera, which is called closed surgery. 3. Gala knife, which is a radiation technique, to treat brain lesions without opening the skull, but through radiation therapy. 4. Transphenoidal excision, through the nose, in case of pituitary tumors. This method avoids trepanation and uses anatomical ways through the nasal bone. 5. Endovascular catheterization to treat brain aneurysm and other vascular malformations by inserting catheters in the jugular vein, without trephination of the skull. In all these cases, the patient experiences mild pain, mainly due to the wound, which is well dominated by Ibuprofen or Tylenol. So, just like other surgery but the main thing is that brain tissue does not hurt. So, nothing tremendous happens after surgery. Recovery is quite painless, compared to other types of surgery." } ]
[ { "from": "human", "value": "Hi doctor, Before two years, my father was diagnosed with prostate cancer and has been undergoing treatment using Eligard and Xgeva. Early this year, he got diagnosed with vallecula carcinoma and for which he underwent chemo (Erbitux) six sittings and radiation therapy for 27 days. While vallecula seems to have subsided, he is now detected with tumor in some of the lymph nodes and for which operation has been recommended by the doctor. Also, as observed in PET scan cancer seems to be spreading to other parts as there are some areas highlighted in the lower part of the lungs. Doctor has not given clear guidance about that. We have been exploring the other options to retard spread of his cancer. We need your guidance on therapies that can be considered to extend his healthy life span. He is 73 years old. Wanted to check around immunotherapy for treatment and its availability. Thank you." }, { "from": "gpt", "value": "Hi. I went through the details of your father's illness and I will concentrate on the present problem. For further information consult a medical oncologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 21 years old. I have a tongue side gum recession in lower front six teeth. I am feeling sensitivity and my teeth are slightly mobile. I have gum receding near about 6 mm. Can gum be again gained to its original position? What should I do?" }, { "from": "gpt", "value": "Hi. Your gum recession is not very severe. You just have to get scaling done at every 8 to 10 months time period. And for sensitivity, use Protect (Potassium Nitrate) mouthwash for sensitivity for one month twice a day. And do saltwater mouthrinses before sleeping for two weeks with lukewarm water. Sensitivity will get better then. You should also use sensitivity relieving toothpaste like Sensodyne sensitive or Colgate sensitive and put the toothpaste like cream in these six teeth and leave as it is for two minutes and then after it, do brushing. Doing all these will definitely lower down sensitivity and will promote the growth of healthy gums in this area in three weeks, provided you follow it all consistently. Give me a follow-up after two weeks. Stay happy and blessed." } ]
[ { "from": "human", "value": "Hello doctor, I would like to know why people have blackheads and when you try to remove it, it creates acne and blemishes on the cheeks and mouth area. It is concerning my skin on my face. I have been feeling insecure about my skin later due to the blemishes and acne on it. I get a lot of blackhead on my cheeks and jawlines. Moreover, I get a little bump rising when I wash my face or when I exfoliate it with natural exfoliators. Whenever I try to remove the blackheads, it gives me blemishes and acne scars which really bothers me." }, { "from": "gpt", "value": "Hello. Acne is related to sebaceous glands. Some individuals have acne prone skin in which normal follicles becomes clogged with keratin, sebum, organisms, etc., resulting in blackheads formation. When inflammation occurs blackheads convert to pimples and bigger pimples lead to cyst and nodule formation. Treatment of acne is important because it can lead to scarring if not treated early and properly. Its treatment starts with oral and topical antibiotics. For blackheads and whiteheads recommended treatment is topical Retinoid. Do you have oily skin or dry skin? I will suggest you start with antibiotics and at night time topical retinoid. Acne vulgaris. Tablet Azithromycin 250 mg BD for the first three days, then on alternate days for three weeks. Apply Clindamycin lotion over the lesions BD, apply Tretinoin gel plus cold cream at night on the whole face in small quantity. Wash face with mild soap and water. Avoid using irritants. Use sunblock SPF 60, moisturizer if skin gets dry." } ]
[ { "from": "human", "value": "Hello doctor,I have shoulder pain. I was told that where my three fibers meet from my deltoid the point is inflamed or something. She told me it would heal in 4 to 6 weeks but it still bothers me when I do gymnastics. I train in gymnastics seven hours a week." }, { "from": "gpt", "value": "Hello. As you had inflammation at the junction of the meet-up of the tendon to muscles it takes usually 4 to 6 weeks of time. The doctor was right. Post which you should opt for physiotherapy for better assistance. As there is inflammation and the limb stays immobilized for 4 to 6 weeks for regular ADL it might have some sort of weakness of the shoulder girdle muscles and that need attention. So I would advise you to do exercise which helps in stabilizing the shoulder girdle but that should be free exercise and not of any weights. Continue the same for 2 to 3 weeks and then indulge into weight bearing for 2 to 3 weeks. Post which you can start low-intensity weight training and progress gradually. There is a difference between weight bearing and weight training. Please do not misunderstand that. In my clinical practice of over 12 years, most cases have been reported for similar complaints but with sports shoulder rehabilitation program they respond well. I will advise you the above program and not going straight to high-intensity activities." } ]
[ { "from": "human", "value": "Hi doctor, I was suffering from molar pain for the past two weeks and then decided to see a doctor. One of my molars decayed and I needed a root canal. But here is a thing, my tooth is very very short for a crown, it is between 1 and 2 mm in height. Is it fine to just put a post and then refill the tooth? How essential is the crown?" }, { "from": "gpt", "value": "Hi. If your root canal is being in process and the crown length is very low, it is best to have post and core done on it after a final step of the root canal. This will strengthen your tooth and it will last long for like 10 years or more. If you do not get the post and core buildup on it and will go for a cap on such small crown portion the cap will be taken out in your chewing process more often and there will be a chance of breakage of tooth also that is saved through root canal treatment. So, I will advise you to get the post done. And one kind advice is that wait at least a week before your cap is placed so that you may rule out any pain or sensitivity issues of tooth in this time period, as once cap is placed and then you start feeling some sensitivity in the root canal or any symptoms of pain then cap removal will be difficult procedure. So, do not rush for the cap. Get post and core buildup done. Finish antibiotics, then take some time without medicines to see if all is fine. Then after a week or two get cap done. Stay happy and blessed." } ]
[ { "from": "human", "value": "Hello doctor, I was diagnosed with a UTI a few days back and prescribed Cephalexin 500 mg four times a day. I only have four pills left and some of my symptoms are gone but some still remain. I was told this is caused by strep B. I am 18 weeks pregnant and will be 19 weeks in a few days. I want the baby to be healthy and safe and am unsure what to do next. This is my third pregnancy and baby and this will be my third cesarean. I worry about this affecting the baby." }, { "from": "gpt", "value": "Hello. You may repeat the urinary routine microscopy test again and if the symptoms are still present, likely that you are resistant to Cephalexin and hence can be started on Nitrofurantoin 100 mg which is category B pregnancy drug and safe in pregnancy. It can be prophylactically taken daily once till delivery and then two weeks post-partum to avoid any chances of recurrent UTI during pregnancy and negating canes of preterm labor. You may discuss with your obstetrician and discuss the option." } ]
[ { "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 want to know if my two sister's grandson and granddaughter get married, will their baby become abnormal? Or will the marriage affect their kid in any other way? Please explain." }, { "from": "gpt", "value": "Hello. For further information consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have a birthmark on the left-hand side of my face around or near my eye. Not too big in size. I do not know the name of the particular birthmark but it is brown in color. With and without insurance, how much would it cost to get the birthmark lasered? How many sessions would I need? How long is the healing process in between each session? Would it leave a scar? If this is not an option or if there are better alternatives, such as creams, what kind of birthmark removal creams do you recommend for my kind of birthmark? Do they work? How long would it take for it to fade when using the cream properly?" }, { "from": "gpt", "value": "Hello. It would have been better if you could attach pictures of your lesion for proper diagnosis and treatment. From your description, it could be a port wine stain or may be congenital melanocytic nevus. For its treatment, lasers are available like pulsed dye laser, an alexandrite laser, etc. Its price varies in different countries. But usually considered to be an expensive procedure. 6 to 8 sessions are usually required but can vary according to the lesion. Lasers can have side effects if not properly performed like scarring, etc., but in the majority, it has good results. There is no such cream that can fade birth-marks. The only treatment option is laser." } ]
[ { "from": "human", "value": "Hi doctor, I am 23 years old. My problem is whenever I press my lower abdomen especially right lower part I feel some watery sound. When I wake up in the morning I feel pain in my lower abdomen. Also, my weight is decreasing at an alarming rate. Last year it was 68 kg and now it is only 52 kg. I had all the checkup like endoscopy, stool check, colonoscopy and all the blood test related to swelling in my intestines. Everything was normal. One doctor said it as IBS and the other said it is only swelling. But, over a year I am facing this problem. When I get nervous, my stomach gets upset and I have an urge to go for the washroom. Please help with my problem." }, { "from": "gpt", "value": "Hi. Considering your symptoms, I will also go with the diagnosis of IBS. But, my line of treatment will be based on ayurveda diagnosis. In your case, it is Vata Koshta - your digestive system afflicted by vata (increase in the gas in the intestines). Treatment for IBS will be a three-pronged approach. Follow all three religiously for best results. 1. Outside food causing infection in intestines. 2. Anxiety and nervousness. Medication: I can see that you have started some medications already. Better you go for the following medicines. 1. Bilwadi Lehyam - A semisolid preparation. Take 5 g of this 10 minutes before food twice daily. 2. Lavana-Bhaskar Churnam - A powder. Take 2 teaspoon and mix it with a glass of warm water or preferably with a glass of buttermilk and have it 10 minutes after dinner. This powder will be salty to taste. 3. Jeerakadyarishtam - A liquid preparation. 3 teaspoon of this liquid diluted with 10 teaspoon of water and take after food twice daily. You can take this after breakfast and lunch. 4. Dhanwantaram Gulika - A tablet. This medicine need not be taken regularly. You complained of nervousness causing stomach upset. In case you develop such a feeling, then pop two tablets. This will manage the problem. Before food or after food does not matter. Take these medications for 45 days and revert back. Then I will add medication for weight gain. Exercise: 30 minutes of regular exercise is mandatory. You can pick whichever you like such as walking, yoga, playing, cycling and gym. Apart from this do 10 rounds of deep breathing exercises twice daily. Diet: 1. Have curry leaves, fresh fruits especially citrus fruits and pomegranates are very good for you. 2. Have nutritious food and fibrous veggies like beans, carrots and all gourds are recommended. 3. Soak about 8 to 10 dry grapes or raisins overnight in water and have it the next day. 4. Try having at least 1 bowl each of fruits and vegetables daily. 1. Avoid overtly spicy food, deep fried food and stale food. 2. Stay calm. This condition is easily curable." } ]
[ { "from": "human", "value": "Hi doctor, I am 26 weeks pregnant. Yesterday, I went for an ultrasound scan named targeted imaging for fetal anomalies. Other than hypoplasia of nasal bone, everything is normal. I need an expert opinion regarding advanced tests of ultrasound or amniocentesis, karyotyping or any ultrasound scan to conclude markers of Down's syndrome (DS). In case of Down's syndrome, is termination of pregnancy is a must? Is it safe to terminate at this term? What if we keep baby after conclusion of DS? Kindly help us." }, { "from": "gpt", "value": "Hi. I have gone through your reports (attachment removed to protect patient identity) in toto. At 26 weeks period of gestation, the overall growth of the fetus is fine. But the concern here is hypoplastic nasal bone seen in the second trimester TIFFA (targeted imaging for fetal anomalies) scan. One has to understand that nasal bone hypoplasia (underdevelopment of nasal bone) have been designated as a single marker for Down's syndrome with a likelihood ratio of 81. There are other soft markers for Down's syndrome which indicate towards the likelihood namely:- Also what can be done in second-trimester screening for Down's syndrome is the quadruple screening, which is ideally done between 11-14 weeks of the period of gestation. It involves serological markers MSS2. In your case now there is only one marker present on TIFFA, but a strong marker indeed. So, amniocentesis (amniotic fluid test) is indicated under expert hands. As 26 weeks, the chances of initiating preterm labor are fairly high as the baby is already 900+ g weight. But, considering that the AFI (amniotic fluid index) is high at 20, it can be attempted. Following amniocentesis, the fetal cells so obtained can be subjected to karyotyping studies (to check chromosome count), which would be conclusive if it shows Trisomy 21 pattern on chromosomal studies. Now, presuming that the result is positive for DS, there is a legal hassle where pregnancy cannot be terminated beyond 20 weeks period of gestation as per MTP ACT (Medical Termination of Pregnancy Act). Only under special conditions where the child is either going to be harmful to the mother's health or affecting the mental status of the mother psychologically, with a legal intervention the termination can be undertaken with the opinion of two doctors plus one legal counselor. The termination would be a vaginal route and chances of the post part hemorrhage at this period of gestation are very high and can be dangerous for the mother. So ideally, we do not advise at all. Hence, we prefer regular ANC (antenatal care) visits so that any anomalies are caught early in the antenatal period. If you plan to deliver the child, it will take the course of normal pregnancy. One has to accept the fact that post birth, the child would have delayed milestones and maximum life expectancy is 17-18 years as recorded in literature. The scan undertaken has good resolution indeed, and they have undertaken a 4D scan for TIFFA. However, you may choose any diagnostic center or hospital for a scan to reconfirm the report. You may consult your gynecologist for the same. I would suggest an amniocentesis and karyotyping at the earliest." } ]
[ { "from": "human", "value": "Hi doctor, I am 27 years old and soon I am going to get married. My doubts are, what are the birth control methods I can follow. What precaution should I follow for short-term and long-term birth control? May I know the difficulties which a girl face during her periods? I have no idea about that. She might be shy to express her difficulty. If I have prior knowledge, then I can trigger an indirect manner and communicate with her smoothly. During which period can I have intercourse for fertility? And when it can be avoided?" }, { "from": "gpt", "value": "Hi. I have read and understood your problem. Regarding birth control, you can use a condom or your wife can use oral contraceptive pill OCP. There are several brands having no major difference so use easily available one. These are the two best suitable for newlyweds. It can be used for both short-term and long-term. Other methods like intrauterine device and long-acting injections are more suitable after first childbirth. Regarding periods, you have the wrong ideas that it is a difficult time for them. Periods are just a normal thing. Some of them may get pain or more bleeding which is controllable by medicine. You can have premarital counseling to know everything in detail. The so-called safe period is not 100% foolproof to avoid pregnancy. Pregnancy can take place at any time except during periods. But is less probable during first and last week of the monthly cycle. If you want to avoid pregnancy, then use a contraceptive. If you want to get pregnancy, then try the whole month except for the bleeding phase. There is no need to restrict your pleasure and limit your chance." } ]
[ { "from": "human", "value": "Hello doctor,My uncle 52 years old, complains of pain in the right leg for one month. The pain starts from the lower back and radiates to toes. Sometimes pain occurs from knee to toes only. There is a tingling sensation in sole after the movement for some time." }, { "from": "gpt", "value": "Hi. This is typically a radicular pain which could be due to compression in the lumbar spine. There are three ways of treatment. First is medications. I am sure you have not taken the proper dose of Pregabalin. If not responding to medications, then we can give a transforaminal injection. If not responded to both, then the third option is surgery." } ]
[ { "from": "human", "value": "Hello doctor, I have lower and upper jaw pain, toothache, pain opening the mouth and a neck ache." }, { "from": "gpt", "value": "Hi. You might have a habit of clenching your teeth very tightly, that is why you are having joint pain on opening and closing of the mouth. Your TMJ must be disrupted. For its relief, take tablet Brufen 400 mg twice a day for three days. And take any best muscle relaxant tablet like Nospa twice a day for five days. Moreover, do some hot compress at your temporomandibular joint three times a day for two weeks. Try not to yawn, eat with a spoon and try limiting your mouth opening wide as much as possible. For toothache, I need more elaborated history, minor pain will be covered through Brufen, but if a severe infection is there, it definitely needs treatment through the dentist. Give me a follow-up after three days. Stay happy and blessed." } ]
[ { "from": "human", "value": "Hello doctor, I am currently pregnant seven weeks now. I had a missed miscarriage eight months back. I used to drink cheap Folic acid and Pregomega. I drank Pregomega up until the end of the last month. I stopped drinking the cheap Folic acid and started Inofolic on the first of last month. When I contacted my gynecologist, he said I must stop taking all medication until my eight weeks appointment. Is this fine? I stopped the Pregomega, but I am still taking Inofolic as I know how important Folic acid is for the baby's growth." }, { "from": "gpt", "value": "Hello. A pre-pregnancy Folic acid requirement is there. Actually Folic acid is best to start three months in advance before conception. As soon as the lady misses her first period, an initial base of central nervous system had already been kept as neuropores close before 28 days of the menstrual cycle even before confirming pregnancy in most of the ladies. So Folic acid is best to take three months periconceptually. In early eight weeks, Folic acid supplements are better to have. From the start, if pregnancy hemoglobin should be normal as in advanced pregnancy due to physiological changes there could be more reduction to hemoglobin so more Iron oral and dietary supplements are required. Calcium with Vitamin D is needed also in few ladies. Have a balanced diet with lots of fruits, vegetables and plenty of water. Have complete treatment of any health issue you have. Have recreational activities and quit recreational drugs. Hemoglobin needs to be maintained in the future period of pregnancy." } ]
[ { "from": "human", "value": "Hello doctor,I am of 21 and I am suffering from permanent blurry eye vision in my only right one. It is by birth. Is there any chance to cure it without any permanent glasses and without any operations. Suggest me, please." }, { "from": "gpt", "value": "Hello. I understand that you are having blurred vision in your right eye since birth. This kind of presentation can be due to a variety of reasons, the most important being amblyopia. This is a weakness in your vision nerve and the vision centers of your brain. This diagnosis can be made after the examination of your eye and vision. In case you suffer only from a problem which is cured by wearing glasses, you have the option of getting the surgery done. In case you have amblyopia or other neurological problems, they are not corrected by glasses or surgery, that needs attention. My suggestion is to get your eye test done and read through the job requirements of the jobs you are applying for. In case you are having any trouble understanding or need some help with technical details, please send a scanned copy of your doctors report and your job requirements. I will do my best to help you." } ]
[ { "from": "human", "value": "Hi doctor, I am 29 weeks pregnant. Yesterday, I had an ultrasound and the impressions are single live intrauterine fetus of 29 weeks gestation with posterior placenta of grade 2 maturity with adequate liquor with active fetal movements. Cervical length 3.91 cm, FHR 150 per minute, AFI 14.6 cm, EFW 1322 +/- 128 g, 51 ST centile, with normal Doppler flow parameters with head low down well approximated to LUS. I was given IV Ferium 10 ml as my hemoglobin is 9 g/dL. Nuchal translucency, nasal bone, double marker test, glucose test and anomaly studies were normal. I am very much worried that my doctor suggested me to take complete bed rest as head is very low down to uterus and it may lead to preterm labor. I was given injection Betnesol two doses 24 hours apart on yesterday and today. Please suggest me the precautions which I should take to avoid preterm labor and also suggest me diet during this term." }, { "from": "gpt", "value": "Hi. I went through your query. Your report is absolutely normal. The head in the current scan is low down but at this stage, the baby keeps moving around. At present, it is down and the next moment it could be up or even in breach. So, the position of the baby is not very significant at this stage. The chances of preterm labor can be determined by the cervical length, which in your case is absolutely normal. Anything less than 3.5 cm could because of concern. Normally, it is around 2.5 cm when we say that preterm delivery is very likely. You can be assured about that. Your doctor's advice is also correct and valid, it is just that you need to take care of yourself. Do not do activities which can induce the cervix to ripen this early. For example, do not do squatting movements, avoid intercourse, avoid walking, avoid lifting a heavy load, etc. Basically should avoid movements which would further push the baby downwards. But, it is not necessary to be on total bed rest. If you repeat the scan in some time, you will notice that the baby may be in a totally different location and position." } ]
[ { "from": "human", "value": "Hello doctor, I am having constant eye floaters, low back and hip pain, also my rib cage hurts. I feel depressed and anxious like never before. I cannot sleep at night. MRI of brain shows tiny flair. Radiologists are saying that it is nothing to worry about. What should I do?" }, { "from": "gpt", "value": "Hi. Eye floaters are commonly associated with some issues with the visual field. So I would recommend consulting with an ophthalmologist to rule out any issues with your eyes. It can also be associated with migraine headaches. Low back pain and hip pain are common symptoms as well but I do not feel it is related to your eye floaters. I would recommend getting a few blood tests such as vitamin D, calcium levels, thyroid and vitamin B12. If above is negative then investigating into rheumatological causes depends on your clinical exam findings. MRI brain showing flair changes is non-specific." } ]
[ { "from": "human", "value": "Hi doctor, I have attached my two ECG reports here. Are they normal? They were taken consecutively, 1 minute apart, the one with 106 heart rate was taken first and the second one with 93 heart rate was taken later). I see some broad peak in the second one. I am not sure if it is an error or something else. My questions are as follows: Do both ECG charts represent healthy heart? The reason why I went to the hospital is that I felt chest pain and I checked my heart rate by a phone application. It gave a normal reading except for one time it gave 39, but immediately after that it gave 79. Do you think the 39 heart rate is an error? Should I feel relaxed and be assured that my heart is fine? What is that broad peak? I have very mild mitral valve regurgitation that was diagnosed to not have any treatments. Also, before I did the ECG, I just ate and I was very concerned about the chest pain. Please explain. Thank you." }, { "from": "gpt", "value": "Hi. You may rest assured as I have carefully reviewed your health query, including both the attachments with different heart rates (attachment removed to protect patient identity). For further information consult a cardiologist 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, My wife was diagnosed with infantile hereditary optic atrophy when she was young. She is now 52. Can you provide me with some up-to-date information or a webpage that explains the disease, its symptoms, if it goes by any other name or is a symptom of another disease, etc? I can only find some pages so far that are not very clear or shows a copy of an explanation from 45 years back. Has anything changed in the past 35 years or so in regards to the disease that we should be aware of or is it basically still the same issue it was back then?" }, { "from": "gpt", "value": "Hello. I am very sorry about your wife, optic atrophy is an irreversible process and once the optic nerve has atrophied, there is nothing we can do. It is regarded as the end stage of the inflammatory process of the optic nerve called optic neuritis, optic neuropathy. Regarding the disease, you can read online about optic neuropathy, hereditary optic neuropathy, this should tell more about how the disease progresses, its inheritance patterns if it spreads to your children and how we can diagnose it early and try to prevent the progression to optic atrophy. Regarding newer advances in treatment, these are confined to optic neuropathy and no treatment currently available has been found to reverse optic atrophy. A few noteworthy and well-acclaimed treatment trails are ONTT- optic neuritis treatment trial and CHAMPS- controlled high-risk Avonex in multiple sclerosis study." } ]
[ { "from": "human", "value": "Hello doctor, I have been waiting for over a year to meet with a rheumatologist in my area. I am 39 years old, and a year and a half ago I was in the best shape of my life, having 10 % body fat, working out 4 to 5 days a week. I own my company and work on a computer daily, and my hobbies include tinkering with the computer, building guns, and doing a lot of things with my hands that require fine motor skills. I have lost that ability lately, I have lost the sense of feeling in roughly my thumb and index finger. My thumbs are both swollen at the joint, all of my knuckles get red and warm, nothing I take seems to help (although I have not taken any rheumatoid medication yet). I am just getting very depressed, frustrated, and just want some sort of help on easing my symptoms and getting back to a normal life. My knees and ankles occasionally give me issues, as well as my toes swell the same as my hands. I do experience dry eyes frequently. I would like a recommendation as to what I need to tell our local rheumatologist if I ever get in to see one. I have a general practitioner that is working overtime trying to help in the meantime, but she is out of her realm on advising any treatments prior to getting into the specialist. Any advice will be greatly welcomed as I am just at a loss for how everything has changed in the last year and a half. I have taken tons of over-the-counter medicines and nothing works. I just want something to help take the inflammation away so I can be normal again." }, { "from": "gpt", "value": "Hi. Yes, the possibility of inflammatory arthritis is definitely there, however that can be confirmed only when a rheumatologist examines you. The other symptoms are prolonged stiffness in your hands lasting more than half an hour, swollen knuckles and tenderness. The pain which is usually worse in the morning and better after rest. This pain usually gets better with anti-inflammatory medicines. This is confirmed by doing a rheumatoid factor, anti-CCP, ESR, CRP done. I suggest do hot fomentation and mild exercises too. Make sure that levels of vitamin D are fine." } ]
[ { "from": "human", "value": "Hello doctor, I just had my nose cauterized for the second time a week back and have a flight booked in two days. I am worried that it is too soon to fly as flying triggered my nose bleeds. I can change my flight to stay longer so it can heal further. Not sure. Just do not want it to start bleeding again and start the whole process over again. I am guessing that you can only be cauterized so many times." }, { "from": "gpt", "value": "Hi. Nose bleed is a very common problem. It is treated with cautery which may need repeating a few times. Since you had it only a few days ago, it might be better to avoid flying for 3 to 4 weeks, if possible. Carry on using the ointment for one month and then have yourself reviewed by your doctor. This is the standard practice everywhere. Nose bleed. Ointment in the nose for one month. Avoid nose blowing and picking. Keep blood pressure under control. Avoid blood thinners." } ]
[ { "from": "human", "value": "Hi doctor, I had a gastroscopy a week back and when I asked the doctor if I had cancer she said no. On arriving home I saw on the report that there was a tiny nodule in the cardia which has been biopsied. My question is, why would she say emphatically that I do not have cancer if she has done a biopsy?" }, { "from": "gpt", "value": "Hi. I have gone through your query in detail. The endoscopy has shown a healing ulcer and is showing healing as well as a small hiatus hernia. There is a very tiny nodule in cardia (proximal part of the stomach), which has been biopsied. These tiny nodules are usually innocuous, but as a routine approach, it is biopsied to rule out any kind of early changes, if any. The report is very clear that they have not found anything sinister (please read it as cancer). I am almost certain that the biopsy is going to come out as benign. Please continue with PPI and wait for the biopsy. Once you have the biopsy and have any further concerns, you could always get back in touch." } ]
[ { "from": "human", "value": "Hello doctor, My sugar level is 210 after breakfast. Is it normal or high? Can I control sugar level?" }, { "from": "gpt", "value": "Hi. The sugar level 210 after eating food cannot be considered normal. It is suggestive of diabetes mellitus. However, you should repeat your serum fasting blood sugar estimation, serum post-prandial blood sugar estimation, and HbA1c estimation to confirm diabetes. In this early stage, you can control diabetes with weight reduction, less fatty foods, and regular exercise." } ]
[ { "from": "human", "value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?" }, { "from": "gpt", "value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am getting no erection in the morning. Rarely it occurs. Is it good or bad not getting an erection during the morning. And I have masturbated over four years. Whether due to that reason I am diseased. Also, I had a same-gender sex." }, { "from": "gpt", "value": "Hello. You might have erectile dysfunction problem as erection is poor as per history. Usually, during sleep time in the morning due to sympathetic stimulation, penis erection should occur for at least 30 minutes to 1 hour at such a young age. You need to rule out hypertension and diabetes problem by blood pressure measurement and random blood sugar estimation. It is advisable to check your serum testosterone level as well. I suggest you consult nearby psychiatrist or sexologist for detailed evaluation. Masturbation is safe and pleasure giving procedure which usually does not lead to erectile dysfunction." } ]
[ { "from": "human", "value": "Hello doctor, My left eye has a spot near black circle. I do not know what it is and how it will vanish. I did not remember but it is from years in my eyes." }, { "from": "gpt", "value": "Hello. I have gone through your photo (attachment removed to protect patient identity). I feel it could be a conjunctival nevus, given that you have had it since a long time and it did not cause you to have any symptoms. Such swellings have a tendency to grow in size during teenage or early adulthood, but usually, stop growing spontaneously. They do not cause any symptoms and are harmless in the long run. On the other hand, it could rarely be a small cancerous growth. Such swelling is called melanoma, although rare it presents with pain, foreign body sensation, redness and blood vessels growing around it. The best way to confirm the diagnosis is by excision biopsy wherein the swelling is cut out and put under a microscope. Given the rarity of this cancer and you being asymptomatic, I suggest that an eye examination whenever possible would suffice to clear your doubts." } ]
[ { "from": "human", "value": "Hello doctor, My daughter is 6 years old and weighs about 24 to 25 kg. She is having throat pain and cough and running a fever of 100.5 degree since yesterday. She got throat infection from me. I consulted with my doctor and she gave p250 7.5 ml and Betadine gargle for her and told us to consult a Pediatrician. But my daughter is not getting better. Please help." }, { "from": "gpt", "value": "Hi. Please continue the same treatment as going on. An antibiotic like Augmentin may need to be added based on the clinical examination of the child (to see if it is required). Also, Ibugesic may be started to reduce the pain and inflammation (if any) based on the clinical examination. As of now to relieve the pain you can use Ibugesic 8 ml (SOS only). As far as the cough is concerned, you may cut down on the Betadine gargles and instead take one teaspoon of honey with lukewarm water twice a day for a soothing effect. Show the pediatrician tomorrow for further course of treatment." } ]
[ { "from": "human", "value": "Hello doctor, I have been suffering from rosacea. So went under proper treatment but now around my lips area, there is dryness. Though I used all the creams on my face, I did not apply creams on the lips area. So is it because of that?" }, { "from": "gpt", "value": "Hello. This is perioral dermatitis (attachment removed to protect patient identity). A type of eczema that occurs around the oral cavity. The most common reason is the steroid that causes it whether they are present in products we use on face or from the treatment we do. Yes, it can be part of rosacea, in fact, perioral dermatitis come under the umbrella of rosacea. The most important thing is hydration of skin for which you have to apply emollient. Apply simple Vaseline (Petroleum Jelly) 4 to 5 times a day. Wash your face with mild soap and water. Apply good sunblock of SPF 60. Follow at two weeks. Perioral dermatitis." } ]
[ { "from": "human", "value": "Hi doctor, I recently had an eye exam and was able to see clearly by the time the doctor was done with my exam. I ordered the glasses and they just arrived yesterday. I out them on and it is as if I am not wearing glasses because with the glasses or without the glasses everything is blurry. I told them that and was told I have to wait for seven days for my eyes to adjust. How do I do that when I cannot read without straining my eyes either way?" }, { "from": "gpt", "value": "Hi. As you told your vision was fine with the glasses or lenses your doctor uses during eye exam and now you are having trouble with your glasses then most probably you need to recheck your glasses if they are dispensed according to your prescription or is there any error. Sometimes a minor error in dispensing cause much trouble especially if you having cylindrical number or axis. I think your glasses are not according to your prescription or it gets mixed with someone else. So first go and verify your glasses number and match with your glasses prescription." } ]
[ { "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 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have pain in the tooth, both upper and lower and it is fluctuating for the last five days." }, { "from": "gpt", "value": "Hi. Your right upper last wisdom tooth is erupting in a bit of horizontal pattern and hitting the second last tooth and has caused infection in it (attachment removed to protect patient identity). You might need extraction of upper right wisdom and root canal treatment of upper second last tooth. Moreover, there is some gum disease also called periodontitis. It is causing bone loss in the anterior segment of your teeth and this could be healed up to some extent through scaling treatment. Get an appointment for it as soon as possible. Once treatment gets started, do one course of antibiotics as well, that will help along with treatment. Keep doing salt rinses and take painkiller three times a day at every eight hours for three days. Good luck with the treatment. Stay happy and blessed." } ]
[ { "from": "human", "value": "Hello doctor, I am planning for pregnancy aged about 36 years. But I am an OCD patient on a prescription of Clofranil 50 mg daily. So what are the risks involved, is it safe to use the medicine during pregnancy?" }, { "from": "gpt", "value": "Hi, Welcome to iclinq.com. Clofranil (Clomipramine) should not be used in pregnancy. It is a category C drug that means if potential benefits justify the risk to the fetus, then you can use. As far as of now no well-controlled studies in humans, but it will not cause anomalies but it may affect your neonate after delivery like seizures, jitteriness, tremors, and dullness may occur. These symptoms will occur to your baby as withdrawal symptoms after delivery. But do not worry your doctor will manage during pregnancy by lowering your tablet dose and during delivery by tapering your tablet dose. But make sure that you take Folic acid tablets even preconceptionally." } ]
[ { "from": "human", "value": "Hi doctor, I have had a CT scan with contrast and they found this: The noncoronary sinus of valsalva is prominent. At this level, in the coronal plane, the aortic root measures 4.0 cm in diameter. What does this mean and should I do anything about it? I am 37 years old male, exercise a lot. Resting pulse is 45. My father died in the late 40s of heart disease." }, { "from": "gpt", "value": "Hello. Your aortic root is mildly dilated. If you do not have any other systemic diseases like any diagnosed syndrome like Marfans or Ehler Danlos etc., then this needs no treatment at present, but just observation. At this borderline dimensions, we just observe the patients and if it increases more than 50 to 55, then needs surgery. However, if it is genetic, then surgery is done at lesser dimensions. So, you will need regular follow up and 1 to 2 yearly CT scan to keep watch over the dimensions of the aorta. This could be done with echo as well. You should also have an echo if you did not have any. You should get yourself examined by a local doctor once to rule out syndromes. Also, mild to moderate exercises, avoid heavy activities like lifting heavy weights, etc. Avoid all addictions, if any. Low pulse rate is probably related to activities. Do you have any details about your father? You should try to search and if available will help in prophylactic measures." } ]
[ { "from": "human", "value": "Hello doctor,Last week, I went to play basketball for 3 to 4 days and after playing, there was muscle pain in fibula part of the leg. And if I take one day rest, and again go to play, then again the pain resumes. Please suggest me some cure." }, { "from": "gpt", "value": "Hello. As this pain looks to be more of muscle fatigue. As the fatigue is going to set in because of a less muscular part in the leg region. Mostly the anterior portion of the leg pains which is the fascia pain. You can use icing to reduce the pain. For having a good sports fitness you need to do some small warm-up and stretching exercises before the game. Also doing regular jogging for 20 minutes should give a good outcome score. Most sports injury happens due to lack of fitness levels and performing warm-up and stretching before sports can help avoid pains and Injuries." } ]
[ { "from": "human", "value": "Hello doctor,I have had iritis for the past 20 or so years. I currently have a flare up after not having an episode for the past four years. My question is related to treatment since I currently do not have insurance. Is there an eye drop treatment that is OTC that replicates Pred Forte and whatever the drops that dilate the eye (cannot remember the name)?" }, { "from": "gpt", "value": "Hello. I understand that you are suffering from iritis, usually, iritis has an underlying cause like immune system disorders. If you are adequately treated for this causative problem, your iritis will subside by itself. Coming to if there are over-the-counter medication for iritis, there are not any treatments at present specifically aimed at uveitis. Although several studies have shown a natural derivative Curcumin to have a beneficial effect on the disease process. These are available as tablets." } ]
[ { "from": "human", "value": "Hello doctor, I went to a salon to have a skin cleaning and they used on my face blackhead extractor. And I am worried now if I could get hepatitis or HIV if they did not clean it between the clients. Is it possible to get any disease?" }, { "from": "gpt", "value": "Hi, Welcome to iciniq.com. If instruments are not properly sterilized and if the blood of any patient who has hepatitis, etc., present over that, it is possible that it can be transmitted. Usually, in salons the exfoliator they use does not penetrate the body and procedure is very superficial, it does not come into contact with your blood, the risk is very very low. For caution next time, you should buy your own instrument and bring that to a salon. You should not be worried now as the transmission risk of hepatitis after needle stick injury is very low and even lower for HIV." } ]
[ { "from": "human", "value": "Hello doctor, Please, I was diagnosed with hepatitis B positive last week. I had the symptoms for about five days but now I am feeling better without any symptoms. What does that mean?" }, { "from": "gpt", "value": "Hello. I need to know these things first. 1. How did you come to know about having hepatitis B, usually HBsAg (surface antigen) is detected in the routine kits? 2. Had there been, any past history of jaundice? 3. Were you immunized for hepatitis B in the past? 4. Were there any other tests performed to check for chronicity of hepatitis B? What happens in hepatitis B is if the virus is not acquired by birth (like acquired during adult life), the body can clear the infection in about 90 to 95 percent of the patients, but in about 5 percent cases the chronicity develops. But, if the virus is acquired from mother at the time of birth, then the chances of hepatitis B, being chronic are very high. If one has been immunized for hepatitis B in the past and active immunity has developed, then even if the body gets an infection from hepatitis B, the body can eliminate the virus on its own. You should get yourself tested for chronicity for hepatitis B, for that get yourself tested for IgM anti-HBc (antibody against core antigen), if it is positive there are high chances you had an acute infection which your body can fight out most of the time (~95 %), but, if it is negative then you need to get yourself worked up for chronic hepatitis B, and if eligible, should start treatment." } ]
[ { "from": "human", "value": "Hello doctor, For the past week, I had been having extra discharge down there. It is white and watery and has a bad smell. Also, my vagina has been red and looks swollen. Is it from douching or from sex? I have been with the same partner for a year now. Please help." }, { "from": "gpt", "value": "Hi. Is it a fishy smell? Is the discharge thin and milky or cottage cheese like? If yes, you seem to be suffering from bacterial vaginosis along with yeast infection. Does your partner have some symptoms too? Please stop douching, it tends to wash away the good protective bacterial flora of the vagina. It does more harm than good. Increase the probiotic portion in your food, you need to take Clotrimazole and Clindamycin vaginal pessary every night before going to bed for six nights. If your partner has the symptoms, tell him to have tablet Secnidazole 2 gm single dose. Avoid sex for the six nights. Try to use condoms, it greatly reduces the episodes of vaginal infection and STI." } ]
[ { "from": "human", "value": "Hello doctor, I have redness on my cheeks that is not acne. I have used Sodium Sulfacetamide as a wash and Benzoyl Peroxide gel which just seem to worsen the condition. I have struggled with this issue and cannot seem to find a solution." }, { "from": "gpt", "value": "Hello. From the photo, it seems like rosacea (attachment removed to protect patient identity). It is a common skin disease characterized by a tendency to blush or flush more easily than other people. Treatment consists of preventing the aggravation of symptoms. This is possible through finding and avoiding triggering factors like foods, weather temperatures, or any cosmetic. Do put always sunscreen with SPF 30 or higher. Avoid rubbing your face skin, avoid skin irritants. To ease the redness, you should apply Azelaic acid cream locally twice daily. Plus, should apply Aloe vera gel throughout the day." } ]
[ { "from": "human", "value": "Hello doctor,My mother is now 55 years and has been suffering from irritable bowel syndrome (IBS) for over a year. Her condition was not so bad before. She was diagnosed with intestinal disease and was given some antibiotics like Flagyl or Metronidazole. After she took those pills for a month, she had frequent loose or watery stool (without blood) and could not eat spicy or fatty food, sugar or any foods containing lactose. I found a probiotic supplement called Bifina, which helped a lot in controlling her toilet routine and her diet but needed to use together with Smecta. She still cannot eat spicy or fatty food, but she can have a drink or juice with an acceptable amount of sugar, which serves as a rehydration drink. She no longer has loose or watery stool. Once in a while if she reacts with a kind of food or eat more sugar than necessary, her stool will be softer with a few bubbles. In general, her bowel movement is under control.She is starting to recover but her long-term IBS resulted in her exhaustion. As I previously mentioned, she is now still using the probiotic supplement, Bifina, which helps a lot with the intestine treatment makes her easily feel tired or a little dizzy. I asked for support from a relative who works as a nurse because the doctors in my neighborhood just told her to get a rest and give her pills that did not help a lot. So, the nurse frequently gives her some vitamin B12 shots, Glucose 5% intravenous infusion and lactated Ringer's solution 500 ml for injection. This proves to help, but she tells me that she do not have enough energy. We went back to phlebotomy department to have her blood tested. It turned out to be fine, but every time her scores were very low. We thought the hospital could give her any session like fluid infusion or blood transfusion because she had diarrhea for over 10 months. It just stopped about 2 months ago and really has worn her out. But, they just informed me to go to another department like division of general internal medicine. We have already been there and have checked everything like x-ray, heart, liver, and kidney. Attached below are some images of her test results. Could you tell me if we are right to say she needs blood transfusion to help her recover better? Or she needs another solution? Or just stick to what we are doing now? I express a huge thanks for being patient and reading for so long now. I appreciate every answer. Thanks again." }, { "from": "gpt", "value": "Hi. I have gone through your query and reports (attachment removed to protect patient identity). I can understand your concern. As you told that your mother had IBS (irritable bowel syndrome), I want to tell you that antibiotics are not the treatment for IBS. Probiotics can help. She might have developed antibiotic induced diarrhea after taking tablet Flagyl (Metronidazole). I have seen her reports and they seem to be normal except ultrasound which is difficult to interpret as it is not clear. No need to worry she might have developed malabsorption syndrome because of chronic diarrhea as she cannot tolerate lactose containing food. There is no need to give excess vitamin B12 unless there is deficiency. Your mother needs proper evaluation and blood transfusion is not required. Get her serum vitamin B12, folate, serum calcium, vitamin D, stool routine and occult blood checked. Consult a gastroenterologist. As she had chronic diarrhea she needs colonoscopy also. Revert back after the tests to an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "gpt", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]
[ { "from": "human", "value": "Hello doctor,I 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 cannot see with both of my eyes but I can recognize the light and can see a dark shape of the human body if anyone stands in front of me. My eye sight was lost on drinking a glass of whiskey where I doubt that one of my evil-minded friends added something in that glass because after drinking that glass of wine I felt pain in my eyes and the next day my eyes lost it sight. I went to the hospital and there I came to know that my optic nerve got damaged." }, { "from": "gpt", "value": "Hello. The condition that you are describing is referred to in medical terminology as methyl alcohol or toxic amblyopia. This presents exactly as you mentioned, with patient losing vision after alcohol intake. The course is variable and patients can have a total loss of vision with optic nerve atrophy. The doctors are treating you for this condition to prevent the involvement of the other eye also and to replenish vitamins lost due to drinking. The important thing is we cannot accurately predict to what extent the vision may improve and how much vision can be saved. The only assurance here is that the treatment will be protective for disease in the other eye, so you will not be completely blinded. My suggestion is to undergo alcohol de-addiction and continue with your current treatment." } ]
[ { "from": "human", "value": "Hello doctor,I am 24 years old. I am married. I have a bit problem in my sexual life. Whenever I insert my penis in her vagina she told me that when I insert full penis in her she feels pain. Is it normal or not?" }, { "from": "gpt", "value": "Hi. Painful penetration in women may be caused by any injury or lacerations in vaginal walls, infection of the genital tract, forceful or violent sex, lack of lubrication in the vagina. I think you should do a lot of foreplay before penetration so that her vagina may get lubricated naturally. Also, it is highly recommended to use a water-based lubricant like KY jelly. Always be gentle to your partner while having sex. That is the key." } ]
[ { "from": "human", "value": "Hello doctor, I have depression, anxiety, lack of confidence, social anxiety, sweating and fast heartbeat, suicidal thoughts, weakness for the last 15 years. I am 38 years old, male and started masturbation at the age of 18. After some days, I started feeling nightfall regularly. I feel I ruined my life and went to a local doctor and they said that masturbation creates weakness in you. I was shocked and afraid and went into a deep depression thinking that I have destroyed my life. I avoid to meet people and soon had a lack of sleep with low energy. I lost my confidence and deeply regret and this phobia causes me depression and anxiety. I had taken so my ayurvedic medicine but no result. Finally, I tried lots of psychiatrist but medicine made me less active and I was not able to come out of my depression and anxiety and weakness. Then I went to meet a psychiatrist. They prescribed me Nexito 10 mg in the morning and Buspar 5 mg day and night. Presently I am taking these medications. But there is no proper improvement. In the past, I have taken lots of psychiatric medicines like Mirtaz 15 mg, Paxil, Prestiq, Stablon but no result. Please suggest should I go with my current treatment of Nexito 10 mg once and Buspar 5 mg twice or I should add other medicine or should I increase my dose of current medicine. I also feel sexually weak. Please help me with your expert advice." }, { "from": "gpt", "value": "Hi. Let me make it very clear. Masturbation is a completely harmless and natural sexual act. Almost 100 % of teenagers masturbate. Nightfall is a natural phenomenon and occurs to everyone in adolescence. Physical power and energy have nothing to do with masturbation. If you want to get fit, start exercising. Now, as you have been slipped into depression because of guilt and self-reproach, you first have to believe that you are just as normal as any random healthy guy. To get out of this depressive episode you need to take antidepressants in a sufficient dose and duration. The antidepressants you should take must be devoid of sexual side effects. The commonest sexual side effect of Nexito (Escitalopram) is a loss of libido. Moreover, the drugs you were given were not in a sufficient dose. I suggest you meet your psychiatrist and ask for drugs like Bupropion (starting dose 150 mg and to be increased to 300 mg). You may have an option to increase the dosage of Nexito to 20 mg in two divided doses. Buspar (Buspirone) is an antianxiety drug whose effective dose is 20 mg to 40 mg. Along with medication, you may go for psychotherapy." } ]
[ { "from": "human", "value": "Hi doctor, I slipped from stairs before five months and got fracture. My orthopedic doctor diagnosed it as heel bone fracture in both legs. I mean intra-articular calcaneal fracture. I have lost subtle movements in heel and ankle area. He advised me to walk on toes for 20 minutes twice a day. He did not prescribe any medicine other than a pain killer. But, he told me that the pain killer has to be taken only when there is unbearable pain. He told me that it will take at least a year for complete recovery and if not then we will plan for surgery. At present, I can walk very slowly and I cannot walk on toes as doctor prescribed. I would like to have a second opinion for this. Do all intra-articular calcaneal fractures require surgery? Why my doctor did not recommend a surgery right now? Please help me in this regard." }, { "from": "gpt", "value": "Hi. Revert back with old and current x-ray to an orthopaedician and traumatologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I had three sessions of a root canal, but I am still having a dental abscess. The treated tooth does not hurt and the root canal seems to be properly done but the abscess keeps coming back even after taking antibiotics. Why is this happening? Also, how can I know what type of abscess it is (periodontal, gingival, or periapical)?" }, { "from": "gpt", "value": "Hi. An X-ray would be required. Mostly, such cases have to go for a treatment known as apicoectomy which is draining the abscess by making a passage through bone. Some abscesses are recurrent which cause necrosis of bone at the root level. Such conditions make root canal treatment unfavorable. In such situations, extraction and replacement of the tooth will be the best option going forward." } ]
[ { "from": "human", "value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well." }, { "from": "gpt", "value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help." } ]
[ { "from": "human", "value": "Hello doctor, I had driven the car for almost 1700 km in the five days duration. From last week onwards I am getting lower back pain on the right side. Today I visited the local orthopedic. They suggested to use ECT Forte tablet twice a day and Gaba plus containing Gabapentin 400 mg and dosage is one tablet after dinner. Is that Gaba plus tablet safe to use for lower back pain? Kindly suggest." }, { "from": "gpt", "value": "Hello. Yes, Gabapentin is pretty safe. The usual side effects are that you might get some dizziness for the first 2 to 3 times that you took the tablet. Also, nausea and vomiting are other common side effects. But overall it is a safe tablet to take. So, I would advise you to continue the treatment. You would also need some physiotherapy once the pain settles down." } ]
[ { "from": "human", "value": "Hello doctor, I am experiencing swelling of the gum on my molar and bleeding, as well as a bad taste in my mouth. I have a picture and it looks as though there might be some food stuck in my gum or even my wisdom tooth coming in. I am not entirely sure but I would like an opinion on the picture, if possible?" }, { "from": "gpt", "value": "Hello. I can see in the attached picture (attachment removed to protect patient identity). There is an infection present in your last molar region, most probably it is due to third molar impaction and known as pericoronitis. Sometimes it is also due to abnormal cheek biting. You should avoid spicy and hot food. Make proper oral hygiene, you could also use salted water to rinse your mouth. Please see your dentist for a clinical examination and treatment. A dental X-ray should be taken." } ]
[ { "from": "human", "value": "Hello doctor, I am 33 years old married woman with a kid, working. Recently, took a health check-up and found that my vitamin D levels are very low 5.24 ng/ml, vitamin B12 332 pg/ml. Every now and then I have stiffness in my neck and uneasiness in my knees. Can you please suggest me vitamin D supplements to overcome this deficiency, duration of intake and side effects, if any. I am a non-vegetarian and currently not taking any supplements and not under any medication. Should I be taking any other supplements apart from vitamin D considering my age is above 30. Apart from the vitamin D deficiency, I could see some abnormal values for lymphocyte percentage, lymphocytes absolute count, monocytes absolute count, total RBC, platelet distribution width (PDW) and platelet to large cell ratio (PLCR). Attaching my health report for your further reference. Please advise." }, { "from": "gpt", "value": "Hello. Your vitamin D and HDL are low, and iron levels are low normal. Rest all reports are fine (attachment removed to protect patient identity). So, for vitamin D, you should have tablet Uprise D3 (or Calcitriol sachets) 60,000 units with milk once a week for eight weeks and then once a month for the next six months. This will cure deficiency and also replenish your stores. May cause some gastritis, otherwise safe. For HDL, you do not need to have anything, but just have a healthy lifestyle like avoiding fatty oily food, regular exercises like brisk walking or running according to capacity. Also, for iron, have iron rich food like green leafy vegetables like spinach or jaggery, etc." } ]
[ { "from": "human", "value": "Hello doctor, I am 35 years old, female. I went to the emergency room a few days back. The CT scan was done to check my ovary and when I look at my blood work for the past few years, I was wondering if there was any relation between some of the rising levels especially if anything is not functioning apparently. I keep getting dismissed as if there is nothing wrong. I am pushing for MRCP, but I keep losing weight and most of the pain is on my left side even though my dysfunctional gallbladder is in the right side but I know this pain is on the left side. Would you be suspicious of cancer, based on these results?" }, { "from": "gpt", "value": "Hello. Your attached reports are not suggesting any specific cancer (attachment removed to protect patient identity). The left-sided abdominal pain could be due to gastritis or diverticulitis. For that, fiber diet can be taken more and antacid like Rabeprazole can be prescribed. Avoid the intake of excess spicy foods. If you are taking excess stress, then weight loss can be due to anxiety. So rule out anxiety problem as well. Your urine report shows the presence of blood in the urine. So, urine routine microscopic examination should be done to rule out urinary tract infection. PT, APTT, BT like primary coagulation study also can be done. As your spleen is mildly enlarged, I recommend you to consult nearby MD internal medicine specialist for your detailed evaluation. As far as the attached report is concerned, it does not suggest any specific cancer." } ]
[ { "from": "human", "value": "Hello doctor, I just had my acromioclavicular joint separation (grade 2 or 3), AC ligament torn. I am ready to accept the recovery time. My question is can I do pull ups again in my life? Or any permanent disability may occur?" }, { "from": "gpt", "value": "Hello. Sure the X-ray looks kind of AC joint separation due to the ligament injury. With the image, the injury looks between grade II or III. I will advise you to take the call for the MRI shoulder to focus on the AC joint. This will help us understand the extent of the ligament injury as from outside examining will be a little tough. Once we get the MRI, we will be able to see the internal soft tissues including the ligaments and muscles. Post which your query of doing pull-up can be answered. But for now, do not do any movements of the shoulder and let all the healing to occur. Meantime, please take the MRI so we can judge the trauma to the fibers of the ligament. Once we get hold of the MRI we can plan the exercise prescription if the ligament is not completely torn and in future can prepare you for the pull-ups. In case if found complete tear then can advise for the next course of action. I will wait for your response." } ]
[ { "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 -->" } ]

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