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qucklecrabik

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[ { "from": "human", "value": "For consecutive three weeks, I have been suffering from acute sore throat and swelling and ear heaviness. In the first week, I took cefixime for six days. Then I took pulmocef 500 mg for with winolap tab and tab dolonex dt for 7 days. In this week, sore throat, tonsil pain, swelling in throat, stiffness of walls of throat, post nasal drip. I am taking cepodem xp with montair fx now for the last three days. Still I am seeing thick mucus in back of throat, as frequent post nasal drip. Even full swing fan is causing sinus problem now. Please guide. Uric acid 6.81, male 47 yrs, hba1c 6.3 no diabetes no htn so far" }, { "from": "gpt", "value": "Hello I am enabling you a free query so that you can reply back to us." } ]

[ { "from": "human", "value": "Hello doctor, I had a root canal done two years ago. They had to drill into a new crown. The crown was filled afterward. Today I noticed a hole where the filling was. I am scared now that the root canal is going to get reinfected. Is there a good chance that the crown can just be refilled? Or is there an equally good chance that bacteria has already gotten in? I do not think it has been longer than two weeks based on my last dental visit." }, { "from": "gpt", "value": "Hi. I have gone through your question and I can understand your concern. In case there is no pain and swelling, the tooth is not infected. The root canal is always filled with gutta percha material and sealed. The filling is done after the root canal procedure is properly done. Even if there is an infection that would be treated with antibiotics and refilled after that. My advice is that visit your dentist as soon as possible and get it refilled. There will be only restoration and not new root canal treatment. Fallen restoration. IOPAR X-ray. Prosthetic crown fracture. Rerestoration." } ]

[ { "from": "human", "value": "Hello doctor, I am 18 years old. My period is always regular and exactly on time (every 34 days x 7 days of bleeding each time) but this time it is two weeks late. I am getting hot flushes, fever, I am cold all the time, dizzy, lightheaded, very weak. My abdomen is cramping and hurting, been so for a few days, the discharge has not changed since ovulation. I am very emotional, crying all the time. I cannot be pregnant, I am single and a virgin. I have a healthy weight, do not have any eating disorders, have not been under lots of stress or anything similar lately. I am just so scared. Feels like period cramps but less intense. Been going on for days. I really do not know what to do. I do not want to go to a gynecologist. I am afraid and really not ready for that. I just want all this to go away and to get my period back. Please help." }, { "from": "gpt", "value": "Hello. According to your history and symptoms, it seems that nothing is wrong with your body system. Sometimes, periods get disturbed. Your symptoms are pointing towards signs of PMS and I feel that you are panicked by the situation which is making the condition worse. I would suggest that you have not to worry about it and just wait for a few more days. Hopefully, your cycle would resume by itself because unrecognized stress results in delaying of the cycle." } ]

[ { "from": "human", "value": "Hello doctor, Injured foot in football four days back, badly bruised, very little pain but now have no movement in the fourth toe." }, { "from": "gpt", "value": "Hello. Sorry to hear about the injury. The first thing you should do now is to take an X-ray for a safety case. Ignoring cannot be beneficial. Usually, the fracture is uncommon but still have to take an X-ray to rule out any fracture possibility. Also, for now, do icing and stabilize the part. In case if it is fracture you may find some discoloration of the skin in that area and need immediate attention. Always use the RICE protocol in injuries which can avoid major damage to soft tissue. Please take up an X-ray and if X-ray reveals no fracture then we can guide for home care therapy for the same. Please get back after taking up an X-ray. Sports injury. X-ray. Fracture. Ligament sprain. RICE. Immobilize the part." } ]

[ { "from": "human", "value": "Hi doctor, Almost 5 years back, my father had an operation for a brain tumor in the left tempero-parietal region. He had Dexamethasone injections 12 mg and radiation on a linear accelerator 51 and 45. After two years, he had a CT and everything was fine. He even walked. But, when we started lowering the dose of the hormone he stopped walking. He took those 12 mg for five months. Now, he has steroid diabetes and retinopathy. We lowered the dose of Dexamethasone slowly and currently, it is 0.88. Now his bile production is bad and his stool is yellow. When the dose was 0.96 everything was fine with the bile. He takes Essentiale three times a day, Pankreatin 8000 thrice daily, Omez 20 mg once a day, Ascorutin thrice daily and Citrocalcium. When we lowered the dose of the evil hormone to 0.88, the bile problem started. When we started to give double the dose of Essentiale, everything started to be fine again. But, with the usual dose again the problem has come. Because of this hormone his sugar level does not drop. He is getting Insulin injection and the sugar level is 5.2. My questions are does the gall problem occur because of Dexamethasone? Is there any medicine to restore adrenal cortex function? How can one stop taking this hormone? How can we make him walk again? Will he ever be fully functional again? Thanks in advance." }, { "from": "gpt", "value": "Hi. I would like to know a few things very clear here. From your history, I gather that he had surgery on the brain and was on steroids post-op. And also he received radiotherapy. For what condition the brain surgery was done? He might be having what is called as steroid-induced diabetes and for which Insulin is the treatment. Steroids can harm the liverover time, but they would have been prescribed because the benefit at that time was more than the harm that would have been caused. We need to know the clinical improvement with reduced dose for further reduction. There are no medicines that can restore the adrenal cortex function. His steroid production is suppressed due to exogenous steroids. It needs tapering and then if possible can be stopped. I can comment on his recovery only after knowing his exact detail of the medical procedure done and the diagnosis." } ]

[ { "from": "human", "value": "Hi doctor,I have been having some issues with my penis. At first, a month ago I thought I had balanitis and so I used Terrarisil balanitis cream but I have only used a few times and now I see that one of my veins got swollen and it feels like it aches a little. I do not know what to do with both these issues. Can I treat myself at home before it gets worse?" }, { "from": "gpt", "value": "Hi. I would like to know your age, are you sexually active? To me it looks like Mondor disease, a condition in which veins get swollen for which there can be many reasons like penile injury, sexual activity, etc. The condition is treatable. You have to take oral antibiotic and pain killer along with antihistamine. Mondor disease. Tablet Co-Amoxiclav 1 gm BD for one week, tablet Ibuprofen or Aspirin for one week. Non-sedating antihistamine tablet. Maintain hygiene of the area, wash with soap and water." } ]

[ { "from": "human", "value": "Hi doctor, I am currently awaiting a call from my doctor on my ultrasound results. However, I am concerned about my ultrasound report and I am impatient now. The radiologist's notes on my pelvic ultrasound were as follows. CX appears WNL AS VIS. ENDOM appears thickened, complex with increased vascularity and could not define any solid mass at this time. Left ovary with hypoechoic area. Right ovary appears WNL AS VIS. Blood flow to the bilateral ovary. No FF seen. Does it seem like a normal prognosis? Or do I have a reason to be concerned?" }, { "from": "gpt", "value": "Hi.I have read through your query in detail. Please find my observations below. The cervix appears normal. This is the mouth of the uterus and is normal. The inner layer of the uterus is called the endometrium. It is thickened but there is no measurement given. It is also described as a complex appearance with increased blood flow. The left ovary probably shows a follicular cyst and is normal. The right ovary is normal. No free fluid is seen in the pelvis. This is a normal finding. Keeping in mind the increased endometrial thickening with vascularity, many possibilities exist including the following If there was a pregnancy sometime in the past, less likely since your test is negative, then retained products of conception might be considered in the differential diagnosis." } ]

[ { "from": "human", "value": "Hi doctor, I am a 36 year old male. I am suffering with OCD and I stammer for past 15 years along with laziness and tiredness all the time. My appetite is not good and so my weight is approximately 53 to 55 kg only. I have changed many psychiatrists in last 15 years. I had Nexito 20 mg, Ciplar 40 mg and Lonazep 25 mg twice a day and a capsule Performax for libido under doctor supervision. Few days back I went to a physician and I told him about my issues. He prescribed me Fluoxetine 20 mg to take in the morning and Nexito 10 mg at night that is 2 SSRIs together. After which my libido was totally reduced. I am single now. So, what should I tell to my partner about my issues? First of all, should I tell or not? Because medications can be life-long and I do not like either my partner or in-laws questioning me for that after marriage. My parents and friends advised me not to tell anything now. Second thing, as I told you, in the past I was having good libido but now it become less. Earlier I used to masturbate regularly but now once in two weeks. Should I get this issue solved before marriage? I had an affair in the past. After break up, sometimes I feel like does not want to mingle with anyone. I faced a lot of negativity in my life and still not able to prepare myself completely for marriage. Please give a genuine marriage." }, { "from": "gpt", "value": "Hi. I have read the query, and I can understand your concern. You have OCD (obsessive-compulsive disorder) and co-morbid anxiety. The combination of Fluoxetine 20 mg and 10 mg Escitalopram (Nexito) was totally irrational. It is not advisable to take two SSRIs (Selective serotonin reuptake inhibitor) at the same time. Both drugs have the same mechanism of action so using two drugs together increase the risk of side effects only. This was the probable reason that you suffered a loss of libido. In my opinion, there is no need to tell your future partner about the issues related to libido. You can tell your future partner about issues only related to OCD. Anxiety disorders are not the contraindication for marriage. Your libido was normal, and I do not think there should be any problem in the marriage. One broken affair should not cause any hurdle in marriage. One should move away from any past. You are young and have a whole life ahead. Getting married will improve your mood and anxiety. So do not afraid of marriage. Try to look for good examples and avoid thinking about negativity. Ignore anything that causes negative effects on you. It is common in OCD patients to have ambivalence about anything. Try to remain relaxed, these thoughts will reduce with time. Continue to take medicine regularly. Spend at least an hour for exercise, and you will see improvement in mood. The negative thoughts are due to OCD symptoms and depression. With treatment, these symptoms will decrease." } ]

[ { "from": "human", "value": "Hi doctor, I am 30 years old. My weight is 140 lbs and height is 6'3\". I am doing a computer-based job. My diet is poor for the past 2-1/2 years. As I often work at night my sleep too gets disturbed. I am single and never had sexual contact with anyone. There is no history of skin disease, smoking and alcohol. My current issue is, I have a wart-like growth on the penis. It is located on the shaft, middle of penis, slightly towards the right side. I have this for over 20 years. It has never been carried over or has affected any other area of my body. There are no such growths anywhere in my body. I first observed it when I was 8 or 9 years old. It was neither painful nor caused discomfort. It is a flat, long hard mass appears as if inserted into pinched skin. Three years back, I had a very slight negligible discomfort after a long period of erection. When I was pinching, it came out of the sleeve of skin. It was growing in and detached from the body. It actually did not grow down into the penis, rather perpendicular. Six days ago, I had a long period of erection. Afterwards, the sensation of very slight pinching, localized pain focused on a few millimeters deep where the growth is. It is still there, but not bothering me much. But, this time it is slightly higher on the sensation scale and it is not going away. I have noticed some increase in the width. I am trying to keep it clean by frequent washing. There has never been any bleeding, redness on or around the affected area. It does not cause any problems in full erection. In fact, I feel less discomfort in full erection. Is this a wart? Is this dangerous? Would it be contagious to my sex partner? I am scared of surgery and I really prefer something non-invasive. Please suggest any topical cream or oral medication? What would be the expected time frame of recovery? Is prevention possible? It is quite close to the dorsal vein. Would it have any effect on the neurovascular bundles? Please see all the attached images. I am paranoid and scared because I think this will make my life very hard." }, { "from": "gpt", "value": "Hi. I have gone through your history and relevant pictures (attachment removed to protect patient identity) and I appreciate the same. As I can see that you do not have any signs of wart or contagious disease, please relax. The lesion you are having is just a dilated hair follicle or pore which is not dangerous. It is similar to a black head seen on the face, but a bigger one. It is commonly seen as a single lesion and forms a canal in the skin which contains skin debris that is frequently shed. Occasional pain or irritation is because of the debris hardening and poking to the stretched skin. There is no topical treatment for this as the creams cannot reach till root of the canal. The only effective way is to get it excised and sutured. It is a very simple and affording procedure with hardly any recurrences. Please go ahead with the surgery as it does cause irritation during erection and intercourse." } ]

[ { "from": "human", "value": "Hi doctor, I have a bent penis that causes pain and dissatisfaction. Please suggest me a solution." }, { "from": "gpt", "value": "Hi. A downward bent of the penis is an absolutely normal variation and is present in 15% - 30% of men. It will be a problem only when it is extremely bent and difficult to penetrate. Pain in the penis can be because of anxiety. If it has been since a long time, then there are chances of it being a cause of urethritis or some scarring in the musculature of penis known as Peyronie's disease. You do not have to worry unless erection is normal. I would suggest you consult a urologist for physical evaluation to check whether the bent in the penis is a normal physiological variation or not. Stay calm and do not get tensed." } ]

[ { "from": "human", "value": "Hello doctor, I have disc desiccation. There is a pain in my right leg while walking." }, { "from": "gpt", "value": "Hello, Welcome to iclinq.com. In Ayurvedic Panchakarma therapy, there is a procedure named kati basti, which is helpful in this problem and your treating Ayurvedic physician will also prescribe you oral medications while performing this procedure. It is a noninvasive procedure done with the help of medicated Ayurvedic oils. You can visit a nearby Ayurvedic hospital or Panchakarma center and ask for the details." } ]

[ { "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 potassium is 5.5. Is that high because I am nauseated a lot, hands and feet get tingly or go numb a lot. I am tired a lot and my heartbeat feels irregular a lot plus I have had diarrhea or very thin stool for past few months. Cancer too runs in my family." }, { "from": "gpt", "value": "Hello. Yes, serum potassium of 5.5 mEq is a bit high. The usual range of serum potassium is 3.5 to 5 mEq/L. Although 5.5 mEq/L is not that high to produce symptoms, but as your query suggested you are feeling the irregular heartbeat, I would suggest you get an ECG (EKG) done at the earliest. You might need medications to control the hyperkalemia (increased potassium). Regarding the history of cancers in your family, I cannot comment upon the hyperkalemia developing due to it or not." } ]

[ { "from": "human", "value": "Hello doctor, I have severe and uncomfortable abdominal pain when I have my monthly period. My menstrual cycle and pain last for 5 to 6 days each month." }, { "from": "gpt", "value": "Hi. I have read your symptoms. It looks like the regular pain that comes on during the menstrual cycle. So I just want to know if you have any medical conditions like hypothyroidism, diabetes or any other general medical conditions if you have had any surgery in the past, is there any symptoms like vomiting, loose stools associated with this. I would like to know your diet habit and if you have a family history. This looks like inflammatory muscle pain. I would advise you to take Mefenamic acid 250 milligrams with Dicyclomine 10 mg twice daily whenever you have this pain and also drink a lot of fluids that will help you with reducing pain. Drink plenty of fluids. That is very important. Inflammatory muscle pain during the menstrual cycle. Mefenamic acid 250 mg and Dicyclomine 10 mg as needed. Plenty of fluids to drink." } ]

[ { "from": "human", "value": "Hello doctor, My wisdom tooth is growing. It is very painful. What is the solution?" }, { "from": "gpt", "value": "Hi. This eruption pain occurs in every 2 or 3 months. To suppress it you must do this antibiotic course: Tablet Augmentin 625 mg, two times a day, tablet Metronidazole 400 mg, two times a day, tablet Brufen (painkiller) 400 mg, two times a day but if the pain is severe take three times a day. Do this course for three days. And do saltwater mouthrinses 3 to 5 times a day for a week. Put a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses. Give me followup after two days. Take care." } ]

[ { "from": "human", "value": "Hello doctor, I am facing acute neck pain since last three months and have been diagnosed with moderate degeneration in the cervical spine. Hands get pins and needles feeling sometimes during sleep. Legs get pins and needles feeling if not moved for say more than 10 minutes. Earlier arms were also paining but that has subsided now. I am male, 45 years. I also take 50 mg Thyronorm for hypothyroidism." }, { "from": "gpt", "value": "Hello. You may have cervical osteoarthritis. It is due to cervical spine degeneration. It is due to the wear and tear of cartilage and bones, which are present in the cervical spine. It causes chronic, severe pain and stiffness. Actually, it is age-related problem. Causes for this are bone spurs, dehydrated spinal discs, herniated discs, injury, ligament stiffness, etc. You need homeopathic medicines with physiotherapy. Cervical X-ray AP and lateral. Cervical osteoarthritis. Bryonia 30 daily 10 pills for 15 days, Calcaria flour 6X daily two tabs three times, Nyctanthus Q daily 10 drops with cup water two times daily. Heat pad apply or cold pack, use neck brace or soft collar." } ]

[ { "from": "human", "value": "Hello doctor, Based on the health check reports attached, please confirm if any of the parameters are our side range which needs to be monitored, especially the ones marked as L or H (RDW, total blood count, lymphocytes, indirect bilirubin, potassium serum, etc). This is for a 33-year-old female." }, { "from": "gpt", "value": "Hi, Welcome to iclinq.com. I just went through your blood reports and urine protein examination in blood reports (attachment removed to protect patient identity). Your hemoglobin level seems to be normal 12.5 also and then other components like white blood cells, red blood cells platelets all are within normal limits. Your liver function test is also quiet normal, nothing is to be worried. Coming to your kidney function your creatinine also seems to be quiet normal. Except your potassium level is 5.14 which seems to be little high normal needs to be taken care of. Avoid drinking tender coconut water, avoid eating bananas and avoid anything that is rich in potassium. Normal level is 3.5 to 5.5 so you are close to the high normal, so avoid foods that are rich in potassium. The next thing is your thyroid function is very normal, no need to be worried. Vitamin D is on the low side. It is 15, so what I advise is take tablet Calciquik 60K units calcium once a week for eight weeks followed by one tablet every month for the next 10 months. Your serum vitamin B12 also seems to be normal everything is normal except for your low vitamin D and potassium is on the higher side." } ]

[ { "from": "human", "value": "Hi doctor, I am 16 years old. I just recently discovered that I have scoliosis. I do not know much about it but I will tell you what I know. My scoliosis currently has only a 3-degree curve and I am pretty confident it is a C shaped curve, although I am not sure. What do you think are the chances that my scoliosis will develop into adulthood? Do you think it will stop progressing once I am fully grown?" }, { "from": "gpt", "value": "Hello. Before going into the progress of scoliosis, I would like to make you some clarity about the facts on it. 1) The Cobb angle is a measure of the curvature of the spine in degrees. This helps to determine what type of treatment is necessary. A Cobb angle of 10 degrees is regarded as a minimum angulation to define scoliosis. 2) A scoliosis curve of 10 to 15 degrees normally does not require any treatment except for regular check-ups. 3) If the scoliosis curve is 20 to 40 degrees, the orthopedic doctor will prescribe a back brace help to keep the spine from developing more of a curve. 4) More than 45 degrees need correction surgery keeping many pedicle screw and osteotomy to correct the curve. I hope you go for x ray done of your spine and it will be easy to measure properly about the curvature." } ]

[ { "from": "human", "value": "Hello doctor, Age of the child: 20 Months Gender: Male Weight: 12 Kilograms Height: 30 inches Started Walking: 15 Months Started Sitting: 5 months Started Crawling: 12 months Problem: My baby has started walking at the age of 15 months and is very active. He runs, jumps, rolls, and can climb stairs with the help of an adult. And can speak 2 words sentences. The problem we are facing is a balance issue. He is an active child but has an issue in maintaining good posture and is easy to fall. When standing straight and static an observer can feel that he is dizzy and swings slightly left and right to maintain the balance. He also has lazy neck control. At 2 months of age he suffered from “Torticollis” which we have managed to minimize by exercises recommended by other pediatrics. He also has digestion problems since birth and has loose motion after 1 week. He has also slight drooling. My question: Is this balance probelm common in this age group or should we choose to consult an in-person doctor which I am avoiding due to COVID-19 crisis as the hospitals are crowded." }, { "from": "gpt", "value": "Hello. First, let me appreciate you for describing whatever your child has appropriately. As you have said that the baby has just started walking about 5 months ago, the problem with balance could be just his learning curve. Kids normally do fall while learning to walk, am sure even you will be aware of that. He is able to walk, rule and climb stairs only means he is growing normally. Now, to say if the balancing issue is normal or not you can make a small video of it and show me. It is difficult to say without seeing the baby. Let us assume that it is a part of normal development, then you do not have to go to a doctor and you do not have to worry about it. Now, if we assume that it could be because of a physical problem, the child will have to be examined. My advise is to wait till he completes 2 years. If the problem still persists, then you have to go to a doctor." } ]

[ { "from": "human", "value": "Hi doctor, My current medications are 60 mg Cymbalta for depression and 300 mg Seroquel for the sleep disorder. I am in my 40s and I have had a few episodes of depression during my lifetime. I was lucky enough to be able to attend a psychiatrist in a country I lived in for a long time. It was a great help. My question at the moment is about medication. When I was quite depressed I took Cymbalta and another antidepressant which I am fairly certain was Wellbutrin. I dropped the secondary antidepressant after a year or so as I began to feel better. I am just considering using it again as I am now in a state of emotional upheaval due to a family death. I have just got in touch with a GP for an appointment in the next two weeks. What I would like to know is, it safe to take Cymbalta, Seroquel, and go back to Wellbutrin? How would I work the dosage? Would I start with 150 mg of Wellbutrin and possibly go up to 300 mg? When should I take the antidepressants? Can I take them both at the same time, or do I need to space them out? I am not prone to seizures and I have never had one. I am a female." }, { "from": "gpt", "value": "Hi. Thank you for taking help from a psychiatrist. You can take Cymbalta and Seroquel. You are already on both medications, so you should continue both medications. If you fill depressed then take tablet Wellbutrin 150 mg once in the morning for a short period of time, then we can taper off within 6 months. If you do not improve your depression on 150 mg of dose after 15 days then we can increase the dosage as per requirement. You can take medications together and you do not need to space out. But you must take Seroquel at night as it causes sedation. Even you should follow some non-pharmacological management as mentioned below. 1. Do exercises daily for 30-45 minutes like walking. 2. Do meditation for 20 minutes daily. 3. Eat healthy home cooked foods, avoid junk foods. 4. Spend quality time with friends and family daily. 5. Spend time for creative hobbies like read good books, write journals, painting, drawings, learn new skills or language or musical instruments. 6. Take enough (7-8 hours) sleep daily. 7. Avoid tobacco or alcohol or any substance abuse. I hope this helps." } ]

[ { "from": "human", "value": "Hello doctor, My daughter's age is 05 years 05 months 24 days. Her height is 41 inch and the weight is 19 kg. She vomits when she travels by car. Tomorrow we will start our travel by car and my assumption is she will start vomit. Earlier we gave her Ondem syrup. But it did not work. So, we request you to kindly prescribe something (like Avomine tablet) to get rid off. Please note that everything is normal. She is a little fragile. She did not vomit in the train and plane journey." }, { "from": "gpt", "value": "Hi. Your daughter has motion sickness. It usually occurs in bus or car. You can give tablet Avomime ½ tablet 30 minutes before the start of the journey. Also, make her sit near the window. Also, good ventilation with fresh air lessens the vomiting sensation. Do not give too much food before the journey. Peppermint also helps. Take care." } ]

[ { "from": "human", "value": "Hello doctor,My wife aged 72, weight 65 kg, is a diabetic type 2 for the past six years, hypertensive for the past two years, is suffering from moderate tricuspid regurgitation, aortic valve sclerosis, and pulmonary hypertension for the past two years. Her systolic function is good and there is no diastolic dysfunction.No drugs are prescribed for AS or TR. For hypertension, she was prescribed Telmisartan 40 one tablet per day with which her BP is about 145-150/90-85. Diabetes is under control. Other parameters are normal. Whether the present medication is adequate or she needs further medication such as Tadalafil to treat PAH. Any medication for TR? Please advise." }, { "from": "gpt", "value": "Hi. On the face of diabetes and hypertension with raised cholesterol and LDL, I suggest you add tablet Rosuvas (Rosuvastatin) one tablet daily after dinner. Consult your doctor. I think the dose of anti-diabetes medicine could be adjusted to reduce his blood sugar level to reduce further to near the desired level along with BP medicine dose to adjust to achieve BP around 130/80. Regarding PAH and other valvular diseases, your Cardiologists will decide after going through different parameters." } ]

[ { "from": "human", "value": "Hello doctor,I am 32 years old. I have been drinking for the last five years. LFT before six months showed normal and CT scan whole abdomen did 10 months back showed the liver is normal. Pancreas normal no gallstones but I have been drinking heavily these six months due to stress. Now I have stopped. For protection prevention, can I take Ursodeoxycholic acid 300 and Evion 400 and Metadoxine 500 for a month or two? Will it be of help to regenerate or eliminate toxins from the liver? UDCA, vitamin E, Metadoxine, will it help? Please suggest the dose and before after meal." }, { "from": "gpt", "value": "Hi. You need to stop drinking as first which will lead to recovery. The body will naturally heal itself since your LFT and CT was normal. Regarding medicines, they have a limited role in such situations. Although there is no harm in the above medication for a couple of months under medical supervision. Please consult a nearby doctor who can examine you also." } ]

[ { "from": "human", "value": "Hi doctor, Actually, I want to know something about my skin. In my armpits area, there is some kind of infection like I do not really know what that is but it looks like an infection and my sweat and sweat odor is due to that particular infection. Now I am describing the infection I used to wax my armpits and there is something that grows over my armpit hair a yellowish something and if I try to remove whatever the thing is, it gets out of the hair in powdered form. At first, I thought it as a fungal infection. I used a serum to remove fungus but nothing happened. It does not hurt but only if I use hair removal cream in the area." }, { "from": "gpt", "value": "Hi. Yes, it is a condition in certain individuals that is called as trichomycosis axillaris. It is due to bacteria the coryneform bacteria and yellow color thing is their colonies. You need antibacterial not antifungal agents. And antiperspirant is the recommended treatment for this condition. Apply topical Aluminum chloride over it. Tricomycosis axillaris. Tablet Erythromycin 500 mg QID. Apply Aluminum chloride antiperspirant over the area. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." } ]

[ { "from": "human", "value": "Hi doctor, I am writing to you regarding the health status of an elderly person. She is 85 years old and still in pretty good condition. Her current cardiological status rated to be very well with no diabetes or any other medical issues. But from last year she shows a myelodysplastic syndrome. A bone marrow biopsy was attempted a couple of weeks ago. Unfortunately, the material made available to the laboratory was of not adequate in quality and no result could be given. However, I read in the report that the material was of fibrino-leukocytic consistency and assuming that there is refractory anemia with excess blasts. Is the material of fibrino leucocytic nature possibly proving the suspected condition?" }, { "from": "gpt", "value": "Hi.I have carefully worked through your case and want to assure you that proper care and expert opinion will be extended. Actually, when there is a hematology report which questions the quality of the biopsy specimen, we cannot just comment on the outcome of the test or to what should have had been there it was like that or the other way. The fibrino-leukocytic consistency just means that there were just a few leukocyte cells in the background matrix of fibers. I preferably suggest that this is a mistake in taking the proper specimen, or if the technique was fine then due to the replacement of the bone marrow with fibrous tissue to some extent causing anemia. My final suggestion is to repeat the diagnostic test and expert hands needed." } ]

[ { "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 brother os recently on Tagrisso. His recent scan is attached which shows improvement. He is vomiting while eating grains. What is the reason for vomiting and what can be done for this? Please tell me about this response to Tagrisso. If it is good? How much time does Tagrisso take for the remission if it works like this? What is the average duration for Tagrisso to become resistant? Please clear my doubts." }, { "from": "gpt", "value": "Hi, Welcome to icliniq.com. In reply to your question for Osimertinib (Tagrisso), Osimertinib demonstrated improvement in PFS (18.9 versus 10.2 months, HR 0.46, 95% CI 0.37-0.57) and duration of response (17.2 versus 8.5 months) relative to other TKI. The PFS (progression-free survival) benefit was consistent across subgroups, including either patient with or without brain metastases. Response rates for Osimertinib is around 80 %. To put it to simple terms, the disease is controlled for more than 1.5 years with Osimertinib. Treatment with an EGFR TKI is generally continued until there is disease progression. If there is persistent vomiting, we need to do more tests to confirm whether it is leptomeningeal (LM) disease which is diagnosed in approximately 5 percent of patients with metastatic cancer. The most common solid tumors giving rise to LM are breast cancer (12 to 35 percent), lung cancer (10 to 26 percent), melanoma (5 to 25 percent). Headache is the most common initial symptom of LM, present in 30 to 50 percent of patients with symptoms of confusion, forgetfulness, disorientation, subtle personality changes, and/or lethargy collectively referred to as encephalopathy or altered mental status, are common in patients with LM. I would request to do Gadolinium-enhanced magnetic resonance imaging (MRI) of the brain and spine which often provides important evidence of LM. The definitive diagnostic finding for LM is the cytologic identification of malignant cells within the CSF (cerebrospinal fluid)." } ]

[ { "from": "human", "value": "Hello doctor, I am a 25 year old male. My weight is 65 kg and height is 5'5\". I am having enlarged breast and very less facial hair. Will this lead to infertility? I am not taking any medicine. I have consulted an endocrinologist regarding this. He examined my chest and suggested me to get a hormone analysis and ultrasound of breasts. My hormone levels found in the analysis are as follows. My serum beta-hCG is <0.100 mIU/mL, total testosterone level is 4.14 ng/mL, TSH level is 4.02 uIU/mL, free T4 is 1.21 ng/dL, LH is 9.23 mIU/mL, prolactin level is 19.79 ng/mL, and estradiol (E2) is 32.43 pg/mL. I would like to know, are these hormone levels normal for an adult male? As suggested, I got my ultrasonogram done for my breasts and the reports are as follows. Nipple and subareolar tissue are normal. There is no retraction or skin thickening, no abnormal calcification and no axillary lymph nodes seen. The pectoralis and retromammary space appears normal. No focal or diffused lesions observed. Looking into my results, doctor told me that there are no abnormalities seen in both the breasts. In addition to all this, doctor asked me to try few exercise and check if there is any reduction in the size of the breast. In spite of trying everything, if the breast size did not reduce the he told me to get them removed. Now my question is that, will enlarged breast affect my marriage life? Beard hair growth is fine, but the mustache hair is very less. Is there any medicine that can cure my problem? Please help." }, { "from": "gpt", "value": "Hi. I can understand your concern and what you are going through from your report (attachment removed to protect patient identity), there is nothing to worry since it is not a major problem. Your condition is false gynecomastia. There is excess fat in your breast area and no extra breast tissue formation. Do not get depressed by thinking about it. Relax, stay calm and move according to my advice which is as follows." } ]

[ { "from": "human", "value": "Hi doctor, Few days back, I felt little dizzy and when checked my BP was quite high around 149/89. My recent lipid profile is also worrisome. What should I do now? I prefer eating junk food most of the time and dairy products like cheese and paneer more. I gained some weight now. I feel some slight vibration in the left side of my chest when I shout loudly. Apart from this, I have few kidney stones of about 3-5 mm. Now I am taking approximately 2.5 liters of water a day. Otherwise, I am healthy. I do not take any medicines except for kidney stones and injection Voveran for the same." }, { "from": "gpt", "value": "Hi. My advice to you as per your complaints and reports (attachment removed to protect patient identity), Avoid stress and follow the instructions and repeat your lipid profile after 6 months. Blood pressure (BP) also will improve with jogging and exercise but weekly once BP should be checked. If it is high like this, then we have to think of medicine." } ]

[ { "from": "human", "value": "Hi doctor, I am suffering from low-grade fever, hair loss, and extreme tiredness. There is pain and burning sensation in my stomach along with loss of appetite and weight gain. I got my ANA test done and it came positive. My ESR level has increased. All my other test results found to be negative. Please help." }, { "from": "gpt", "value": "Hi. I went through your reports (attachment removed to protect patient's identity) and observed that there is no autoimmune disease present. Since you have been suffering from multiple joint pains for the past one year, you should have tested for rheumatoid arthritis (RA) factor and got done ASO (Anti-streptolysin O) titer. ANA (anti-nuclear autoantibodies) can be elevated even in slight fever, hence no need to worry for the same. Did you get affected by chikungunya anytime before? It has been mentioned that your 3D reports are normal. Please do attach those reports for my reference. I would suggest you to kindly get the following tests done:" } ]

[ { "from": "human", "value": "Hi doctor, I am a 30 year old male. My weight is 84 kg and height is 177 cm. My blood test results are leukocyte 10.94000, lymphocyte 14%, neutrophils 75000, MCHC 31.2% and RDW-SD and PDW are high. My SGOT and SGPT levels are high too. Please guide." }, { "from": "gpt", "value": "Hi. I want to assure you need not 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. You have low iron, but the deficiency can be covered by diet. 2. There is an increased white blood cell count which indicates an infection. 3. Deranged liver enzymes may be due to the hepatic disease, viral hepatitis or alcohol intake. Body weakness and fever along with raised hepatic enzymes gives suspicion for liver disease. 1. HBsAg (hepatitis B surface antigen). 2. Anti-HCV (anti-hepatitis C virus). 3. Vitamin B12 and D levels. 5. CBC (complete blood count) with ESR (erythrocyte sedimentation rate). 6. Complete urinalysis. 7. Complete abdominal ultrasound. 1. Take green leafy vegetables such as spinach, broccoli and cabbage. 2. Take the diet which includes carrot, cucumber, kiwi, avocado, fresh pineapple and fish. 3. Take plenty of coconut water, which is good for your condition. 4. Take almonds, walnuts, cashews, nuts and beans. 5. Add Citrucel (methylcellulose) dietary fiber supplement. Take plenty of fluids and keep away from spicy, fast and fried foods." } ]

[ { "from": "human", "value": "Hello doctor, I am a student. Due to extensive use of the laptop for thesis writing and book readings, I am suffering from hair loss and hair whiteness, both problems are increasing day by day. Some people say that it might be due to the extensive use of laptop. Kindly suggest me some multivitamins to prevent hair fall and whitening." }, { "from": "gpt", "value": "Hi. There is no link of hair loss and hair whitening and laptop usage, however, it can be due to stress which a student has. There is as such no treatment for reversing the hair whiteness. However, to stop that take Biotin supplements and use Vitamin-rich shampoo. Diffuse hair loss, premature canities. Tablet Priorin BD for three months, Photonic max shampoo three times per week." } ]

[ { "from": "human", "value": "Hello doctor, My age is 41 years. I have taken Care 3 injections of B12, after seven days, test results are greater than 1500 pg/ml. Before injections 100 pg/ml. Please suggest how to decrease and was it dangerous to my body?" }, { "from": "gpt", "value": "Hello. Do not worry. It is not dangerous. It is a water-soluble vitamin and will be excreted in urine. You do not need to take any medicines for that, just have plenty of water. Measure level again after two weeks. Avoid injections of Vitamins, just have tablets for both Vitamin D and Vitamin B12, if necessary in future after checking levels only." } ]

[ { "from": "human", "value": "Hello doctor,I have an ulcer on top of the tooth on the gums (a white raised ulcer). Please help." }, { "from": "gpt", "value": "Hi. This is not an ulcer, infact it is big pus boil that has occurred due to some infection in your underlying tooth. You should start with an antibiotic regime immediately and get it treated. Most probably root canal treatment and scaling will be done of teeth under question. If it is not paining that does not mean it will remain silent for long. It can trigger up anytime. You must see the dentist as soon as possible. If you get a late appointment then I can prescribe medicine for you. Give me followup after a day for it." } ]

[ { "from": "human", "value": "Hello doctor, There is a feeling of little itching inside my vagina. I noticed something weird inside." }, { "from": "gpt", "value": "Hi. I have gone through your history and understand your concern. It could be due to vaginitis caused by fungal and bacterial infection. You can take antifungal and antibiotics for the same. Keep the area dry and clean and drink a lot of warm water and eat lots of vegetables and fruits." } ]

[ { "from": "human", "value": "Hello doctor, I suddenly felt out of balance and threat of falling. Occurred frequently. Took MR brain with angio. In observation, the report said the following. Chronic lacunar infarct with gliosis in left corona radiata. Discreet diffusion non restricted subcortical FLAIR hyperintensities noted- small vessel ischemic changes. Cerebral and cerebellar atrophy prominent cerebral sulci and ventricular system. No evidence of acute infarct, hemmorrhage or space occupying mass lesion noted. I had a TIA issue 18 years back, which lasted a few minutes and became fine. Last 17 years there was no issue. Can you please interpret the report and tell me if there is any serious problem." }, { "from": "gpt", "value": "Hello. I read carefully your MRI report (attachment removed to protect patient identity) and would explain that it indicates small repeated strokes due to small vessel disease of the brain. For this reason, it is important for taking daily Aspirin 100 mg or 80 mg and closely monitor your blood pressure values. It is also important checking your blood lipid profile and taking statins (Atorvastatin) in case of increased cholesterol levels." } ]

[ { "from": "human", "value": "Hello doctor,Burning penis (pain), urine color yellow, smell like fish or ammonia. Whenever I eat hot food or hot drinks sometimes the burning increases. I feel a little better whenever I drink water. Please give me medicine for the above problem." }, { "from": "gpt", "value": "Hi. You can have acute urinary tract infection. For that, you can investigate with urine routine microscopic examination. If pus cells and bacteria present then urine culture can be done for further work up. It is advisable to drink lots of water and fruit juices. Avoid the intake of excess spicy foods. You can revert back with urine routine microscopic report once done." } ]

[ { "from": "human", "value": "Hello doctor, I had normal vaginal delivery 10 months ago and breastfeeding my baby. Since then I did not have my periods. But yesterday, around 10 PM I felt some brown stains, but I started worrying when I saw the flow as it is really heavy. I used three pads in three hours and that too there were literally in a situation of dripping. I do not know whether I should expect this or not? Could you please help me to find the problem and any medication I can go for?" }, { "from": "gpt", "value": "Hello. While a woman is breastfeeding post-delivery, menstrual cycles usually do not resume until 6-12 months, and it will vary from person to person. This is like a natural birth control devices by nature to prevent subsequent pregnancies at a shorter interval. But however, this is not 100% effective. The excessive bleeding that you experienced is definitely not normal even if you have resumed your cycles. One possibility is that you could have ovulated and got pregnant in the same cycle before you could get your actual periods, and it got miscarried (if you were not using any birth control methods). So I would advise to check your urine pregnancy test once if there is any history of sexual intercourse. The second possibility could be excessive bleeding due to other causes like fibroids or any other structural problems or hormonal disturbances which will have to be evaluated. Please get an ultrasound if possible to look for the same. Meanwhile, to control your excessive bleeding, I prescribe some medications which will help to control your flow. Please feel free to revert back with the urine pregnancy test results to rule out the possibility of pregnancy first. Urine pregnancy test. Ultrasound abdomen and pelvis. Tablet Tranexa (Tranexamic acid) 500 mg thrice daily after food. Follow up with the urine pregancy test results." } ]

[ { "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 brother had an eye trauma. So, he had laser surgery for retina after two months of trauma. But he masturbated the next day of laser surgery (after 19 hours). Will that cause any problem to his retina or retinal nerve? Will it increase intraocular pressure? Please give a detailed answer as we are worried." }, { "from": "gpt", "value": "Hello. Masturbation will not have any adverse effect on laser treatment of retina or retina. There may be a minimal increase of intraocular pressure with masturbation but that must be non-significant. Kindly share the file to guide you better." } ]

[ { "from": "human", "value": "Hello doctor, My age is 18 years. Few days before I do not know somehow I had forgotten many easy spellings of those that I knew well before. And I have my HS examination on in a few days. Please tell me what shall I do to solve my problems." }, { "from": "gpt", "value": "Hi. I just read through your complaints. It looks like absent-mindedness which is common in old age. But at a young age, it is not so common what I would advise is get me some basic blood investigations. Complete blood count, kidney function test, liver function test, and urine routine examination, serum vitamin B12, folic acid, and vitamin D. With that, I will be able to assess you what has been going. In the meantime, I would advise you to eat healthily, eat green leafy vegetables. A green leafy vegetable called Brahmi leaves help to improve your memory power and also reduces your absent-mindedness. Any fruits or any food that is rich in DHA most importantly I want you to eat dry fruits that includes walnut, pista, badam, cashews and whichever you like got a more amount of DHA that improve your nerve functions in your brain and it indirectly helps you remember things rather than forgetting things." } ]

[ { "from": "human", "value": "Hello doctor, My mother is not able to walk properly and she cannot move properly. She met with ischemic stroke eight years back and she is diabetic and has BP, and seizures (epilepsy) treated with Insulin, and BP suppressants, Atorvastatin, Levetiracetam, Phenytoin (Eptoin) since seven years, but she is not able to walk properly and she is not able to move her hands and legs properly. Her thinking and behavior have also become very mild. Please suggest me the correct medication for her." }, { "from": "gpt", "value": "Hi. Ischemic stroke is a condition where there is incomplete blood supply to a certain part of the brain leading to permanent damage to that part of the brain. Consequently, the function carried out by the affected part of the brain is lost. The only way to recover function following permanent damage is physiotherapy which enables the existing normal part of the brain tore-learn the function that was earlier carried out by the now non-functional brain. In the case of your mother, physiotherapy is the only way to improve the lost function. In addition, we can make things in the house and around in a way that is easy for your mother to navigate such as having a motorized wheelchair, etc." } ]

[ { "from": "human", "value": "Hello doctor, I a male, 27 years old. I got blood while pooping without pain today morning twice but without any pain." }, { "from": "gpt", "value": "Hi. Blood in stools can have multiple reasons from simple hemorrhoids to some serious ailments. I would advise you to visit a gastroenterologist and get a sigmoidoscopy done. It is a simple test and takes hardly 10 minutes. It involves passing a small tube-shaped soft camera from the anus into the large intestine and trying to find the source of bleed. It is a painless procedure with the only sensation being mild bloating." } ]

[ { "from": "human", "value": "Hello doctor,I am having marital issues. I have a lot of anger and do not react well to my wife with very little patience. She is high conflict. I struggle because many things become bigger issues than they should be and emotional abuse occurs followed by verbal abuse. She will deny things she does or says later on. She yells very quickly and goes from 0 to 100. I am direct. I can be critical. I am grumpy for some days. If something bothers me she cannot take it. We argue, we can go back and forth whoever initiates but she turns it up to yelling and aggressiveness too quickly so I push back.I have become verbally abusive as I told her not to curse long ago. She yells and curses so I immaturely followed suit. Now I am off the handle. I name call and curse because she loses it quickly and tries to take control and I cannot handle it well at all. Is this mutual abuse? She can get physical at times. Then I do something to make her stop and scare her. I do not ever hit her but I am forced to get aggressive. I am very reactive. I start in or can criticize but I do not start screaming and yelling as soon as she does. I need a break down here for clarity. Fights go off the handle. Very bad. We love each other but we fight way too often and with harsh name calling especially now on my end. She starts with bad words and I can lose it. It is bizarre that we have so much love, no deceit, but we cannot get it together.Together two years. Married 4.5 months. I am 40 she is 28. She has a history of being verbally abused. I have anger that once triggered is fiery. We spend an awful lot of time together. She is not working, just taking online classes. So she is home a lot. I am working part-time hours for now. What do you think? We have to fix this. The cursing and yelling and battling and jealousy is a lot. Both ends there. Please let me know what this looks like as far as abuse." }, { "from": "gpt", "value": "Hi. Marriage is a relationship which demands most of our compromise, understanding each other, handling each other's fault and try to maintain an equilibrium but at times the equilibrium disturbs and it results into a series of conflicts. One thing leads to other and even small things starts irritating as the dissatisfaction from relationship occurs. Our thoughts start imagining things in extreme. So there remains always a state of unrest at both the sides. The best way to go with it are: Sit together, go to a dinner or a park, make rules of conversation like each one will speak one by one, no interruptions while first one is speaking. Set some rules at home like no shouting or yelling or using bad words. Try to control the response, the biggest problem always remain is we respond too quickly and stop listening and start blaming another one. If you people can, then try to get some marital therapy sessions, they will help you a lot. Plan some holidays, give her small gifts and surprises, give evidence of your love to her." } ]

[ { "from": "human", "value": "Hello doctor, I was wondering if anyone could tell me about my condition. I used to go to an eye doctor when I was little but I cannot remember when I last went. I was never pushed to go by my parents when I was younger, only when I needed a new pair of glasses. I was born with one eye small, the other normal. My vision is fine, I am very nearsighted but with glasses, I see quite well. My depth perception is normal too, I can see most things and when I tried to drive once, it went well. In my affected eye pupil is floating around. I cannot see much out of it, and it is not big enough. Other than that, no other health conditions. Could anyone tell me what this is? Is it something that progresses and will I go blind someday?" }, { "from": "gpt", "value": "Hi. You have unilateral microphthalmos i.e. your one eye which in your case is right eye is not fully developed and has developed a squint. Other eyes appear normal but I will advise you to get a fundus in the left eye also to rule out any retinal anomaly. The condition in the right will always remain like this and this condition will not affect the left eye. If it is normal just do not engage in activities that can lead do an injury in the left eye also. So please consult a vitreoretinal specialist to rule out any retinal lesions in the left eye and get yourself rechecked for glasses every six months. Though your left eye appears very normal from outside but since you are nearsighted I will advise you to get retinal examination in your normal eye too, so that if there is any treatable lesion we can fix it at an early stage." } ]

[ { "from": "human", "value": "Hello doctor, My daughter is 6.5 years old. When she was 1, she had a seizure for a couple of times in two years, for which she took medicine and now she is off from medicine for the last three years. Now recently she was diagnosed with adenoids for which we are going homeopathy. My concern is she is right now 112 cm tall and 21 kg weight. I find her too short compared to her friends, my wife is only 5 feet tall and I myself is 5'7\". Is this the reason she is not growing, since last 4 to 5 months her height is the same, or due to adenoids or medication which she took in the past? What should we do regarding her height? I want her to be at least 5'4\", up to what age girls height can grow? She takes Pediasure, two eggs in terms of protein every day and four days a week swimming, is there anything special I can do? Kindly advise." }, { "from": "gpt", "value": "Hi. Here are certain points of advise I would like to give you. Weight is absolutely normal for her age as per growth charts. As per the height mentioned (112 cm), the child is shorter as per other children in the growth chart but considering the parent's height, the child seems fine. If the child's height had to be affected by adenoids the weight also would be effected but it is not. Girls grow in height up to the age of 14 to 16 years. The final height of the child should be close to 5 feet, 2 inches considering the parent's height. The current age of the child is 6 years so you have a time period of 8 to 9 years for height growth. There is no exercise or supplement specifically for height. However, it has been noted that children who are very active and have a good diet end up with good heights and weights (with respect to the parent's height). Both of these are well-taken care by you as your child seems to be active and feeding well (as per history). So, I would not worry much. As related to adenoids, I would suggest taking the opinion of an ENT doctor for the same. If they do not cause many issues, they can be left alone. An X-ray neck lateral can be taken to see if they are enlarged." } ]

[ { "from": "human", "value": "Hello doctor, My daughter is 18 months of age. She was born at 38 weeks due to placenta failure and oxygen issues. She was 5 lbs 10 ounces at birth and was healthy (did not have to stay in the NICU). She hit all of her milestones in terms of rolling over, crawling and walking (walked at 14.5 months), but is a toe walker. Her left leg (to us) is weaker than her right and her left leg does not bend as much as her right leg. She began to speak around 10 months of age then her speech left. We came to find out she had chronic fluid and a month back she had tubes placed. I am hearing more vowel and consonants now but no true words yet. She makes fine eye contact. Her non-verbal communication is good. She responds to her name but not always. She is beginning to learn more of what we are saying, she plays with some toys, is not terribly social. We are thinking that she may be on the autism spectrum and we have an evaluation soon to determine that. But my question is, could this be cerebral palsy?" }, { "from": "gpt", "value": "Hi. I understand the situation you are facing with your child. As there is no history of perinatal insult and NICU stay at birth, cerebral palsy could be less likely at this early age to diagnose. The description you made is more of a like to be an autistic spectrum disorder. But this could be just a small delay in catching up all milestones. Some kids learn early and some little late. So, observe over a period and if no improvement is seen, then consult a pediatric neurologist and developmental specialist for further evaluation and management." } ]

[ { "from": "human", "value": "Hi doctor, I feel fatigue despite good sleep of about 7 to 8 hours. I have sporadic pain in the body. I feel cold and freeze rapidly especially on air conditioning. Otherwise, constant palm sweat is present. I am getting discomfort with lights. I have a sense of fullness in the head as if I were on a plane. I am getting fear of the future, especially of disease and death. I could not identify the source of these symptoms. If these are psychological, then what is the solution?" }, { "from": "gpt", "value": "Hi. I want to assure you do not 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. Such an issue happens due to either of the following causes. Thyroid disease, diabetes mellitus, hepatic disease, heart disease as endocarditis, hypertension and autoimmune disease where body's immune system gets against the body's own tissues. Situation like this may also have a psychological part of the disease. Can you please tell me how much time elapsed for such symptoms? Is this a continuous one or on and off? Do you or anyone else at your home know that you snore while sleeping? What are your blood pressure, pulse rate, and respiratory rate today? Respiratory rate is when you sit quiet and count for one minute that how many times you inhale and exhale, a complete respiratory cycle. Pulse rate, you may count by keeping the finger on wrist and counting the feeling of pulse in one minute. Do you have fever? How active are you? Can you please upload the tests you went for? Diagnosis is the key to proper treatment. We can rule out certain causes from diagnostic tests. If not available, no problem I have written all the necessary tests. You must get it done as soon as possible so that we may proceed further. Get the following investigations done and upload the report: 1. CBC (complete blood count) with ESR (erythrocyte sedimentation rate) and differentials. 2. Fasting blood sugar levels. 3. Fasting lipid profile. 4. Thyroid profile. 5. EKG (electrocardiogram). 6. Total CPK (creatine phosphokinase) levels. 7. HBSAg (hepatitis B surface antigen) and Anti-HCV (anti-hepatitis C virus) levels. It will be decided on follow up details. Do not worry, it can be managed." } ]

[ { "from": "human", "value": "Hi doctor, I am a 36 year old female. My height is 164 cm and weight is 48 kg. I was healthy with fine ligaments. Two years back, I had spine surgery for a herniated disk at the level of L5/S1. Soon after the operation, I got something like sleep myoclonus. The neurologist said that as benign, but I did not have anything like before. I am suffering from loose and weak ligaments in my spine and elsewhere. I am also having TMJ dysfunction, sacroiliac joint dysfunction, and ligament laxity. During anesthesia, I was given one dosage of Midazolam 2 mg, Propofol 200 mg, Cefazolin 2 mg, Atropine 1 mg, Fentanyl 0.3 mg, Rocuronium 40 mg, Neostigmine 2.5 mg, and Sevoflurane 63.05 mL. The operation duration was around 2 hours and 34 minutes. I do not have any drug allergy. But, I did not receive any inhaled anesthetics before. Does ligament laxity occur as a side effect of Sevoflurane?" }, { "from": "gpt", "value": "Hi. I have read through your query in detail. Please find my observations below. Myoclonus or muscle twitching is a known side effect of Sevoflurane use, and it is not a serious concern. Sevoflurane does not cause laxity of ligaments. Very common side effects of Sevoflurane occurring in more than 10 % of patients are nausea, vomiting, hypotension, bradycardia, cough, and increased agitation. Common side effects occurring in 1 to 10 percent of patients are increased salivation, tachycardia, hypertension, laryngospasm, airway obstruction, breath holding, apnea, respiratory disorder, somnolence, dizziness, shivering, fever, hypothermia, headache, increased fluoride in blood, abnormal liver function test and abnormal blood glucose level. Uncommon side effects occurring in 0.1 to 1 % of patients are dry mouth, arrhythmia, ECG abnormalities, increased sputum, hypoxia, wheezing, bronchospasm, hyperventilation, pharyngitis, hiccup, hypoventilation, dyspnea, stridor, hypoxia, asthma, crying, nervousness, confusion, insomnia, confusional state, syncope, hypertonia, taste perversion, asthenia, pain, fluorosis, increase in AST (aspartate aminotransferase), increase in ALT (alanine transaminase), bilirubinemia, increase in LDH (lactate dehydrogenase), increase in alkaline phosphatase, hypophosphatemia, acidosis, hyperglycemia, increase in BUN (blood urea nitrogen), increase in creatinine, glycosuria, albuminuria, amblyopia, conjunctivitis, urination impaired, urine abnormality, urinary retention, oliguria, pruritus, and rash. Rare side effects occurring in less than 0.1 % of patients is malignant hyperthermia. Female hormones progesterone (before menstruation) and relaxin (during early pregnancy) cause joint hypermobility and ligament laxity. But, it is difficult to predict whether these factors are causing your symptoms or not. People with connective tissue disorder also might have laxity of joints." } ]

[ { "from": "human", "value": "Hi doctor, My father has undergone angioplasty last year. He went for TMT review last week. His TMT report shows variations, but he has no symptoms. His blood profile is normal for blood sugar and cholesterol. He is currently taking the following drugs, Deplatt 75 mg (0-1-0), Rozat 5 mg (0-0-1) and Envas 2.5 mg (0-0-1). He is in proper regular diet. Does this indicate anything serious? Please say any further angiography is needed. The doctor has added tablet Starcad 12.5 mg and tablet Flavedon MR after the TMT report." }, { "from": "gpt", "value": "Hi. I have read your query in detail and I understand your concern. I need to know a few more details to help you better." } ]

[ { "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, My baby has a bump behind her ear and head. I searched it online and found it as lymph node. I do not know what exactly it is but she is so irritated and she has a fever, I do not know what to do. Please help. She is only 1 year old and I am giving her Tempra." }, { "from": "gpt", "value": "Hi. You are absolutely right, these are lymph nodes. Everyone has it but due to so many different reasons, they become a bit enlarged and can be felt. If they are not increasing in size, and not painful on touch along with a normal skin over it, then not to worry. It does not require any specific medication. In case any of the above-mentioned symptoms and signs are there, then it needs to be taken care of. Presently what have explained regarding fever and skin rash seems a viral infection, but if you can share a picture, I will reconfirm it. Meanwhile, give these medications, syrup Cetrizine 2.5 ml once daily for three days, syrup Tempra (Paracetamol) 5 ml as and when she has a fever you can repeat it every four hours if needed." } ]

[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. My weight is 58 kg and height is 5'6\". My problems are gray hair and hair fall. I have an allergy to dust, perfume, and smoke. Sometimes, I have breathing problem and cough in early morning, I am working in shift. I am suffering with constipation too. My blood sugar is normal and my BP is 120/80. My blood group is O positive. There is no sugar or albumin found in my urine. For breathing problem, I am taking Montek-LC. But, there is no complete relief. Please suggest me some treatment." }, { "from": "gpt", "value": "Hi. The main reason for premature graying of hairs and hair fall is stress due to rotation shift. So, try to fix your shift. Take hair nourishing food like raisin, dates, fig, curry leaves and spinach. Avoid curd and pickle. Try to reduce your salt intake. Take Triphala Churna 1 teaspoon mixed with little ghee and more honey at bedtime for constipation. Tablet Asthiposhak 2 tablets after food twice a day for hair fall. Drink milk after boiling with a pinch of turmeric and pepper. It will improve your immunity and will help for hair growth too. But, it is common for everyone that 100 strands will fall every day. Use mild herbal shampoo to wash your hair twice a week. You can also apply Neelibringadi Thaila in your scalp 1 hour before hair wash or on the previous night." } ]

[ { "from": "human", "value": "Hi doctor, I feel itchy and a cut sensation in the corner of the eye and top of the eye lid. My eye lid looks crumbled in the morning. There is also some cut lines on the upper part of the nose and top of eye lid. I am suffering with this over last two days. But, I do not have any vision problem. I am attaching a picture for your reference. Please advice." }, { "from": "gpt", "value": "Hi. I have gone through the photo (attachment removed to protect patient identity). It looks like traumatic skin abrasions most likely nails, which do happen unknowingly when you are asleep. Just apply antibiotic ointment and clean with Dettol to prevent secondary infections and itchiness of eyes. You will be fine in three to four days." } ]

[ { "from": "human", "value": "Hi doctor, I have a problem. Can anyone help? It is just when I talk, even when it is dead quiet around me my voice will get progressively louder. And by the middle of my conversation, I will be nearly shouting. I do not understand or know why and it is affecting my daily life. It happens when I am at school, work, talking on the phone, or even talking to myself (I am a writer and I will say my character's lines out loud to see how they sound). Today I got called into my boss's office about it. Is there something wrong with me? I do not have the money to see a doctor or psychiatrist about it. Does anyone know?" }, { "from": "gpt", "value": "Hi. One of the reasons for loud volume while talking is hearing loss. Some mild hearing loss is not so evident to the person and usually, one of the first things a person does is speak loudly. To be sure about it you will need to get yourself examined by a specialist. Other causes can be getting into your characters makes you excited and that excitement reflects in day-to-day things. Or you get easily annoyed or irritated due to others and raise your voice to them." } ]

[ { "from": "human", "value": "Hi doctor, Yesterday, I woke up with bumps on my face and neck. It started off small and it was really itchy, so I itched the bumps and they started to get bigger. I washed my hands after and got some cream to stop it from itching. Later on, more bumps started to appear after itching my self and it’s on my fingers and the back of my neck, and I have no idea what I have and it’s hard to find treatments without knowing what it is. I do have a feeling it is an allergic reaction, since I ate a whole packet of sweets and it had a weird texture to it." }, { "from": "gpt", "value": "Hi. It is urticaria and you are right it is an allergic reaction. Urticaria can be due to drugs, any food material to which your body is allergic. You have to keenly observe and note the things that can flare it up or cause it. Do not worry. You will get better with proper treatment and medication. Urticaria. Urticaria. Apply Betamethasone propionate lotion, mix with Calamine lotion BD over the lesions. Take antihistamine BD like Loratidine 20 mg. Avoid things that flare it up. Do not eat food from outside the home. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." } ]

[ { "from": "human", "value": "Hello doctor, I have red rashes on the face for the past six months but its intensity changes frequently. Whenever I eat spicy or hot, go in the sun, its intensity increases otherwise redness decreases a bit. It itches sometimes, the skin is rough there. A year back, I went to the dermatologist and she recommended HH Sone cream. After that medicine, it got cured but it appeared after two months. Please help me." }, { "from": "gpt", "value": "Hello. I understand your problem. But you did not mention for how long did you apply HH Sone cream. All your symptoms match with rosacea. However, it can also be steroid induced skin atrophy if you have used the cream for a longer time. Kindly get back to me with details. Take care." } ]

[ { "from": "human", "value": "Hello doctor,I have had a dandruff problem for very long. So, I started shampooing my hair every day. Even then skipping even a single day of shampooing leaves my hair full of dirt and makes it completely oily. And an itchy scalp is always there no matter what I do. I have started losing a lot of hair recently and I think it is because of all the above problems I mentioned above. What would you suggest me to do?" }, { "from": "gpt", "value": "Hello. As you have told, you have a dandruff problem and oily scalp that is seborrheic dermatitis which can be mild or can be severe. And yes hair can fall due to dandruff problem. I will suggest a few things for this. For proper hair growth ensure proper diet with Vitamins and Minerals. For dandruff problem, use Zinc Pyrithione based shampoos. Take Biotin supplements that are very important for hair growth. Apply Zinc Pyrithione shampoo or Selsun blue shampoo three times per week. Take Biotin tablet supplements. Apply shampoo for 5 minutes and then wash it." } ]

[ { "from": "human", "value": "Hi doctor, My query is about premature ejaculation which is not letting me last longer and just wanted to know what could be done." }, { "from": "gpt", "value": "Hi. It usually occurs in the early days of becoming sexually active. Gradually the staying time gets better. Try diverting your attention during sex. More frequent sex or masturbation in between also helps. You can also try stop-and-squeeze technique just before ejaculation. Using a condom or applying anesthetic cream (small amount) to head of the penis just before intercourse may help. Finally, you can take medication for some time if all the above do not help (tablet Duralast 30 mg one hour prior to intercourse)." } ]

[ { "from": "human", "value": "Hello doctor, How far is the left ventricular diastolic dysfunction serious? I am 68 years old. I also suffer from diabetes, BP, heart issues. I have had an angioplasty done 10 years back and again an angiography five years back. Please advice." }, { "from": "gpt", "value": "Hi. You have LV dysfunction possibly due to a combination of hypertension and coronary artery disease. I would like to know whether the severity of LV dysfunction is critical or not, what type of LV dysfunction is there and what is the ejection fraction? I would be happy if you could send me 2D echo report for my perusal and prognostication." } ]

[ { "from": "human", "value": "Hello doctor, I am facing hair fall from the last 4 to 5 months. Also facing graying of hairs from last three years." }, { "from": "gpt", "value": "Hi. Does this problem exist in your family? If yes it is androgenetic alopecia that is common in males and related to male hormones. Premature greying of hair is also genetic and as such there is no treatment for reversing of grey hair. However, you can take Biotin supplements to reduce it. Use Minoxidil spray for this patch of hair (attachment removed to protect patient identity). Androgenetic alopecia? Use Minoxidil spray BD over the scalp. Take Biotin supplements." } ]

[ { "from": "human", "value": "Hello doctor, My back upper left molar had a cavity deep enough to warrant a crown last month. Since then, I have been back to the dentist twice to get adjustments on the crown, under the suspicion that its slight misfit with my bite was causing the dull-to-sharp pain I experience when I use that molar. Despite the adjustments, no improvements have been made. During both adjustments, the dentist asked me questions regarding the pain type, sensitivity, etc. (I would presume to determine if a root canal or something else is necessary) and nothing raised flags- No passive pain, no sensitivity to hot or cold air. I have pain from use only, but it is significant enough that I have not used the left side of my mouth to chew since that time. Should I go to another dentist to get a second opinion? I feel strange repeatedly going back to basically say he or she must be wrong and that no improvements are being made. Any advice would be appreciated." }, { "from": "gpt", "value": "Hi. In your case, there are three possibilities. The first line of treatment is as done by your dentist. After crown placement, slight misfit issues occur that need to be adjusted by trimming of occlusal or biting surface. It gets better soon after trimming or relieving pressure. Otherwise, it gives continuous pain only at biting. So by symptoms, you are having pain on chewing and your dentist has not trimmed it to your comfort level I guess, or you might be having very deep bite that porcelain surface space would not be available and it needs to be trimmed now and dentist is avoiding it as metal will get exposed and it will not look good aesthetically. 90 % of crown issues and pain gets fine by trimming high spots. Now the second line of treatment: If still pain persists and you feel the pressure inside the tooth, you experience pain at night or on lying down, or slight infection in gums right above the crown tooth, then it is an indication of root canal treatment. As the cavity was already deep, it was filled and then tooth was trimmed down for crown preparation so that it is vital and it becomes sensitive and there are only 10 % chances that your pulp of root might have been exposed or silent infection of cavity might have got triggered up after deep cleaning. So now, root canal treatment is to be done in such case. Or before attempting root canal if antibiotics are given, then such infection subsides and you might feel absolutely okay with this tooth during medications. After the course is over you will start feeling pain again. And then it would be better to opt for a root canal. The third line of treatment: If you do not have any root canal issues and still pain persists on chewing, then there is 1 to 2% possibility of fracture of the tooth due to uneven biting pressure over the crown. In such worst case scenario, extraction is recommended, the root canal does not help it. I hope this is not the case. Hopefully, you have a better idea of treatment options in your case. If you have further queries let me know. My advice is to go to another dentist and ask him to trim the crown as much as he can to make it comfortable, leaving aesthetics aside. If it does not work, do an antibiotic regime course it will work." } ]

[ { "from": "human", "value": "Hello doctor, I have cervical pain radiating to the right shoulder, neck, and arm until fingers. I have this problem for the past eight months and I am currently on medications for diabetics." }, { "from": "gpt", "value": "Hello. The symptoms that you have described point towards cervical disc issues with a small disc and bone (osteophyte) that is irritating to the right-sided nerve at C5-6 level as mentioned in the MRI reports. Usually, such cases heal within 6-8 weeks. On and off pain is common. But persistent pain in the arm and hand is nagging and decreases productivity especially if it is a dominant hand. We need to take MRI films to interpret the severity of the disc problem, know the handedness, know the exact location of the pain and if associated with tingling or numbness, and any weakness in the hand or arm. Until then do warm water fomentation. Apply pain killer gel locally over the neck and arm. Avoid lifting weights or jerks to the neck, and avoid bad roads." } ]

[ { "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, Right now, I am not on any birth control method except for the rhythm method. I have tried multiple birth control methods in the past, such as the implant, the pill, the ring, the patch and had annoying side effects with each of them. I had spotting that would not go away with the ring and implant probably due to low estrogen in the devices, compared to the pill. My doctor ended up removing the implant for this reason. I have used each method for a long enough period for my body to get used to them, so it is not like I have not been giving them a chance. With the implant and ring, it got to be too expensive buying so many pads or tampons and it really puts a damper on my sex life. In addition, when I was on the pill I was not very good about taking it on time. I am looking to try a long-term contraceptive method, that I would not have ongoing spotting with. I have heard that one can get the implant or an IUD and take estrogen or birth control pill that would stop bleeding in between periods. I would really like to receive some advice on this. Thank you." }, { "from": "gpt", "value": "Hello. You have described elaborately about your experience about all the contraceptives. For further information consult an obstetrician and gynaecologist online -->" } ]

[ { "from": "human", "value": "Hi doctor, Yesterday, I took the blood test because of excess gas release and in that my red blood cells showed some impressions. Please help. I have attached my report. I am afraid and shivering. Is there any problem in my blood test?" }, { "from": "gpt", "value": "Hello. Your CBC report is normal and does not suggest a specific abnormality. The red blood cell count is within the limit so do not worry about that. In the attached report, serum amylase and lipase are elevated (attachment removed to protect patient identity). So pancreas inflammation has to be ruled out. For that, you need to investigate with ultrasonography of the abdomen. Meanwhile, symptomatic management has to be done. For stomach pain, Rabeprazole antacid has to be prescribed. For gas problem Simethicone containing tablet or syrup has to be prescribed. After one week, repeat your serum B12 level. It is water soluble vitamin, so mostly it will bring down to the normal level after a few days. I suggest you consult a nearby physician for detailed evaluation." } ]

[ { "from": "human", "value": "Hello doctor, I have skin peeling on my glans penis and also some white dots near the skin joint on glans. It is a bit itchy too and there is no white discharge. What would you advise? More details about the presenting complaint: Started 2 to 3 days back. I did have intercourse." }, { "from": "gpt", "value": "Hi. I have gone through your case. Keep your skin well moisturized by frequent application of liquid Paraffin. Mix Hydrocortisone and Clotrimazole cream in equal amount and apply two times a day for 14 days. Maintain good hygiene. Avoid friction." } ]

[ { "from": "human", "value": "Hi doctor, I had a bad throat recently and I took Doxcef 200 for five days from a previous prescription thinking it would help. However, now I have a throat ulcer I guess as my throat hurts when I gulp. It is predominantly on the right side. It happened once last year and based on that prescription, I am doing Betadine gargle and taking Bevon capsule once a day. I am not taking Rebagen although doctor prescribed. There is no improvement and moreover, I feel that my stomach is gassy all the time with belching. Please let me know how I can take care of this." }, { "from": "gpt", "value": "Hello. I would say that you did a mistake by taking the medicines from the previous prescription. Most likely you have caused unnecessary gastritis due to proper dosage of antibiotic pertaining to the current problem. Most of the throat problems like soreness and cold are due to viral causes and seasonal changes. On top of those weather changes and allergy and pollution add to the soreness. One does not need a strong antibiotic like Doxcef 200 every time this occurs. If you had consulted one of us we would have guided you on how to go about. Now that is you have taken a course of strong antibiotic, it is likely that the friendly bacteria in your stomach have got destroyed and resistant bacteria have colonized causing vitamin deficiencies. These cause the current problems you face. You need to stop the gargles. If possible take a picture of your throat with open mouth showing details of the back of the throat with tonsils and send to me. Would like to check if there is post nasal drip, granular pharyngitis, allergic mucin, tonsillitis, etc. Nextly, you need to follow some dietary changes until you get better. You would need a proton pump inhibitor taken in empty stomach for appropriate dosage as per your weight. Depending on the symptoms you may need a prokinetic drug like Domperidone. To help you better I want more details about your problems and habits. 1. Gas formation occurs after diet or its when your stomach is empty, that is, between meals? 2. Smoking, drinking or tobacco chewing or pan paraag? 3. Alcohol intake? 4. Type of food: spicy, oily? 5. Vegetables and fruits in the diet? 6. Bowel habits - normal, loose or constipated? 7. Burning sensation in the mouth? Do revert back with more details so that we can guide you appropriately." } ]

[ { "from": "human", "value": "Hello doctor, A portion of right lower number 7 tooth chipped off (the light cured section was done two years back) along with partial silver filling done in that tooth during taking food. The dentist took an X-ray and suggested RCT with a crown. I have started the RCT but she has said that the RCT will be completed in two sessions. My questions are: My previous experience with RCT is that it took 5 or 7 sittings. Can RCT be completed in two sittings? Can I go for a permanent filling after RCT rather than going for the crown as suggested?" }, { "from": "gpt", "value": "Hi. Your first concern is regarding the number of days of your RCT. RCT can be done in a single session or 2 or 3 sittings depending upon the severity of your case. If there is severe pain or infection, the dentist may have to delay for treatment for 3 or 4 sittings. You should go for a permanent filling after RCT, which is mandatory. But, you definitely should wear a crown because your teeth are more brittle after RCT, so there is more chance to break off. You can go for a crown after six months once you make sure you have got no pain." } ]

[ { "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": "Hi doctor, I am a 30-year-old male suffering from infertility. Recent semen analysis test shows no sperm found in semen, FSH- 0.08, LH- 0.02. Total test 3460.80 results. What should I do?" }, { "from": "gpt", "value": "Hi. You are suffering from azoospermia. Pre and post-testicular azoospermia are frequently correctible, while testicular azoospermia is usually permanent. Go for serum prolactin level, a testicular biopsy may be required to find out the exact cause so I would advise you to consult local urosurgeon as physical examination is also required." } ]

[ { "from": "human", "value": "Hello doctor, My bipolar girlfriend just broke up with me. She told me that her medicines were stolen at the beginning of a trip. 75 pills stolen. She started acting differently after about three days. After five days, she broke up with me saying she did not want to drag me down with her. Now she has quit her job and quit school to move away and follow a dream. My questions are that are there bipolar medications that have street value? Can an abrupt stop to medication cause someone to relapse that fast? How long does it take to come out of this episode?" }, { "from": "gpt", "value": "Hello. Bipolar illness is a severe mental illness. It needs constant treatment. Stopping or switching the medicines on your own can lead to relapse. Medicines are provided by a registered medical practitioner and cannot be sold OTC (over-the-counter). She has to be started on medicines. She cannot come out of it on her own. Without medicines, her condition will worsen." } ]

[ { "from": "human", "value": "Hi doctor, I am an 86 year old healthy male. I had sudden seizures. What is the reason behind it? I have attached my MRI brain with this. Please explain." }, { "from": "gpt", "value": "Hi. I have read through your query and reports (attachment removed to protect patient identity) in detail. Please find my observations below. There are mild age-related changes like prominent markings on the surface of the brain, prominent ventricles which are fluid spaces and periventricular hyperintensities. This is expected at 86 years of age. There are few small hyperintensities on T2 and FLAIR (fluid-attenuated inversion recovery) in the white matter which is probably due to small vessel ischemic changes and is acceptable at this age. Mild bilateral maxillary sinusitis is noted. This is not related to the seizures and is an incidental finding. There is no tumor or bleeding in the brain. There is no obvious acute infarct. Cerebrovascular disease, infections, primary neurodegenerative disorders, brain tumor, traumatic head injury, stroke, and acute metabolic disturbance are the most common causes of seizures in the elderly and no specific cause has been found in this scan. Sometimes early scans can be normal. It is important to know if the patient has any medical condition (though it is mentioned normal health) and whether any abnormal laboratory tests have been found. Seizures can happen due to sudden abnormal electrical activity in the brain. Keeping in mind the seizures it will help to do electroencephalography (EEG) to know the probable site of abnormal brain waves which triggered the seizure." } ]

[ { "from": "human", "value": "Hi doctor, I am a 20 year old boy. I am suffering from hair fall. How to get it cured? Please advice." }, { "from": "gpt", "value": "Hi. It is very normal for around 100 hairs to fall each day. We do not notice this because all of those do not fall at once. Second of all, I would like to ask you whether is it hereditary on your maternal and paternal side? It is called androgenic hair loss. With these major queries ruled out, I would shift the focus on diet and sleep. Diet should be regular with a lot of greens and milk. Eat a good amount of protein as this should reduce the rate of hair fall and also provide a good body to your thinning hair. Hair is precious and does not play with it by trying out new brands with overwhelming claims. Stick to a gentle daily cleanser, medicated products are much more quality assured than fancy brands in the market. Hence, I suggest you use products like Kerawash shampoo and a good conditioner. Washing your hair at least three to four times a week is mandatory. Conaderm (combination of Ketoconazole and Zinc pyrithione) is good for dandruff. But if there is no dandruff and simply continuing with the anti-dandruff shampoo will eventually cause hair loss on chronic repeated use.Any medication beyond a particular time period will cause a side effect. So, stop using it if the desired result has been achieved. If not then treat dandruff first. The only shampoo will not help. You have to take medicines and use an anti-dandruff shampoo at the same time. The proper way to use an anti-dandruff shampoo is to apply it on scalp rather than the hair and once desired foaming is achieved, let it stay in the head for 2-3 minutes so that the medication has got sufficient time to act on your scalp. Observe good hygiene wherein you wash your pillow cover every four to five days in summer and seven to eight days in winter. Because the germs causing dandruff can be inside the pillow cover and after you shampoo and clean your hair, it can come and sit there again when you sleep so the treatment has got no effect overall. If it is a hormonal problem, then we need to start the medicine as soon as possible so that to control the effect of hormones on your hair.Once desired control is achieved over a period of two months then we can shift the focus on regrowing the lost hair and cover the bald patches.Send me some clear pictures of your scalp of different parts and we can start treatment as soon as possible. Do not worry, it is just a matter of time before we control your hair fall and you can have your desired hairstyle done. Stay positive." } ]

[ { "from": "human", "value": "Hi doctor, I recently took the Alere Determine HIV-1/2 Ag/Ab rapid test. The counselor used two drops of buffer. The test brochure said to use only one drop. I would like to know whether the test is still valid or not." }, { "from": "gpt", "value": "Hi. Yes, the test is valid. There is nothing to worry about." } ]

[ { "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 -->" } ]