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qucklecrabik
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mc_dataset

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train · 257k rows

conversations listlengths 2 2
[ { "from": "human", "value": "Hello doctor, I have been having very irregular periods since I began getting them. I have been on birth control to help manage and track them, but as of recently, I have been having more sporadic periods. For instance, from the beginning of January through the end of February, the pill I was on was no longer helping and I was on my period for two weeks at a time with five days gap in between each period. And I have been experiencing more intense cramps during my period that start in my lower abdomen and extend through to my butt. If I had to describe it, it feels like a stabbing pain from my belly button straight through my body to butt if that makes sense. I am 19 years old and I have never been to a gynecologist. Please help." }, { "from": "gpt", "value": "Hello, Welcome to iclinq.com. I can understand your concern and what you are going through is a hormonal problem. The regularity gradually sets in with maturation of the HPO (hypothalamic-pituitary-ovarian) axis ( as you grow older), and the treatment of choice is hormonal pills. The possibilities of your problem despite pills maybe 1) Missing pills in between. 2) Taking pills not on time (these two are the most common causes for such a scenario). 3) Dose of the pill may not be enough. However, as you are complaining of severe pain, have an in-person gynecologist opinion. USG (ultrasound) abdomen is done to rule out uterine, and ovarian pathology. Nothing big to worry about and continue with hematinics. I hope this helps. Hormonal. USG abdomen and pelvis, Hb. Uterine/ Ovarian causes. Hormonal. OCP (oral contraceptive pills) after the scan. Excess weight gain can alter your cycle, so concentrate on weight reduction and iron-rich diet." } ]
[ { "from": "human", "value": "Hi doctor, I have been struggling with skin problems since I was a baby. I was told I have eczema and not allowed to eat things like tin food and my body gets itchy when I play in the grass and after taking a bath. I get a rash, teary eyes, runny nose, when seasons change my skin gets dry too especially in winter. Now as a 25-year-old female my skin tone is uneven, my face is worse, at times my lips and eyelids swell up and I am not sure why. I have recently been using some products for a month and I still see no difference. Which skin repair products can you recommend?" }, { "from": "gpt", "value": "Hi. You are suffering from atopic dermatitis. You have a family history of atopy. You have all the symptoms of atopy that is runny nose, eyes problem and now swelling. It is a condition in which a person has an inherent tendency of being allergic to so many things. We have a natural moisturizing factor in our skin but that factor is missing in atopic individuals. That is why skin is very dry and itchy. It is affected by different climatic conditions, whether change, clothing, infections. In some people it can get better with age, in others it continues for long periods. You have to avoid the factors that aggravate your condition and I will also suggest you take opinion from an eye specialist as well. Your medications are correct. The main thing is to moisturize the skin. Atopic dermatitis. Atopic dermatitis. Apply white soft Paraffin plus liquid Paraffin and apply over body 3 to 4 times a day, take antihistamine tablet, mild steroid preparation like Hydrocortisone ointment can be used if skin feels inflamed. Apply moisturizer to your face. Use sunscreen for face. Avoid long baths in water, avoid woolen clothing, Immediately moisturize your body after taking a bath, avoid extremes of temperature, do take opinion from an eye specialist." } ]
[ { "from": "human", "value": "Hello doctor, I recently started getting cystic acne all over my cheeks and chin. I am 21 and I had never had any problem with acne until about nine months ago when this red, inflamed underground acne started occurring and mostly only on my cheeks. It has been five months since my last big flare up, acne trickling in now, and I have had dark red marks left behind. I have been using a gentle cleanser, Vitamin C products, prescribed antibiotic ointment, moisturizer, and sunscreen. I wash my sheets and pillow cases every week, avoiding foods that encourage inflammation. My skin is healthier than it has ever been but these marks have not gotten any lighter whatsoever. What do I do? I am ashamed to have anybody see me without makeup on. I want my face back." }, { "from": "gpt", "value": "Hi. I can understand. Do not worry. You will get better. Kindly attach pictures of your lesions for proper diagnosis. Have you taken oral medicines for your acne? I am prescribing you night cream. Hope you will get better with it. Continue with your rest of treatment. Acne. Acne. Apply Tretinoin gel plus cold cream at night. Continue your rest of medication. Maintain hygiene of area. Wash with soap and water. Avoid using Dettol and other irritants." } ]
[ { "from": "human", "value": "Hello doctor, I just did some EKGs on a portable device and they all said not abnormal. Would just like an expert to look them over to make sure they agree and it is correct? I just started Citalopram 10 mg for about five days and now on 20 mg daily for the past two days. Saw that it could cause a QT prolongation. So, just wanted to make sure this was not occurring." }, { "from": "gpt", "value": "Hello. After carefully reviewing your uploaded ECG recordings, I would like to assure you that your QTc interval is not more 440 ms, which is not dangerous or life-threatening for a female patient. Coming to this point, you are not actually at an increased risk of cardiac arrhythmia under your current therapy (Citalopram). In addition, I would recommend to frequently control your ECG (at least every three months) coupled with blood electrolytes levels and avoid any potential adverse events induced by this therapy." } ]
[ { "from": "human", "value": "Hello doctor, My blood work is showing high WBC and RBC. WBC is 11.3 (normal should be 11), and RBC is 5.14 (normal should be 5.0). Neutrophils are 7.6 (normal should be 7.5). Erythrocytes are at 2 not showing the normal number it should be at. However, it is flagged as high. My alkaline phosphatase is at 121 (normal should be 120), and alanine aminotransferase is showing at 75 (normal should be at 36). I also had an ultrasound done and showing 3.5 cm of bile sludge. Would these results indicate to you that I require gall bladder surgery? I do have pain under my right side rib cage into my right side upper back- tolerant pain. So my surgeon said to think about gall bladder surgery. Do my blood results and sludge showing in ultrasound reflect that I should have this surgery?" }, { "from": "gpt", "value": "Hello. The concept of when to get the surgery depends upon how much pain you have, how bad is the underlying disease and how long you have the inflammation. Given the history of pain, a slightly elevated white count, abnormal liver function test and biliary sludge. It would be a good idea to consider laparoscopic gallbladder surgery. The timing of the surgery whether to do it during an acute attack of pain or as an elective procedure depends upon the surgeon you are seeing." } ]
[ { "from": "human", "value": "Hello doctor, I have white bumps on the face. Please advise the treatment." }, { "from": "gpt", "value": "Hi. These are milias. These are small keratin cysts that appear on the skin. There are different treatment options available for it. But the best and definitive treatment is to cauterize it. Milias. Milias. Apply Tretinoin gel plus cold cream on the whole face at night. Cautery of the lesions from a nearby health facility. Maintain hygiene of the area, wash with soap and water, avoid using Dettol and other irritants." } ]
[ { "from": "human", "value": "Hello doctor, We are married for three months, and my wife has not got pregnant yet. We are continuously tracking the cycle and ovulation days since the first month to have effective intercourse. We barely skipped a day during the fertile window for the last two cycles. My wife also gets early pregnancy symptoms to some extent every now and then but conception is not getting through. Any precautions to take care or any advice to increase the chances." }, { "from": "gpt", "value": "Hi. There are a few precautions that can be helpful. Three months time is just start so not to worry actually if she has regular cycles. I will advise some healthy lifestyle habits, some precautions. Have a balanced weight and BMI by having a daily walk and exercise. It reduces the risk of medical issues and hormonal imbalance. Have recreational activities to have better emotional and mental health. For males, better to quit smoking as it reduces fertility and can show some effects on the fetus. Have complete treatment of any health issue you have. A woman should take Folic acid daily if normal BMI and no chronic health issue, then 0.4 mg and if high BMI and health issues then 5 mg daily. Have a balanced diet with less salt, sugar, oil and spice, more fish, dry fruits, vegetables, and fruits. Have sex in the fertile period of the cycle, check positioning during sex to have better penetration and female better to stay asleep after sex to move semen gradually to the destination rather than move and wash away in the toilet. Actually, investigations and treatment need to be taken after complete one year of unprotected sex without conception." } ]
[ { "from": "human", "value": "Hi doctor, I have a spot on my skin for about two weeks and is not healing. It started out like a pimple and is now spreading. I thought it was an infected pimple and applied Bactroban which did not help. It tingles and burns.I do not know whether it is a fungal infection or not. I had something similar to that last year, and that took long to heal as well. It healed and left a dark mark on my face as you can see in the picture.I had a blood test done, and everything came back normal. I am taking Multivitamin, Vitamin D and B12 now. The spot is bothering me because I am very fair and it is right on my cheek." }, { "from": "gpt", "value": "Hi. I am sure your problem is distressing and is affecting you severely. Let us understand your case. Since you are a very fair skin type patient, you are naturally more exposed to sun radiation which is UV-A and UV-B (ultraviolet A and B) rays. In effect what it does is, it disrupts the self-healing power of your skin and makes you more vulnerable to sun damage. The damage surmounts over time and the net result is skin changes along with the symptoms you described in your questionnaire. Microscopically, the cells in the deepest layers undergo irreversible changes and the cellular environment becomes a very rampant scenario where the speed to clear the damaged cells falls short of the rate at which the cells are damaged. So it results in pigmentation, slow or non-healing and damage at the molecular level. In my professional opinion, gauging from the picture (attachment removed to protect patient identity) alone my diagnosis goes in favor of discoid lupus erythematosus or DLE. It is a chronic or longstanding skin response to sun damage. It is a reversible benign condition if we institute the treatment right away. However, if we leave it to change letting time be the healer, it can transform itself into a more severe form of skin condition. It would include wearing a good sunscreen like SPF50+ (sun protection factor) or SPF70 with PA+++ on a daily basis. It should be applied liberally on all the sun-exposed sites of the body like arms, face, neck, etc. You must apply it 15-20 minutes before going outdoors. It should be reapplied again after 2-3 hours. If the face becomes oily, it is a good idea to cleanse the face with a face wash and then reapply the sunblock. My advice is to visit your dermatologist and take a skin biopsy to analyze the edges and the cell changes to clinch the perfect diagnosis. Biopsy is the definitive diagnosis. The treatment option is adequate sun protection. You can use mid-potent steroid cream like Mometasone on the affected part every night for 12-14 days and you can see a dramatic improvement. Avoid sun at all costs. Use a cloth to cover the area when you go outside. Strict sun protection is the cornerstone of the treatment. Try eating more of beta-carotene in diet from sources like carrots which act as natural sunscreens." } ]
[ { "from": "human", "value": "Hi doctor, I am suffering from acute eruptive lichen planus. I consulted a doctor and had some medicines. But still the marks are there and itching too. I am applying Lobate cream. Even now I can see new eruptions especially in my legs which are red in color and itchy. Please suggest some good medicine" }, { "from": "gpt", "value": "Hi. Lichen planus is a chronic and self-limiting disease. It has been seen that skin lesions subside within 9-12 months in about 50 percent of the cases. Since you are still developing fresh lesions you will have to take a course of tablet Prednisolone 20 mg daily for 6 weeks which can be reduced gradually. You seem to have severe itching which is not responding much to Levocetirizine. I would recommend you take tablet Hydroxyzine 25 mg twice daily till the itchy subsides. Along with this apply Clobetasol propionate on the itchy areas. But if large surface area is involved, dilute it in a moisturizing lotion in the ratio of 1:4. This will surely help you. 1. Immune dysfunction. 2. Genetic causes. 3. Dental amalgam. 4. Stress. 5. Anxiety. 6. Depression. Lichenoid drug eruption. Lichen planus. Reduce stress and anxiety." } ]
[ { "from": "human", "value": "Hi doctor, This morning I took my usual stimulant, but at a higher dose (Vyvanse 50 mg, rather than the usual 30 mg). In addition to the usual coffee, I have tried for the first time a dietary supplement with caffeine (200 mg), Niacin (10 mg, 50% daily value), and vitamin B12 (1000 mcg, 16,667% daily value). Now, I am experiencing accelerated heart rate and in particular, irregular heartbeat. It was usual with what I have taken so far, and I will not repeat this mistake. However, I would like to understand whether I need urgent care or not. I have attached the ECG, and I have recorded it with my mobile as it has a heartbeat sensor." }, { "from": "gpt", "value": "Hi. I welcome you and 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. I have seen the heart beat monitored through your smartphone (attachment removed to protect patient identity). I want to assure you that this is not a big concern of medical emergency. You need not worry as it is a temporary increase in heartbeat. You will soon be normal. You need no antidote as your body will adjust at its own. When there is a high dose of the stimulants in the body, the heart rate increases due to the effects of the drugs. Our heartbeat increase and it is sensed by the sensors. It leads to an increased parasympathetic activity and that causes a decrease in the heart rate and heart beat goes normally. This is a natural reflex activity that happens in all. You also will get normal heart rate and normal heart beat. I do not think this is a medical emergency and you need not worry much. Relax and sit calm. I am happy to know that you will not do it again. It is necessary to know that if you will do it again and again it will have very dangerous effect on the heart and may cause severe damage or heart failure due to enlargement or sudden cardiac death which occurs in severe cases when heart gets an abnormal rhythm (arrhythmia). The heart beats in the mobile sensor are not reliable but I have seen hundreds of them. So when I decode yours, it is harmless for now. There is nothing significant. Nothing needed much. Take plenty of water and avoid caffeinated drinks of any type." } ]
[ { "from": "human", "value": "Hi doctor, Five years ago my mother was diagnosed with fibromyalgia. I think she also has rheumatoid arthritis. For the past five years, she was managing the pain with anti-inflammatory medicine, Lyrica, Mythycobal, Voltaren injections, herbal creams, etc. You can see the veins in her hands popping out. I also realized that the pain has got worse now. For about 12 months the doctor put her only on Prednisolone 5 mg/day and painkiller when necessary. She was fine till last month but the pain increased in her hands now. In the daytime she is fine and the pain starts mildly in the evening. When she lies down in the bed she gets electrical tingling in her legs by which her sleep gets disturbed. She has undergone several tests last week and I attached them for your reference. She did not consult a rheumatologist yet. What medication can I give to reduce the inflammation and cure her? Her ESR, CPR, and ANA are quite high. The pain in her hands and the tingling in her legs at night are agonizing her life. Kindly provide your expert advice." }, { "from": "gpt", "value": "Hi. First of all your mother does not have rheumatoid arthritis or fibromyalgia. From her reports (attachment removed to protect patient identity) I found that she has connective tissue disorder and the most possible diagnosis would be systemic lupus erythematosus (SLE). The joint pain, high ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), positive ANA (antinuclear antibody) and response to Prednisolone favors the diagnosis of connective tissue disorder. She definitely does not have functional pain which occurs in fibromyalgia. Her pain and suffering are very true.Now to help you better I need some more details: Revert back with the answers for the above questions to a rheumatologist online -->" } ]
[ { "from": "human", "value": "My wife age 46. Suffering from heavy blooding during menstruation period. She came into same phase after eight months.(almost eight months no periods at all). Periods started on 13 days back, continue till date. Using 5-6 senetary pads during each day. Also passing through senior abdominal pain several days...also having complain of constipation since last three days. Consult local physician and than gynecologist in my city. She is swollowing medicines as per below... Tranexa mf/Trexakind thrice a day. Spasmodart/voveran if abdominal pain persists. Shelcal one per day. From yesterday she is taking injection of aquairon 25mg. (Three prescribed by local gynecologist. One taken) Also feeling weakness. I want second opinion and finest treatment suggestions online.... Please guide on above case and suggest finest treatment" }, { "from": "gpt", "value": "Hello, Thanks for the query, With the history, it is clear that she is in her peri-menopausal status and experiencing menorrhagia or excessive bleeding since 13 days, which is often seen in peri-menopausal women. She has been given antifibrinolytics in form or tranexa-mf which is fine, but if bleeding is still not getting controlled then she would require an ultrasound pelvis first to check for her present endometrial thickness . If the endometrial thickness is still more than 9 mm then she would have to be started on progesterone pills for 10 days to control bleeding along with diosmin and antifibrinolytics together. Also if she is feeling dizziness and weakness, then she may require hospitalization for intravenous support as well. Regards" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am getting wisdom teeth at the back of my mouth. Now I am 22. But I am teething and it feels uncomfortable. What to do to get relief from it?" }, { "from": "gpt", "value": "Hi. Wisdom tooth eruption will occur periodically. You will feel pain and pressure in months. For relief, you may take tablet Brufen 400 mg twice a day for three days. Put oral gel Clinica (Chlorhexidine with Metronidazole) three to four times a day for a week in that particular area. And lastly that is most important, do saline water mouthrinses three times a day for two weeks. It will relieve the soreness of gum areas. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses." } ]
[ { "from": "human", "value": "Hi doctor, Currently, I am using Epiduo (Adapalene + Benzoyl peroxide) gel for acne treatment. My doctor advised me to not to use any other beauty product. Because of winter my skin is becoming dry now. So, can I use any cold cream along with Epiduo? If yes, which one can I use? It has controlled acne for some extent but still pimples are there in my face. So, please suggest me any other tablet to control acne." }, { "from": "gpt", "value": "Hi.I have noted your complaints. In such a situation, the following strategy works efficiently. It takes several months to control acne even if these are moderate intensity. Therefore, waiting, for now, would be ideal. In general, your current treatment is something which is both ideal and effective while being safe. Have faith and do your best under guidance. I hope you will notice further improvement in the coming weeks and get good results." } ]
[ { "from": "human", "value": "Hello doctor, I had an MRV done. In the report, it said my right internal jugular vein was not visualized at the skull base. What could this possibly mean? It was never followed upon. I get terrible headaches." }, { "from": "gpt", "value": "Hi. The internal jugular vein carries blood from the brain and neck area to the heart. There are many reasons for the non-visualization of the internal jugular vein on MRV and the causes can be technical due to slow flow of blood or can be due to a mild compression of the vein due to a secondary cause. Rarely it can be from a thrombus in the lumen of the vein. If the MRV of the brain and rest of the internal jugular vein is normal, then the non-visualization is likely due to technical reasons and is artefactual. If you are having headaches, then it is better to talk to your doctors and get a neck venous Doppler done to rule out any external compression of the vein or any luminal thrombosis of chronic nature." } ]
[ { "from": "human", "value": "Hello doctor, Most often, I have heard from doctors that there is a liquid between every joint which is similar to an oil or grease to gears in the vehicle. They say, when we crack our bone, an element of that liquid gives the cracking sound and if we do it often, then the liquid declines and we can have severe joint pain. Now the question is that chiropractic doctor most often cracks the bones which may relax for time being but would give severe pain after 50 years of age, is this fact?" }, { "from": "gpt", "value": "Hello. Cracking of joints is not advisable as there is a release of nitrogen molecule which in later stages can give trouble to joints more. In chiropractic practice, there is just unlocking of the joint so that the sensory system which is located over the joint gets released of the pressure and pain comes down. Now to make it more principle way, when there is pressure on the joint this might be due to the weakness of the muscle. As the muscular system acts as a support system to maintain the gap between the joints so that the proprioceptive system of the joint do not get pressure and also joint friction is avoided. I would advise you that you focus on strengthening the muscular system so that the pressure on the joint can be relieved and also the joint proprioception do not get trouble. Please feel free to contact me if you have any questions. Reduced joint space. X-ray. Ligament injury. Knee injury. Exercise." } ]
[ { "from": "human", "value": "Hello doctor, I am coughing yellow colored mucus or sputum for almost a week now with post-nasal drip. Does this mean I have a bacterial infection and I need antibiotic? Please look at the attached image." }, { "from": "gpt", "value": "Hi. I read your complaints. You have been having yellow colored sputum which means that you have an infection for sure but then does not mean that it has to be a viral or bacterial infection. If you have a fever and you have a productive cough like this then you will have to have an antibiotic for now. Then, when you do not have fever and just only this cough and sputum I would advise you to take medicine called Fexopen 120 milligram at night for five days and then you try steam inhalation for about five days everyday once. At this point in time, do not advise any antibiotic. I would also want you to get a basic blood investigations CBC and a chest X-ray as well to look for what kind of infection. If you have been smoking I would advise you to strongly quit smoking at present and also forever. I do not think that you will require an antibiotic if you do not have any fever. But if you do have a fever please let me know." } ]
[ { "from": "human", "value": "Hello doctor, How common is it to develop a blood clot or PE with no underlying clotting disorder, surgery, not on birth control, etc.? Like can a PE happen out of nowhere? Or is there always a culprit?" }, { "from": "gpt", "value": "Hello. Usually, there is always an underlying risk factor for the development of deep vein thrombosis. Advanced age, genetic conditions, smoking, obesity, trauma, surgery, etc., are some of the risk factors. The genetic disease includes protein C deficiency, protein S deficiency, prothrombin gene mutation, etc. So it can be ruled out by full coagulation profile testing. Low molecular weight Heparin and oral anticoagulant drug like Apixaban are the modes of treatment for that. Usually, there is always some risk factor present for PE." } ]
[ { "from": "human", "value": "Hello doctor,The last exposure was a year back, had pin-prick sensations on head and arms. After three months, I had three HIV tests, two were blood and one rapid test oral. Eight months later, I had a PCR RNA qualitative and another fourth-generation blood test antigen and antibody, both were negative. I also got tested for Hepatitis C, HTLV I and II. But signs of lipodystrophy are present, fat relocation to the abdomen. Legs are thinning. Low testosterone, lipid abnormalities as well. Elevated sedimentation rate and CRP come and go as well. I really think this is HIV but if it does not show up on a test I cannot get treatment. Or if this is not HIV what else should I get tested for?" }, { "from": "gpt", "value": "Hi. As per description, you are more obsessed with HIV rather than the actual scenario. Any infection will have a remnant in the body, called the footprint of the infection. In case of HIV, the virus leaves its particles in the body, of which p24 is the core protein that protects HIV DNA. For HIV to infect human CD4 cells, it needs to break this core protein and release RNA material from the virus which passes to human cells and then further replication continues and the virus spreads through the body. So, we test for p24 particles in the body. If they are present, then you are infected and if it is not present, then you are not infected in any case (even you highly suspect or think). So, the fourth generation detects, not just these particles but also the body's response to these particles, called p24 antibodies. So, if you are negative after three months by this test, then there is no chance of being positive with the exposure. You have to accept the truth. And coming to other conditions, lipodystrophy, check for the endocrine problem which may be a cause of low testosterone. All your complaints may have undiagnosed conditions but HIV is not at all the cause. Do not be obsessive, accept the truth that you are free of infection." } ]
[ { "from": "human", "value": "Hello doctor, I get tanned really easily. My skin is super sensitive. None of the sunscreens really helped me with this problem. If I am under the sun even for five minutes, I get super super tanned." }, { "from": "gpt", "value": "Hi. Which sunscreen are you using and its SPF? Actually, sunscreens are of two types. Physical and chemical. Physical sunscreen is better in protecting from suns radiation but the problem is that they are not cosmetically acceptable. Because they are visibly seen on the face. I will suggest you use topical Vitamin C preparation along with your sunblock. Properly use sunblock of SPF 60 frequently. Apply it every two hourly and evenly. Apply sunblock of SPF 60, Use Vitamin C preparation BD." } ]
[ { "from": "human", "value": "Hello doctor, I have recently had an MRI and ultrasound scan for acute cholecystitis and they showed multiple cysts and a 16 cm x 12 cm cyst in my liver. Please could you tell me is that large for a cyst as I have been told it needs further surveillance. It is showing two benign looking hepatic cysts." }, { "from": "gpt", "value": "Hello. A 16 cm cyst is a bit large cyst. A few more details about your condition would be quite informative. Have you ever had any pain in the abdomen or jaundice in the past? Any contact with sheep, any pet dog? Kindly inform what was the management for acute cholecystitis, was cholecystectomy done or just managed with antibiotics and other medicines? If it is possible to upload the images or reports of the ultrasound and MRI, it would be really helpful to give a comprehensive opinion." } ]
[ { "from": "human", "value": "Hello doctor, I have a question about HPV. I am a 28-year-old male with one genital wart and I wanted to know if this is for life? Will this keep coming back every so often? What are the best ways to get rid of the wart and a way to prevent them from coming back? I also read that the immune system plays a big part in clearing the virus. I was thinking about taking medical mushrooms and Inosine Pranabox for immune boosting." }, { "from": "gpt", "value": "Hi. Warts are treatable. Kindly always attach the picture of the lesion for reference. It is not necessary that warts come and go. Once you are treated properly it does not mean you have to suffer from it again and again. It is human papilloma viral infection. This virus has 150 types because our immunity has to fight with this. That is why it is very important that our immune system should be healthy. The best treatment for genital wart is cryotherapy. Other can be CO2 laser. Sometimes a small wart can shed off itself but that depends upon the type of the wart. To boost your immunity you can use Zinc preparation. It has a role in preventing further warts. Genital wart. Cryotherapy for wart. Use Zinc preparation to prevent it." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I just want to know how long do you have to wait to get tested for hepatitis B? I got checked for the first three months and it was negative. I am just nervous thinking was it too early? Six months later I did a liver test and blood test and everything came back fine. I just want to know should I get rechecked or am I good? Are liver tests good enough to check for hepatitis B and C?" }, { "from": "gpt", "value": "Hi. It is very important to know, why are you willing to get hepatitis B and C tested? If you had exposure, please mention what exposure it was. Also, mention when did you get the exposure and when did you get the test done?" } ]
[ { "from": "human", "value": "Hello doctor, What are these lesions?" }, { "from": "gpt", "value": "Hello. Please provide me with more details. How does this lesion develop? Any recent history of unprotected high-risk sexual intercourse? Any discharge from penis? Any pain? The lesion appears to be vesicle (attachment removed to protect patient identity)." } ]
[ { "from": "human", "value": "Hello doctor, I get angry easily and I become violent. Then I hit my wife due to no fault of hers." }, { "from": "gpt", "value": "Hello. It is not acceptable to be violent toward your spouse. Domestic violence is a crime. Many families break apart due to domestic violence. It is positive that you are insightful of your anger issues and want to seek help. Have you always been an angry person since childhood or is it something you developed in recent years? Are you violent outside home as well? Are there any stressors in your life contributing to your angry outbursts? You will benefit from counseling for anger management. It will also be helpful to understand whether there are any underlying emotional problems that are driving your anger. You can also try these self-help interventions. It is important for you to develop positive coping strategies. Try to have a positive relationship with your family members even though your views may be different. Try to look at the good things provided by your family. Exercise regularly. It will lift your mood and help you to feel good about yourself. Do not isolate yourself. It will worsen your situation. Try to open up and talk to like-minded people. Eat regularly and sleep well. Avoid alcohol and too many fast foods. Try yoga or meditation to calm yourself. Try progressive muscle relaxation exercises and deep breathing exercises." } ]
[ { "from": "human", "value": "Hello doctor, I had a rhinoplasty performed 3.5 weeks ago. About a week after the surgery, I developed some form of dermatitis on my nostrils. My surgeon prescribed me with antibiotics and steroid cream. It helped and cleared up temporarily. He advised me to use Vaseline on the area to help wound healing. Although three days later, dermatitis has flared up again. I am very concerned." }, { "from": "gpt", "value": "Hi. It seems like post inflammatory erythema and few follicular papules over your nasal area (attachment removed to protect patient identity). A simple bacterial infection could be the cause that can happen after surgery. Please avoid using steroid like Hydrocortisone preparation over the area. Rather use an oral antibiotic. Did you notice any fluid-filled lesion over nostril? I mean blister? You will get better with an oral and topical antibiotic. Do not worry. Bacterial infection, post inflammatory erythema. Tablet Co-Amoxiclav 1 gm BD for one week, apply Fusidic acid ointment BD, take antihistamine tablet OD. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." } ]
[ { "from": "human", "value": "Hi doctor, I am 33 years old female smoker 170 cm, 72 kg and recently have my MRI scan on the brain. My reason for MRI was dizziness, headaches, and pain in joints, legs. Can you please tell me your opinion about the result? This the impression: T2 FLAIR hyperintensity foci within the white matter in the centrum semi ovale and near the vertex which are more than expected given patient's age. The distribution is non-specific. Most of these are atypical for demyelination." }, { "from": "gpt", "value": "Hi. I understand the issue. In my opinion, the finding in your MRI suggests that some of the nerve coverings (neuronal coverings) in your brain have weakened. The changes are subtle, not to that extent when we can call it a disease. Giddiness you have is very less likely to be directly related to these changes but we can relate it to the probably associated weakness in the coverings of the balance nerves. Please let me know in detail about the pattern of your giddiness. Is it present all the time? Or episodic? Is it more when you are in stress? Is it associated with hearing problems? Do you hear any extra sounds from your ear? Please let me know so that we can discuss further." } ]
[ { "from": "human", "value": "Hi doctor, I am having a weird feeling and discomfort around the opening of my penis for several months now. I have got both UTI and STD urine test done but everything came up negative. The discomfort lessened considerably a week or two, after which it is still around. I went again for another UTI and STD urine sample and a blood test which was clear. But they said I did have a good bit of white blood cells in my urine. The discomfort is tolerable but still mind screwing. I have had genital herpes for about a decade and kidney stones before as well. I am pretty rough when intimate and the first sign of this issue was a couple of days after intercourse. My main concern is that I am starting to get intimate with another person with genital herpes as well. There is no discharge, swelling or blood at all and my erections did not hurt. I did not even remember it unless I think about it or when I am occupied. It seems like its presence is less or gone when I am standing or walking for periods of time. I would like to confirm what it is?" }, { "from": "gpt", "value": "Hi. Yours is one of the most common problems which I see in my outdoor department every day. It has different terminology amongst different clinicians such as urethritis, prostatitis, chronic pelvic pain syndrome, etc. Probable reasons are some irritation of nerves around the prostate area. The reason for it is generally unknown but in majority tends to get worse with stress. It is physically harmless except that it is bothersome. Most of the tests will be normal. It can be controlled with medicines. However, it tends to come and go; aggravated especially during the period of stress and tends to disappear when you stop bothering or thinking about it. Treatment steps are as follows: Most of my patients respond to the above treatment. If the problem comes back again after a few weeks or months, then I generally repeat Amitriptyline for a few more days." } ]
[ { "from": "human", "value": "Hi doctor, I am a 20 year old male. My weight is 114 kg and I am 5 feet 11 inches tall. I want to reduce my acne as soon as possible. I have a few hard bumps along with normal pimples. Mostly they are painless. I need an effective cure. I have attached a relevant picture. I have been using aloe vera gel now." }, { "from": "gpt", "value": "Hi. I have gone through your history and attached photograph (attachment removed to protect patient identity). You should continue with Dermadew acne soap but stop using aloe vera gel. Besides this, you need oral as well as topical medications for your acne. Start with tablet Azithromycin 500 mg once daily for three consecutive days in a week for 4-6 weeks along with Nadifloxacin gel in the morning and Benzoyl peroxide 2.5 percent gel at night on the pimples. I hope it will help you. If a satisfactory response is not seen in six weeks we might need to add another capsule. You can revert back to me after six weeks for follow up. Also, keep your face dry, avoid applying oily creams and moisturizers, avoid oiling of the scalp, reduce the intake of sugary foods and try to reduce your weight. Seborrhea and hormonal imbalance. Acne vulgaris." } ]
[ { "from": "human", "value": "Hi doctor, I am 32 years now and my wife is 31. Today in pregnancy test kit, result came as double red line (a red line for C and a red line for T). Is this positive for pregnancy? Actually yesterday is her date for periods, but this has also not occurred yet. What precautions should we take? We were planning to travel by car (nano) to native by tomorrow for about 8 hours journey. Is it advisable now to travel by car or should we cancel it? Also kindly advise her what to eat and what to avoid? Also how to take care of herself?" }, { "from": "gpt", "value": "Hi. The (UPT Kit) urine pregnancy test kit with two red lines indicates a positive result and that she is at present pregnant. The confirmation for an intrauterine pregnancy can be further done with a transvaginal ultrasound scan. She should be placed on tablet Folic Acid hence and may be started on tablet Micronized Progesterone daily for pregnancy support. Travel by nano for eight hours in this early pregnancy is not advised at all. As the pregnancy is way too small and the bumps on roads and breaks while driving may cause an increased pressure intra-abdominally and may cause threatened abortion. So, traveling by car is completely not advisable till at least 14-16 weeks of pregnancy." } ]
[ { "from": "human", "value": "Hi doctor, I have left supraclavicular lymph node enlargement of around 1 cm in size over four months. I have body pain and occasional low back pain. I have pain in areas such as shoulder, right groin, hand under the elbow and sometimes feel difficulties in chest. Only one lymph node got enlarged. My blood work is reported four times and is normal. I had an antibiotic course twice for two weeks. In these four months, though I was in stress I gained 12 pounds of weight.I need your opinion on the following. Do all lymph nodes seen around or in left supraclavicular areas are more prone to cancer such as lymphoma, NHL or gastric cancer? What is the probability for that? How much is the size of the lymph node to be cancerous or worry about? Do you think I have lymphoma or Non-Hodgkin lymphoma? I am having pale skin, black stool, blood in stool and stomach swelling, is this due to the stomach or gastric cancer? Why my node is not growing in size? Everybody says the node related with lymphoma and NHL is persistent and one. Is that right?" }, { "from": "gpt", "value": "Hi. Based on your queries, my opinion is as follows: Node is partially fibrotic, so it is not able to go back to its original size. There is no reason for it to grow, as there is no infection or cancer. Yes, nodes are persistent and usually multiple and increasing in size. But here it is not. At your age, very low chance for cancer. If doubtful, get an FNAC or biopsy of lymph node done. It will confirm. Blood work is useless, unless it is blood cancer. Do get back with the biopsy of the lymph node and stool examination report for further opinion. At present, no cancer based on clinical details. 1. Lymph node biopsy. 2. Ultrasound abdomen. 3. Stool examination." } ]
[ { "from": "human", "value": "Hi doctor, I am a 30 year old guy, and I have phimosis. Many times, I have tried to retract my foreskin, but always in vain. I would like to know if circumcision is mandatory to rectify the problem. Is there any other method which I could opt for? I am going to get married soon, and so I would like to get this problem solved. Please suggest." }, { "from": "gpt", "value": "Hi. Phimosis is a common problem. The simplest, long-term and permanent solution for phimosis is circumcision and is a minor day care procedure. However, if you want to try medicines you can use ointment Fludrocortisone along with Clotrimazole ointment to be applied daily for three weeks. If it does not improve, go for circumcision. Even if you get relief with ointment it is likely to be a temporary solution. Moreover, after circumcision, it is easy to maintain hygiene and there is less chance of repeat infection. After circumcision, you can resume normal activities within one or two days and sexual activity after a month. In my opinion, if indicated, go ahead with circumcision." } ]
[ { "from": "human", "value": "Hello doctor, Redness and cut like lesions on groin immediately after sex. I noticed burning and irritation immediately after sex. I do not know if it is herpes or just skin irritation from contact or friction." }, { "from": "gpt", "value": "Hi. These are fissures, usually in groin area infection can present in the form of fissures and cuts. Other causes can be Crohn disease but your complaint is acute one so most probably this is an infection. Do not worry, it will get better with proper medication and treatment. Try to maintain hygiene of the area and avoid sexual contact until you get better. I would like to know if your partner has any such problem? Infection. Bacterial infection. Tablet Co-Amoxiclav 1 gm BD for one week. Apply Fusidic acid ointment BD over the lesions. Take pain killer tablets like Ibuprofen for pain relief. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." } ]
[ { "from": "human", "value": "I am 30 Years old, Missed period for 8 days now. Since my 24 day of menstrual cycle was starting using duphaston drug once daily and finish the prescribed dose yesterday. And my menstrual cycle is between 26-28 days, this month on the days of my periods I got cramps but nothing come out. Could this be side effects of duphaston or?" }, { "from": "gpt", "value": "Hello, Welcome to Icliniq. I would like to know the reason why you had been taking Duphaston? If you have been planning for a pregnancy, then it would be advisable to check your urine pregnancy test once. If negative you can wait upto two week for your Periods to come as you just finished your course of Duphaston yesterday. It may Take maximum upto two weeks for the withdrawal bleed to happen once the Duphaston is stopped. If you got pregnant this cycle, then you may not have periods even after 2 weeks. So check.accordingly. please feel free to revert back anytime with any further queries. Have a nice day." } ]
[ { "from": "human", "value": "Hi doctor, I was not sexually active for the last one year, but recently I resumed my sexual life. I am not able to maintain my erection during sex (although I am able to achieve it, but it is not that hard). I never faced this issue before and was not sure what is causing this problem. I am 30 years old. Please help." }, { "from": "gpt", "value": "Hello. Before moving directly to any treatment follow the advice as given below. You are indeed developing the signs of ED (erectile dysfunction) and PME (premature ejaculation). We may need the reports of the following tests to rule out physical causes of erectile dysfunction and premature ejaculation. 1. CBC (complete blood count). 2. T3, T4, TSH (thyroid-stimulating hormone). 3. HbA1c (glycated hemoglobin). 4. Serum testosterone. 5. Serum prolactin. To rule out psychological causes please answer my questions. How is your mood? How are your energy levels? How is your appetite? Do you have any sleep disturbances or do you oversleep? Any past history of anxiety or depression? Any family members suffering from anxiety or depression? Describe in detail about any use of cigarettes, tobacco, alcohol, cannabis or any other substances of abuse. Please respond to the above questions and send me reports to enable me to make a complete assessment of your condition and advise treatment accordingly. Depression can cause ED, PME, and masturbation guilt or compulsive masturbation. All that you may require is proper consultation and treatment about your sexual problems." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I currently suffer from osteoarthritis and sciatica in my lower back. I have been told by a personal trainer that taking up mixed martial arts classes would be good for my conditions. Can you confirm whether this is correct?" }, { "from": "gpt", "value": "Hello. What I feel is mixed martial arts would damage the tissue more for now until we come up to some level of muscle strength. I would advise you to focus on some exercises which are listed below. This exercise should be gradually increased from week to week and continued for 12 to 15 weeks. First set of exercise to lay on your back and performed for both the lower limbs. 1. Straight leg raise. 2. Pressing the knee down keeping the leg straight. 3. Bridging exercise. 4. Leg raise two inches of floor sideways. 5. Leg raise and circle-clockwise and anticlockwise. 6. Both the legs up and down. The second set of exercise to lay on your stomach and performed for both lower limbs. 1. Knee bend and lifting it up. 2. Knee bend and lifting it up two inches and sideways. 3. Leg straight up and performing circle- clockwise and anticlockwise. 4. Fold the leg and try to lift both the knees up and down. The third set of exercise is to lay on your side and perform for both legs one after another. 1. Straight leg raise. 2. Circle- clockwise and anticlockwise. Please follow this routine as it will help stabilize the core and also will help improve the lower limb muscles to become stronger. Please contact after a week so we can figure out which exercise is difficult and which needs modification. Please do 20 repetitions of each movement. We will reassess and plan the next course of action. Wear and tear. None. Back pain. Disc disease with OA. Exercise. None." } ]
[ { "from": "human", "value": "Hi doctor, Kindly tell me the ayurvedic medicines for hemorrhoids third grade and constipation. Which is safe and what dietary control should be taken for this till it gets healed without any allopathic processes." }, { "from": "gpt", "value": "Hi. Mostly piles generate after changing food habits and lifestyles. Frequently constipated bowel, sedentary lifestyle, smoking, and drinking may cause piles. Third-grade piles need Ksharasutra ligation treatment along with ayurvedic medications. Now it can be managed naturally through ayurvedic medicines. Constipation, irregular food habits, reduced physical activities, frequently smoking and drinking. Fissure in ano, fistula in ano, sentinel tags. Take the following medicines regularly for one month. Rx, 1. Panchasakar Churna 3 gm with Arshoghni Vati two tablets and Arogyavardhini Vati one tablet twice a day with warm water after meals. 2. Abhayaristam 15 ml twice a day with an equal amount of water after meals. Avoid spicy and fried junk foods. Drink plenty of lukewarm water. Quit smoking and drinking if you have these habits. Do regular kapalbhati, mandukasana, and ardhamatsyendrasana regularly as well as pranayamas like anuloma vilom, nadi sodhan, and bhramari." } ]
[ { "from": "human", "value": "Hello doctor, I need a few of my ECG’s read from my health records. I have chest pain, sharp that spreads across the chest, shortness of breath, rapid or fluttering heartbeat. Extremely low pulse rate to extremely high. At present, I have not been able to get my heart rate below 120 BMP for a few hours." }, { "from": "gpt", "value": "Hi. It is not relief of your chest pain only. Diagnosis of your problem and proper treatment has to be started. A beta blocker is effective in lowering fast heart rate but in case of bradycardia, it will further reduce the heart rate. To identify any sinus pause is there or not, Holter monitoring and echocardiography have to be done along with freeT4, T3 and TSH. Sometimes, thyroid function problem may give irregular heartbeat. So, do not worry, do the tests and start treatment accordingly. Attend hospital for the above tests." } ]
[ { "from": "human", "value": "Hello doctor, I am newly married for 25 days. 10 days ago, I had UTI with burning sensation while urinating for which I was prescribed Augmentin 625 and Cital syrup. I took medicine for three days and had some relief. Then three days back suddenly I was not able to urinate at all. My bladder was full but I was not able to dispense urine. I visited the doctor. They emptied my bladder using Foleys and 500 ml was emptied. I was prescribed: 1. Tablet Oflox 400 mg once daily. 2. Tablet Flotral (Alfuzosin) 10 mg once daily. 3. Tablet Urispas (Flavoxate) thrice daily. 4. Cranbe (Cranberry) capsule 300 mg twice daily. I was advised a urine culture and ultrasound KUB. Reports are attached. Now I am able to urinate but have to apply all my force. I feel my bladder is full then I go and sit for 10 minutes but urine does not come till I apply full force. It is very painful for me. I am not able to pee normally for the last five days. What has happened to me? And how to return to normalcy?" }, { "from": "gpt", "value": "Hi. Urinary infection is common in young married women. You had UTI and it was treated with antibiotics, causing no growth on culture. Only thing of note is draining 400 ml through a catheter, usually, retention is not common. You should not hold urine for long. Never postpone urine for more than three hours. Do you have associated constipation? How many times you get up at night to void, do you feel an urge to pass urine? Was there straining to void before this UTI episode or passing urine was effortless? Any fever?" } ]
[ { "from": "human", "value": "Hello doctor, My daughter is 1 year and 10 months old and is suffering from severe cough and cold. She also had some kind of cough and cold since 15 to 20 days and after a dose of Azitral for five days she got cured. Now again she has caught cough mainly dry cough. in the night situation became worse and could not sleep the whole night due to severe dry cough. Now the doctor has adviced Augmentin duo syrup 5 ml per day for five days. Really disturbed by her reproductive dry cough. Do frequent medication harm her internally? Should we use nebulization? Is that better than antibiotics? She is taking Ascoril LS syrup. She does not have any breathing difficulty, only dry cough with fever (100 F)." }, { "from": "gpt", "value": "Hello. I note that your daughter is having a second episode of cough and cold within 15 to 20 days. Cough is quite common and tends to be more noticeable at night. Many children suffer during seasonal changes. Your doctor may have prescribed Augmentin Duo (antibiotic) to treat any underlying infection. Kindly complete the course of antibiotics as recommended. Usually, there are no long term side effects. Ascoril-LS sometimes helps in managing cough but cough remedies are not always able to relieve cough. They are commonly used but not recommended in this age group. Does your daughter wheeze as well? Your doctor will be able to check by listening to her chest during the examination. If there is significant wheeze, nebulization can be considered. Other tips for managing cough and cold are as follows. Give her frequent sips of warm water. It will hydrate her. Make her sleep reclining with head in a slightly higher position. You can make her sleep in your shoulder if she is more comfortable. You can try saline nasal drops, especially before feeds. Ensure that the room is clean and has adequate ventilation. (No smoking, no pets). If the cough does not get better with a week, kindly see your pediatrician again to review your daughter." } ]
[ { "from": "human", "value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?" }, { "from": "gpt", "value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 27 years old and pregnant. My last period was two months back but the baby only shows six weeks and three days gestation as of today with a heart rate of 77. I have a picture of my ultrasound from today and I was hoping you could explain what it was showing." }, { "from": "gpt", "value": "Hi. For a lady, with regular periods previously, generally ovulation occurs around 14th day of the cycle, so fertilization can take place only after that. In your case (if your periods are regular), you ovulated around 22nd two months back and fertilization took place only after that. So originally, the baby will always be two weeks less than what is calculated by LMP. Secondly, first-trimester USG can have an error of up to seven days while second and third trimester up to 2 and 3 weeks respectively, so do not worry if the calculation and USG are not exactly the same." } ]
[ { "from": "human", "value": "Hello doctor, I had a pimple on my foreskin around 15 days ago. I squeezed it and applied an antibacterial cream, but there was very little improvement . From the same day, I am having some stomach problem and anxiety. So, I visited my physician today, and he prescribed Vapal 150 and Cufix 200, and asked me to follow up after five days. I have attached a picture for your consideration." }, { "from": "gpt", "value": "Hello. I read your query and understand your concerns. I hope this helps you. For more information consult a dermatologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, Is it fine to eat carbohydrate and sugar within 40 minutes of growth hormone injection? Because, it is believed that after injecting growth hormone, a person should wait for at least 40 minutes to eat carbohydrate or sugar. Please explain." }, { "from": "gpt", "value": "Hi. I can understand your concern. For further clarifications consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am an 18-year-old male. I was playing football on Monday and my left foot slipped, naturally I tried to stop myself from falling but my weight went down on my left knee and it bent backward. I did not fall on the ground, I was still standing but it was sore for a few minutes then it went, but when I tried to bend my knee backward, now it feels like something is about to pop. Any advice?" }, { "from": "gpt", "value": "Hello. As you mentioned the nature of the injury and now the knee bending is difficult and painful, the first thing you did good was to stabilize the injured knee in the bandage. Now immobilizing the injured part is of utmost importance to avoid further damage to the joint and it is internal structures. Since this has happened in past as well where you were not seriously noticing to seek medical help, over a period of time ligament injury might have developed. There might be ACL injury which is common in football players and needs to be conscious about it as the game is full of fun and enjoyment. I advise you to seek an orthopedic, for getting your knee assessed as it might be of importance. He might do a checkup on a clinical basis of your knee and if needed an MRI which is of utmost importance to check the extent of the injury to the tissues within the knee joint. Please do not ignore such injuries as you can be a better player in every game you take upon. Now, there are types of ligament injuries. Some are a sprain, a partial tear or complete tear. Based on what type of injury it is we have to take up the call for the treatment plan. But be assured that all the treatment are designed to get you back in the game and live action. Post analyzing the proper injury a good exercise regimen can help you a lot more than just leaving it unattended. I hope you understand that the knee is one of the major joints for weight bearing and should not be ignored. Sports injury. MRI. ACL, ligament sprain. ACL injury. Based on MRI scan. Avoid moving the knee, avoid weight bearing, avoid knee bending." } ]
[ { "from": "human", "value": "Hello doctor, I have been in combination birth control pills for over a year and recently got MMR shots. I had a fever and diarrhea and got pregnant during the symptoms. Is this an issue? Will the MMR cause birth defects?" }, { "from": "gpt", "value": "Hi. MMR is measles, mumps and rubella vaccine. Rubella specifically has a hazardous effect on pregnancy if occurs during the first trimester. If the shots were more than a month from your last period date, then you should not worry so much, as the antibodies are already formed, but if it is less than a month between the shots and a missed period, I guess it becomes risky. Please revert back with your vaccine date and last menstrual date. Congenital rubella can cause cardiovascular defects, congenital cataracts and hearing issues in the baby." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am quite allergic to dogs, cats, and pretty much anything with fur, which exacerbated my asthma, sneezing, and itchy eyes. I am hoping to get a job at home health, but many people have dogs and cats. Is there anything that could be done for me to enable to work in home health? Furthermore, my kids would love a little doggy at some point, if possible." }, { "from": "gpt", "value": "Hi. Is your allergy based on your assessment or has any allergy testing been done? The best way to prevent allergy is to avoid the requisite allergens altogether. We even suggest a change of profession and change of place to our patients. In that case, I feel you should not be wanting that job or the dog in your house. But before that, we can check for allergies either by skin prick testing or blood immunocap testing. Skin prick testing is more authentic and specific than blood testing." } ]
[ { "from": "human", "value": "Hello doctor, I have gas problem and bloating after I eat any normal size meal. I have struggled with constipation for years, but paid very close attention to that issue. Currently, it is not the problem. I have had colonoscopy and stool tests and they were fine. I did have colitis back due to use of antibiotics but have had no problems since then it was clear with medication. Before 16 years, I had ruptured disc L5-S1, which caused me to have emergency surgery and an acute onset of cauda equina syndrome (CES). The CES caused problems with my colon, rectum, bladder and sex organs. All areas have improved over time, but they are not normal, I also had nerve damage. I have tried everything over-the-counter, all kinds of probiotics, supplements, peppermint tea, but nothing helps. Please advice." }, { "from": "gpt", "value": "Hi. These kind of problems are very common due to our dietary habits and sedentary lifestyle. Sometimes it is due to deficiency of enzymes also, this is uncommon and the main factor is lifestyle. The syndrome of bloating and constipation is known as Irritable Bowel Syndrome (IBS). This is a very common problem and involves around 10-30%of population. Stressful lifestyle also causes such problem. You already have one stress due to chronic illness. The management is very simple, it includes avoidance of fatty and spicy meal with plenty of water, regular exercise and alleviation of tension. Treatment of constipation is the key to get rid of these problems. Most of the time it improves after adequate management of constipation. We need to take high fiber diet along with fiber supplement and some laxatives may be needed for short term. Dietary habits, lack of water intake, excess intake of stored food and fast food and stressful lifestyle. It is a clinical diagnosis, investigations are not required. 1. Take high fibre diet. 2. Take plenty of water, a minimum of 4-5 litres per day. 3. Avoid fatty and spicy meal, stored food and fast food. 4. Do regular physical exercise. 5. Take tablet Lansoprazole 40 mg two times a day half an hour before food intake. 6. Avoid charcoal, it may cause constipation. 7. Take methyl cellulose 3 spoon two times in a day. 8. Brush your teeth and then have half a litre of water, before going for defecation." } ]
[ { "from": "human", "value": "Hi doctor, I feel extreme fatigue in the morning. I have tremor and right leg tingling. I am experiencing brain fog, Parkinson like symptoms but I did not feel any improvement with Levodopa. My manganese levels are high. Please help." }, { "from": "gpt", "value": "Hi. I want to assure you that do not worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. First thing is unless the diagnosis is made by an expert physician, the resembling symptoms do not mean straight that you have Parkinson's disease. There are many other drugs that are to be used as an adjunct to the Levodopa and that show a good result in many patients. Such as Levodopa with Carbidopa (a peripheral decarboxylase inhibitor) is a good combination. Also we have Ach-Acetylcholinesterase inhibitors, NMDA (N-Methyl-D-Aspartate) antagonists, COMT (catechol-O-methyl transferase) inhibitors, MAO-B (Monoamine oxidase-B) inhibitors, anticholinergics, etc. Your symptoms can also be due to other conditions such as liver disease (hepatitis and cirrhosis), anemia, fluid and electrolyte imbalance, thyroid disease and blood pressure issues. Please answer the below mentioned questions for better diagnosis and treatment. 1. What is your age, gender, height, weight and waist circumference? 2. What is your manganese level? If you have the laboratory reports kindly upload. 3. Have you checked your pulse rate, blood pressure and blood sugar level recently? 4. Please send me all laboratory reports, MRI, CT, radiographs, etc., relevant to your query. Investigations you need includes, 1. Comprehensive metabolic panel. 2. Liver viral markers for hepatitis B and C. 3. Thyroid profile. 1. Liver disease. 2. Anemia. 3. Thyroid disease. 4. Diabetes. Treatment will be decided according to your laboratory reports. As there are many possibilities, we have to proceed with care." } ]
[ { "from": "human", "value": "Hi doctor, My father suffered from high fever over last week and he was alright. But today again he is feeling a mild rise in his temperature. Is this anything serious?" }, { "from": "gpt", "value": "Hi. I want to assure you that do not worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. Fever is just a symptom of other illnesses like infection, inflammation etc. So, we have to rule out some basic infections possible in him. Also some background of your father's overall health is needed. Please answer the following questions to assist him in the best possible way:- 1. Does he have or had any of the following symptoms in the last week, the symptoms include sore throat, neck glands enlargement or enlarged lymph nodes? 2. Did he experience any painful urination, frequent urination or urge to urinate even after coming from restroom, all time feeling of bladder fullness as if he needs to urinate? 3. Are there any symptoms of constipation, vomiting, nausea, diarrhea, abdominal pains, cough with/without sputum, nasal discharge, flu, eye redness, etc? 4. Does he have any skin condition/disease? 5. Is he diabetic or hypertensive? Whether he takes any regular medication? If yes, then please mention it. 6. Is there any allergic history for food or medication? 7. Is he a known hepatitis patient? 8. Does he have any gallbladder issues or history of kidney stones? Treatment will be decided with follow-up details." } ]
[ { "from": "human", "value": "Hello doctor, I am suffering from attention deficit and disturbed memory problems. It affects the speed of my work. Presently I am taking tablet Fenofibrate 145 mg once daily and tablet Avital once daily for high triglycerides and disturbed lipids. Kindly suggest a treatment for my above problems." }, { "from": "gpt", "value": "Hi I have thoroughly read your query. But only with this much detail of symptoms, it is difficult to reach the diagnosis. So, please elaborate on your symptoms and answer a few questions. Revert back to me with the following answers, so that I would be able to help you better." } ]
[ { "from": "human", "value": "Hi doctor, I am a 52 year old male. Every alternate day, I used to play tennis and swim for an hour. My weight is 100 kg and I am 5 feet 11 inches tall. All my blood reports are normal. I am taking a few medicines regularly, which includes Losar H, Amlopin 2.5, Rozavel 20, Glycomet SR 500. My average blood pressure is 135/85 and my sugar is 109. My water retention around ankles (inner side) is 6.1. Please explain the reason for ankle swelling." }, { "from": "gpt", "value": "Hi. For your age of 52, you appear to be very active. With all parameters, your BMI is on a higher side, and you have to lose some weight. It seems that you have been prescribed medications by your general physician for management of diabetes and hypertension. There are many causes of swelling in the legs and associated regions like ankle, etc. The most common reason is posture, and many patients develop it when they stand for a long time. But as soon as they elevate their leg up, the swelling will subside. It is also a common manifestation of systemic pathologies like diabetes, cardiac causes, etc. It can happen after infection or inflammation too. Sometimes heavy physical activity may also lead to swelling in your calf muscles and around ankle region. But we have to look at medical causes as well. Chronic cardiac conditions can lead to swelling. Any pathology which leads to low protein in the body like deranged liver function tests, kidney function tests, etc., can also lead to swelling. Hypothyroidism can also lead to generalized swelling like appearance in the body. So for accurate diagnosis, we need to clinically evaluate and get some appropriate tests done. It includes CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), LFT (liver function test), KFT (kidney function test), serum electrolytes and thyroid profile. Most of the conditions can be managed under the supervision of a good physician especially if there is no history of any injury which is also very unlikely to happen around both ankles simultaneously. 1. Postural. 2. Cardiac causes and hypertension. 3. Systemic pathology like diabetes." } ]
[ { "from": "human", "value": "Hello doctor, I got my teeth cleaned two weeks ago by a dentist and now a tooth is sensitive to heat." }, { "from": "gpt", "value": "Hi. Sensitivity is a common encounter after scaling and cleaning. I reckon you should try toothpastes which help reduce sensitivity. But even after using them if you feel sensitive to hot or cold then visit your dentist again to check for any hidden cavities. X-rays might be required to find them out." } ]
[ { "from": "human", "value": "Hello doctor, I have about 4 inches of patches of ringworms on both of my buttocks and a 3-inch patch on my vaginal area. I am using Covate GM cream for the treatment but it is not showing any results. Please help." }, { "from": "gpt", "value": "Hi. If you have ringworm infection, kindly use oral and topical antifungal agents. If it is very red, mild steroid combined with an antifungal agent is to be used. You will get better after treatment. Scraping for fungus. Tinea cruris. Tinea cruris. Tablet Terbinafine 250 mg OD. Apply topical Terbinafine ointment BD. Apply a combination of Hydrocortisone plus Clotrimazole (like Hydrozole) at night. Take antihistamine OD. Maintain hygiene of the area. Wash with soap and water. Avoid using Dettol and other irritants." } ]
[ { "from": "human", "value": "Hello doctor, My mother is 80 years old. Height 5\", weight 40 Kg. No history of sugar or BP. The respiratory system is normal. Diet is normal, two or three chapatis. She is suffering from cramp in legs and hands for the last one year. She is advised for Methylcobalamin 1500 OD with Becozinc multivitamin for the last six months. There is a relief of about 20 % by this treatment. Will you please advice any other medicine?" }, { "from": "gpt", "value": "Hi. I read about your mother's complaint. I would advise you to have a basic blood investigation to look for serum potassium level. If potassium is low, she will need extra potassium in her diet like tender coconut water and other dietary supplementation. You will also require a complete physical examination. She has been taking Vitamin B12 which is fine in case of neuropathic pain but here she might be beneficial if she takes some muscle relaxants like Myoril 8 mg twice daily for three days." } ]
[ { "from": "human", "value": "Hello doctor, I am 37 weeks pregnant and I have been having excruciating back pain since last night. It does not seem to go away no matter what I do. It hurts to move or do anything. Could I be in labor? And do I need to go to the hospital?" }, { "from": "gpt", "value": "Hello. The sudden onset back pain in a full term pregnant patient is likely to be due to lightening when the baby's head goes down in pelvis and the sacrum and coccyx bone extend to accommodate the presenting part. If there is no abdominal tightness and contractions which are of increasing intensity and lasting for more than 15 to 20 seconds each, then unlikely that you are in labor. But it is always recommended to go to the hospital and get yourself evaluated by the obstetrician." } ]
[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "gpt", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am concerned about my tonsils. I honestly need them removed but have other health issues and just cannot right now. I had a cyst last year that slowly shrunk away to nothing, I have tonsil stones. The full range of issues. Right now I have these large white areas toward the bottom of my left tonsil. They are not stones and will not move. But I also do not have any pain or discomfort. What is this? It is really worrying me." }, { "from": "gpt", "value": "Hi. They are pus or keratotic patches (attachment removed to protect patient identity). If pus, then it should be painful. Most likely keratotic patches over the tonsil. Can you take pictures where both tonsils can be visualized? Do you have such spots on the other tonsil as well? Do you have any difficulty in swallowing? Is one tonsil larger than the other? What chronic illness do you have, if at all you do? Are you on any kind of steroids or immunosuppressant medications?" } ]
[ { "from": "human", "value": "Hi doctor, Three weeks ago a very small part, about 1/8th part of my tooth fell and I went to the dentist. He suggested filling but I was reluctant because it involved grinding. Can I prevent any further damage to my tooth by taking proper care that is brushing twice, using mouthwash and gargling every time I eat?" }, { "from": "gpt", "value": "Hello. As explained by you, this seems to be the case of crown fracture in which no deep part of the tooth is involved. Even simple fracture of the crown (enamel) may cause sensitivity and roughnesses caused by fracture may cause traumatic ulcers. So it is advisable to go for grinding of the tooth (enameloplasty) to remove sharp edges and filling is advisable to prevent any sensitivity. Heavy biting forces. Ellis class1 fracture. Enameloplasty and restoration." } ]
[ { "from": "human", "value": "Hello doctor, I have been diagnosed with chronic tension headache. Next, to the headache, I have observed a decline in my cognitive skills (learning, concentration). I can take care of the headache using meditation techniques, however, I am not able to deal with the decline, which is causing degradation of my private and work-related performance. Apparently, there is a medicine available that can enhance cognitive performance- Modafinil. I wanted to ask you for an opinion, how to take the medicine, what should I pay attention to (dosage, cycles)." }, { "from": "gpt", "value": "Hello. I understand your concern and would explain that Modafinil is a drug used in other medical conditions, but I do not think that this drug is appropriate in your clinical condition. This drug is usually indicated in persons suffering from increased daily sleepiness or sleep apnea. I do not think that this is the case. You should know that chronic tension headache does not lead to cognitive decline, especially at your age. The cognitive decline in your case could be attributed to the lack of concentration due to accumulated psychological stress. When you cannot concentrate, you cannot learn, and this makes you think that you suffer from a cognitive decline, which is not true. The good news is that this is quite a reversible situation, with the proper therapy. That is also the main cause underlying tension-type headache. Coming to this point, I would recommend starting SSRI (Fluoxetine, Paroxetine, Sertraline, etc.), which can help reduce the tension-type headache and also improve your concentration and your cognitive skills. Yoga can also help improve your situation. Psychological stress. Troubles with concentration. Tension-type headache and troubles with concentration. SSRI." } ]
[ { "from": "human", "value": "Hello doctor, I want to ask that is there any method with which we can have periods earlier than due date? Also, if we can use any tablet to delay monthly periods?" }, { "from": "gpt", "value": "Hi. There are medicines to delay periods but to bring it early might be dicey, as spotting may stay, finally botching the occasion. Please start taking tablet Norethisterone 5 mg twice a day two days prior to the expected date of periods and continue till the day you want to. Periods usually commence within 3 to 7 days of stopping the medicine." } ]
[ { "from": "human", "value": "Hello doctor, I have personal dermatitis. I was prescribed 12 weeks of 100 mg Doxycycline. However, I am skeptical about taking antibiotics as I have read that with a lot of people the rash returns upon finishing treatment. Also, it can mess up your gut which is apparently linked to perioral dermatitis. I have gone gluten, dairy and sugar free, started Probiotics, Zinc and Omega 3 supplements and the rash still persists. I also use Metro gel and also it helps my rash is still there. It is mild but is very annoying and sore. If I take antibiotics will it make things worse? Or should I go get allergy testing? I have also cut out flouride toothpaste and eliminated SLS." }, { "from": "gpt", "value": "Hi. You can skip Doxycycline, if you have gut problems and you cannot tolerate it. If you are suspecting that your perioral dermatitis is due to contact of any allergic material, then go for allergy testing. Otherwise it will not benefit you. I would like to know your work. Any allergy to known material and picture of your leison? You can use mild steroid preparation over it for relief. Perioral dermatitis Apply hydrocortisone 1% ointment over leisons bd for 2 weeks Take antihistamine if you have itching Rest continue with your measures Maintain hygiene of the area Wash with soap and water Avoid using dettol and other irritants Follow at 2 weeks with pics plz" } ]
[ { "from": "human", "value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well." }, { "from": "gpt", "value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help." } ]
[ { "from": "human", "value": "Hi doctor, My son is 3 years old and has serious tooth decay. The doctor has suggested root canal treatment and that procedure will be done under general anesthesia. The whole procedure will take three hours of time as number of tooth is eight. My question is that is it safe to go through three hours of anesthesia for such a small kid? What is the risk factor?" }, { "from": "gpt", "value": "Hello. As a parent, I can understand your nervousness. First thing it is inhalational anesthesia and most commonly used in pediatric procedure, it means there is no use of any kind of drug for anesthesia. Only a gas mask placed on face and a balanced ratio of N2O (laughing gas) and oxygen release for a conscious sedation. For continues monitoring an anesthesiologist should be present all time during procedure. After procedure within a minute child will wake up from sedation. So, please do not worry about this. It is safe and used world wide for child procedure. If you do not want a long sitting then you could ask your dentist for two or more settings but it may be more expensive." } ]
[ { "from": "human", "value": "Hi doctor, Can you tell me, do all the diabetics develop diabetic neuropathy? My relative is 25 and just got diagnosed with type 2 diabetics. Will she definitely develop neuropathy. Can you also tell me the estimates of the number of diabetics developing it? She is diabetic but is not a BP patient." }, { "from": "gpt", "value": "Hello. Almost all the people having diabetes will sometime during the course of the disease will develop diabetic neuropathy. The reason is damage to microvasculature (small blood vessels supplying the nerves) get affected. Even with fairly well controlled diabetes this does happen. In case if the control is poor then severity increases rapidly. Hence it is very essential to achieve a strict glucose control all through out the course of the disease." } ]
[ { "from": "human", "value": "Hi doctor, I am suffering from irritation on the back of my neck. Sometimes, it extends up to the throat. But, I do not have any problem in speaking or swallowing. Please help." }, { "from": "gpt", "value": "Hi,Welcome to icliniq.comI understand that you have some irritation at the back of your neck that extends to your throat sometimes. However, there is no difficulty in swallowing or speaking. As a first step, I would suggest you take a course of antibiotics and anti-inflammatory tablets. Amoxicillin-Clavulanic Acid (dosage based on age and weight) and trypsin-chymotrypsin combination can work if it is an infective origin for the irritation. If the same does not resolve, then we have to think of other causes. Malignancy can be a reason which may often be accompanied by loss of weight and appetite. Pain also will frequently present in such a case.Any problem with the vertebra, like TB, spondylolisthesis, etc., can also present similar symptom with minute variation along with additional symptoms. For diagnosing the same we require to do an MRI scan of the neck. Kindly give all the details as I have listed. I suggest you go ahead with a course of antibiotics and see if there is a resolution of symptoms." } ]
[ { "from": "human", "value": "Hi doctor, I am a 31 year old female. Height is 5'3\" and weight 71 kg. I have normal skin. I have started developing fine lines on my face. Just recently I have developed a slight depression in the form of a line starting from under the inner side of the eye running down the cheek (photo attached). I think this is the beginning of cheek sagging. Is this premature aging? Can this be reverted with non-invasive techniques like topical anti-aging serums, facials, massages or exercises? Someone suggested me to use Retinol-A, which I have started using and is suiting me well. I have read a lot about the benefits of topical retinoid, vitamin E and C serum. Please suggest the best ones as I have heard that most of the available vitamin C serums in the market are useless as they oxidize easily and do not penetrate the skin. I have seen some videos of facial exercises online. Do you think they are effective? Also let me know how often should I get facials and which one is for anti-aging? I am also trying to put down weight. In this process I will naturally lose some fat from my face as well, but I do not want my facial skin to become loose. What should I do for this?" }, { "from": "gpt", "value": "Hi,Welcome to icliniq.com.I have read your details and examined your picture (attachment removed to protect patient identity) carefully. I have the following suggestions for you which I am sure will specifically help you significantly in the long run." } ]
[ { "from": "human", "value": "Hello doctor, I was taking Doxycycline for three months. After I got a haircut in third month, I noticed that I had two bald patches (it is not actually bald, they were just super thin with a little bit of hair). I got a haircut again today, and the same problem occurred. I am almost positive that the problem is alopecia areata, and I also have the symptom of nail dystrophy (it appeared around two weeks ago). Do you think Doxycycline caused this issue? How can AA be treated, and how long should I expect for my bald spots to have normal thickness again?" }, { "from": "gpt", "value": "Hi. Doxycycline is Tetracycline antibiotic that can cause photosensitivity and photo-onycolysis (nail dystrophy) but alopecia areata is not linked with this medication. On the other hand, nail problems are common with alopecia areata. Autoimmunity, drug induced. Alopecia areata, drug induced photo-oncolysis. Alopecia areata. Apply steroid preparation over bald patches BD. Oral steroids may be required in future. Maintain hygiene of the area, wash with soap and water, use vitamin containing shampoo preparation." } ]
[ { "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, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]

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