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qucklecrabik
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mc_dataset

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conversations listlengths 2 2
[ { "from": "human", "value": "Hello doctor, I am 29 years old. I got five teeth extracted, three of them being impacted wisdom teeth, before a week. My jaw is killing me. I have this nasty taste in my mouth. My holes look fine with blood clot present. What could be wrong? I cannot keep taking Ibuprofen and Tylenol, it is making me sick. I am just honestly in pain, I cannot eat. It is really bad. Please help. I do salt water rinses and I brush my teeth and the reason I can eat is food gets stuck in the holes and I hate getting it out, it hurts really bad. How many more days will this be like this?" }, { "from": "gpt", "value": "Hi. I reckon you had a traumatic extraction experience as you had five teeth pulled out in one go. This will definitely take sometime to get back to normal. The bad taste in your mouth is due to certain fluids oozing out during the healing process. But you have also mentioned, food getting stuck in those holes.This gives me a question of dry socket. Ideally in seven days time, the gums would have shrunk atleast one-third. For severe pain, you might need to get a prescription for Paracetomol with Codeine from your dentist. And possibly take antibiotics as well. Meanwhile, try to rinse out with Savacol mouth rinse two to three times daily (10 ml of rinse in a cup of water) to get rid of the bad taste and clearing off bacteria." } ]
[ { "from": "human", "value": "Hi doctor, My son is 3 years 9 months now. He has been diagnosed with benign childhood epilepsy. He is taking Clobazam 15 mg at night and Topiramate 100 mg per day for last four months. His seizures are under control and he attends LKG. The issue is that he is not able to concentrate in his studies and he does not like to sit with patience for a while. I am worried whether he is disturbed by his medicines? Please clarify the dosage too as his present weight is 15 kg." }, { "from": "gpt", "value": "Hi Welcome to icliniq.com. I have read your question in detail. The initial dose of Topiramate is 1 mg/kg/day which is gradually increased to 5-10 mg/kg/day. Your child is getting 100 mg Topiramate which is around 6 mg/kg/day. So, the dosage of Topiramate is correct. There are some side effects like anorexia, weight loss, blurring of vision and glaucoma. But these occur at late stages and when higher doses are given. So, in my opinion, Topiramate is not causing any problems in your child. Secondly, the initial dose of Clobazam is 0.1mg/kg/day which is gradually increased to 0.3 to 1 mg/kg/day. In your case, your child is getting 15 mg daily which comes to 1 mg/kg /day. Side effects of Clobazam are constipation, behavior changes, aggression, sleep disturbance, weight gain. So, I think that aggression and behavior changes in your child could be due to Clobazam. You should meet your doctor and ask him to lower the dose of Clobazam or substitute it with another antiepileptic drug." } ]
[ { "from": "human", "value": "Hi doctor, I am a married, 27 year old female. For the last two months, my cycle was like 35-36 days cycle. Now for the past two days, I am having brown color discharge from the vagina, but not always. I had intercourse until 10 days back. What could be the reason for this discharge? Please advice." }, { "from": "gpt", "value": "Hi. I understood your problem. It seems that you are suffering from hormonal imbalance. Did you recently take any new medication? Or are you undergoing any stress which can cause this? It does not seem like a pregnancy issue as that would not cause a brown discharge so early. Besides it is highly unlikely to get pregnant by intercourse on 22nd in a cycle of 35 days. You can take hormone pills for two to three months to stabilize your hormones, and the problem should resolve. But before I prescribe you the medicine, I would like to know if you are under any medication? Have you got any test done for the same?" } ]
[ { "from": "human", "value": "Hi doctor, I have a doubt regarding some general facts. Please explain the following elaborately. Is it fine to pluck out a gray hair? What happens when something gets stuck in between teeth for several days? What is the effect of teeth chatter? What is the growling of the stomach? When does the ear pop? Please explain." }, { "from": "gpt", "value": "Hi. When we pluck out a hair, we feel a slight sharp pain at that point of time. The hair usually breaks along with its follicle, thus that space remains hairless in the future. But if the hair breaks in between with its follicle intact, then the hair will regrow. When food gets stuck in between teeth for many days, the primary problem is the discomfort for one or two days. Then followed by the food particle gets decomposed causing bacteria formation which then causes initiation of caries from sides of both teeth due to acid production. You must pay attention to such a decayed tooth. When our teeth chatter, there is not much discomfort or other problems. But it can cause attrition of incisal edges and sensitivity in the long-term. Our stomach growls when our stomach is empty, thus acid production irritates the stomach walls and gas is formed. This growling is called hunger pangs. It is a physiological method by which the body lets the mind know about the need for food immediately. Our ears pop when there is a pressure change in the atmosphere. For example, when we go to a higher altitude, the eardrum adjusts to the external pressure by changing its position slightly. This helps in creating an equal pressure both inside the ear canal and outside. This maintains our body balance and helps in standing erect." } ]
[ { "from": "human", "value": "Hello doctor, I am experiencing lower back pain. It is hard to sit up and to stand or to do any rotating motions. There is also pain with curving my back. I have tried a massage bed and using tennis balls and a foam roller to stretch out the lower back but that is not helping." }, { "from": "gpt", "value": "Hello. I have gone through history. It appears to me as a sacroiliac joint dysfunction. As it has occurred in the past and resolved, it should not be a big issue this time also. In sacroiliac joint dysfunction, there is a malpositioning of the sacrum and the iliac crest which can lead to sharp shooting pain which is non-radiating or tingling in nature. Maybe you have too much muscle spasm. You can use hot water fomentation and try to lie on your back and tuck the stomach in for 30 seconds, keep repeating this for 10 times with a pause of 30 seconds in between. By 2 to 3 days of time, you should perform well. Post this, you have to start working out for your core and hip muscle strengthening to be precise the gluteus muscles. Muscle weakness. Nothing required. DDD. Muscle spasm with SIJ dysfunction. Hot water fomentation with exercise. Do not try to bend forward or lift heavy object till pain subsides." } ]
[ { "from": "human", "value": "Hello doctor, I have fever of 38 to 38.5 over past seven days. Right testicle swollen for the past five days and left testicle swollen for the past four days. On IV antibiotics, Cravit and Doribax (which replaced Rochephin). C-reactive test above 231. The doctors still cannot identify the cause. Any thoughts or recommendations? I have got ultrasounds but just shows increased blood, no abscesses." }, { "from": "gpt", "value": "Hello. You are suffering from bilateral epididymo-orchitis (infection of the testis). You need to rule out any obstruction in your urine tract which might cause this. Do you have any difficulty in passing urine? Or any problem with urine flow? Get done with uroflowmery test which will rule out any urinary obstruction. If everything is fine then it is spontaneous and will resolve on its own." } ]
[ { "from": "human", "value": "Hi doctor, Whenever I yawn sometimes it feels like I pulled something, and on my bottom jaw I push on it and something goes up." }, { "from": "gpt", "value": "Hi. Your upper and lower jaw are connected with a joint called temperomandibular joint. Similarly we have elbow joint and knee joint. The lower jaw is movable only because of this joint. So whenever you yawn, sounds like that joint is rubbing high and that is why you feel that something is going up. You might be able to hear a clicking noise as well if I am not wrong. If you are feeling sore at your joint every time after yawning, please visit a GP and he or she might give you a script for this like a muscle relaxant." } ]
[ { "from": "human", "value": "Hi doctor, I have hemorrhoids and a lot of gas build up that triggers it painfully, constantly. I have no relief with the constant gas no matter what I do. I tried liquid Kombucha for a few months and found relief but when a hurricane struck us, I had to go without it and went back to square one. In an effort to not be so reliant on it, I am trying probiotics with no luck. Would you recommend any topical treatment as well as probiotics to help treat the gas and hemorrhoids?" }, { "from": "gpt", "value": "Hello. First of all, stop all spicy, junk and fermented food. Consume fruits like banana, papaya, pomogrenate, grapes. Avoid green chilli completely. Take one cup of water, add 1/2 teaspoon of jeera and boil it, do not filter and add 1/2 teaspoon of ghee. Drink warm daily once for 10 days. Have buttermilk daily before lunch. Apply Pilex or Pilorid ointment twice a day on anal region. If still problem does not get solved, consult any ayurvedic doctor face to face. Sometimes patients are telling hemorrhoids but it may be fissure or fistula." } ]
[ { "from": "human", "value": "Hello doctor, I think I have hidradenitis. I get these boils under my armpits that often turns into open lesions and smells sometimes. It is embarrassing and it is taking control over my life. I need help." }, { "from": "gpt", "value": "Hi. Yes, it is hidradenitis suppurativa. I can understand it is a very difficult time for you. This condition requires both medical and surgical treatment. It is the problem with hair follicles and sebaceous glands. Once the glands are out, one can have relief. Right now you have active infection over the area so please start taking antibiotics. Hidradenitis suppurativa. Tablet Augmentin (Amoxiclav) 1 gm BD for two weeks, tablet Rifampicin 450 mg BD for two weeks. Apply Clindamycin lotion over the area. Maintain hygiene of the area, wash with soap and water, avoid irritants and Dettol." } ]
[ { "from": "human", "value": "Hello doctor, Is it fine and safe to take 10 mg of Citalopram twice daily instead of 20 mg of Citalopram once daily?" }, { "from": "gpt", "value": "Hello. Citalopram tablets are recommended to be administered as a single daily dose either in the morning or evening. The usual dose is 20 mg daily but can go up further up to 40 mg daily. I presume you have been prescribed Citalopram to manage depression or anxiety or related emotional disorders. Can I clarify why you want to split the dose? If you are experiencing any side-effect like sedation you can take the dose at night time. How long have you been on Citalopram? Usually, you will get used to the medication by two weeks or so. If side effects are persistent and severe, kindly review with your prescribing doctor. Anecdotally, I have seen a few patients taking Citalopram twice daily instead of once daily. They have responded fine without any adverse effects. But once daily dosage is the well studied and recommended dosage plan." } ]
[ { "from": "human", "value": "Hello doctor, I got the influenza vaccination about a week ago and have a swollen and painful lump in my armpit." }, { "from": "gpt", "value": "Hi. I understand your concern. You are having lymph node swelling axillary post influenza vaccination. Influenza vaccine is a very safe vaccine. Although some may have local pain, swelling, and fever. Some may have local lymphadenopathy. Lymphadenopathy is a swelling of lymph node (normal gland present in our body, which function as clearing harmful substances and providing immunity). Local and systemic reactions mostly began between day 1 and day 2. When a lymph node rapidly increases in size, its capsule stretches and causes pain. Pain is usually the result of an inflammatory process. It is a reactive response of the lymph node to the vaccination. So no need to worry. It can be managed by simple Paracetamol or anti-inflammatory medication such as Serratiopeptidase. It should resolve within a week. If it is associated with fever or any other site enlargement of lymph node you can visit your physician. I hope this helps. Reactive lymphadenitis. CBC (complete blood count), ESR (erythrocyte sedimentation rate), USG (ultrasound) axillary lymph node. Lymphadenopathy. anti-inflammatory Paracetamol 500 mg twice or thrice daily or Aceclofenac, Paracetamol, and Serratiopeptidase combination tablet twice daily for three days. Follow up after three days." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am going to get married after six months. My fiance is my dad's sister's son. Our blood groups are the same B+. Will there be any problem to the baby? If yes, then what is the solution?" }, { "from": "gpt", "value": "Hi. The blood group will not be a problem but, there are chances of high consanguinity. Consanguineous marriages are associated with an increased risk for congenital malformations and autosomal recessive diseases, with some resultant increased postnatal mortality in the offspring of first cousin couples." } ]
[ { "from": "human", "value": "Hello doctor, I am 24 years old and my height is 5'2\" and weight is approximately 48 kg. I had my last period on the third of last month and it lasted for seven days. I had intercourse on the first of the same month and took Unwanted 72 on the same day but now I am not getting my periods. I have tested pregnancy test three times till now and it shows negative. I just had two days of bleeding in between." }, { "from": "gpt", "value": "Hi. As per your query, you had bleeding for two days after taking Unwanted 72, so there is definitely no chance of pregnancy in the first place, also proved by the negative pregnancy test. So relax. After such pills, the next 1 to 2 cycles are a bit irregular. Please also try to reschedule your life back to track, as it plays an eminent role in your hormonal regulations. Do you get irregular periods often or this was your first time? Please take the following medications and you shall get your periods in 4 to 10 days after finishing the course. Tablet Primolut N 5 mg twice a day for three days." } ]
[ { "from": "human", "value": "Hi doctor, I suffer from anxiety and depression. I keep having these few minute long incidents where I get stuck with a thought repeating over and over in my head. It is a question which I then answer and then the question and answer process keeps repeating. I realize what I am doing and freak out thinking I will be stuck in this mode of thought forever. After a few minutes,it stops but I am usually incredibly upset and mentally exhausted after. This started about a year ago." }, { "from": "gpt", "value": "Hello. These thoughts are part of anxiety only. Repetitive unwanted purposeless thoughts are seen commonly in anxiety. You are not able to control these thoughts and these thoughts produce stress. You should visit your psychiatrist again for re-evaluation. SSRI drugs like Escitalopram or Citalopram can be used to reduce anxiety and will surely help you." } ]
[ { "from": "human", "value": "Hello doctor, I am 18 and currently have all teeth (except wisdom teeth) and braces for 10 months. My teeth are straight at this point but a few very small misalignments that will easily be fixed soon. I have an impacted tooth above my right-side second pre molar on my top row of teeth that is facing the wrong direction and needs to be removed. The problem is that my orthodontist wants to take out the tooth below it, the parallel second premolar on the left side of my top row and the two teeth on my bottom row matching where the top two are to balance out my mouth so it is not asymmetrical. (After these, the removed the braces would continue to close the gaps). Do I really need to get four teeth taken out (five including the impacted one) in order to fix this issue? Not only does it seem like such a large amount of teeth to lose at a young age but I have also heard many scary stories about how this will change the permanent shape of my face and jawline. Do you agree with this decision? My orthodontist does seem knowledgable but I have never heard of someone personally who has had to get five teeth on all sides of their mouth removed for one impact. I am just really scared that my face will look terrible." }, { "from": "gpt", "value": "Hi. Actually, by book, this is the only way the Orthodontist can make your face look symmetrical. Ideally, only four teeth are extracted as described by your dentist on each side of the jaw in crowded teeth but unfortunately, your fifth one is impacted so it has to go too. He is absolutely right according to his treatment plan. But now looking up to a broader aspect, I want to offer you a second treatment option too that many patients go for because they do not want to prolong ortho treatment too much and want to avoid many extractions. This second treatment plan has an extraction of 2 or 1 tooth only. If the maxillofacial surgeon is able to remove the impacted tooth only without touching or removing the tooth below it, it is best. Then you do not have to go for any extractions. Your case will simply end up as it is. But if the below tooth and impacted tooth both are removed, there will be space left for one socket. In this socket, implant screw can be placed and once it gets firmer with bone in 4 to 6 months then a cap will be placed on it. First, get ortho done and keep this space of socket intact through space maintainer, you do not need orthodontist to move teeth here to close the gap. End up treatment and then place the implant in this socket. That is simple, no more extractions will be needed then. The third treatment plan is that get extracted both impacted and the below tooth. Keep space of socket intact till your braces get off, then get a bridge of three units done here. Two teeth of support and one missing tooth will be covered. That is the most economical option to go for. Implant and prolonged ortho treatment both look costly and time taking as compared to it. The only cons of this is that slight 2 mm grinding of natural teeth is done that is not harmful at all. I would suggest you personally for the third option. Rest you can decide well. Hopefully, you would have got a clear idea of all treatment plans. If you can afford, then for you, the second treatment plan will be best as no adjacent natural teeth will be involved, only a single implant will be placed in bone directly." } ]
[ { "from": "human", "value": "Hi doctor, I have struggled with staph for nine years. I have tested positive for MRSA on at least three occasions in the last 10 years and at least two other different strains of staph. I have taken Doxycycline several times, Bacetrine, and several other oral antibiotics in the past. I have also been given injections in the butt along with taking the antibiotics. After several years of this, the outbreaks are usually confined to my face. Mostly my nose. I use antibiotic ointment a lot but it does not seem to help either. When I take the oral antibiotics they usually clear my face up but the outbreaks keep coming back after I stop taking them. I believe that I probably have staph in my bloodstream and it just sleeps when the antibiotics are being taken and then comes back out once I stop taking them. It usually coagulates in my nose and the outbreaks start there. What is the most effective treatment for this?" }, { "from": "gpt", "value": "Hi. Thank you for your inquiry. Here are some strategies to minimize the risk of these recurrent MRSA skin infections. 1. Hygiene: The bacteria that cause skin infections are transmitted by skin contact. Wash your hands diligently and frequently to minimize the spread of bacteria to other parts of your body, to other people, and to objects you touch. 2. Decontaminate yourself: Bleach baths are an effective way to reduce the amounts of bacteria living on your skin (see instructions below). If you are unable to do bleach baths, you may use antiseptic wipes (Chlorhexidine) to wash your body daily. Your doctor will give you a prescription for Chlorhexidine if required. 3. Antibiotics: Not all skin infections require oral or IV antibiotics, as many of them are self-limiting. Antibiotics should be reserved for more severe infections. Your doctor may prescribe a topical antibiotic to apply inside your nose to reduce the amount of the skin infection-causing bacteria. 4. Decontaminate Your Environment: The bacteria that causes skin infections also live in your environment. You should routinely decontaminate high contact surfaces, like tabletops, countertops, doorknobs or handles, chairs, handheld devices, etc., with antiseptic solutions. Do not reuse the same towels before they have been thoroughly washed. Clean your linens frequently. Avoid sharing personal items such as razor blades, nail clippers, towels, clothing, etc. 5. Cover open wounds: If you have an open wound on your skin, it is important to keep it covered to prevent the spread of bacteria. Do not participate in activities requiring skin-to-skin contact with others until wounds are fully healed. Do not share personal items that come in contact with the wound. Bleach Baths: Add ¼ to ½ cup of common 5 % household bleach to a bathtub full of water (40 gallons). Soak your entire body, keeping your head above water, for about 10 to 15 minutes. Limit diluted bleach baths to not more than twice a week. Do not submerge your head and be very careful to avoid getting the diluted bleach into the eyes. Rinse off with fresh water and apply moisturizer." } ]
[ { "from": "human", "value": "A couple of weeks before I got severe heartburn, I often felt really bloated and nauseous especially after meals but I kept ignoring it as the symptoms would go away. A month back, I had a faint heartburn throughout the day, and woke up in the middle of the night with severe heartburn all over my chest . Mid week it was so bad that it went in my throat and everything. I went to the hospital and was immediately prescribed ranitidine 150mg for 14days. As it came to week 2, I got only worse, with no sleep whatsoever, lump in my throat, extreme fatigue where my leg was involuntarily fluttering and my lip was voluntarily twitching. By third week I started omeprazole 40mg with the ranitidine and the heartburn intensity reduced but I experienced lots of other symptoms like bloatedness, stomach making noises all the time, nausea, breathlessness was the main one, heart palpitations which were never ending and this constant pressure on my nose and head. I’m now in week 5 and unfortunately the heartburn is still very much there, it comes and goes. The lump in My throat has improved from the second week but it still feels very heavy, I can almost press it and feel something clicking. Doc has said to double my dose of omeprazole so to take 80mg plus ranitidine. Will I get any relief at all from this constant heartburn and all the other symptoms? Am I in some sort of serious trouble? I’ve lost quite a bit of weight, I’m on bland food, elevated at night and all the lot but yet my quality of life is so heavily impacted as I can’t do anything throughout the day because of the constant palpitations, heartburn or pressure in my nose and head or the bloatedness and nausea. The heartburn gets worse after i eat. Please help! I’m only 28 and don’t understand why this happened to me as i was never obese or had any health conditions except hypothyroidism. Last thing to mention, my stools since having acid reflux issue has been a pale yellow and has only recently started to be brown again, what could this mean as well? Any help would be appreciated, as docs are just putting it down to anxiety and stress all the time." }, { "from": "gpt", "value": "Hello. I welcome you to icliniq. I can understand that must very much frustrated for your ongoing non resolving symptoms. I want you to understand why this symptoms of heartburn occurs in reality. Hear burn is a common symptoms, that can occur in normal subjects as well but does remain long. In some people heart burn occur secondary to acid reflux in food pipe (esophagus)- which usually settles with one dose acid suppressant medication or twice daily capsule. However, there is a third group of individuals where by the maximum does acid suppressant does not effect very much-as in your case. We call this condition as refractory Gastroesophageal reflux disease (GERD). So why I started emphasizing on all this, because management is different. The work up of refractory GERD start with an endoscopy-a procedure where by a gastroenterologist puts a tube with camera in to your esophagus and see what is inside. Also there are other battery of test which could confirm what is exactly a problem- may be straightforward i..e. reflux, but it can be some thing which is mimicking GERD. The GERD mimickers are many. The one of most common are esophageal motility disorders-which are another set of disorders in itself. So to cut the story short, I want you to first of all optimize the acid suppressant treatment. I know you taking omeprazole 40 mg twice daily, but it is important you take these medication 30 minutes or sometime 45 min. before meal. It is very important, since at times it is timing which is important than the drug itself. But, if you are doing it already in that manner, I would recommend you to think about endoscopy now. But it would help us to determine some other more information not necessarily the acid reflux. Keep taking gaviscon, but increase the dose. Take 15 to 20 ml at one time, 4 to 5 times daily and half hour after meals. The rest of your symptoms such as feeling lump in throat is common if someone has reflux. It is called as globus sensation. Dont worry about that. It will go away once your acid controlled adequately. The stress and anxiety sometime create a vicious cycles, where the disorder is perpetuated and influenced by it. But I think this is not the only explanation of your problem. The stress is obvious thing in one with non resolving symptoms. For example if do not reach to a particular diagnosis by endoscopy, I would consider testing for esophageal motility disorders, and some more allergic and hyperalgesic problems of esophagus. But for now, let the above treatment plan work. Meanwhile get some blood test done as advised below. I hope this would be helpful for you Let me know if you need any future consultations. Have a good day Refractory GERD complete blood count Check your thyroid status. TSH, FT4, FT3 GERD Motility disorders Esinophilic esophagitis After 1 week" } ]
[ { "from": "human", "value": "Hello doctor, I just want to ask that where can I buy an EC pill? I had unprotected sex last night at 12 AM and I wanted an emergency contraceptive but I do not know what to buy and where to buy it." }, { "from": "gpt", "value": "Hi. You can have Levonorgestrel 1.5 gm emergency contraception orally but if you have epilepsy or any medications that you are using, then dose would be higher 3 gm. This is the original name and many brands are available for it. It should be taken within 48 to 72 hours of unprotected sex, without vomiting and with proper dose as I advised above. I hope you will get it but another contraceptive that you can have is copper-containing intrauterine device but it needs to be inserted and can cover up to 120 hours post-sex. Unprotected sex. Levenogestrel 1.5 gm per oral if no epilepsy (epileptic patient needs to have 3 gm). Copper containing intrauterine e-contraceptive device can be helpful. You can have regular cyclic combined oral contraception cyclically from withdrawal bleed." } ]
[ { "from": "human", "value": "Hello doctor, I have a complete retinal detachment in my left eye from an early age (11 to 12), went to many places including renowned eye care hospitals but nothing worked. Anyways, after a few days my left eye started to go outward and within a short time went completely outward (divergent squint). At that time, I did not care nor did my parents but now I am 22 years of age and suffer from social anxiety because of my eye. So the question is can it be corrected with surgery? Is there any chance of me having double vision after the surgery assuming everything goes well? Thirdly, an eye doctor said it may again turn one day. Is that true? Is there any possibility of eye turning again after surgery?" }, { "from": "gpt", "value": "Hi. Firstly, as you have mentioned that you have had a total retinal detachment (RD) in your LE during childhood, I would like to emphasize on the fact that RD surgery will not help in improving your vision. The squint you are talking about is an adaptive mechanism of the eye towards poor vision due to RD (abnormal retinal correspondence). Even after squint surgery, the vision would not improve. Squint surgery involves either lengthening or shortening of the muscle. So the amount of correction needed is only a subjective measure. Only for cosmetic reasons, squint can be corrected. The outcome of surgery can be analyzed only by performing certain tests. Also, whether the squint can revert back or not can be decided only by the test results. So, kindly revert back to me with the following test reports. Refraction testing, intraocular pressure, dilated fundus examination, B scan of LE, OCT of LE, squint evaluation (qualitative and quantitative). Coming back to your questions. Firstly, squint correction can be done for cosmetic reasons with no visual outcome. There are chances of having double vision or diplopia after squit surgery, depending on whether there is over or under correction. There are chances of squint reverting back (due to various other reasons). Kindly revert back with your reports." } ]
[ { "from": "human", "value": "Hello doctor, I am an 18-year-old female, no current medications, no known conditions, family history of many different heart problems on both maternal and paternal sides, seen by a cardiologist for bigeminy and irregular heartbeat over the summer, palpations still happen pretty often, chest and shoulder pain both on the left side still happening occasionally. Told by my cardiologist that I have nothing to worry about at all, have not talked to her since then. Yesterday, I got my paperwork and my test results from wearing the 24 hour Holter monitor and I am extremely worried." }, { "from": "gpt", "value": "Hi. What you have is called premature ventricular contractions (AKA PVCs), which are extra beats coming from the bottom chamber of the heart and in some occasions they present in every other beat (what is called ventricular bigeminy) (attachment removed to protect patient identity). These beats can be tolerated as normal in many individuals, However, there are two things that are the most important factors to consider: 1. What is the burden (amount or percentage of PVCs in 24 hours in your heart? While some people say that up to 6 PVCs per hour is normal, the number that cardiologist gets worried is more than 10,000 or more than 20,000 in 24 hours. The main reason we get worried with this number is because this is the limit when PVCs can be associated with impairment of the squeezing function of the heart. 2. What is the heart function, in particular, what is the ejection fraction (squeezing function) which in other words is the ability to pump the blood? If the ejection fraction is low, we have to explore the amount of PVCs (particularly if more than 10,000 in 24 hours) as a potential cause of this low pumping function. This is something that can be done with an ultrasound of the heart. If we do see that the pumping function is low and there are more than 10000 PVCs in 24 hours, we need to consider treating this with medications, a catheter-based procedure or both. Finally, it is important to determine if you have a lot of symptoms, in particular, palpitations, dizziness, fainting or chest pain, in a regular basis and if these symptoms are interfering with your life. PVCs. Echocardiogram, treadmill stress test, to assess if the PVCs get suppressed or not during exercise. PACs with aberrancy. PVCs. Echocardiogram, treadmill stress test. Low dose beta blocker (Metoprolol or Propanolol) can be used once we have a confirmatory burden in the Holter. Please verify if the Holter report has a percentage of PVCs in 24 hours. I did not see it in the attached picture." } ]
[ { "from": "human", "value": "Hello doctor, Thought to have likely acute AIH for the past eight months. Currently, being treated with Prednisolone 8 mg to go to 5 mg and Azathioprine 50 much. My ALT/AST are within normal range last two months coming down from almost 2000. ESR has been steadily rising since past five months, commenced Azathioprine later, ESR was normal. Can you tell me your thoughts? I did not see the consultant for two months. I have been told all other blood reports are fine, ESR now is 52." }, { "from": "gpt", "value": "Hi. In general, ESR is a very non-specific marker. It has no significance in isolation. However, in countries where tuberculosis is predominant, we always consider it while a person is on immunosuppressive drugs. So you can ask your doctor for a chest X-ray. It is however not essential if you do not have any symptoms in general. So go ahead with your treatment. If you have any symptoms like cough, weight loss, then we need to do work-up for tuberculosis." } ]
[ { "from": "human", "value": "Hello doctor, I have a problem controlling my anger and anxieties which leads to erratic, eruptive behavior. It is hard to let bad things go for me. My expectations from others are very high and that leads to making them feel bad for not doing enough." }, { "from": "gpt", "value": "Hello. Could you please provide more details about the problem? Do you think that the anger issues are persistent since years or are these issues occurring in episodes? Like you become irritable and have anger outbursts for a few weeks and then you are totally alright? The repetitive anger outbursts could occur in some mood disorders like bipolar disorder. But other symptoms like stubbornness, increased activity, the risk-taking behavior, decreased need for sleep, disinhibited behavior, etc., are also seen. These symptoms usually occur in episodes. This could be due to intermittent explosive disorders. Episodes of anger outbursts are seen usually and sometimes after that, individuals feel guilty because of their behavior. Even atypical depression can present with irritability which cannot be explained. Low mood, sensitivity to rejection, anxiety, etc., are seen. You should visit a psychiatrist for evaluation and treatment. Drugs like Sodium Valproate can be used for controlling mood and will reduce the anger episodes." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My baby just turned 6 months. I gave him Nan Optipro One for his 1st to 6 months, now I gave him the follow up milk which is Nan Optipro Two. After two days of drinking, he is suddenly having diarrhea now (five times a day). I tried reaching out for a pediatrician in our area but they are not accepting the appointments. He is also irritated because of his blooming teeth and he is eating oatmeal with banana puree. I wanted to ask if it is just his tummy adjusting or is there any underlying problem?" }, { "from": "gpt", "value": "Hello. I appreciate your concern regarding your child. I would like to advise that transition can cause diarrhea but it should settle within four to five days. If it does not then we should change the feed. Ensure hydration, give him ORS (oral rehydration solution) solution (dissolved one packet in one liter of water). She must take 90 ml of this solution after each loose stool. This ORS contains electrolytes that have lost by stool. Give it until loose stool subsides. Syrup Zinc 5 ml once a day for 14 days, it will fulfill zinc deficiency in your child and prevent further episodes of diarrhea and pneumonia also. Give him semi-solid food more along with curd (this will help to improve the digestion). During this illness watch for any color change in urine output or decreased urine output, and any lethargy. In case they come please consult." } ]
[ { "from": "human", "value": "Hello doctor, Unsure of diagnosis (could be a combination). My questions are as follows: 1. What is my diagnosis (they say schizophrenia and autism high spectrum) memorized 200 digits of pi in one day? 2. Could I not have mental illness and Marijuana was a one-time incidence? 3. If I do need medicines and stay on Lithium, how do I get off of Olanzapine after taking it for 20 days 5 mg and 10 days 10 mg? So not to go manic from the stop. Took a lot of medical Marijuana with them and went crazy, they took me to the psych ward. Put me on medicines for the first time. Risperidone and Luvox and did great, so good I stopped taking it which I relapsed (did it too fast I believe) but the doctor will not put me back on. Then I went on Invega Sustena monthly shot and cut my self out of anger, did not really want to live, they took me off. Put me on Lithium 900, did great for six months, then I missed a few doses and mania started coming to play. They added Olanzapine and that is where my problems started. Slammed the refrigerator door 10 times, broke it. Felt the need to listen to a message of jumping out a window (I did it on the ground floor), then broke a second story window due to a message in a song. I feel Olanzapine is increasing the message and I read that it can increase hallucinations. Can I just stop Olanzapine cold turkey? Still getting messages at 10 mg but never had messages before the Olanzapine (except during medical Marijuana)." }, { "from": "gpt", "value": "Hi. I read your query and understand your concerns about the diagnosis and problems encountered by you. Although the provided information is not sufficient to make a diagnosis of a case, but from the available description, it appears to me that you are suffering from cannabis-induced psychosis, a variant of schizophrenia which often starts with the use of cannabis. Although this has a cause, elimination of cause itself never sufficient to cure the problem. I must acknowledge that before making a diagnosis I need to have access to all your records or at least 30 minutes interaction with you. As stated above I do not think your mental illness and Marijuana can be separated from each other. Although the literature is scarce I have seen multiple numbers of patients with cannabis-induced psychosis. Since the problem is already there I think there is a need to treat. Since you have responded well to Risperidone or Invega, I see more merit with Risperidone use in your case in compare to Olanzapine. Although Olanzapine can be discontinued cold turkey, there is a need to manage those voices with the use of any other medication, preferably Risperidone as stated above. So I mean to say that it is fine to discontinue Olanzapine but simultaneously talk to your psychiatrist to prescribe Risperidone to manage those hallucinations. Having said this, I would like to inform you that we need to have a one to one discussion for making a proper diagnosis and designing the best strategy for the cure of your problem. This can be done through online consultation provided you are comfortable with the idea of online consultation." } ]
[ { "from": "human", "value": "Hello doctor, What does both kidney slightly hyperechoic in an ultrasound indicate? I am 19 weeks pregnant and very worried about my baby." }, { "from": "gpt", "value": "Hi. Hyperechogenicity in kidneys is seen in some congenital polycystic renal diseases leading to renal failure in late childhood or adulthood. But in fetuses, this marker has been studied sparsely. These studies have shown that if the amniotic fluid around the baby is adequate as per gestational age, outcomes are favorable like no kidney impairment. Please follow up with USG growth scan every three weeks to note the fluid level and liver echogenicity as well. If follow up reports remain within normal limits, it is just a normal variant. No need to worry in such conditions." } ]
[ { "from": "human", "value": "Hello doctor,My child had critical pulmonary stenosis and had balloon dilation at three months. She is now 13. She has moderate pulmonary regurgitation, her LV ejaculation fraction is 69 %. She has a mildly dilated RV and pulmonary artery. She gets breathlessness. Should I be concerned?" }, { "from": "gpt", "value": "Hi. As per cardiac MRI (attachment removed to protect patient identity), the degree of pulmonary valve regurgitation is moderate at the most with only mildly dilate RV. Please be assured at this stage. However, she still needs yearly follow-ups either with an echo or another cardiac MRI. If you have the full report of the MRI, I am happy to go through with you." } ]
[ { "from": "human", "value": "Hello doctor, I am 18 years old female, 137 lbs, and on no medications. I have had irregular periods since I was 13. The longest I have gone without a period was three months. I have had multiple negative pregnancy tests. I have not had my period since last month and I am not pregnant. I am worried about my health although this has happened before." }, { "from": "gpt", "value": "Hi. Please answer the following questions: 1. Putting on weight, and unable to lose that? 2. Acne? 3. Facial hair increased? 4. Hair loss? 5. Thick hairs on chest, back, thighs, arms, belly? 6. Any known hormonal issues? 7. Any long-term medication taken? 8. Sedentary lifestyle? 9. Are your parents diabetic or prediabetic? First few years of menarche can give you irregular periods, and that is normal as your hormonal axis is not matured enough to have a cycle, but by 15 years, it should generally be fine which in your case is not. You could be suffering from some hormonal imbalance. Work out the following: 1. A balanced diet containing loads of yellow fruits and green vegetables. 2. Regular physical exercise for 30 minutes to keep heart rate above 100 during the activity. 3. Add cinnamon and turmeric to your diet. These small changes can bring a lot of difference. Do it for the next three months. I can assure, you will feel the difference in a month but continue it. You also need to get USG pelvis done to rule out polycystic ovarian syndrome." } ]
[ { "from": "human", "value": "Hello doctor, I want to ask whether composite dental bonding is durable or if I bite a mutton stew or chicken leg piece, it will come out? Is it for a lifetime? If it dismantles anyway, is it freely replaceable or I need to pay again? Also, I have heard that laser treatment leads to early fall of adult teeth in the late 50s. Is it so?" }, { "from": "gpt", "value": "Hi. I had gone through your question. I can understand your concern. Yes, you can eat whatever you want to eat, there is no issue of chewing. Make sure you do not eat any hard substance for the first 24 hours. After that, you can eat mutton or chicken anytime. Better is to go with the best possible restoration provided by your dentist. Less expensive fillings are also available these days but their efficiency is not too good. No, laser curing composite does not affect your teeth or make them prone to fall. If the fillings fall or come out, it will be replaced by your dentist free provided it falls early, if it falls after two or three years it may not be replaced without charges." } ]
[ { "from": "human", "value": "Hello doctor,I have 10 months old baby. Since yesterday, she is suffering from diarrhea. Yesterday five times, today three times, and I have not used any medication for this. Can you please suggest any medications?" }, { "from": "gpt", "value": "Hi. Diarrhea is most viral in nature in children. Requires symptomatic treatment. Replace fluid loss with ORS. Add Zinc supplement (2 mg/kg) for 14 days. Watch for urine output. Give syrup Vizylac 2.5 ml BD as probiotics. If severe dehydration, visit the hospital. Any episode of vomiting?" } ]
[ { "from": "human", "value": "Hello doctor, I had unprotected sex with my husband a month back and my LMP five days before that. I took Plan B pill within 10 hours of intercourse. My cycle is usually 25 days and I have not got periods yet. I tested 10 times, all were negative. Should I go to gynecologist and request for an ultrasound? Will ultrasound detect early pregnancy?" }, { "from": "gpt", "value": "Hi. I can understand your concern. The possibility of pregnancy is very less and the possibility of hormonal imbalance is more likely. Please let me know. Do you have any other symptoms like breast tenderness, abdominal pain or fullness? Have you taken Plan B before? In my opinion, you should wait for 1 to 2 weeks more before going to the gynecologist for an ultrasound. Please reply me with answers to the above-asked questions, so that I can guide you better. I will be happy to help you further." } ]
[ { "from": "human", "value": "Hello doctor, My father is 58 years old, last week he had a heart attack and turned out he had a blockage of 75 percent in the left anterior descending artery (widowmaker). So, he had a cardiac catheterization and one stent, so we feared that the side effects of quitting smoking might affect his heart since he is in no position to go through them. Is E-cigarette safe way to quit? Can it give him another heart attack? Also, he has diabetes stage 2, but we are still monitoring it." }, { "from": "gpt", "value": "Hi. I am sorry to hear about your father but I am glad he survived and was appropriately treated. If he wants to increase his survival and decrease the possibility of dying, having another heart attack or developing heart failure (weak heart), he must stop smoking. There is no risk of stopping smoking related to this heart disease. The real risk is not to stop smoking. In regards to E-Cigarettes, they have been found to have a risk to the heart and lungs that do not make them a safer alternative to regular smoking. However, there are plenty of therapies and measurements to help him quit and although it is not easy, they might be very effective if used appropriately. And if he fails and recurs, it is totally fine and he can try again, over and over until he quits." } ]
[ { "from": "human", "value": "Hello doctor, My exams are about to start. I was not serious at the start but from the past few days, I have been working really hard. People near me say it is too late now something worse is going to happen. But the way I have planned things I know I could easily score good marks but the problem is I am not able to do as I thought. I am wasting most of the day wondering here and there. Plus the masturbation has also increased. Please tell me what should I do." }, { "from": "gpt", "value": "Hi. From the description, it seems that you had confidence regarding the exams before some days. But it seems that, for now, you have lost your confidence. Why have you lost your confidence? Is it because of other people who try to demotivate you? Is it because you could not perform well in mock tests? In any of the case, do not worry or think too much. The answer to your question is simple. You will score good marks if you have prepared well. You will score low marks if your performance is low and medium marks if your performance is medium. That simple. There is one more limelight. You have prepared 60 % and if almost all the questions are from the portion that you have prepared, there is still a chance of scoring 90 %. So do not be demotivated. You still have time. Last minute preparation provides more insight and knowledge. All the best." } ]
[ { "from": "human", "value": "Hi doctor, I had a C-section eight years ago with my son and a C-section seven months back with my daughter. I am interested in having another child and wanted to plan on coming off of birth control till mid of this year. My doctor said that, in general, they prefer women to have two years between deliveries. My question is, when will my uterus get completely healed and ready to handle the pressure of another pregnancy? If I get pregnant sooner than later, I would be a few months less of the two-year mark." }, { "from": "gpt", "value": "Hi, Welcome to iclinq.com. Generally, by book, it needs 18 months for your uterus to heal from the previous cesarean cut, but healing is regulated by many factors like intrinsic tissue quality, general nutritional status of the lady, the healing power of the body, diabetes, postoperative convalescence, sepsis, the presence of protein diet, etc. Since you had another C-section, did the doctor mention the difficulty of the cesarean section at that time? Did your first and second cesarean go well or was associated with greater care than general? Since the healing is dependent on a lot of things, and also the uterus can never come back to its original strength due to two scars on the body, so the two-year safety mark. So, if you wish to take the pregnancy sooner, you should be compliant in visiting a doctor in a tertiary care center, with an emergency OT and blood bank facility." } ]
[ { "from": "human", "value": "Hello doctor, Actually, I have been feeling low energy, tired, and fatigue for a couple months now. Also, I get light dizzy, light-headed, and headache, it gets worse when I walk or stand up. The headache is concentrated from the sides and sometimes forehead and around eyes. However, I have been suffering from anxtiey and depression. My anxiety is moderate sometimes it lasts the whole day. I took multivitamins, zinc, and vitamin D. Now I am taking Feroglobin two times a day for a week now. I did not see much improvement. How to cure tiredness and lack of energy? How to reduce anxiety levels?" }, { "from": "gpt", "value": "Hello. It may happen sometimes but it will be solved very soon. Avoid those stressful conditions. Medication has to be given. Generalized weakness. Serum creatinine. CBC (complete blood count). Urine routine and examination. Fasting blood sugar. Lipid profile. Hypothyroidism. PCOS (polycystic ovary syndrome). Tablet Diazepam 10 mg 1 tablet in bedtime daily for 15 days, tablet Tolfenamic acid 200 mg 1+1+1 for five days, tablet Iron polymaltose complex + Folic acid + Zinc (150 mg + 500 mg + 22.5 mg) 1+1+1 for three months, Folic acid 5 mg 1+1+1 for three months. Avoid anxiety. Sound sleep needed. Eat healthy foods. Drink plenty of water. Recreation needed. Avoid stressful work. Always think positive. Please tell me about your menstrual life, sexual life, and family history." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, My son is 5 years old, weight 19.5 kg. He has got a stye kind of boil in his right upper and lower eyelid. Yesterday afternoon, I noticed it in the upper eyelid. I applied the paste of white clay stick and applied oil for his hair to reduce his body temperature. But now, there is another boil coming up in the same eye in the lower lid. It is a bit painful to touch. No fever. He is active as always. I gave a warm application for the eye. What to do now? Can you advise some medicine like eye drop? How to avoid it further?" }, { "from": "gpt", "value": "Hi. Yes, there is inflammation over eyelids (Stye) (attachment removed to protect patient identity). You can use Toba eye drop 3 to 4 times a day for five days. He can take a plain pain killer like Crocin 7.5 ml thrice a day. Do not apply anything except eye drop. You can use lukewarm water cloth to cover over the eyelid. Keep for 10 to 15 minutes. It will help reduce swelling faster. Do it only if he is comfortable." } ]
[ { "from": "human", "value": "Hi doctor, I have just found out that I am very low in vitamin D. I have just had lots of different blood tests, bone profile, 12 folates complete blood count, vitamin D and a couple of others, all came back normal apart from vitamin D. I have been getting an aching pain in my upper arm and elbow, hip and knee but mostly my upper arm. Can it be the low vitamin D that is causing it?" }, { "from": "gpt", "value": "Hi. I cannot say it with utmost certainty, but yes it could be due to low vitamin D3 levels. The majority of patients with moderate to mild vitamin D deficiency (serum vitamin D between 15 and 20. The majority of patients with moderate to mild vitamin D deficiency (serum 25[OH]D between 15 and 20 ng/mL [37.5 to 50 nmol/L]) are asymptomatic. Serum calcium, phosphorus, and alkaline phosphatase are typically normal. Serum parathyroid hormone (PTH) levels are elevated in about 40 and 50 percent of patients with serum vitamin D levels less than 20 and 10 ng/mL, respectively. Patients with low vitamin D and increased PTH (secondary increase) are at increased risk of having rapid bone loss, seen as low bone mineral density (BMD) in dual-energy X-ray absorptiometry [DEXA scans]), fragility fractures. With chronically low vitamin D levels one can develop secondary hyperparathyroidism, which can affect serum calcium and phosphorus levels. The patient usually develops symptoms at this stage with features of osteomalacia (bony pain, etc.). I do not know your vitamin D levels, but there is usually no harm in taking vitamin D supplements orally weekly or daily." } ]
[ { "from": "human", "value": "Hello doctor,There is some thrush coming out of my vagina and it is slightly yellowish like cottage cheese and along with that, my vagina is burning, itching, and inflamed." }, { "from": "gpt", "value": "Hi. Have you been treated for any other health issue like diabetes or any other chronic issue? If yes, it is better to have a regular check-up and proper treatment for that. Diabetes increases risks for infections. Overtreatment can destroy normal vaginal flora to make it more prone to the infection. You already have Fluconazole tablet, it is better to have 150 mg but it would be better if you take a high vaginal swab to check in the laboratory before starting treatment. Have strict hygiene, use condoms to avoid transmission of infection. Wear soft comfortable undergarments. Avoid cosmetics and products locally and use water and soft razor for removing hairs. Have sitz baths frequently. After swab collection, have tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg eight hourly for 14 days along with Clotrimazole and Clindamycin vaginal suppository for alternate three nights. Collect swab report and discuss. Infection. HVS." } ]
[ { "from": "human", "value": "Hello doctor, I was eating a hot curry last week when the top of my mouth blistered over as if I had burnt the hard palate, which I thought was unusual as I felt the heat on my tongue first but did not. The blister has gone but left a small dent in my hard palate which I am concerned about as it is leaving a bad taste in my mouth. Is this common?" }, { "from": "gpt", "value": "Hi. Yes, this is common. You do not need to worry. The mucosa of palate is very sensitive as compared to the tongue. So it gets affected easily. You just put an Oral gel Clinica (Chlorhexidine with Metronidazole) gel on the spot for three days and three times a day. Then give me a followup after five days. Hopefully, everything will be fine. New mucosa on palate grows after almost 10 days." } ]
[ { "from": "human", "value": "Hi doctor, I am using 75 mg Zoloft for the past seven months for anxiety disorder. I have started with 25 mg and my doctor increased the dosage slowly for my panic attacks. But for the past two months, I do not have any strong panic attacks and when I have the small ones, I am capable of handling it. I want to stop to taking medication. Could you please advise me how to do it in order to avoid withdrawal syndromes of Zoloft. How should I quit? How much I should reduce the dosage and how long should I continue?" }, { "from": "gpt", "value": "Hello. Zoloft (Sertraline) is a good medication for anxiety disorder. You are on a low moderate dose of 75 mg once daily (dose range is 50 mg to 200 mg once daily). It is good that you are feeling better for the past two months. It is recommended to continue Sertraline for at least six months after you are feeling better. So it is advisable to continue for at least another four months. During this period also develop psychological strategies to manage anxiety (talking therapy or CBT will help you to achieve this). If stable after four months, discuss with your prescribing doctor about gradually tapering down the dosage gradually. You can try cutting down to 50 mg once daily and see whether you continue to be stable. After a month, you can consider cutting down further to 25 mg once daily. Continue for another month then stop completely. Remember, if symptoms reappear at any time during tapering down, you have to go back on the higher dose. To sum up, continue Zoloft at least for another four months. Get CBT if not done already. Then if stable after four months, taper down gradually under medical supervision." } ]
[ { "from": "human", "value": "Hello doctor, My wife is having toothache and swollen and inflamed gums for four days. This is due to wisdom teeth. Currently, she is taking Cataflam 50 mg two tablets in 24 hours for the past two days for pain relief. Her age is 36 years and her weight is 56 kg. She does not have any past medical history. Currently, we feel visiting the dentist should be avoided. Please advise for medication." }, { "from": "gpt", "value": "Hi. The proper treatment of wisdom tooth is extraction as wisdom tooth is not able to perform its function of chewing because it is present in the most posterior position of our oral cavity. So it is of no use in saving it by RCT (root canal treatment) and crown and wasting money and time in it. So it is better to go for extraction after lockdown overs and kindly visit a dentist who is taking all the sterilization measures with PPE (personal protective equipment) kit. Until that time, do saline and warm water gargle three to four times a day for seven days. Take hot pack from outside the mouth and apply it on the affected cheek area to reduce the swelling twice a day for seven days. Take tablet Augmentin (Amoxicillin and Clavulanic acid) 625 mg BD for five days, Zerodol SP (Aceclofenac, Serratiopeptidase, and Paracetamol) BD for five days, Pan 40 (Pantoprazole) OD before food in the morning, and capsule Becosule OD. In case of severe pain take tablet Ketorol - DT (two tablets dissolve in a glass of water). I hope this helps." } ]
[ { "from": "human", "value": "Hello doctor,A 5-year-old boy has a neck mass or lump on his right side of the neck under the jaw. He feels pain while swallowing food and if he touches it. No fever, no cough, no cold, no complications. The lump is visible and was observed yesterday. We have visited a doctor and he advised to take antibiotics (Taxim-O Forte) with Paracetamol syrup for seven days. After seven days, if it does not go away, he suggested some additional tests. Could you please let me know if this is some major problem and any further diagnosis needs to be done immediately?" }, { "from": "gpt", "value": "Hello. The mass or lump that is being felt may be inflammation of local gland due to infection or lymph node enlargement. Both of these will respond to the antibiotics given. In case that it does not resolve, then a further workup is recommended which include radiological, pathological as well as blood investigation. Followup clinical examination is necessary to delineate any kind of pathological condition. So followup visit to a pediatrician for clinical evaluation is necessary." } ]
[ { "from": "human", "value": "Hello doctor, I think my maxillary lateral incisors are not in perfect shape but my dentist thinks they are. I just need a second opinion." }, { "from": "gpt", "value": "Hi. Your maxillary lateral incisors are perfect in shape and place (attachment removed to protect patient identity). Only, maxillary left central incisor is a bit down from occlusion that only dentist or you can feel the difference. If your case is about to end, ask the dentist to remove the bracket from #1 left side upper and put it back just 0.5 mm above and then put the wire back for like 2 or 3 weeks. Then this tooth will be intruded and will be perfect in place. Otherwise, if he feels like he can do slight slicing of this incisor too so that both the incisors will be same in place. 19, 20 difference would not be much obvious. Give me followup after your next visit to the dentist." } ]
[ { "from": "human", "value": "Hello doctor, I just got married. Right after two days, my wife experienced a sharp pain on her right head to the neck, it felt like someone hammering the head. Then after 20 to 25 minutes, she slept and it stopped. Then again after 5 to 6 days, it came up again in the same frequency and same pattern just right side of the head to the neck (right side) and then again after three days, it came back. Can you please suggest something?" }, { "from": "gpt", "value": "Hi. If she does not have any other deficits like a hand or leg weakness or giddiness or cognitive deficits, then most likely it is a migraine. It is just recent in onset. So, we can wait with medicines. Tablet Topiramate 25 mg at bedtime for 21 days, tablet Sibilium 5 mg at bedtime for 21 days. Initially, she may get more sleep, but with lightheadedness for 3 to 4 days, then her symptoms will improve gradually." } ]
[ { "from": "human", "value": "Hello doctor, We are concerned about our 3 years old boy. He started urinating very often at the day time. He urinated about 40 times a day today. Every couple minutes, sometimes 5-10-15 minute gaps with a small amount urine. Our boy has no temperature, no pain, seems happy, playing like usual. Sleeps well and does not urinate at night. Hopefully, you will give me an advice. I will look forward to hearing from you soon." }, { "from": "gpt", "value": "Hi. From what you are describing, there may seem to be an overactive bladder. It is more during the day and normal at night in this case. In such cases, it is usually transient. I would also want to know the psychological state of this child if he has been shouted at or beaten by someone. Since this is a very common reason for such a phenomenon, it should go away in a while once the offending agent is taken care of. It is advisable to do an ADH level for this child if this persists for more than a week. Oxybutynin may need to be started if symptoms are severe and not resolving." } ]
[ { "from": "human", "value": "Hi doctor, Three months ago, I saw a dark brown mole under my right breast. The mole does not produce any symptoms. The mole when touched is noticeable bulging, is not smooth as other moles that I have. What can it be?" }, { "from": "gpt", "value": "Hi. It could be a normal melanocytic nevus. If there is a sudden increase in shape and size with irregular border, an increase in color or rapidly evolving, then you can go for a non-invasive technique like dermoscopy and invasive technique like skin biopsy to confirm whether it is benign or malignant." } ]
[ { "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": "I’ve been on my period for 3 weeks. It’s beyond heavy. I soak thru a pad and ultra tampon hourly. I am also passing golf ball size clots and massive gushes of blood! I have some cramping as well! No dr can see me for 3 weeks due to Covid and I don’t know what else to do." }, { "from": "gpt", "value": "Hi, bleeding so heavily for 3weeks is really painful and tiring . I salute to you for bearing it for so long I want you to know that endometriosis can only be suppressed with taking contraceptive pills continuously . for now take tab .deviry (medroxyprogesterone ) 10mg thrice daily for one week followed by twice daily for next one week and followed by once daily for next one week and stop eventually. I am also concerned about your Hemoglobin levels following such heavy bleeding .please get hemogram ,an ultrasound done . For now you can take iron ,folic acid and bit B12 tablets to combat anemia. please get back to me if u have any queries regards" } ]
[ { "from": "human", "value": "Hello doctor, I believe I have broken my right side molar in half vertically. The left side is very loose and I cannot bare any pressure without significant pain. What is the best course of action without insurance and can the tooth be saved?" }, { "from": "gpt", "value": "Hi. If the broken part is not causing much pain, try to eat something sticky like wet dates or eclairs type candy or chocolate so the broken part gets removed through it and then follow this antibiotic regime for three days. Tablet Augmentin 625 mg twice a day, tablet Metronidazole 400 mg twice a day, tablet Brufen 400 mg twice a day or eight hourly if the pain is severe. Hopefully, the tooth will get okay if this is a slight fracture but if it is hurting you badly there is no option other than extraction of the whole tooth. You should get it extracted as soon as possible otherwise you cannot eat from this side. Give me followup after three days about your condition. Stay happy and blessed. Take care." } ]
[ { "from": "human", "value": "Hello doctor,My daughter is 3 years old. When she was 2, we shifted to a new place and from there she started having allergy problem like bronchitis. Every time she catches a cold and it developed into allergic bronchitis. In X-ray report, it says she has hyperreactive airway disease. Now finally, I changed place again. How long will it take to improve as she still sneezes a lot?" }, { "from": "gpt", "value": "Hello. As per the history and the doctor's notes, I understand your daughter has allergic rhinitis and lower airway hyperreactivity. There is no easy solution for allergy. Allergy is due to some component in the air that she breathes. We must identify what she is allergic to. Some of the following you may need to do. 1. After using the Duonase spray for 15 days as given by your doctor, change it to Mometasone and use it once daily. Two puffs in each nostril for 30 days and thereafter one puff each nostril. There is a particular way to use spray. If you do not know that then revert back. 2. Continue the Montair LC syrup for a couple of weeks and keep using it on an SOS basis whenever she gets allergy. When you start, continue it for a day. A single daily dosage is sufficient usually. 3. Inhalers like Asthalin and Seroflo are to be used as per the chest physician advice. Keep both handy and may need to be used whenever there are flare-ups. 4. Maintain a diary and write down whenever she gets allergic symptoms, when she goes to some new place, when she opens any old book, garden, pollen, any relation to the food she eats, linens, beddings, etc. 5. Keep house and surroundings extremely clean and tidy. 6. Stop exposure to smoke, pollution dust, and direct cold air. Do revert back to me for further support and help. It is important the kid has a healthy childhood for appropriate development physically and mentally." } ]
[ { "from": "human", "value": "Hello doctor, Does masturbation cause vata derangement? I am experiencing digestive issues from the past one year. Is this because of masturbation? Also, does masturbation cause dry skin? How can I reverse these effects?" }, { "from": "gpt", "value": "Hello. The masturbation causes dry skin and causes weakness also. First of all, stop it. Work on your digestive trouble first. Have 3 to 5 soaked almonds daily morning along with 10 Munakka (black dried grapes), weekly twice black dates and fig (alternate). Take one cup of water with 1/2 teaspoon of jeera powder-boil, do not filter, add half teaspoon ghee in it and drink warm-daily once for 10 days. Ashvagandharishta (450 ml bottle) 15 ml twice daily with equal water after food. Go to any ayurvedic panchakarma center for rejuvenation therapy after 15 days if still feeling weak." } ]
[ { "from": "human", "value": "Hello doctor, Three weeks ago, I had an internal stye and my doctor prescribed oral antibiotics. But, in the end, it became a chalazion, plus some pus was drained. Now, the stye is coming back and it itches a lot (I can see a big white spot in my eyelid margin). It is not as bad as it was before, but I am worried. Why is it happening? Is there a chance of antibiotic resistance?" }, { "from": "gpt", "value": "Hi. I can understand what you have been going through. Now, as you can see the pus point at the lid margin, it is an external hordeolum or stye. Recurrences can occur with respect to stye. The reasons being multiple. If possible, could you revert back with pictures of your eye so that I could make a more definitive diagnosis? The chances of antibiotic resistance with respect to stye is highly unlikely. Once it is drained, the neighboring meibomian duct might get inflamed resulting in a stye. However, recurrences are common in diabetics, uncorrected refractive error, and immunocompromised states. Kindly revert back with the picture of your eye." } ]
[ { "from": "human", "value": "Hi doctor, I am 28 years old and married. I am trying to conceive for the last four months but not achieved. I have done blood, all hormones and sugar test. They all are normal. But in TVS test, they have diagnosed that I have bilateral hydrosalpinx. From that, I am so tense. Could I get pregnant naturally? Please advise." }, { "from": "gpt", "value": "Hello. The ultrasound reports show that you have hydrosalpinx and bilateral endometriotic ovarian cysts (attachment removed to protect patient identity). Hydrosalpinx indicates a chronic pelvic infection which can be treated with two weeks course of antibiotics and endometriosis shall require GnRH analogues for six months to reduce endometriosis, post which a repeat ultrasound and HSG test would have to be performed to check for the latency of the tubes. The infection has to subside. You may follow up with all your reports." } ]
[ { "from": "human", "value": "Hello doctor, I am 27 years old, male. My problem started five months back. Due to viral fever, my platelets count is low. The report is attached. This time I took antibiotics. Then my digestion system got poor. After some days I started suffering from cold and cough and fever. This time I am not feeling well." }, { "from": "gpt", "value": "Hello. To me, the changes are due to viral infection you have been experiencing all this while. Now, we should not rely on the complete blood count report only. Sometimes, there is a destruction of platelets due to chemicals inside the sample carrier. I think you should repeat complete blood count and run a microscopical examination of the blood sample to count the actual number of thrombocytes (platelets) for better evaluation." } ]
[ { "from": "human", "value": "Hello doctor, I quite often suffer from feeling numbness in the part of my head, face, and hand. I also quite often feel something like weak convulsions in the head. Those are very often with a headache. I am also very sensitive to the light and temperature changes. Those very often cause very strong headache and tearing. When there is cold outside, for it becomes difficult to speak. While walking sometimes for me it is very difficult to keep the coordination. I often feel trembling and weakness in the face and hands. I have visited neurologist a few years ago and magnetic resonance tomography was indicated. However, I have not gone for this medical examination. I have just started taking indicated medicines Tanakan. It helped me a little bit, but all those symptoms have stayed. I live with it for quite a long years. What illness it may be? What treatment and indications would be in this case?" }, { "from": "gpt", "value": "Hello. I read carefully your question and would explain that your symptoms could be related to different possible causes like fibromyalgia, vitamin D or vitamin B12 deficiency, tension-type headache related to psychological stress, multiple sclerosis, small vessel disease of the brain, etc. Tanacan can help improve blood circulation in the brain. I would like to know your age and past medical history. I also agree with your doctor on the recommendation for a brain MRI, as it is very important to exclude some of the above possible causes. I would also recommend performing some other blood laboratory tests like complete blood count for anemia, vitamin D and vitamin B12 levels, plasma levels for possible deficiency, PCR for inflammation, thyroid hormone levels for thyroid gland dysfunction. You should discuss with your doctor on the above tests." } ]
[ { "from": "human", "value": "Hello doctor, In the case of twin pregnancy with a different placenta, the packet of amniotic fluid is also different or there is only one packet on which both babies are living?" }, { "from": "gpt", "value": "Hi. Twin pregnancy is of four types. One with two amniotic sacs and two placentae which is known as a diamniotic dichorionic twin. If there is only one sac and one placenta it is called monochorionic monoamniotic twin. If there are just one sac and two placentae, it is monoamniotic dichorionic. If there are two sac and one placenta it is called dichorionic monoamniotic twin. However, if you have a doubt then get back to me." } ]
[ { "from": "human", "value": "Hello doctor, I feel so depressed from the past few weeks. I am in a relationship wherein, my fiance is not able to give me time. We are in the relationship for the past 5 years. I am so addicted to him that I do not have any other friends in my life and I feel he is my everything. Due to some reason, he is not giving me time and that is hurting me a lot. I do not feel like staying at home. On weekends also, I plan to go to the office. I try keeping my self busy. On sunday, I am at home. I go for a drive or go shopping so that I would feel better but from the past few days, whatever I do, I am not feeling good. I am not feeling like going out for shopping nor for the drive. Things which gave me happiness are also irritating me. I just sit and think about things and keep crying all the time." }, { "from": "gpt", "value": "Hi. I can see you are in a tough situation. Every relationship has many aspects which are mutual like mutual respect, mutual care, mutual love, mutual expectations. The problem arises when there is an imbalance in partners mutual love, care, expectations, etc. And it is more hurtful for the partner who gives more, the one who takes things little bit granted does not get affected. In this situation, my advise to you would be a direct and clear communication on what are your expectations and what things are hurting you. Do not plead in front of your partner for his time, love and care. This will make you even more granted in his life. Try to make friends also. Do not make this relationship your whole life, it will increase your fiance's authority to hurt you. Try these things." } ]
[ { "from": "human", "value": "Hello doctor, My mother, 53 years old, has been suffering from severe stomach pain for the past few days. It started with running fever and dysentery 10 days back and both have subsided. Since then she has following complaints of stomach pain, have to pass stools after every food intake, stool 4 to 5 times a day, severe tiredness. She had recently done her yearly general health check-up and no abnormalities were found. Please let me know how I should get her treated." }, { "from": "gpt", "value": "Hi. Has she taken any medications when she was having a fever and dysentery?" } ]
[ { "from": "human", "value": "Hello doctor, My 85-year-old father had mild pain in his thighs and shoulder girdle for two months which intensified in the past two weeks to a point that he could not get up from his bed. He was started on oral steroids 30 mg once daily for the past three days and has shown a 40% response but cannot stand. Blood tests were done yesterday showing normal serum electrolytes, bilirubin, TSH, and CBC with some iron deficiency. Raised values are CPK - 272, BUN - 50, SGOT - 50, SGPT - 100, and leucocytes - 29000. His Hb is 9 and eosinophilia 42 since before. Kindly suggest the diagnosis." }, { "from": "gpt", "value": "Hello. Well as per your history, it does look.like a diagnosis of polymyalgia rheumatica. I would like to ask you a few more queries related to his illness. When is the pattern of pain more mornings or evenings? Does he experience morning stiffness as well? Any history of weight loss or appetite loss? Any history of jaw pain or headache or fever? Do you have his reports of ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), rheumatoid factor available? As they are the most important to monitor and diagnose. Did they do any scans of the chest and abdomen? As of now the reports do not seem very great with high leukocyte count and low Hb. Diagnosis of polymyalgia rheumatica looks certain but we should rule out any underlying trigger." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am Rh negative. I recently had an abortion of six weeks and was not given the Rh injection. Is my health status safe to prevent future complications in pregnancies? This is the third week into the abortion. Can I still go for this injection?" }, { "from": "gpt", "value": "Hi. Injection anti-D is needed to be taken in case of bleeding within 72 hours of the event. So, it is late already. Most mothers have well-developed immunity against rhesus positive blood group in her second pregnancy if the first child had Rhesus positive blood group. But in the case of fetomaternal hemorrhage also antibodies develop. Rhesus negative issue arises if your partner is Rhesus negative. So first of all, check the blood group of your partner. If he is negative, then there are fewer chances of the fetus to have a positive blood group, so fewer chances of Rhesus isoimmunization issue in coming pregnancies. You can have antibody titer to be on safe side if the husband 's blood group is positive. But if the husband has blood group positive then in next pregnancy as per protocol you will have to get anti-D at 28 and 32, if pregnancy remains uneventful otherwise more time you could receive. Rhesus negative with a history of miscarriage. Husband's blood group. Balanced diet. Normal BMI, weight. If the husband's blood group is positive, then early booking for the next pregnancy to have better care." } ]
[ { "from": "human", "value": "Hello doctor, I am 32 years old, and I am kind of facing the issue of fantasy in my head and mind deconcentration. Whenever I am busy or in social gathering most of the time I am fine. But when I am alone, walking alone and traveling alone, my mind goes into the fantasy. I kind of see this thing becoming common in people and while observing them I noticed that whenever I am in this situation my body is at rest while facial expression is changing according to what I am thinking. As I watched a lot of fantasies movies and seasons, my mind keeps stuck in these, thinking about different scenarios along with facial expression like smiling, anger, etc. It is kind of embarrassing when someone notices me. I would like to know what it is. People are saying it as daydreaming. My question is whether it is really daydreaming, or if not what it is? How can I overcome it?" }, { "from": "gpt", "value": "Hi. Yes, you are suffering from excessive imagination or daydreaming, which is common in every individual. But some people do it more which becomes a kind of habit. Sometimes, we also use this kind of defense and imagination in order to avoid day-to-day stress. It becomes a form of avoidance behavior. Distract yourself with some positive and productive strategies like focus on your career, practice your hobbies, make a day-to-day schedule, try to follow it, use some aversive stimulation to prevent yourself from going deep in imagination like pinching yourself hard on the hand." } ]
[ { "from": "human", "value": "Hello doctor, I am 54 years old and I have never taken good care of my teeth until a couple of months when I started noticing a very rapid erosion of enamel on my front teeth near the gum line. This area was becoming very thin on a couple of teeth and turning brown and no amount of brushing, cleaning, etc., was making the brown go away. So I went to a dentist for the first time in about 46 years and had a deep cleaning done and a brief consultation. The cleaning got rid of the brown stains but then the brown stains returned within a week on the same thinning areas next to the gum line. I keep brushing and trying different things (a whitener, baking soda, peroxide, a mineralizing toothpaste, avoiding food and drink that causes staining, brushing right after eating) but the staining just continues to get worse and is now happening on all of my front teeth (near the gum line). It has been about three weeks since the deep cleaning and in a couple more weeks I have an appointment with a different dentist who is going to clean them again and hopefully give me some advice on what I can do about this including dental bonding perhaps. My question is, what can I do to get rid of these brown stains and keep them away. Are they just going to keep coming back and getting worse no matter what? Did the deep cleaning somehow cause this to be worse? It seems like it did. Can dental bonding cover these stains and stop them from getting bigger? I have changed my diet also in order to promote healthier teeth. Eating more nutrient foods with more Vitamin D, Magnesium, Vitamin K2, making sure I get enough calcium, using Celtic sea salt instead of regular salt, anything that is known to help promote better teeth and gums. Please, any advice you can give me would be very appreciated." }, { "from": "gpt", "value": "Hi. Just checked your given picture and thanks for detailed history (attachment removed to protect patient identity). These brown marks are because of smoking. You have not left me with anything to suggest you as you have already done with home remedies, peroxides, care, etc. Now, if you do not want these brown lines to come back you have to quit smoking for it. Correct your brushing technique. You have to brush your teeth with light hand pressure because I can see at some points you do brushing vigorously that caused enamel to wear off. I would say it is erosion and abrasion at gumlines, where you put a slightly more pressure to get rid of brown lines. You immediately need to stop this. Stop getting angry. Do not be surprised, as your teeth say so. I guess either you are introvert, do not express your feelings or pour out your anger on others and keep grinding your teeth instead or you are a person who takes stress too much. Is it so? Do let me know about it. I can say you are suffering from a condition called bruxism, that is, clenching of jaws or habit of grinding your teeth consciously or unconsciously at night. For it, you definitely need a night guard so your teeth might not get minor fractures or uneven occlusal surfaces can be arrested right away. This is just an additional finding I diagnosed by seeing your ground teeth. Regarding your presenting complaint, yes bonding will definitely work in arresting these gumline abrasions you made yourself by brushing harshly and smoking brown stains will also be limited by it. Rest, for getting permanently rid of it you need to leave your beer and smoke which are definitely injurious to your health. Do give me followup after next visit and after breaking down your habits." } ]
[ { "from": "human", "value": "Hello doctor, I have hypothyroidism and I take 50 mcg tablets every weekend. Can I conceive even though I have this condition?" }, { "from": "gpt", "value": "Hi. Thyroid abnormalities have many side effects related to fertility but the patient conceives and gets a healthy outcome as well if we take proper care and regular continuous treatment and strict check on it. Thyroid can cause fertility issues, miscarriages, congenital anomalies, etc., so it is better to try for conception as soon as possible otherwise with age complications increase. Try to have a strict check and control over thyroid and keep in touch with your physician. Thyroid levels for normal females also fluctuate in pregnancy. So just prepare the body for pregnancy. Have complete treatment of any health issue you have. Have a balanced diet, weight, and BMI. Have folic acid 5 mg. Partner also needs to have a balanced health condition. Have early booking and continuous regular antenatal visits in the maternal medicine antenatal clinic. Serial scans also need to be done for fetal well being and to diagnose any abnormality. In pregnancy, Propylthiouracil is more preferable. Better to have a double marker test at 13 weeks. Continue folic acid, iron and calcium supplements. Balanced diet, weight and BMI matter. I hope things would be better if given proper attention. Regular checkups with physicians. Try to conceive as soon as possible. Sex in the fertile period. Complete attention on physical condition for both the partners. Quit recreational drugs and have recreational activities. Have complete treatment of all health issue, if you and your partner have." } ]
[ { "from": "human", "value": "Hello doctor, I am 65 years old, male, otherwise in good health but BMI around 31. I have a damaged spinal cord at C4 (due to disk herniation) and had anterior discectomy with fusion in 14 years back. I have had left sided peripheral neuropathy since my surgery (15 years). All sensory, no motor issues. However, I have noticed recently a weakness or tired feeling in the left flank, abdomen, and chest that gets worse through the day in addition to increased burning neuritis (eight months). After night's rest, I do not have the symptoms or less. Symptoms return late afternoon into the evening. MRI and CT scans normal. My question is that can exercise improve strength to muscles otherwise compromised by nerve damage? Can exercise relieve neuropathy symptoms? I swim but I have not noticed any improvements. Any recommendations?" }, { "from": "gpt", "value": "Hello. I read carefully your question and reviewed your uploaded test reports and would explain that physical activity is important to maintain a normal muscle force and avoid muscle stiffness due to a damaged spinal cord. Regarding neuropathy, maybe it cannot help improve the situation as it was before the injury at 100 % but it can help reduce the progression and maintain normal muscle strength. It can also help reduce back pain by reinforcing the back muscles and correcting the posture. I would also recommend taking a diet rich in vitamins." } ]
[ { "from": "human", "value": "Hello doctor, I am a 44-year-old male. I had a hard lump on the left lower back between top of the hip bone and lower ribs. No pain to the touch. It feels about the size of a marble or the end of a pinky finger. What is it most likely? I did have a hard fall on my back about a year ago in that area, but I am not sure if that could be related. I want to know what is the chances of something like kidney cancer as that is what comes up when I use Dr. Google. Can you feel a lump from the kidney that close to the surface? Does it feel like what I described? I included an image of the same. I am currently using Prilosec." }, { "from": "gpt", "value": "Hello. I have seen the picture. (attachment removed to protect patient identity). Looking at the location you pointed there should be no lump ideally in that area as it is purely muscular. Having said that, in your case since you had a fall at that point last year, possibly a hematoma has formed and not totally dissolved due to lack of movement or physiotherapy. This is quite normal and not worrisome. Chances of kidney cancer if it is painless, are actually one in a million if you have no other symptoms especially urinary symptoms. I would recommend an ultrasound abdomen-pelvis once feasible." } ]
[ { "from": "human", "value": "Hello doctor,I took my HbA1c blood test and it came back 6.3. Am I diabetic or pre-diabetic? I have brought a change in my eating habits completely and exercising twice per day. Will this reduce my results in six months or I should take diabetic medicines?" }, { "from": "gpt", "value": "Hello. HbA1c % 6.3 is considered a pre-diabetic state. Following are the criteria to diagnose diabetes: 1. Normal: FBG: 70 to 100 mg/100 ml, PP: less than 140 mg and HbA1c % less than 5.7. 2. Pre-diabetes: FBG: 101 to 125 mg, PP 141 to 199 mg and HbA1c % 5.7 to 6.4. 3. Diabetes: FBG: 126 mg and above, PP: 200 mg and above and HbA1c % 6.5 % and above. Fortunately, when a person is in a prediabetic state, it can be reversed or prevented from progressing to diabetes or progression to diabetes can be delayed for a very long time by adopting a modified lifestyle. Which means taking a properly balanced diet that provides calories just as much required based on ideal body weight and extent of daily exercise. Secondly, exercising regularly for over one hour and maintaining near normal weight. Plus avoiding sweets, junk foods, pastries, bakery items and increasing the intake of fiber-containing foods, green leafy vegetables, salads, and fruits. Refraining from alcohol and smoking is also helpful." } ]
[ { "from": "human", "value": "Hello doctor,I have had unprotected sex. I took Plan B (72 hours) pill almost right after, four hours later. I consulted with the pharmacist on the phone but she sounded careless and told me it was safe to use. I am too young. The main question is I do not know if I should even call this vaginal sex because he did not cum and we decided to call it off after three minutes because we were scared of the consequences. But I took the pills anyway, just in case. Can you help me?" }, { "from": "gpt", "value": "Hi. Plan B is an emergency contraceptive to be taken in case of male ejaculation inside vagina. If you have already taken the medicine, nothing much can be done right now. I hope you have attained menarche, so then you should get your periods in the next two weeks. The next period might be a bit irregular due to the pill effect. If there was no ejaculation or pre-cum, there is no chance of pregnancy." } ]
[ { "from": "human", "value": "Hello doctor, I had my mother's ultrasound done today. She is a 39-year-old anemia patient admitted to the hospital. She has hypothyroidism from the last 12 years and is overweighed and obese. Her ultrasound shows 19 cm liver from the mid-clavicular line with increased echogenicity. Is this something of concern? If yes then what has to be done?" }, { "from": "gpt", "value": "Hi. I have reviewed the ultrasound report (attachment removed to protect patient identity) and I can say that she has hepatosplenomegaly probably due to fatty liver disease. This is why to my opinion she needs to do liver enzyme tests like AST, ALT, GGT and alkaline phosphatase, blood work too. It is important to lose weight and to avoid fatty foods." } ]
[ { "from": "human", "value": "Hello doctor, I am 21 years old. Since childhood, some of my teeth are sort of crisscross. So the accumulation of food has led to yellow spots in some places. I brush once a day but properly. I consulted a dentist and she suggested me to get my teeth cleaned. But that is not a permanent solution. What can I do for permanent white and well-aligned teeth?" }, { "from": "gpt", "value": "Hi. Your teeth are actually crowded. So, deposition of food and stains have lead to these brown marks on your teeth. What you have to do to make your teeth white is go for proper scaling and polishing, and brush your teeth twice daily regularly. Second Option, if still, it is the same, even after scaling and polishing, marks are not going, you can go for a veneer. Now let me ask you some questions. Are you a frequent user of some tea, coffee or black tea, beverages? Are you taking any medicines regularly? These all can cause these marks to appear again. Then for proper alignment for your teeth, you can go for a fixed orthodontic treatment. You can also use aligners if there is only a small difference in alignment." } ]
[ { "from": "human", "value": "Hello doctor, I am currently on 40 mg of Fluoxetine. For the past four days, I was put up from 30 mg to 40 mg as my 20 mg stopped working after three years. While on the 30 mg, my symptoms got better for a couple weeks and then I went back down to where I was, in the beginning, feeling extremely depressed, anxious and completely awful. I was wondering why this happened?" }, { "from": "gpt", "value": "Hello. Fluoxetine 20 mg OD is the usual dose prescribed in managing depression and anxiety. Sometimes Fluoxetine dose needs to be increased to 40 mg OD if the previous dose is no longer effective. You have been on 40 mg for the past four days. You may be aware that you need to wait for at least 2 to 4 weeks to see the maximum therapeutic response. In addition to medication, you will benefit from counseling, CBT to manage your emotional difficulties. Discuss with your GP, CMHT in case you have not had taking therapy before. Try to exercise daily. Even brisk walking outdoors for 30 minutes daily can help to improve your mood and lower anxiety. In case, if you do not get better even on Fluoxetine 40 mg OD. Kindly consult with your doctor. You may need a reassessment of your symptoms and sometimes alternative SSRI needs to be considered." } ]
[ { "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 19 years old and asthmatic. I weigh around 56 kg. My asthma is not severe and it is seasonal asthma and only happens during season change. Lately, my asthma is not going away I did a myteka and fexet course along an antibiotic course. I do use Ventolin inhaler which gives me relief. Normally, these days when I wake up I feel short of breath, again it is not that severe it is like 20%. When I am not sick my asthma goes away it does not bother me at all during any physical activities. I am a chain-smoker and have been smoking for two years yet it never made a problem. Any suggestions?" }, { "from": "gpt", "value": "Hi. I can see that you are worried about your asthma. Let us start from scratch. Firstly, let us confirm your diagnosis of asthma and because you are having symptoms now it is the best time to perform spirometry. Secondly, for asthma, you have to use inhalational medication for at least a year after diagnosis and then we can taper-off as you are relieved of symptoms. I totally understand this is a long duration, but we need the medication for controlling your future symptoms. Thirdly, the medicine (Ventorlin) will provide you immediate relief but it will not prevent further attacks, so you need to add inhalational corticosteroids to your medication. And last but not least, you need to quit smoking. You already know the health hazards of smoking and in your case, it is worsening your asthma symptoms. It will be a difficult job but I can help you with that, only if you want. I hope this helps. Poorly controlled asthma due to smoking, not taking medicine regularly and not taking inhalational corticosteroid as well. Spirometry with bronchodilator reversibility testing. Poorly controlled asthma. Inhaler (Formoterol 6 mcg + Budesonide 200 mcg) with spacer, two puffs twice daily and can be taken up to four times daily if required and once exacerbation is over it can be tapered off for a month. Tablet Fexofenadine 120 mg once a day for a month. Quit smoking. Avoid exposure to allergens. PEFR (peak expiratory flow rate) monitoring. Follow up with investigations." } ]
[ { "from": "human", "value": "Hello doctor, I went last night to get tested for STD for fishy discharge smell and 20 minutes ago I went to the bathroom and noticed I was bleeding down there, which is weird for me since I just finished a none-day period a week ago. So I am worried if I need to get checked out right away or wait." }, { "from": "gpt", "value": "Hello. A fishy smell is indicative of bacterial vaginosis and not yeast infection alone. If not accompanied by curdy white vaginal discharge, pathognomic of vaginal candidiasis. Also bleeding per vaginum on nonmenstrual days can be due to cervical erosions which can be confirmed or evaluated with a per speculum examination and a pap smear." } ]

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