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qucklecrabik
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mc_dataset

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train · 257k rows

conversations listlengths 2 2
[ { "from": "human", "value": "Hello doctor, I am a breast-feeding woman. I used to be a smoker before I got pregnant. I am really stressed out. If I have one and wait three hours before feeding, will it be fine?" }, { "from": "gpt", "value": "Hi. I would recommend trying to quit entirely. Cigarette exposure in infants increases the risk for several problems, including asthma, SIDS (sudden infant death syndrome), eczema, and many more. There are several options to help quit, including nicotine patches, gum, and even some medications. I would speak to your doctor about quitting. If you must smoke, try doing it before breastfeeding. It takes 90 minutes for half of the nicotine in your body to be eliminated, so it is very difficult to eliminate it entirely. Additionally, never smoke around your baby, always do it outside, wash your hands and change your clothes before returning to your baby. A good rule of thumb is that if you can smell the smoke, your baby is being exposed to it. That being said, the benefits of breastfeeding are immense and are generally thought to outweigh the risk of minor nicotine exposure in breast milk. So in summary, try to quit if you can, but if you cannot, take the above steps to minimize your baby's exposure. Please let me know if you have any more questions and have a nice day." } ]
[ { "from": "human", "value": "Hello doctor, I have found this spot on my tongue for the past seven months and for the most part, has not really changed. No symptoms, but can sometimes feel the bumps when I run my finger over it. Does this look like it is a frictional problem or something worse? I am guessing friction based on what I have been told before but want to confirm with another opinion." }, { "from": "gpt", "value": "Hi. I had gone through your question and understand your concern. As per your photographs (attachment removed to protect patient identity), it does not look like any severe problem. This could be the friction or irritational in nature due to a sharp tooth edge. This lesion only looks like hyperkeratotic and nothing else. So, there is no need to worry about it. Please let me know if there is any sharp tooth edge, also if there is any swelling under your mandible (chin). You can also take high Vitamin A diet like carrot or Vitamin A supplements for at least a month, it will be helpful and the lesion will disappear soon. Sharp tooth edge or faulty brushing technique. Traumatic ulcer. Frictional hyperkeratosis. Enameloplasty, if there is a sharp tooth edge. Brushing (modified Bass technique). Use ultrasoft toothbrush." } ]
[ { "from": "human", "value": "Hello doctor, I was wondering whether conceiving a second child will be safe after having a history of blood clots with first pregnancy and postpartum." }, { "from": "gpt", "value": "Hello. You have a history of blood clot in the previous pregnancy. So there is more chance of blood clot in the second pregnancy as well. A thorough investigation should be done like PT, APTT, BT, coagulation profile, cardiolipin antibody estimation, etc., for you. The low dose of low molecular weight Heparin can be given in pregnancy to prevent blood clot as it does not cross the placenta. But you should discuss all these with your treating gynecologist." } ]
[ { "from": "human", "value": "Hello doctor, My 5-year-old son has a wheezing problem right from one and a half years. A year back the doctor prescribed Foracort 100. I administered Foracort 1 puff daily for one year. Now, I have stopped it as adviced by the doctor. Still, he gets wheezing minimum one time a month and a maximum of three times during winter. He also gets wheezing whenever he has a throat infection. The allergy test was done and the doctor said my son does not have an allergy. Primary complex test (Mantoux test) proved positive but the doctor also looked at the chest X-ray and enquired about family history (no smokers, vegetarians, non-alcoholics). So she asked us to wait. No medicines were given. Why does he get frequent wheezing even when he has no allergy? Does he have asthma?" }, { "from": "gpt", "value": "Hi. Generally, we would label your son a recurrent wheezer at this age. Asthma is not a diagnosis of the tender age. Wheezing is generally associated with allergy and not always can be found with a blood test. It can be an allergy to dust, pollution, dampness, pets or anything. Sometimes, we use Montelukast for a long duration to modify the wheezing condition. Ask your doctor for the same. Giving an annual flu vaccine also helps. Mantoux test is a non-specific test and does not confirm tuberculosis. Other investigations are performed in addition to the Mantoux test to confirm TB." } ]
[ { "from": "human", "value": "Hello doctor, Please check my X-ray and guide me. I have minor pain and sensitivity in tooth." }, { "from": "gpt", "value": "Hello. I have been through your query and I can understand your concern. In the X-ray, I want to know if you are referring to the last tooth. In the X-ray, there are the following findings: 1. The second molar seems to have developed secondary caries which seem to approach the pulp (not fully though) which might be the cause of pain. However, The extension of the lesion cannot be determined as the X-ray seems to have elongated the structures. Proximal caries in the second (last molar of the mesial side, that is, between the two molars). 2. The fillings seem to have developed secondary caries but that seems mild. (This might also be the elongation error of the X-ray). The correct evaluation and examination of the teeth will confirm the diagnosis and accordingly will chart out the prognosis of the teeth." } ]
[ { "from": "human", "value": "Hello doctor, I am very much anxious about my upcoming exam. This is my second drop. Last year because of my fear I ended up doing mistakes in the questions which I knew very well and just after coming out of the exam center I was able to answer all of them. This year too I am more fearful. I am very afraid as I do not want to take another drop and want to live my dream. Please help me out." }, { "from": "gpt", "value": "Hi. You seem to be suffering from some anxiety disorder. Detailed exploration of the problem is needed. Do not let this thing ruin your career. I would recommend you to go to a local psychiatrist and get some help. Meanwhile, you can try these things. Deep breathing exercise, as many times as possible. Yoga, meditation. Sleep and wake up at the right time. Positive self-talk, motivate yourself. You can try Propranolol 20 mg sustained-release tablets before going to the exam, to control your anxiety but it would be best if you consult a psychiatrist before that." } ]
[ { "from": "human", "value": "Hello doctor, My baby's birth vaccine has been delayed by one week due to health issues (my baby was born on 15th but the birth vaccine was given on 22nd). So, the next vaccine which was supposed to be given in six weeks has been given on 7th of this month (after two months) but if I see according to his birth it should be near 1st or 2nd and the next vaccine which is in 10 weeks comes on 7th or 8th of next month but according to his birth the 10 weeks completes by 1st of next month. So my question is are the vaccination being given as per the day of birth or as per the time from when the birth vaccine was received? Please solve my problem and tell me whether my baby is on the right track of recieving vaccination." }, { "from": "gpt", "value": "Hi. I understand your concern. Vaccines are given as the birth age for a full-term normal weight baby. If the baby was premature and hospitalized, then it can be delayed. If it is delayed then one month gap is usually kept between two vaccines for better vaccine uptake. You are right, your baby's next dose schedule is around 1 or 2 of this month. There must be a reason for the delay, as I mentioned earlier. In the long run, it usually does not make a lot of difference. Make sure all the necessary vaccines are received." } ]
[ { "from": "human", "value": "Hello doctor, I have a tooth filling that has come out, and woke with a white lump beneath it on gum, swollen lower face too on the other side of the site of lump. I had a dull, drumming pain during the night before. I rinsed with warm salt water this morning. Wondering if Flucloxacillin 500 mg which I was prescribed for a bad reaction to summer insect bites and too worried to take, would they help gum infection or abscess? Are four tablets a day all right? I have a dental phobia and will need to wait to be treated at my local hospital." }, { "from": "gpt", "value": "Hi. Your tooth is probably infected which has caused the white lump on your gums. The decay has gone inside the pulp, almost touching your nerve and there is infection beneath the root of your teeth which has caused this swelling. You will have to confirm the status of your teeth by taking an X-ray, to check how much the infection is affecting your tooth. I will not suggest you having Flucloxacillin 500 mg because it is not effective for dental infections. To suggest an antibiotic, I need to know the proper medical history of yours. At present, take an antibiotic and pain killer so the swelling subsides and meet a dentist as soon as possible for further treatment. Can I know if you have any allergies for any medicine, or any systemic diseases present? If so, I can prescribe the medicine for you." } ]
[ { "from": "human", "value": "Hello doctor, I am having excessive gas and belching to the point where it feels like I am being choked. My stomach area also feels tight, but that might be from the bloating." }, { "from": "gpt", "value": "Hi. The symptoms look more from gastritis and acid reflux. You need to modify your dietary habits as well as add a few medicines. Practice small frequent feeds rather than heavy meals. Avoid excess water when you eat food. Avoid talking while having food as this leads to aerophagia. Practice being in erect position for at least an hour after food. Avoid foods which worsen acid reflux like coffee, excess spicy foods, etc. You can add tablets like Pantoprazole 40 mg in the morning with Domperidone 10 mg twice daily 30 minutes before food for two weeks. Follow these dietary measures consistently for a month and see the response. If symptoms are not improving, you need to consider an evaluation." } ]
[ { "from": "human", "value": "Hi. My grandmother is 80years of age. Over the past year, her hillucinations have increased with time, from what was occasionally to now daily. I've had her to the doc for blood tests, she's perfectly healthy in all bodily aspects. Treated for mild kidney infection on two occasions recently. Hillucinations seem to be in patterned images like floors, tiles, counter tops & clothing. Her most recent GP has not quite ruled it as Dementia as yet. Short term memory has faded. Aggression has also increased. Re-arranges the bedroom on a daily basis. Accusations of personal possessions being stolen by these so-called persons in her bedroom. How can we treat this? Desperately needing some advice as to the next steps to take. Thank you in advance." }, { "from": "gpt", "value": "Hello Dear dementia with hallucinations may be common in old age people. Intermittent episodes of delirium may increase the future risk of dementia. Most commonly infections ( urinary, respiratory), electrolyte imbalance, hormonal imbalance, drugs or recent surgery cause delirium. Dementia may be due to Alzheimer's or multi infract or Louie body or Multisystemic atrophy etc. For delirium we may give low dose of benzodiazapines . What is the cause to be evaluated by MRI brain, serum electrolytes, blood sugar levels, thyroid profile and urine examination. so please consult your neurophysician he will examine and treat you accordingly. Take care." } ]
[ { "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, Why deep bradycardia (35 BPM) is a disease for some people and for other people is a sign of fitness and health? What makes the difference in the deep bradycardia (35 BPM) between disease and fitness?" }, { "from": "gpt", "value": "Hi, Welcome back to icliniq.com. You raised a very good point. Cardiologist usually looks at the ECG and patient's symptoms. If the ECG does not show any features of conduction abnormalities and the patient is fit, healthy and has no symptoms, then it is reassuring especially if they are athletes. However, if the ECG shows a conduction abnormality or delays then it is of a concern and if the patient has symptoms of lightheadedness, fainting, collapses or exertional breathlessness, then it is of concern and needs more investigations and possible pacemakers if the condition persists after stopping all heart slowing medications. You need to bear in mind that a single ECG could confirm a conduction abnormality if present, but does not 100 % exclude as the condition could be intermittent, This is why a period of continuous cardiac monitoring is recommended for the patients who have symptoms could be related to conduction abnormalities." } ]
[ { "from": "human", "value": "Hello doctor, My daughter, 11 years old, has her eardrum damaged. I want to know the advantages and disadvantages of ear drum surgery." }, { "from": "gpt", "value": "Hi. I understand your concern and here I would like to say that if your daughter is having an acute perforation of eardrum then that may heal by consecutive medical treatment. On the other hand, if it is a chronic perforation then surgery is the only treatment. Usually surgical results are good and the patient gets cured but unfortunately, sometimes complications develop like the failure of surgery by a rejection of the graft, hearing loss, recurrence of discharge, facial palsy." } ]
[ { "from": "human", "value": "Hello doctor, I had a blood test done two months back and my RBC was 6.0, hemoglobin 17.2, and hematocrit 51, which were all high especially RBC. The blood test was in the morning and I had not eaten or drunk for eight hours before. I am an 18-year-old 130 lb male, and I was wondering if the blood test was high because I had fasting and it was in the morning. My doctor told me it might be polycythemia and to go back for another test in three months." }, { "from": "gpt", "value": "Hello. The dehydration for prolonged duration can lead to high RBC count, high hematocrit and high hemoglobin level. But eight-hour fasting cannot lead to such findings. It is advisable to repeat your test after a few days. Until then, keep yourself well hydrated with lots of water. If still, it comes high after a few days, then further workup for polycythemia should be done in form of EPO estimation, chest X-ray, EKG and JAK2 mutation testing as per need." } ]
[ { "from": "human", "value": "Hello doctor, I have my niece with red islands or patches on the tongue surface. Her age is 23 months. This is there for the past one year." }, { "from": "gpt", "value": "Hello. These patches are related to vitamin B deficiency and gastric discomfort. Sometimes, they also have superadded infection of bacterial or fungal origin. I would advise you to start a Multivitamin syrup, deworm the child and apply Candid mouth paint for 4 to 5 days. Syrup A to Z 5 ml once daily for 30 days, syrup Zentel 10 ml single Stat dose, Enterogermina suspension 5 ml twice daily for three days. Candid mouth paint local application for 4 to 5 days." } ]
[ { "from": "human", "value": "Hi doctor, I am 33 years old, female. I suffer from tachycardia (heart checked, everything is normal) and anxiety and depression, and dizziness only when I am walking. I am not having dizziness when I am lying, and I am a smoker too. I have a headache often but I cannot recognize if it is a migraine or not, and recently have my MRI scan on the brain. Can you please tell me your opinion about the result? This is the impression: T2 FLAIR hyperintensity foci within the white matter in the centrum semi ovale and near the vertex which is more than expected, given patient's age. The distribution is non-specific. Most of this is atypical for demyelination." }, { "from": "gpt", "value": "Hello. The tachycardia you are experiencing if the usual cardiac exam and diagnostics were already been done and showed normal result may have been coming from anxiety. This should be well tolerated and cannot produce you any harm. The dizziness and headaches should coincide with the same problem either what comes first will lead to the other symptom. Dizziness basically comes from so many factors like lack low iron supply in the blood or low red blood cell count. Other factors that can precipitate to this is benign positional paroxysmal vertigo or simply BPPV (basically a condition coming from your middle ear). Diagnosis entails having blood exams like your complete blood count (CBC) and otological exam using an otoscope to check for inflammation and infection of the ears (which is a fairly common problem with BPPV. The exact mechanism on this is the head position that you need to identify so as to keep this dizziness to reoccur in certain positions. It would be helpful taking some Betahistine 16 mg tablet twice a day for this bout of dizziness. Headaches, on the other hand, could also be of so many things but usual causes are myogenic in nature. It can range from migraine headaches, cluster headaches, tension headaches, etc., and the treatment entails primarily with a Nonsteroidal anti-inflammatory drug (NSAID) like Ibuprofen taken every eight hours, but remember to take this religiously without fail to keep the drug's potency so as to make it effective. Migraines usually occur with a strong family history. If you have a family member that exhibits this kind of headaches, then possibly you also have it. They are most of the time precipitated with a stressful insult, may it be from lack of sleep, skipping meals to a tiresome job. It is helpful if you could identify this stressor so as to avoid it. It would definitely help you. The MRI findings T2 flair hyperintensities foci within the white matter in the centrum semi ovale and near the vertex are incidental findings that do not correlate well to a disease. This particular signals in the brain are most often than not seen also in normal individuals and does not cause any symptoms at all. To conclude, it is nothing important and will not cause you trouble. This all should help you best as your guide." } ]
[ { "from": "human", "value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?" }, { "from": "gpt", "value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My neck has weird red lines all over it which seems to me as stretch marks. I am currently 18. Is there a way to cure this?" }, { "from": "gpt", "value": "Hello doctor, The pictures uploaded did not show the said stretch mark (attachment removed to protect patient identity). However, what readily comes to one's mind is that it may be spider veins (widened tiny blood vessels just below your skin). The doctors call such condition telangiectasia. Use of corticosteroids, certain abrasive creams, and soaps, alcohol abuse, pregnancy, increasing age, hardening and contraction of the skin, inflammation of the skin and the muscle under it, systemic lupus erythematosus, or it may be part of HHT-hereditary hemorrhagic telangiectasia. Investigations to rule out underlying disorder include clotting profile, CT scan, MRI. Spider angioma, Sturge Weber disease, hereditary hemorrhagic telangiectasia. Spider veins- telangiectasia. Treatment options include sclerotherapy, laser therapy, and surgery. Cut down on alcohol, avoid working outdoors for long, shed weight- not applicable to my index patient, avoid misuse of corticosteroids, reduce prolonged standing." } ]
[ { "from": "human", "value": "Hello doctor, I feel like my calf muscles are gonna pull and I want to prevent it. It does not hurt, but I can feel the tightness. What should I do to stop this? I am scared." }, { "from": "gpt", "value": "Hi. This sounds like calf tightness, but it may be a few other things that are more concerning. If the tightness is only in one calf, you need to get follow up, especially if you are on birth control or have another risk for blood clots. Depending on your age, you may be at risk for problems with your blood vessels that can cause calf pain when walking. Calf tightness is very common especially in athletes and in women who wear high heels and is usually from overuse of muscles that have not been stretched properly, causing inflammation and tired muscles. For treatment, I suggest starting with a massage to the area, which can include rolling your calves on a foam roller or even a small ball. There are specific trigger points that are particularly helpful in treating the knot in your muscles. Do this for several minutes a few times a day. For treatment and prevention, research a few calf stretching exercises and do those several times a day as well. Another important thing for sore muscles is hydration and electrolyte repletion. If you are doing exercise, remember to stretch for 15 to 20 minutes before and after, and ice your calves after exercise. Finding out if your tightness is more due to inflammation or fatigue can be helpful in guiding a more personalized treatment plan, but would require more questions. Also, it would help figure out if you may also have a strain or even small tears that would need to be treated more carefully. Delayed onset of a muscle disorder, muscle strain." } ]
[ { "from": "human", "value": "Hello doctor, My penis length really frustrates me. I have read that it is the average size. I am still a virgin (19). I want to know if there is anything that I can do to surpass this kind of fear or doubt that I will never please a woman in bed." }, { "from": "gpt", "value": "Hi. The dissatisfaction with penis size is one of the commonest issues with men. The roots of this insecurity about self lie within our cultural prejudices and fears. Let me tell you that the length of the penis or shape of the penis has nothing to do with sexual satisfaction and the ability to have good and enjoyable sex. It is the way you handle your partner in and out of bed. You need to show how much you take care of her emotional needs and how much you love getting intimate with her. Women are aroused by the emotional component of sexual intercourse rather than by the size of your penis. A good foreplay followed by gentle yet passionate sex is what makes them happy and content rather than the size, color, and shape of the penis. So, do not worry and be confident about yourself." } ]
[ { "from": "human", "value": "Hello doctor, My kids are getting cold and fever because of tank water. Is there anything available so that we can put inside the tank to avoid disease?" }, { "from": "gpt", "value": "Hello. I just read your query. Use tank water after boiling. Give your children lukewarm water for drinking not cold water. Give them steam of plain water two to three times a day whenever they get cold. Strengthen their immunity. You can give them one teaspoon of Chyawanprasha with lukewarm milk in the morning. Chyawanprasha can be given in children above three years of age." } ]
[ { "from": "human", "value": "Hi doctor, I am 62 and male. I am on anti-hypertensive medication for years, my current BP is in the range of 140 to 150 (sys)/60 to 70 (dia). Is this BP good enough for my age? Any suggestions, please?" }, { "from": "gpt", "value": "Hello. Diastolic BP is fine, but systolic is mildly elevated. According to recent evidences and guidelines, lower is better. If BP is persistently elevated above 140, then it is better to add some other medicines to keep it atleast below 140 consistently and preferably below 130 systolic. We are not much concerned about diastolic BP even if goes lower. Since pulse rate is 60, then Concor dose may be increased to 7.5 or 10, but cautiously monitoring pulse rate. Instead better option is to add another medicines like Losartan 25 mg or Chlorthalidone 25 mg. Should also have low salt diet and regular exercises. So, overall, we should target BP a bit lower." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]
[ { "from": "human", "value": "Hello doctor,I had ectopic pregnancy last year and now am 11 weeks pregnant (normal). Can I travel through flight for more than 20 hours? I have thyroid. Right now my thyroid level is bit higher. I am on medication for thyroid." }, { "from": "gpt", "value": "Hi. Please ensure that you are not a high-risk pregnancy as per your obstetrician before traveling. Air travel is allowed during pregnancy (except high-risk cases like threatened pregnancy, high BP, diabetic, twins), just keep the following things in mind especially for more than four hours stretch flight. Drink plenty of water to keep you hydrated. Move around in the flight to keep the blood flowing through your legs, otherwise, you may develop foot swelling and cramps. Do some stretching exercises of legs while even sitting and watching the movies every 30 minutes. Prefer a break journey flight, so you do not feel nauseated due to closed flight space. Maintain sleep pattern same to prevent jet lag and sleeplessness. Take your usual medicines and an extra dose of antacid and anti-emetic. Also, travel with all pregnancy-related documents, and have a fit to fly certificate from your obstetrician, as many flights ask for it in advanced pregnancy. Have light and frequent meals, keep some food stacked in your purse, for frequent snacking, rather than hostess serving you at fixed times. Wear graduated compression stockings in flight long haul flights. Enjoy your journey without worrying much." } ]
[ { "from": "human", "value": "Hello doctor, My BP is very high 200/75. I have made aortic valve replacement surgery with metal valve nine years ago. The BP is high for the past four days and nothing gets it down. In an emergency clinic, they gave me a Nitroglycerin patch which made my BP reach 170/75, however, it did not get the BP more down. My physician prescribed me Coversyl 5/2.5 and Concor 5. I am a chronic Coumadin user." }, { "from": "gpt", "value": "Hello. There are multiple options available for you. Firstly, it is better to shift to other drugs like Telmisartan 80 mg or Losartan 100 mg instead of Coversyl plus because combination makes it difficult to titrate. If you want to stick to the same then some other medicines like Amlodipine 5 mg and if not effective 10 mg in addition to Coversyl plus and Concor, will control your BP. Also, if BP remains elevated then tablet Prazosin XL 2.5 mg should be added which can be increased to 10 mg if necessary. So, overall, you may have tablet Coversyl plus, Concor and the third drug should be added like Amlodipine 5/10 mg (or similar medicine Cilnidipine). Next in the line if necessary is Prazosin. Also, the dose of Coversyl could be increased later if necessary. In an emergency situation, you should discuss with your doctor regarding intravenous Labetalol or intravenous Nitroglycerin drip for immediate BP control." } ]
[ { "from": "human", "value": "Hello doctor, I am a black male. I have a burning sensation when urinating and my eyes feel tired and a bit watery from time to time. I have itching between my anus and my scrotum. Recently, I have noticed a dark black mark on my penis shaft just below the crown of my penis and about a month ago, I had a hard blister like spot on one of my bum cheeks which burst a week or so later with a watery looking discharge. Lastly, I notice a cottage cheese like discharge underneath my foreskin from time to time. Can you help me by telling me what is the cause of these things?" }, { "from": "gpt", "value": "Hi. The hard nodule bursting on your buttocks was an infected sebaceous cyst. If recurrent on the same spot, you may need a small surgery of cyst excision. For eyes, get refractive error checked and if needed specs. Burning urination is with poor flow, straining of urine? How many times you get up at night. Kindly get urine analysis and USG KUB and share the report to suggest treatment. For itchy perianal area sit in a warm sitz bath for 15 minutes, if persistent, show to a general surgeon. Black patch on the penis can be commented only after seeing the picture. Smegma under prepuce is a white deposit and you daily need to retract the prepuce and wash it with water during bath." } ]
[ { "from": "human", "value": "Hi doctor, I suffer from jaundice and typhoid. I have vomiting, high fever, rashes, drowsiness, and stomach pain. Whenever I consult the doctor, he gives me medicines. I do not understand, and I am confused whether he gives tablets for jaundice and typhoid or whether he provides tablets for cough, headache, and vomiting. Please suggest." }, { "from": "gpt", "value": "Hi. First of all, jaundice is a symptom, and typhoid fever is a diagnosis. Jaundice is a state in the human body in which there is an increase in bilirubin (produced in the liver) level causing yellowish discoloration of sclera and skin. I am not sure whether you have typhoid or not. These symptoms you have seem to be due to acute viral hepatitis. But the picture you have attached (attachment removed to protect patient identity) is of antibiotic combination which is used in the treatment of typhoid fever (Cefixime and Ofloxacin). We cannot diagnose typhoid just by symptoms, and we need to perform some blood tests for it. You should take a lot of fluids and glucose water. If it is acute viral hepatitis, the yellowish discoloration or jaundice takes a month to disappear. You should not worry much about it, but get a full liver function test done along with PT (prothrombin time) and INR (international normalized ratio). Also if interested, get a screen for IgM anti HAV (hepatitis A virus) and HEV (hepatitis E virus) serology. Acute viral hepatitis occurs mostly due to improper hand hygiene or contaminated water source. You will get well soon." } ]
[ { "from": "human", "value": "Hello doctor, I have been facing testicular pain since last few days. What could be the cause?" }, { "from": "gpt", "value": "Hi. Testicular pain can be due to many reasons. Ascertaining the reason of pain without proper history and examination is not a good idea. The wrong diagnosis will eventually lead to the wrong treatment. You should visit a surgeon in person and get yourself examined. Urine examination and an Ultrasonography may be needed to ascertain the cause of pain. Do not feel shy and do not delay. If you are not able to consult a doctor or if a doctor is not in reach, please again ask your query with details of pain like, from where it starts and where it radiates, how it started and any associated symptoms. Get a urine routine examination and TLC, DLC done and share the reports." } ]
[ { "from": "human", "value": "Hello doctor, I am nursing a 2 month old, and I was told that I need to take Omeprazole. I have gallstones. So, my question is, is it safe to take 40 mg Omeprazole once daily while breastfeeding? My PCP says I should not, but the baby's pediatrician said it is alright. So, I am not sure what to do." }, { "from": "gpt", "value": "Hello. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am a 19 year old female. I have been having a mucus infection since two years. Early last year, after a sputum culture test, it was found out that I suffer from a Klebsiella infection. I have been receiving Ceftriaxone injections thrice a month for the last six months and in each case, the infection subsides but comes back after two weeks. I am now taking Ciprofloxacin for a week, but still, the infection is present. I do not know what to do." }, { "from": "gpt", "value": "Hello. Take care. Have a nice day. For more information consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am suffering from cold and fever and something that I do not know of." }, { "from": "gpt", "value": "Hi. The disease in which there is continuous flows of secretion from nose is rhinitis. It may be due to inflammation, infection or allergies. The symptoms may be sneezing, malaise, nose congestion, itching, fever, heaviness, etc. Infections, inflammation, allergies. CBC. It can be managed after taking some ayurvedic medicines like Shitopaladi Churna, Laxmivilas Rasa, Shring Bhasma, etc. Avoid spicy and fried junk foods. Protect yourself from cold weather and cold drinks as well as allergens." } ]
[ { "from": "human", "value": "Hello doctor,My son is 3 years old. He eats too much chocolates and sweets. His health is down and having anus itching. He has worms. What to do? I am very sad and upset about his health." }, { "from": "gpt", "value": "Hi. For further information consult a paediatrician online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have blackening around my mouth since two months and it is not fading. I went to Dermatologist, she prescribed me a deepwhite cream. But it is not working. What should I do? Please help me." }, { "from": "gpt", "value": "Hi. Keep applying that cream plus start taking tablet Folic acid twice a day for 10 days, then make it once a day for next two weeks. Cranking around lip corners occur due to deficiency of Multivitamins, Folic acid and winter season can also be a reason. As far as home remedy is concerned, put olive oil on finger and put it around your lips so that soreness is reduced. Do it before sleeping for a week. And above all start drinking water, like 1 litre per day mandatory." } ]
[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "gpt", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, Just two days back I suddenly experienced an upset stomach with just a semi-solid consistency of stool. However a day later, I found that I had the urge to pee more often than usual immediately after emptying my bladder. I am 40 years old and my last period was a month back. I am 5'3\" and weigh 70 kg. I have no pain at all while urinating. However, this sudden new symptom has caused me to be very anxious. I also have some PMS symptoms like muscle ache and so on. Could you please advise doctor?" }, { "from": "gpt", "value": "Hi. Sometimes urine symptoms can happen whenever there is altered stool pattern. If there is any problem in stool passage, it may reflect as a burning sensation or frequency of urine as the nerve supply to both areas is same. In case there is no fever, and stomach is still upset, you can start with a probiotic like Econorm sachet twice a day for three days. If symptoms persist beyond 2 to 3 days, then get urine routine test and an ultrasound KUB and revert. A short course of antibiotic like Nitrofurantoin 100 mg twice a day for three days and Solifenacin 5 mg once a day for five days can be started after consultation with your GP." } ]
[ { "from": "human", "value": "Hello doctor, What is the best tan removal treatment for me? I am suffering from tan since 16. I am now 23. My tan is all over my face, but when I put on a beard for a month and then shave it off, it all goes away back to original. Is my tan deep or stubborn or easily removable? Sunscreen application is recommended every two hours. I am thinking of day Vitamin C serum application. I need to wash my face with water before re-applying sunscreen? Can I wash my face? Will washing off for sunscreen reapplication deter the efficacy of Vitamin C serum?" }, { "from": "gpt", "value": "Hi. Tanning is due to sun. When you grow beard your hair protects the underneath skin hence it looks fair when you shave. Tan is not deep or stubborn. (attachment removed to protect patient identity). Keep Vitamin C application in evening and night and sunscreen should be used only when you go out in sun. It is useless to use sunscreen when at home. Any medication applied leave it for 2 to 3 hours before washing." } ]
[ { "from": "human", "value": "Hi doctor, I am suffering from depression. I consulted a doctor and he prescribed me tablet Nexito and Lonazep. After taking the tablet for a month, I stopped it now. I am suffering with headache again. Should I continue the medication?" }, { "from": "gpt", "value": "Hi. I can understand your concern. Depression is a mood disorder and the disorder occurs in episodes. The treatment also should be continued for a long duration. Nexito is Escitalopram and the drug should be continued for at least three to six months post remission of symptoms in the first episode. You have stopped taking the drug within a month and that too abruptly. This is the reason you are having withdrawal symptoms in the form of a headache. If the symptoms are persisting and are causing significant distress then, in my opinion, the drug should be continued again. Consult your doctor for reevaluation and start taking tablet again. Do not get feared by the drug. The drug if taken under a proper prescription does not cause dependence and is safe. This will help you to come out of your depression." } ]
[ { "from": "human", "value": "Hi doctor, I am a 25 year old, fairly healthy female. I have been suffering from kidney stones since the age of 15. Mostly the stones would go away on their own without causing any pain. But in the last seven to eight months, I had been suffering from recurrent UTIs and mild pain in the kidney. Around four months back, I got an ultrasound done and found a 10 mm stone in the middle pole and 6 mm stone in the lower pole. At that point, I started on ayurvedic medicine (Calcury). I got an ultrasound done a month later and found the stone size remains the same. But there was no pain or infection of any sort at that time. Last month (I was still asymptomatic) I got a KUB done. It showed only one stone, it did not look like a staghorn stone. A few days later, I got another ultrasound at a different place and according to that doctor, my stone was 17 mm (in the middle pole) and 8 mm (in the lower pole). In the last 15 days, I passed two tiny stones of 3-4 mm which were very soft and pebble-shaped. This made me realize that I may possibly have struvite stones. However, for the last week, I am getting immense pain after a workout. My creatinine was 0.9 last month. I would like to ask you the following questions:- What should be my course of action after this? What is causing this sudden pain? How can I find out what kind of stones do I have? Will shockwave lithotripsy be possible in my case? How accurate is the number 17 mm and 8 mm?" }, { "from": "gpt", "value": "Hi. Since you have got stone problem so early and since you are a recurrent kidney stone former, you need a thorough evaluation to prevent further stone episodes. You should collect the stone you pass in urine and do FTIR (Fourier Transform Infrared) spectroscopy analysis to know the composition. You also need a 24 hours urinary metabolic evaluation to know the exact problem leading to stone formation. The stone size as per ultrasound may not be accurate, so please get a CT KUB (computed tomography of kidneys, ureters, and bladder), to know the exact number and size of the stone. Pain is due to blockage of the ureter when the stone comes down from the kidney. ESWL (extracorporeal shockwave lithotripsy) is definitely a good option for stones up to 15 mm size." } ]
[ { "from": "human", "value": "Hi doctor, I am a 70 year old female. My height is 165 cm (5'5\") and weight is 70.3 kg (155 lbs). My current medications are Quinapril-HCTZ 20-25 mg and Diltiazem 24HR ER 120 mg. I am experiencing discomfort in the right buttock for the past one year. I had a total body nuclear scan done recently and the narrative is attached. I am being sent for a CT scan. My doubts are, I got a total hip replacement in 2008. Would it be helpful to the CT scan radiologist to see the attached x-ray of the prosthesis since it shows a screw going into soft tissue? As this screw incidentally has been in the same position since 2008 and it has not caused any problem. Would it be helpful to the CT scan radiologist to see the narration of the nuclear scan? Is the CT scan capable of showing a possible bursitis inflammation?" }, { "from": "gpt", "value": "Hi. I have read through your query and reports (attachment removed to protect patient identity) in detail. Please find my observations below. The x-ray is always useful when reporting a CT scan. It provides a two-dimensional picture of the screw which is seen to be partly in the region of soft tissues. As a radiologist, I will always be happy to see an x-ray if available. The nuclear scan shows that there is no infection around the prosthesis. There is a small amount of suspected infection in the bowel or fallopian tube on the right side of the pelvis. This might help the radiologist to specifically look for bowel infection or fallopian tube pathology on the right side of the pelvis. The narration is beneficial to the radiologist to have a detailed look through your CT scan pelvis. CT scan will show bursitis if it is severe. Recent studies have shown an MRI scan to be the investigation of choice for inflammatory bursitis. In your case, bursitis is less likely because the nuclear scan does not show any abnormality in the region." } ]
[ { "from": "human", "value": "Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well." }, { "from": "gpt", "value": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help." } ]
[ { "from": "human", "value": "Hi doctor, I started gym a few days ago. Can I take protein shake (whey protein) after my workout? Is it safe? I do not have any known food allergies. I have attached my anthropometry chart with BMI. I heard that protein will make the person unhealthy after stopping it. Is it true? Please suggest." }, { "from": "gpt", "value": "Hi. First of all, I must say that as per your height and weight your BMI (body mass index) is fine. Now you should start taking good quality foods enriched with protein. Once you are taking whey protein, it is like one-sided food. As you need more energy to do a workout, it is better to go for a balanced diet." } ]
[ { "from": "human", "value": "Hi doctor, What is non-Hodgkin lymphoma? What can cause NHL? Which age group is more commonly affected? Can NHL occur without any family history? Does all left supraclavicular (Virchow's node) node is associated with lymphoma? Can single small but persistent size of lymph node enough for NHL? Why my lymph node is not getting bigger in its size? How fever is related to cancer/NHL? Can NHL/lymphoma/any other form of cancer occur without any symptoms such as fever, weight loss or night sweat? In NHL, the lymph node can develop inside a chest, in the abdomen and inner side of the body. How can we feel them? Which kind of symptoms occurs if they are in? Please explain. In NHL, How to know the swelling of stomach, spleen, and liver as it is not visible outside? Can a cough occur in NHL? In NHL/lymphoma, can we get any clue from the change (decrease/increase) in the level of blood cells such as WBC and platelets?" }, { "from": "gpt", "value": "Hi. Non-Hodgkin lymphoma (NHL) is a group of lymphomas, which does not fall into the classification of Hodgkin's lymphoma. Anything which does not fit the criteria of Hodgkin's is NHL. NHL can be caused due to a viral infection like Epstein Barr Virus, radiation, immune-modifying drugs, etc. Any age group can be affected, but particularly above 50 years. Yes, it can occur even without any previous family history. No, it can rise in infections from surrounding areas or even another type of cancers. Virchow's node is one classically for gastric cancer metastasis to that node. Single lymph node, even if persistent is not a classical sign of lymphoma. Usually increase in size, multiple lymph nodes involvement and at 2 or more sites like axillae, femoral, etc. Single site, single lymph node which is persistent, is usually due to chronic inflammation. Due to chronic inflammation over a long time, intra-lymph node fibrosis (just like scar tissue) must have formed, which would not allow it to reduce in size. So, it will remain the same size. If there is no change in size, then nothing to worry about. Cancer particularly NHL can reduce immunity and increase the possibility of infection and hence fever. Also, in cancers, increased metabolism occurs, which can result in increased metabolic rate and hence sweating or fever can be seen. Night sweats particularly indicate cancer/ NHL. Usually, some symptoms will be found. Depends on the location, the involvement of other areas and the stage symptoms can vary. This way, all cancers start small and are not detectable, even by best methods. Internal lymph nodes require radiological investigation like CT, ultrasound etc for evaluation. Based on symptoms, if any, it can be evaluated. If doubtful, get a lymph node biopsy of the Virchow's node to confirm. You can find spleen and liver enlargement by radiological investigations or deep palpation. Stomach requires a definite ultrasound. A cough is not a classical symptom of NHL and usually, in lymphomas, bloods levels are not affected." } ]
[ { "from": "human", "value": "Hello doctor, My husband is not available whenever I ask him. Whenever his family treats me bad, he never asks anything. If we fight suddenly he is asking me to take care of myself alone. He is not helping me in my work. I am really stressed. I need someone badly to talk." }, { "from": "gpt", "value": "Hello. You are reporting relationship problems which is quite common. Almost all couples go through difficult phases early on in their relationships. Remember there are no perfect couples and no perfect marriages. Everyone has to work proactively to maintain a healthy relationship. Try talking to your husband when things are calm. Discuss with him in a calm manner about situations you find difficult. He may have a different perspective. Both try to approach the problem without accusing each other and follow a problem solving approach. Speak to trusted family members or elders who can discuss with you both in a neutral fashion. Relationship difficulties can be very stressful for both of you. Try to do relaxing activities like walking, exercise regularly, meditation, etc. If things are really difficult, marital counselling can help. You can contact again if further advice is needed." } ]
[ { "from": "human", "value": "Hello doctor, My father aged 54, on USG of whole abdomen shows prostate weight 31 gm. A year back, the prostate weight was 26 gm. He is taking Contiflo Icon 0.4 tablet. The doctor says it is very likely BPH. Can it turn into cancer?" }, { "from": "gpt", "value": "Hello. This prostatic enlargement if suggested to be BPH after examination by an Urologist to be benign then very unlikely to be cancer. Prostate size growth over one year may be falsely positive due to different radiologist performing ultrasound, some variation. And progressive slow growth is expected. For cancer, have a screening (if family history of father or brother). S. PSA and DRE digital rectal examination if normal then unlikely to be cancer. The duration of treatment for BPH depends on symptoms." } ]
[ { "from": "human", "value": "Hi doctor, I am a 28-year-old male, approximately 93 kg, 1.89 cm. Over the past year, I have been getting muscle fasciculations on in my calves (mainly) and also in my quads. I have seen several doctors now and they have checked my reflexes and feeling in my legs and it is all fine. The fasiculations occur, or get worse when I do weights that strain the back of my neck, where it meets the base of my skull. For example shoulder press, or bench press. I have proven that this is the problem many times now. Caffine, alcohol, etc., are all stimulants that make it worse. However, the weights I mentioned above I am certain is the problem. The fasiculations are bad, I have had countless sleepless nights because the twitching is so bad. It is important that I find the problem as I do not want to stop weights permanently. I requested my doctor to prescribe me with blocker drugs and he has given me Gabapentin Milpharm 300 mg. These actually help and reduce the fasiculations. I also went to a chiropractor who was excellent in helping my mobility through my neck and back but could not stop the twitching. He said that I need to see a Neurologist. Does anyone know what is wrong with me? Or what I should do from here?" }, { "from": "gpt", "value": "Hi. Involuntarily muscle twitching or fasciculations could result from various causes. Most common being anxiety, hyperthyroidism, nerve compression at lower back, restless leg syndrome, vitamin B12 deficiency, vitamin D deficiency. If we think of uncommon causes, they could be amyotrophic lateral sclerosis or multiple sclerosis. In my opinion, you need a comprehensive workup first. That includes thyroid profile, vitamin D and B12 levels, blood counts, MRI LS spine, EEG. So, you do not need to rush to a neurologist. First of all, go to your GP. Request him for these tests. Let the report come and then you can go for a neurology opinion. My recommendations in such cases for treatment would be taking Mecobalamineshots, Vitamin D and Calcium supplements. You can also ask your doctor to prescribe you Pregabalin in sustained release form for at least three months." } ]
[ { "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": "No current medications Female Age: 21 Height: 5'2/159 cm Weight: 115 lbs (last known) Why do I always have recurring knee pain...sometimes alternates from left and right... It hurts so much and it keeps coming back even though im not exerting stress on them such as from running." }, { "from": "gpt", "value": "Dear, Sending Love and peace to you ! My dear there are some condition which causes knee pain . I would also suggest to do some test where we can get knee pain on and off these are few condition where there can be like your symptom my dear. I am waiting for your reports to come and i will manage to prescribe drug for you . thank you have a good day" } ]
[ { "from": "human", "value": "Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, Is it possible to do birth control surgery also during C-section during delivery?" }, { "from": "gpt", "value": "Hello. Yes, you can opt for tubal ligation during cesarean section but you have to give consent for the same prior to the cesarean. Usually, the doctor proceeds with the ligation only after the pediatrician confirms that the baby is doing fine. If not, then you are being informed on the table and the doctor usually avoids the procedure in good faith considering the condition of the neonate. The procedure can then be performed after six months to nine months by laparoscopy once the child has been found to be growing healthily." } ]
[ { "from": "human", "value": "Hello doctor, I was diagnosed with anxiety and depression because of work-related issues before two years. Then I was prescribed with Deanxit 10 mg one every day till last month. Now I am trying to withdraw by reducing the dose over a month time, taking one tablet for every two days for two weeks, then half medicine every two days for two weeks. Before this, I tried to withdraw two times under the doctor's supervision. But both times I failed to be able to withdraw as both times, more likely my withdrawal symptoms got severe in three weeks and it was difficult to manage, so put back again on medication. Now I am in a stress-free environment and I hope withdrawal symptoms should be less severe and I might be able to withdraw. If in case, it is going to happen like the previous times causing severe symptoms, what should I do in that case? Is it fine that my method of withdrawal reducing the dose as mentioned above is good enough?" }, { "from": "gpt", "value": "Hi. If psychologically you are feeling stable for at least six months to a year, then you can try to cut down medication gradually. You can try tapering off the medication over a longer period of time to minimize the chances of withdrawal symptoms. For example, try taking half the dose for one day and full the next day alternately for two weeks. If you are not experiencing any withdrawal symptoms, then reduce the drug to half and take it daily for the next two weeks. If you are not experiencing any withdrawal symptoms, then take half-tablet on alternate days for further two weeks. You may stop the medication provided you are comfortable. This is a rough guide. At any stage, if you develop withdrawal symptoms, step up to the previous dose for a longer period and then try again. Sometimes it may take a few months to completely withdraw the medication. I have to say that Deanxit is not the first line medication indicated for anxiety and depression. It is no longer used in many countries due to difficulties in withdrawal and side effects. I will recommend visiting a doctor locally as well to monitor and support you during the withdrawal period. Also, use psychological strategies to prevent any relapse in mood and anxiety symptoms." } ]
[ { "from": "human", "value": "Hello doctor, I am suffering from keratosis pilaris. My upper arms are full of bumps. Please help. It is like rashes in my upper arm and thighs." }, { "from": "gpt", "value": "Hello. The keratosis pilaris is diagnosed by physical examination only. So you should confirm your diagnosis by dermatological consultation. For that you can be prescribed topical exfoliant, topical retinoids like treatment to improve your symptoms. There is no definitive treatment for keratosis pilaris. Usually, this condition precipitates in winter and resolve in summer. You can use warm water while taking bath. Use soap that contains glycerine and oil. Use moisturizing cream over the skin." } ]
[ { "from": "human", "value": "Hello doctor, I am 15 weeks pregnant, 34 years old and am wondering if taking collagen is safe during pregnancy. I have purchased a multi-collagen protein but do not want to start taking it until I am assured it is fine." }, { "from": "gpt", "value": "Hi. Collagen is a natural protein present in your different parts of the body like hair, skin, joints, bones, blood vessels, though different types. Taking collagen supplements is totally safe but dosage should be nearly 20 to 30 gm daily. It has seen to provide lots of benefits to mothers like prevention of stretch marks, hair loss, dryness of skin, etc. So, definitely give it a go and tell me the difference." } ]
[ { "from": "human", "value": "Hi doctor, I just had an EGD with biopsy, polypectomy. It showed a hianal hernia 2 cm. I am attaching photos. The doctor took biopsies, said no cancer. I have had breast cancer in the past. I am having pain in the chest when I swallow, and sternum today. Will that subside? Is it from the bleeding? And, can you recommend the best pill to take for this pain, taking Pantoprazole now? And what should I take for this problem, what should I eat? (Can you assure there is no cancer)?" }, { "from": "gpt", "value": "Hi. I have gone through the reports of your endoscopy (attachment removed to protect patient identity), as per the endoscopy you do not have any evidence of cancer. Have you received the reports of biopsy? If so, please forward it. The medications you have taken are appropriate. If symptoms persist, may consider doing a high-resolution manometry. Continue the same medications. May add Gaviscon tablet after major meals for one week. Refrain from lying down for at least for two hours after food. Elevate head end of the cot by six inches. Restrict citrus fruits. Restrict tea and coffee to two cups per day." } ]
[ { "from": "human", "value": "Hello doctor, I shall be thankful to you if you please answer few of my queries. How CMIA combo for HIV testing is done? How much it is reliable at 175 and 180 post incidence. INDEX was .14 and .08, respectively. What are the chances of error in the result? (Done at two different labs). Even after three years, I have no medical issue. Please give me awareness on procedure reliability." }, { "from": "gpt", "value": "Hi. Below are the specific answers for your questions. CMIA is based on chemiluminescence principle and it is performed on an automated analyzer. It is the most effective technique nowadays to rule out HIV. CMIA can almost 100 % rule out HIV after 90 days of exposure. Usually, in most of the patients, CMIA can be effective after six weeks of exposure. So after 175 days of exposure, you need not to worry about HIV. The index value is cut off value based on which the result is given. The chance of error is very less. After testing for two times the chance of error is almost nil. After three years of exposure there is no medical issue, so the chances of HIV is very less." } ]
[ { "from": "human", "value": "Hello doctor, I want to ask about the kidney transplant that if it is safe to do for my mother. My mother is 60 years old and has diabetic nephropathy, chronic kidney disease, GFR is 6. Creatinine is 543. Potassium is 5. She had congestive heart failure, severe mitral regurgitation. The ejection fraction is 35 %. She had hypertension, hyperthyroidism, dyslipidemia, DM controlled." }, { "from": "gpt", "value": "Hello. I passed carefully through your question and would explain that kidney transplant would be a perfect solution for her low kidney function, but it could be at high risk because of her heart function. You should know that heart failure has a reserved life-expectancy. You should know that only half of the heart failure patients survive after five years from diagnosis. Anyway, this depends on many factors: lifestyle, genetics, treatment, comorbidities, etc. Besides, you should know that a kidney transplant can increase the risk for cardiac complications post-surgery, like myocardial infarction, etc. Being diabetic may indicate being also at an increased cardiovascular risk. That is why it would be necessary performing a Dobutamine stress echo or nuclear cardiac stress test before undergoing the kidney transplant, in order to investigate for the presence of coronary artery disease and undergo coronary catheterization if necessary, in order to avoid complications. So, you can see that benefits should be evaluated comparing them with the risks of surgery and heart complications. You should discuss with your doctor on the above issues." } ]
[ { "from": "human", "value": "Hello doctor,I have sagged skin in lower abs. Please help." }, { "from": "gpt", "value": "Hello. Thank you for sharing the pictures (attachment removed to protect patient identity). Definitely, the excess fat in the flanks and the sagging skin on the anterior tummy can be removed. We do call the procedure as a mini tummy tuck. That will help you in getting a good shape for the abdomen." } ]
[ { "from": "human", "value": "Hi doctor, I have a very sore pimple on the inner side of my outer vagina lips. I have had the occasional one in the past on the same side and usually around the same area. It is like an ingrown hair or clogged follicle. I do shave down there. They usually go away on its own but this one seems very big and very sore and would like to know if there is a way to heal it faster. I only have one bump at a time. My PAP tests have come back normal aside from some yeast. Do you have any suggestions?" }, { "from": "gpt", "value": "Hi. Shaving or waxing the intimate areas often lead to ingrown hairs, infected follicles out there. Either you can cut it out with scissors leaving a bit or go for laser hair removal. These problems settle down forever. Do use douches, just cleanse the area with water during bath. For the boil now, give hot fomentation to the local area. The problem will resolve once the pus comes out, the ingrown hair will be seen, and you can gently pull it out with a tweezer cleaned with alcohol." } ]
[ { "from": "human", "value": "Hi doctor, I have dandruff and hair fall for a longer period of time. I do not take oil or fried food. My face is full of pimples and visible open pores. I tried many options in allopathy but everything was temporary. Please provide a solution for it." }, { "from": "gpt", "value": "Hi. Dandruff, hair fall, and pimples are all interrelated. According to ayurveda, healthy blood will help you have healthy hair and skin. Try the following ayurveda remedies for hair fall and pimple, follow up with me after a month. The medications are available in ayurveda stores." } ]
[ { "from": "human", "value": "Hi. Good Evening. I have fatty lever and feel pain at right side of my stomatch. When I touch with hand it give warm pain and I feel it warm touch incide. Currently taking two times Liv. 52 DS from fee days. The same medicine I was taking 2 to 3 months before then I stopped. From almost a month, I am not walking and doing exercise. Colistrol is under control due to use of Ateroz 10 mg tablets. Please advise. Thank you." }, { "from": "gpt", "value": "Hi. I understand your problem. It seem the pain over your part of stomach i secondary to increase gas production as well as increase acid production. As far as given no weight loss in these last 6 months- I reassure you that it is not some serious problem. There are many factors which could abnormally increase gas and acid production. the common of which are stress, anxiety and sleeplessness and if someone putting on weight. There is one safe antibiotic to be taken for at least 3 weeks to show good results. Tab Rifxamin 200 mg thrice daily for 3 weeks If your symptoms dont resolve see me in 2 weeks we can consider testing it with investigations. For fatty liver there are no approved medication. so there is no use or Liv 52 if you are taking for fatty liver. It is only weight reduction of around 10% of your current body weight which can help to improve your fatty liver. Uninvestigated dyspepsia and Fatty liver disease LIVER FUNCTION TESTS FIBROSCAN see me in 2 weeks time if symptoms does not get better" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, My mother who is 63 years old, suffering from back pain. She is not able to walk even 100 meters. After walking a short distance, she feels numb in her foot and needs to sit for some time to proceed further. While sleeping, she feels needle pricking like effect in either side of her back. My mother was a fish seller till her age of 61 which involved lifting fish box. Now for the past two years she is not going for work. Though she is active at home, is not able to walk as before. Last year, I consulted a bone specialist nearby our town. But after consulting him she is not even walking 100 m. Before that she used to go to our nearest town walking around 1 km. I have attached the previous consultation reports. The doctor had also done some blood test. Most of the blood tests were normal including blood pressure and blood sugar. But there is a slight increase in gamma globulins. I have attached her back x-ray too. I am much worried that after consultation her problem has increased. Please guide me further." }, { "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. Thank you for uploading the lab reports (attachment removed to protect patient identity). Her main issue is her back pain with back bone problems. She has got kyphosis (outward curvature of spine-hunch back) in the lumbar vertebral region. She has got the narrowing of the intervertebral spaces due to age related degeneration of the intervertebral discs at many places. In simple words, she has got issues with cushions that are naturally placed between the two vertebrae of the backbone for properly supporting the body weight. There is no big issue with gamma globulins and that slight change has no impact on her overall health. 1. Improve her diet by giving her plenty of water, salmon fish and a good amount of fruits and vegetables. 2. Give her tablet Acetaminophen (Paracetamol) for pain reduction. 3. Lumbosacral corset for supporting the back and to reduce the pain. 4. Apply Voltaren (Diclofenac topical) gel, massage gently and apply heat pad for soothing effects. 5. Apply ThermaCare heatwraps on the painful and pins and needles sensation areas. 6. Give her by mouth capsule Lyrica (Pregabalin). She will feel much better. Proper rest is necessary for her. If you feel nothing is helping her anymore, please consult a good orthopaedician to get a detailed physical evaluation after an MRI and get the treatment according to that." } ]
[ { "from": "human", "value": "Hello doctor, I have bursitis heel for the last seven months not healing in spite of ultrasound, healing creams, exercises, anti-inflammation medicine. Please suggest." }, { "from": "gpt", "value": "Hi. This is called Enthesitis and is due to inflammation of plantar fascia. You need at least 10 days of anti-inflammatory medications. Do an ESR, CRP and if possible PDUS of the heel. Start capsule Indocap SR 75 once a day along with Pantoprozole 40 mg morning." } ]
[ { "from": "human", "value": "Hi doctor, I wanted to ask if it is possible to use an upper full denture to cover up my three missing teeth in the front? I only have one front tooth left and the other teeth in the back on both sides. Or should I try a different denture? Just wanted to know your opinion on this." }, { "from": "gpt", "value": "Hi. Full dentures are used to replace the whole lot of teeth when absent. In your case, as you have mentioned that you got only one front tooth left, it is much easier to replace only those lost teeth. So, the options here are removable partial dentures. Here you get regular or Valplast to choose. Valplast is much flexible than the regular ones. Fixed partial denture which is nothing but a set of crowns to replace your lost teeth with support in either side from your original back teeth. The options with the material and cost here are ceramic and zirconia where zirconia is much natural looking than ceramic. Dental implants replacing lost teeth with tiny metal screws followed by fixing the ceramic caps or crowns. Might be expensive for multiple teeth and takes time." } ]
[ { "from": "human", "value": "Hello doctor,A part of my skin has become extremely sensitive for no apparent reason. The skin does not look different at all, and it seems to literally be the skin and nothing deeper or muscular. It is an area roughly 10 cm by 10 cm (~5”) on the front of my upper right thigh, the bottom of the area is around where my boxers end. I can clearly outline it by tracing my fingers up my thigh. If I just stand still, I cannot really feel it. Lightly tracing my fingers over it, even through my pants it hurts a fair bit. Rubbing and such hurts more. But applying a lot of pressure straight down does not make it hurt particularly more than the initial touch. Light-fast rubbing hurts the most. Walking or just moving also hurts because my clothes interact with the area. The pain feels sort of like burning, or like touching a burned part of your skin. It started two weeks ago, got worse over the first few days and now I am not sure if it is still getting slowly worse (more painful) or if it is just bothering me more and more. Any ideas?" }, { "from": "gpt", "value": "Hello. Please provide a clear photograph for better understanding. With the description given it can be frictional dermatitis or tinea if it is itching. If there is no itching and only burning sensation, avoid friction of both legs by wearing suitable clothes and apply some moisturizers or aloe vera cream. If there is itching, try Miconazole cream 2 % for 10 days and see if there is any improvement. If there is a visual photograph then we can give better advice." } ]
[ { "from": "human", "value": "Hi doctor, I am 18 years old, male and I have small cuts in the inside of my lips and my tongue. They burn when I drink or eat. They look like cuts." }, { "from": "gpt", "value": "Hi. You have mentioned that you have got chapped lips and tongue along with a burning sensation. Considering your age, the reason for this is mostly vitamin deficiency along with stress. I advise you to apply petroleum jelly for the chapped lips more often a day to help the healing. Also, I advise you to consume green vegetables and legumes especially spinach which is a natural healing medication for such cases. And, keep yourself hydrated. Drink lots of water. No frizzy drinks, please. The above should help you in a more natural way. But in case if the burning sensation is way too much, apply Ointment Dentogel 20 mg directly on the affected region, massage for 10 minutes and then gargle with plain water. Meanwhile, please consider Multivitamin supplements on a regular basis." } ]
[ { "from": "human", "value": "1) I'm having cough & sore throat for many years. sometimes I cough after I wake up from sleep & sometimes I just start coughing randomly. My throat will be itchy sometimes, but no pain. 2) suddenly I get headache Star at the back of my head until my shoulder. I get this headache often. It just start randomly for no reason. I have gastric issue, is this the cause of this pain?" }, { "from": "gpt", "value": "Hi, There are two possibilities for the problem your having 1. A chronic gerd with lpr( gastroesophageal reflux with laryngopharngeal reflux). Basically over here acidic gastric contents have a faulty reflux into your throat and this can be the reason of feeling something stuck in your throat or just a itchy discomfort. You will not have any difficulties with swallowing as such. Inflammation around the throat often results in a irritative cough. 2. A chronic allergic pharyngitis can also be another reason, there could be exposure to some irritative substance indoors itself which can irritate the throat and again be the cause of intermittent cough. What can be done? 1. Avoid exposure to any irritative substance, the best thing to counter this is to wear a n95 mask. 2. Gastric issues have to treated seriously with medications and precautions with more emphasis on the later. You can follow the advice mentioned below. I think this should suffice and keep your symptoms at bay! Hope this helps! Get well soon!" } ]
[ { "from": "human", "value": "Hello doctor, I am 21 and was diagnosed with unspecified mood disorder when I was about 8 for constantly getting angry at my parents, but I behaved well at school and other places outside the house. When I was about 10, I started taking 2 mg of Risperidone once a day and 200 mg of Lamotrigine twice a day for the mood disorder. However, for the past year, I have cut back on my medications to the point where I only take 100 mg of Lamotrigine once a day and have eliminated Risperidone completely. As a result of reducing the medication, I feel much more talkative and impulsive. For example, I am noticing myself interrupt my friends talking more often, but also feel happier (my guess is there are more natural amounts of Dopamine in my brain, almost all the time. In addition, I do not feel angry. My question is what is the science behind the change in my behavior after cutting back on the medication? And should I worry about the potential consequences of my change in behavior and reduced medications?" }, { "from": "gpt", "value": "Hi. The diagnosis of mood disorders is not easily made at the age of 8 years but if you were given that diagnosis then there must have been a detailed assessment of yours. Coming to your questions, our mood, thoughts, and behavior is controlled by certain chemicals in our brain like Dopamine and Serotonin. The imbalance of these chemicals is responsible for inducing the mood and other psychiatric disorders. Risperidone and Lamotrigine both balance these chemicals in your brain and keep your mood in check. Yes, decreasing the dose of medicines without your psychiatrist's supervision worsen the problem. I would advise you to get back to your psychiatrist, he will adjust your doses according to the current state." } ]
[ { "from": "human", "value": "Hello doctor, My daughter is 8 years old and we found out that she has low iron at the end of last month due to fainting episodes she was having. She has been on a liquid Iron supplement that she takes with a glass of orange juice since this month. Her iron levels we found have continued to drop even with the supplements. She is constantly fatigued and sleeps half the time. We also discovered she is vitamin D deficient. The doctor has tried to refer her to a specialist but they have said to continue doing what we have been doing. We have been doing this for two months with the opposite of our desired results. Any suggestion?" }, { "from": "gpt", "value": "Hi. According to the history provided, fatigue, sleepiness, low energy are the main complaints. Let me tell you that in the attached reports (attachment removed to protect patient identity), serum ferritin, serum iron, HB level, WBC counts, platelet count all are within limit. It does not look abnormal. So her iron deficiency anemia seems to be improving. But weakness is still present. Hence, neurological examination and all reflexes should be checked. Investigate with serum TSH, T4 estimation which is strongly recommended to rule out thyroid issues. Check her electrolytes levels also, serum sodium, calcium, and potassium. For low vitamin D level, Cholecalciferol sachet with milk can be prescribed. Check liver and kidney profile also as the disorder also can lead to chronic weakness. If the cause is not identified, then, the muscular dystrophy-like muscular disorder has to be ruled out by EMG like an investigation. Take care. Consult nearby pediatrician doctor or neurophysician for examination and accordingly further work up can be planned (with keeping my answer in mind)." } ]
[ { "from": "human", "value": "Hello doctor, I am a 62-year-old single female with swallowing difficulties and pain in chest and throat when I eat. I am very fragile and live alone. I am scheduled for an endoscopy, colonoscopy but I am considering getting just the endoscopy. Can that test alone show any problems in the stomach or colon? And, there has to be more downtime?" }, { "from": "gpt", "value": "Hi. You need to get an endoscopy for your current symptoms. If it is negative, we may go for other tests. A colonoscopy is not recommended for difficulty in swallowing. I think it was suggested in view of age. Endoscopy can show esophagus and stomach. To visualize colon we have to go from the bottom, that is, colonoscopy itself." } ]
[ { "from": "human", "value": "Hello doctor, I had kissed a prostitute on lips and breast but did not have intercourse with her. I have no cut on lips and mouth. Is there any chance of me getting any STI?" }, { "from": "gpt", "value": "Hi. It is really great that you want to know about an important issue and just do not want to make assumptions on your own. STIs are the diseases that are typically transmitted during sexual intercourse. It is unlikely to catch sexually transmitted infections with kissing alone, but with a few exceptions if the STI has manifested itself orally and/or in oral fluid of that person. Hepatitis B virus can be transmitted through kissing as the virus is found in saliva and other body secretions of HBV infected person. Herpes infection- This can be transmitted through kissing with a person who has a visible cold sore. Human papillomavirus (HPV) or warts and syphilis are less likely to be transmitted through kissing. So far, there is no reported case of HIV transmission through kissing." } ]
[ { "from": "human", "value": "Hello doctor, My son (4.3 years old, 21 kg, 109 cm), seems to have a tendency of increased thirst and urination for the past two months. Can I request you to review the below summary and attached reports to help him get well? There are at least 3 to 4 occasions in past two months when he had drunk up to 4 to 5 liters of fluid in a day and urinates at least in an hour up to 3 to 4 times in an hour in the evening. These days he also seemed to have some amount of sweating and hiccups too. Couple of these occasions happened the next day after he has taken some outside food (like noodles). However, there was no loose motion or fever as such. When he urinates 3 to 4 times in an hour, the urine volume is not that much always, neither there was any color or smell. We have also tested his urine routine twice, but nothing obvious was there (attached). We have taken him to a local doctor a couple of times, who did not find anything wrong clinically. His BP comes up as 90/60 and 88/60, while an instant sugar check (after 1.5 hours of light breakfast) shows 132. He had reported 3 to 4 occasions of a headache and reeling of the head in the past two months or so. He did have some forehead injury (not fall) 3 months ago, which was reviewed by a doctor with antibiotics and the local dressing was done. He has taken two doses of Zentel syrup (5 ml) three months back. He has got two instances of cold, cough, fever in past two months, for which he had taken medicines like Calpol 250 mg (7.5 ml), Xyzal (3.5 ml), Montec LC Kid (4 ml), Ambrolite-S (5 ml) and Lupital (3 ml) since almost past one month. Apart from the above symptoms, he seems to have moderate stomach pain (around naval chord) since today morning along with vomiting tendency and no appetite. We have given him Domestal Syrup (6 ml) twice, which although prevented vomiting, but he seems too tired, weak and unable to do his daily routine, etc." }, { "from": "gpt", "value": "Hello. The urine report uploaded seems to be absolutely normal (attachment removed to protect patient identity). And as suggested by the case history, he was never diagnosed with any chronic illness. Blood sugar and BP was always within normal limits. More amount of water intake is normally observed after having refined food like noodles or any oily food. And more water may lead to more urine output. It is good that you have already dewormed the child. Now, I would recommend a course of probiotics along with Multivitamins. CBC with peripheral smear, vitamin D level. Give Enterogermina suspension 5 ml twice daily for five days. Syrup A to Z 5 ml once daily for 30 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, For the past four weeks, I have had terrible heart palpitations, shortness of breath, and bouts of fatigue. A thing I have started to notice is it seems to get much worse after eating anything with carbohydrates. After I eat, the symptoms ramp up in 30 minutes to one hour. I can exercise without any issues. I am 33 years old and this has never happened to me before. I went to the hospital one week ago who confirmed my heart was racing and temperature slightly up but standard blood tests came back normal and there was nothing on a chest x-ray. Where do I go from here? Will this stop? Many thanks." }, { "from": "gpt", "value": "Hi. Fever causes a faster heart rate. Another reason, which is not uncommon in young people, is vagal atrial fibrillation. This is an irregular fast heartbeat that occurs in bouts after eating and during resting and spontaneously revert back. What did your ECG show? Was it only sinus tachycardia or rhythm problem such as atrial fibrillation? Fever usually causes sinus tachycardia, which is a normal response to fever. When fever subsides, the heart rate slows down. Sometimes it occurs due to gastrointestinal problems, in which eating leads to insulin gush, which lowers blood sugar and sensation like blackout, weakness, palpitations, and fatigue develop. Chances of this are very low. Please send me the ECG strip so that I may diagnose your rhythm. Blood tests that might be helpful include CBC (complete blood count), U&E (urea and electrolytes), TSH (thyroid-stimulating hormone) and the ECG. These are also some rare disorders that cause a sudden rise in heart rate, fever, shortness of breath, and very high blood pressure. This condition is called pheochromocytoma, but it is extremely rare. Please tell me the other symptoms you develop along with fast heart rate feelings and fever. This along with the above tests will guide to reach a diagnosis. If the above tests are normal, I will advise you to have Holter monitoring done for 24-48 hours to catch fast heart rhythm, if not caught on ECG. Regards." } ]
[ { "from": "human", "value": "Hello doctor,I have been suffering from symptoms of gastritis now for over a week. However, I took a capsule of Omeprazole 20 mg, and there seems to be a considerable relief, and I feel a lot better. Is it possible that one capsule can do this? Also, I have read online that Omeprazole can be associated with serious conditions such as pneumonia and heart disease. Is this true?" }, { "from": "gpt", "value": "Hello. For more information consult a general medicine physician online -->" } ]

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