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qucklecrabik
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mc_dataset

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train · 257k rows

conversations listlengths 2 2
[ { "from": "human", "value": "Hi doctor, My chief complaint is severe lower back pain and pain in upper thighs. My medical history is as follows. Carcinoma of the breast three years back, followed by surgery, chemotherapy, and radiotherapy. I am on Tamoxifen for past 3 years, and now I am taking Arimidex. I have been suffering from osteoporosis for over 7 years. Before six years, I had severe osteopenia with maximum bone loss of 21% on L3 and spine, ribs, trunk, and arms with more on the left side. I had undergone the following investigations. Before three years, I had FNAC which showed invasive ductal carcinoma, right breast ER+, PR+, Hercep score \"0.\" Last month, I had an x-ray and MRI, which showed focal altered marrow intensity lesions seen in B/L pelvic bone, sacrum, and left upper femoral shaft consistent with metastasis. I also had a PET scan which showed metabolically active ill-defined lytic destructive lesions in post cortex shaft of left femur, right inferior pubic ramus, B/L iliac bones, sacrum, D5, 7, 11 and L1, 4, sternum, right 3, 5, 7 post ribs with mid-right paravertebral soft tissue lesion at D7 level likely metastasis." }, { "from": "gpt", "value": "Hello. I do not have full information regarding the case from your query. The conclusion I can make from the information which you have given is that the patient has bone metastasis only. The treatment for such a case is a change in hormone therapy. Your medication has already been changed from Tamoxifen to Arimidex. I do not know since how many days or months you are taking Arimidex. Has it made any difference in intensity of your back pain? You also need to take Zoledronic Acid injection (Zometa). This also helps in bone metastasis. You also need adequate pain medications, maybe Morphine preparation to control your pain." } ]
[ { "from": "human", "value": "Hello doctor, My mother is a 68-year-old female, non-smoker. She had a severe cold and cough two months ago. After a course of Azithromycin, her symptoms improved except she just has a dry cough at night. Last week she had a cough with blood. I took her to urgent care, they prescribed antibiotics (Doxycycline) and cough syrup Promethazine. Also, they asked for a chest X-ray to rule out any other serious condition. The X-ray came back with a 2.3 cm lung nodule or scar tissue in left upper lung and recommended a follow-up X-ray after 3 to 4 months or a chest CT scan. CT scan came back with scar tissue in the upper left lung but has a 4 mm nodule in lower left lung. The nodule is visible clearly on the HRCT CT-scan slide (96-97-98) (1.25 mm lung). But slide 99-100 looks like hazy or patchy region posterior to the nodule (the report does not mention that but it is what I think I saw). Does this mean it is a ground glass opacity nodule or nodule is clear and this hazy region is some kind of infection? CT-scan does not mention ground glass opacity where I am worried about but it does mention patchy ground-glass opacity in lingula region and attribute it to infection or aspiration. Only aspiration I can think of is could be my mother lost two chewing tooth in the back and has trouble chewing food. She has been trying a partial denture but it is a task for her and I am not a doctor to make judgment. It has been stressful for me and everyone in my family. I would like some feedback on this. By the way, cough in blood reduced on the very second day and after the third day, there was no more blood in a cough. I want a radiologist to look at the report which mentions mild to moderate bronchiectasis and has Fitchner society guideline for nodule below 6 mm. More details about the presenting complaint: My mother had a severe chest or throat infection two months ago. A course of Azithromycin cleared most of the symptoms except a cough at night time. She had bloody cough (very dark red like cough with clots) that was on the 12th of this month. It subsided after the doctor prescribed Doxycycline. Besides, there is no weight loss. She was taking Repaglinide to control blood sugar. Otherwise, normally she is taking Metformin 250-500-500. Previous history of the same issue: None- my mother remembers a severe episode of a cough for a month around 40+ years. No history of tuberculosis. Current medications: Doxycycline 100 mg twice for 14 days. She has been taking since last week. Metformin 250-500-500 total 1250 in a day for blood sugar, Rosuvastatin 10/Clopidogrel 75, (TMT was done last month- No findings). Lab tests performed: Chest X-ray and CT scan." }, { "from": "gpt", "value": "Hi. I have read through the 10 images uploaded, 8 CT images and two report images (attachment removed to protect patient identity). You are right about the haziness posterior to the nodule in images 97-99/ 241. So what we see is a nodule with hazy margins. Concerning this appearance, it can be reactive changes surrounding the nodule that is slowly healing (as you mentioned a course of Doxycycline is completed and she is feeling better) or it can still mean some residual active infection in the area. Therefore we need to address the issue from a more clinical perspective than an isolated nodule. Fleishner society recommendations are followed to know if a certain nodule is of potential neoplastic etiology. It is true that you are having a stressful situation at the moment but there is no obvious finding in the report that can cause any chronic blood in the cough. The ground glass opacities are a subjective finding and many radiologists mention it where the opacities are prominent. However, I have noted that she is on Clopidogrel 75 mg and if she had a violent cough before the bleeding then it might be possible that she had a small mucosal injury in the aerodigestive tract." } ]
[ { "from": "human", "value": "Hello doctor, Can tubes placed in ears cause pulsating tinnitus? I never had this prior to the tubes. I was getting dizzy all the time. So, they placed tubes in my ears." }, { "from": "gpt", "value": "Hi. Grommets or ventilation tubes should not cause pulsatile tinnitus usually. Is your MRI normal? Can you share the report with me? Any other symptoms? Why were the tubes put in the first place?" } ]
[ { "from": "human", "value": "Hello doctor, I am starting Avenova spray and Cliradex wipes for my eyelids, which have blepharitis and MGD. How far apart should I space each one? I do not want to irritate the eyelids." }, { "from": "gpt", "value": "Hi. Do space them some time apart. 2 to 3 hours would be optimal so that each can act individually. Both have an antiseptic effect on low-grade bacteria causing blepharitis along with add on effects (detergent and non-detergent) and hence improving hygiene. Hence, spacing them would be ideal. However, if you are a busy individual and fund carrying things around a bit difficult, keep at least 15 minutes gap for the action of one medication to set in. Also, do not overuse either, twice a day is ideal frequency. Scrubbing of lashes with baby shampoo is also of some help and simple to follow for blepharitis." } ]
[ { "from": "human", "value": "Hello doctor, My son is 4 months old and started chewing on his tongue. Is this due to teething?" }, { "from": "gpt", "value": "Hello. Teething usually starts about six months of age, but at this time kids try to pet objects more often in the mouth because that is the way they try to learn about objects. It is very natural. But if your child is continually biting on the tongue and not occasionally, it could be something else. You can take a short video that would be more helpful. You can discuss with your doctor when you visit." } ]
[ { "from": "human", "value": "Hello doctor, Is there an association between polycythemia and hemochromatosis? I have a high Hb of 18 and hematocrit of 51 %. I am a student and found to have incidental polycythemia. I tested for all myeloproliferative neoplasm and bone marrow biopsy is negative for MPN. However, I was tested to have hemochromatosis type 4, an autosomal dominant disease for which I am heterozygous. But my HCT and Hb are always high at 18.2. Please advise me." }, { "from": "gpt", "value": "Hello. Usually, in hemochromatosis, storage iron is increased, that is serum ferritin. So you can investigate with serum ferritin as well. If you have myeloproliferative neoplasm like polycythemia, then usually it can be clear from bone marrow study and JAK2 mutation. It comes under primary polycythemia case. You can rule out the secondary cause for polycythemia like lung disease, cardiac problem, high altitude, smoking, etc. Both conditions are different." } ]
[ { "from": "human", "value": "Hi doctor, I am 37 years old and my weight was 104 kg. I am having erectile dysfunction problem and tried before by using Sildenafil 50 mg tablets. Previously, I did not find any issues with this drug but nowadays, I am getting a headache and lower jaw pulling sense. Please suggest what can I do?" }, { "from": "gpt", "value": "Hello. I can understand your problem. Sildenafil is a rapid-acting drug and has a short duration of actions. Sometimes, due to hypotension caused by Sildenafil, individuals might develop symptoms like a headache. This could be the reason in your case too. One option to prevent this is to drink plenty of water before taking the tablet. This will prevent fall in BP. The other option is to replace the drug with Tadalafil which is long-acting and less likely to cause such side effects. You can talk with your doctor about this." } ]
[ { "from": "human", "value": "Hello doctor,My question is regarding chronic testicular pain and the possible treatment options. For the past six months, I have experienced on and off bilateral discomfort in my testicles. It was uncomfortable but not too painful. It would go away for a couple of weeks before returning for a few days at a time. About a month ago, the discomfort returned, changed to pain and got progressively worse. The pain was at times so severe that I could not walk and was bedridden. The pain was at a level of 8 or 9. I went to my GP thrice, the ER twice and the urologist twice. I read about chronic pelvic pain syndrome and started doing some pelvic floor stretches about a week ago. My pain started to significantly subside. But, I am still experiencing a 2 or 3 level of pain. The urologist wants to do spermatic cord denervation surgery. But I think I should try pelvic floor physical therapy first. What is your opinion?" }, { "from": "gpt", "value": "Hello. Relax and do not worry. Thanks. For more information consult a urologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I would like to know if I have any postural defects. So I am sending a file standing straight at the stadiometer measuring height. By how much could I increase my height by fixing defects (if there are any)? I have read that anterior pelvic tilt may affect height by even 2.5 inches, so it would be like 7 cm, which sounds unbelievable. Well, but in my case, do I have any postural defects? By how much, more or less, could it affect my height?" }, { "from": "gpt", "value": "Hello. I saw your attached picture (attachment removed to protect patient identity). Your posture seems to be near normal. Except your anterior pelvic tilt is more with increased lumbar curvature. This compensation may be due to a weak lower abdomen. Tight hip flexor and anterior hip musculature or due to weak gluteus and hamstring muscles. However, you may not gain considerable height by fixing these issues.However, you may have a good strong core which helps you to avoid many issues related to the back. I would like you to work on upper back and scapular strengthening. I recommend you do a lot of core stabilization exercises, stretching of hip flexor and do hip mobility program, glute and hamstring stretching, glute stability program, scapular stability exercises, pectoral stretch." } ]
[ { "from": "human", "value": "Hi! I am a 29 year old male with 171 cm height and 55kg weight and suffer from IBS. Every time I go to toilet, I have pain while defecating and after it, I have a burning sensation in the anus region for the whole day. Sometimes I also have abdominal pain but I think this is due to IBS. Before and after going to the toilet, my anal lining is normal but during defecation, something bulges out and I am not sure if these are hemoroids or this is mucosal rectal prolapse. After defecation I have burning sensation in my anus and mild pain in my left side. I also suffer from constipation (go to toilet 3 times per week) and almost always have to strain when going to toilet. When I am anxious, I suffer from diarrhea and my stool is mostly liquid. But if I am not anxious, I suffer from constipation. I already excluded all wheat / grain as it was causing me gases and pain and my IBS improved but I still have occasional abdominal pain (especially after defecation). Can you please help me understand if I have hemoroids or mucosal rectal prolapse and what I need to do to cure them?" }, { "from": "gpt", "value": "Hi, Hope you are fine. 1) pain while defecating, and feeling of bulge, this is mostly a hemorrhoid, which sometimes could be associated with spot of blood on the toilet seat, and sometimes not. How to differentiate between a hemorrhoid and a rectal prolapse? to be examined by a surgeon, other wise it's difficult by history only. However, being young and healthy, it's unlikely to have a prolapse (it's a disease of elderly and anoreceptor intercourse). prolapse is usually completely circumferential, but hemorrhoids, usually one location (described as clockwise related 3,7,11 o'clock). 2) your abdominal pain, likely it's IBS, having intermittent diarrhea and constipation flavoring it. 3)- so to help ease your symptoms, we need to treat and fix your bowel habits, which is more fibers (green vegetables, avoid carbs), stool softener like Normacol (over the counter drug, which is basically fibers) 1 -2 sachet per day, till having soft easy stool. 4) part of IBS treatment, is psychological therapy, you need to relieve your stress, which will help you a lot with the diarrhea." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My wife is 33 years old. We had six IVF failures. Recently, she had undergone a third pick up cycle. Nine eggs were retrieved, out of which eight eggs were mature, five were fertilized and three embryos reach day 3 stage with two embryos grade A (eight cells) and one embryo grade B (six cells). I was disappointed to hear that only three embryos are developed because in her previous two pick-up cycles 10 embryos each were developed which were of either grade 1 or 2. However the worst part was our doctor told us that the egg quality was not good and there is very little chances of implantation with these embryos and asked us to go for donor egg. Doctor is planning to transfer our own embryos as well as donor egg embryos in single cycle to enhance success rate. I am surprised to hear this as I believed that grade A embryos have a very good chance of implantation. I would be grateful if you could answer my below queries: 1. Can poor egg quality produce grade A embryos? 2. If yes, does chances of these grade A embryos getting implanted are minimal? 3. What would be your recommendation in our case? Should we go for IVF with our own embryos or donor egg embryos?" }, { "from": "gpt", "value": "Hi. How are you doing today? I would like to put forth a few facts of IVF or embryology. 1. Your wife is in the perfect age for pregnancy. 19 to 35 years is the best age. 2. Her body weight is normal, so a hormonal imbalance is ruled out. 3. She has given nine eggs, which is perfect. Of course, 15 or so would have been great. But 9 to 10 is excellent. Of these 8 are mature, so it means egg quality is good, otherwise, they would not have matured. 4. Out of 8 mature eggs, only 3 embryos formed, so I would be more concerned about the health of sperms. Some problem in sperm is not allowing good embryos to be formed. The egg has a lot of corrective capacity. Even if the sperm is damaged, it can correct it. Sperm movement and number may be normal, but if the morphology or health is not up to the mark then there is a lot of chances for the sperm factor to be evaluated and treated. Mixing of donor and self-embryos especially if self embryos are good grade is not a good idea. For your queries: 1. You are right. If eggs are not good, embryo quality will be bad, you cannot get grade A. 2. The grade is only to classify embryos. We get a healthy pregnancy from poor grade and no pregnancy from the best grade of embryos. It alone cannot be used to predict pregnancy chances. 3. I would suggest you have semen factor re-evaluated. You need examination, good antibiotic cover and hormonal priming of sperms, then if needed, go for IVF or if no other causes IUI or ovulation induction, try for few months, you never know, she may get pregnant with these simple, small but very effective methods. An indication of IVF also needs to be thought of." } ]
[ { "from": "human", "value": "Hello doctor, I have undiagnosed chest or back pain which over the last 4 to 5 months has been getting increasingly worse. Full spinal MRI performed, have not seen the report but was told by the doctor that there was nothing there that would account for the pain. I would really appreciate a fresh perspective. Pain (4 to 7/10) behind left breast and radiating around the side and underarm. Not affected by posture or activity but unable to breathe deeply. Episodes last from 90 seconds to 4 to 5 hours, some days it only happens 2 to 3 times, other up to 20 times. Sometimes, the pain will wake me at night. This pain is different from other episodes in that it is much sharper (10/10) and makes lying down impossible. Cardiac causes and blood clots have been eliminated. Nuclear bone scan showed a hot spot at L1, which prompted a lumbar CT. From that, I was told that I have severe arthritis in the lumbar with possible nerve impingement. Advice from spinal MRI was no nerve impingement. Previous history: Have confirmed the diagnosis of DISH in the neck (C3 to C7) and possible diagnosis of ankylosing spondylitis (being treated with Humira, which helps immensely). No problems with any other joints. Current medications: Mobic 15 mg once daily, Humira 40 mg fortnightly, Targin 40/20 mg twice daily, Endone 5 mg as required, Sevikar HCT 40/5/12.5 once daily, Thyroxine 200 mcg once daily, Oestradiol 2 mg once daily. Comments: Have lost 5 cm in height in the last 5 to 6 years. Probably not relevant to my thoracic pain, but when I go to the toilet, most times I have severe lower back pain for some time after, and occasionally pain down the back of both thighs." }, { "from": "gpt", "value": "Hi. Following is the reply after viewing your images (attachment removed to protect patient identity). Review of cervical spine MRI. In C2-C3 disc level, there is a mild left neural foraminal compromise. In C3-C4 and C4-C5 disc levels, there is minimal right and mild left neural foraminal compromise. In C5-C6 and C6-C7 disc levels, there is a minimal bilateral neural foraminal compromise (left greater than right). The features of DISH are persisting. Therefore, it is likely that the pains you are having on the left are due to mild neural foraminal compromise in the above cervical levels. There is mild fluid in C3-C4 and C4-C5 disc levels. There is no significant spinal canal stenosis. Review of thoracic spine MRI shows no significant disc bulge or neural foraminal compromise. Review of lumbar spine MRI and CT. There is no obvious disc bulge but the changes in the vertebrae and the intervertebral facet joints are moderate in nature. There is thickening of the flavum ligamentum in L1-L2, L2-L3 and L3-L4 disc levels causing thecal sac compression and impingement of nerves in the lumbar spinal canal. There is lumbar spinal canal stenosis in many disc levels and is prominent in L1-L2 disc level. There is a moderate bilateral neural foraminal compromise in L3-L4 and L4-L5 disc levels. The increase in pain during bowel movements is likely due to dynamic neural foraminal stenosis. The CT scan shows significant degenerative bone changes and facet joints are showing sclerotic changes in multiple levels." } ]
[ { "from": "human", "value": "Hi doctor,My uncle went to the hospital with breathing trouble before five days and they said he has a heart problem and there is more block and want to do open heart surgery. Kindly advise." }, { "from": "gpt", "value": "Hello. I have gone through an angiography report (attachment removed to protect patient identity). There are multiple blockages including a blockage in a left main coronary artery (LMCA), for which bypass is the best option. So, angioplasty is not possible and should undergo bypass. Also, other medical treatments according to the echo report must be continued. Even after bypass, he should regularly be on medicines and sugar, BP should be adequately controlled. Otherwise, there is a risk of development of new blockages. So, overall needs an early bypass and regular medical therapy." } ]
[ { "from": "human", "value": "Hello doctor,I have a pinched nerve in the neck. The neck spasm and pain. I have two sides cervical ribs taking ultrasound therapy and IFT for neck and cervical ribs but not of much help. Tell best drugs to release a pinched nerve in the neck. One salon guy twisted my neck in childhood and in a bus, the back side of chair hit me on the neck. Ever since then, I have neck spasm. Tell best drugs, please. I am 43 years old. I have BP and diabetes but normal. Tell the best drugs to increase size and nerves in the penis also, please. Tell also the best drugs to decrease aging." }, { "from": "gpt", "value": "Hi. You seem to be having an acute muscular spasm. So to reduce pain and inflammation, I would recommend tablet Flexura D twice daily for five days. Another drug helps a lot in cases of pinched nerves is a combination of Pregabalin and Methylcobalamine (tablet Mahagaba M OD) that to be taken at night. Physiotherapy is the ultimate solution. Please share my opinion with your doctor." } ]
[ { "from": "human", "value": "Hi doctor, This is for my husband. He is a 34-year-old athletic male. Exactly a week back, he got a fever, body pain, cold, and cough. He had a high fever for two days and then a bit high temperature for a day with tiredness. Again he started feeling tired, some fever feeling inside the body (outside no temperature), body pain, throat pain with yellow phlegm and cough. He had Dolo 650. Can you suggest some medicine?" }, { "from": "gpt", "value": "Hi. I can understand your concern. By your history and description, the possibility of pharyngitis is more likely in your husband. Yellow phlegm is suggestive of bacterial infection. So he needs antibiotic like Augmentin for five days. Please let me know his weight so that I can guide you better about the dose of Augmentin. He should also start an anti-histamine drug like Levocetirizine. I will be happy to help you further." } ]
[ { "from": "human", "value": "Hello doctor, I am a diabetic patient for two years and currently entered the third month of pregnancy. And till now, I did not consult any doctor. Is my baby safe? I am taking iron, calcium, and zinc tablets for six months. Please tell me about the precautions and healthy tips." }, { "from": "gpt", "value": "Hello. First of all, diabetes with pregnancy is a high risk pregnancy. The blood sugars should be checked before getting pregnant. In case a woman gets pregnant with high blood sugar levels, then there can be a risk of miscarriages, and certain congenital disabilities in the baby. Please check your blood glucose levels and HbA1c level to see for your glycemic control. Also, I am assuming you are taking folic acid supplements because that is a vitamin that helps prevent certain birth defects (neural tube defects - in other words brain and spine defects) in the baby. It would have been good if you had mentioned the medications that you been taking for your diabetes to check if you could continue them, also if any dose modifications are required. Because pregnancy-induced hormonal changes can disturb the glucose control as the pregnancy advances and it needs close monitoring. Please get back to me with the necessary details so that I can help you better and guide you through your pregnancy. I hope this helps. Have a great day." } ]
[ { "from": "human", "value": "Hello doctor, I have got some itching and infected skin in-between anus and genital area. It started more than a year ago near the anus and it is increasing its area slowly. White dry dead skin comes at the surface of the infected area when not lubricated. I thought it will heal in some time by applying some antiseptic cream but it is not improving at all. Please suggest me whether it is a chronic anal fissure or some kind of infection." }, { "from": "gpt", "value": "Hello. You seem to have a fungal infection. I suggest you take Itraconazole 100 mg capsule (Ceastra XL 100 mg), twice daily for two weeks. In addition, I suggest you apply either Loceryl cream or Fungicros cream, twice daily for four weeks. You may also take an oral antihistamine like Cetirizine 10 mg tablet once a day for symptomatic relief from itching. Take care." } ]
[ { "from": "human", "value": "Hello doctor, I am 24 years old and my weight is 250 pounds. I have attached the other details. I need suggestions to reduce weight." }, { "from": "gpt", "value": "Hi. I understand the stress you would have due to increased body weight and difficulty in losing it, after going through the attached details (attachment removed to protect patient identity). Your BMI (Body Mass Index) is 48. BMI is nothing but a derived value from the weight and height of a person. For your height, your weight should be around 110 to 120 pounds. Normal BMI is around 25. If it is between 25-30, it is overweight. If between 30-35, we call it obesity. Up to 35 BMI, we can reduce weight by exercise, by reducing carbohydrates and by restricted fat diet, etc. If BMI between 35-40, called severe obesity, some tablets like Leptos can be taken along with exercise and diet. But if BMI is more than 40, it is called morbid obesity which cannot be reduced by drugs or exercise and diet. Bariatric surgery should be done to reduce weight which will prevent you from getting diseases like hypertension, diabetes, cardiac disease, kidney problems, and osteoporosis. Your BMI is 48, which cannot be reduced by drugs, exercise or diet. So, please start considering bariatric surgery as an option. I have seen people who shed almost 100 pounds effortlessly after surgery within 3 months. This surgery is completely safe and gives great results and prevents you from getting various diseases which I have mentioned earlier. Think about your heart. It is designed to work for a body which weighs 120 pounds. It is working double the time now, and its life will get reduced. So please consult a surgical gastroenterologist for clinical examination and surgery. All my wishes for your good health." } ]
[ { "from": "human", "value": "Hello doctor, Please help! I am so upset. My daughter had a seizure. She had one 7 months ago too. We thought it was syncope, but now we think it is a seizure. She had CAT scan, blood work, and EKG and all the reports are fine. We saw a neurologist, and he said everything seemed all right. He gave her an overall examination, no other tests though. This time she bit her tongue and also urinated. She got sick when we got home from emergency room too. Do we have to take her back to the neurologist? Does she have epilepsy?" }, { "from": "gpt", "value": "Hi. I have gone through your daughter's comprehensive medical history written by you. Tongue bite and urination indicate that these episodes are seizures. The probable diagnosis would be epilepsy. Tongue bite is not seen in syncope, though urinary incontinence may be rarely observed. I suggest that she should be put on empirical antiepileptic therapy and observed for response. I wish her a good therapeutic response to medicines. Antiepileptic medicines." } ]
[ { "from": "human", "value": "Hello doctor, I am 25 years old. My weight is 63 kg. I have masturbation habit for 6 years. My stomach gets bloated and there is gas formation. I also have tiredness and diarrhea. I have to apply pressure for passing urine and stools. I get the feeling of emptying my bowel whenever I got to go out for work. So, I have fear every time while going for work or going to meet someone. I do not get normal stools or my bladder does not get cleaned properly and I always have the fullness sensation. I have frequent urination problem. I have pain while I urinate and blood in stool like once in the last year. Report of gastroendoscopy says gastroduodenitis. I have checked for piles also but I do not have piles. Doctor's prescription and reports are attached. I had checked with the doctor about 4 months back. I have taken medicine also. But now I do not take any medicine." }, { "from": "gpt", "value": "Hi. I have gone through your reports (attachment removed to protect patient identity). It is a common problem, most of the individuals have bad bowel habits in some forms. This kind of problem is called IBS (Irritable Bowel Syndrome). This disorder leads to bloating and frequent bowel movements. The treatment is simple.Most of the patients respond to simple measures with dietary therapy and Isabgol. We do not need to do further investigation. 1. Take high fibre diet. 2. Take plenty of water. 3. Take Isabgol 3 spoons twice a day in 200 ml water/milk. 4. Avoid fatty foods and fat in meals. 5. Avoid spices in the meal. 6. Do regular exercise, at least for one hour in a day. 7. Take tablet Pantoprazole 40 mg once in a day for 15 days and then we will decrease it and can stop it later on." } ]
[ { "from": "human", "value": "Hello doctor, To avoid an abscess, can I take an antibiotic like Azithromycin? If not, please suggest which one I can take?" }, { "from": "gpt", "value": "Hello. Azithromycin is not recommended for skin and soft tissue infections. Generally, a combination of Amoxicillin and Clavulanate twice daily is used. However, unless you have a skin infection you should not use it. It is used for a treatment and not for prevention. Regards. For more information consult an internal medicine physician 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": "I have had off and on neck head pains kind of like a headache. My scalp in the back center is a little tender and when I cleaned my left ear I had pain deep inside. Started 3 days ago with killer headache coming from left side behind ear. Scalp tenderness towards the back of the head." }, { "from": "gpt", "value": "Hi, Welcome to icliniq. I hope you are doing well. I understand your concern. I understood that you are having an off and on headache, likely a chronic headache. for the last 3 days, you are having a new-onset headache, which is triggered by cleaning your left ear, associated with scalp tenderness and pain behind ear. There are several possible causes of a headache behind the ear. One of the most common causes of such type of headache is occipital neuralgia. in this condition, occipital nerves are injured or inflamed The nature of pain is piercing and sometimes throbbing or similar to the feeling of an electric shock. for such pain, you need evaluation, maybe a scan, medications that decrease nerve pain such as carbamazepine, pregabalin, etc. Another common cause is Mastoiditis. It is an infection of the mastoid bone, which is the bone directly behind the ear. It can cause a headache behind the ear It is mostly associated with fever, discharge from the ear. In your case, it is likely possible as you have a history of ear trauma while cleaning your ear. Simply taking anti-inflammatory medication and antibiotics will help. Other cause includes temporomandibular joints (TMJ) inflammation. These joints can become inflamed and painful. there is sense jaw tightness and pain in addition to a headache behind the ear. Lastly, migraines can present in a various manner. As your having chronic headache it is also a possibility. It is important to find out the specific cause, so it can be treated appropriately. New-onset headache we like to search for red flag symptoms. This are Sudden onset of headache, the onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness such systemic illness (fever, stiff neck, rash)as fever, focal neurologic signs or symptoms. If these red flags are present, it needs urgent medical evaluation. Some home remedy for symptomatic relief of pain are over-the-counter anti-inflammatory drugs, such as ibuprofen, paracetamol massage of neck muscles apply Heat packs, if swelling then apply a cold pack to take rest in a quiet room Hope this is helpful. Regards" } ]
[ { "from": "human", "value": "Hello doctor, I have a 6-year-old son and he weighs 18 kg. He has a tonsils infection. He has a high fever and I am giving him Meftal P every eight hours and Paracetamol three times daily after food as per prescription. Also, the doctor prescribed Azithromycin 200 mg syrup for him. But, from the medical shop, I got only Azithral 60 mg/mL. What is the dosage I can give to him? Please help. Of note, last month also he had tonsillitis and a fever." }, { "from": "gpt", "value": "Hello. Azithromycin dose for children is 10 mg per kg single dose per day for three days. So, you can give a total of 180 to 200 mg per day that is 3 mL of 60 mg/mL syrup once daily for three days. I would suggest you go for Amoxyclav (Amoxicillin and Clavulanic Acid) than Azithromycin for tonsillitis. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. The dose of Amoxyclav will be 440 mg/mL 5 mL twice daily for five days. For more information consult a child health specialist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have the first upper molar root canal treated 15 years ago. It has undergone two root canals treatment but does it seem incomplete? I did a CBCT and it shows a cyst and sinusitis although I have not that much pain. I am 41 and the dentist told me that I have bone resorption at the upper left maxillary region and I also have been recently diagnosed with Hashimoto thyroiditis. Should I get the tooth extracted? Should I try again for a new third root canal? What about periodontitis which is at the beginning?" }, { "from": "gpt", "value": "Hello. At first, I appreciate you because you have so much awareness of your oral health. The life span of normal root canal treated tooth is 5 to 6 years. If you have 15-year-old treated tooth, it means you are so health conscious and take care of your oral hygiene. My opinion is you should go for extraction along with cyst removal because third-time root canal of the same tooth is not a good idea. Periodontitis is nothing but an infection of gum tissue which is totally curable and depends upon your oral hygiene. Bone resorption is a kind of bone loss due to demineralization. There are many things which are responsible for that like age factor, some diseases, calcium level, gingivitis with periodontitis is also a cause of bone loss." } ]
[ { "from": "human", "value": "Hello doctor, I am a 30 year old female. I am 8 weeks pregnant. I have been having epilepsy since 10 years. I had the last seizure a year ago. I am taking the following tablets: tablet Tegretol CR 200 (1-0-2), tablet Frisium 5 mg (0-0-2) and tablet Folic acid 5 mg (0-0-1). Can I take these tablets when I am pregnant?" }, { "from": "gpt", "value": "Hello. Tablet Tegretol should not be used in pregnancy. Only pregnancy-safe drugs should be taken during pregnancy. It is categorized as category D of FDA drugs in pregnancy. Category D means, there is enough evidence that it causes risk to the fetus. So, I would advise you to get back to your neurologist and discuss with him to shift you on safer anti-epileptics like Levetiracetam." } ]
[ { "from": "human", "value": "Hi doctor, I am a 19 year old male and I weigh 46 kg. Over the last seven months, I am suffering from fever along with chest and back pain. I also have body ache and little blocked nose but not runny nose. The mucus keeps coming out from my mouth. I have headache and I feel very tired. My stool is also not regular. It happens in every 3 days and I have no appetite. I visited a doctor, who examined me and suggested Levofloxacin and Azithromycin tablets for 5 days, Nam Cold for 10 days, pre and probiotic capsules for 10 days, Pantoprazole and Domperidone tablets for 2 months along with a cough syrup, if necessary. My question is this that I have searched about Levofloxacin and Azithromycin tablets online and found these tablets have very bad side effects. It is mentioned that it increases the risk of death and serious cardiovascular disease. So, I am very afraid to take these antibiotics. Will it increase the risk of death? I do not know what to do. Please tell me what I need to do. Is there any alternative medicine. And if I take this, will it affect my health badly? Is there any alternative home remedies or antibiotic medicines that prevents bacteria? I have not took any medicines yet. Please suggest." }, { "from": "gpt", "value": "Hi. I have read through your query in detail. Please find my observations below. It is right that tablet Azithromycin might cause heart disorder like increased abnormal rhythm and this is seen usually in the elderly age group. At 19 years of age and if you have no known cardiac disease then you might take tablet Azithromycin. Tablet Levofloxacin is a safe antibiotic in adults. In your case the doctor has given a combination of tablet Levofloxacin and tablet Azithromycin. Since mucus is coming out of mouth, you probably have a bacterial infection in the throat. There are alternative antibiotics like tablet Augmentin (combination of Amoxicillin and Clavulanate) or tablet Cefixime which have been used to treat upper respiratory infections. However, these medicines require prescriptions and to be taken in recommended dose. If you have started taking tablet Levofloxacin and tablet Azithromycin, then you can continue it for five days without any significant risk. If you have not started the medicine then you can talk to your doctor and ask him to give tablet Augmentin for five days. Tablet Nam Cold (Pseudoephedrine) is to reduce cold symptoms and some people might feel drowsy after taking this medicine. Therefore, please avoid driving after taking this. Pre and probiotic capsules will help in digestion. You do not have gastritis and vomiting therefore taking tablet Pantoprazole and tablet Domperidone combination for two months is not required. You can take this also for ten days and then stop. Please have your meal on time and include vegetables and fruits. Your diet must include 2200 kilocalories daily with vitamins and minerals. When you get up in the morning you might drink a glass of warm water and this will help in proper stool habit. Cough syrup is not required for you. For further information consult an internal medicine physician online -->" } ]
[ { "from": "human", "value": "Hello doctor, My tonsils are not symmetrical. I first noticed just two months ago that my right tonsil looks like a kidney bean with a small hole on top while my left tonsil looks oval in shape with a much larger hole. My right tonsil looks like there is a lump of the bottom of it. I am 28 years old and I smoked for just under 10 years and I have not tested positive for HPV. I do not have any lumps that I can feel, have not lost any weight, do not feel regularly sick. I did have a sore throat a month ago and my left tonsil did feel infected. I did push quite a few tonsil stones from it. I am worried that the asymmetry of my tonsils may be an indicator of cancer." }, { "from": "gpt", "value": "Hi. Tonsils are our lymphoid organs which protect us from infections. The shape of tonsil can vary from person to person and asymmetrical shapes are not at all indicators for cancer. The holes you mentioned are called crypts which lodges food particles which can form stones. Hence, regular salt water gargling is advised. A sore throat you had was because of smoking which is a normal phenomenon of a tonsil infection. Hence you need not to worry thinking abnormal shapes of tonsil for cancer which is pretty much normal in all individual. Finally, regular gargling and antibiotic for a sore throat will relieve your problem. If at all tonsils are troubling you a lot, you can get them removed." } ]
[ { "from": "human", "value": "Hello doctor,I am preparing for a competitive exam. For the last one year, I can hear my heartbeat (initially all the time) later mostly when I try to sleep. I have since started yoga, running, which helped me tremendously, but for a couple of months, I have not gotten back to running (with the exam approaching, in fact, I have one on day after tomorrow) and whenever I try to sleep, I cannot because I can hear my heartbeat. I am also worried about not getting enough sleep before the exam. Last year, the doctor prescribed an anti-anxiety tablet but I did not take, took up yoga, meditation instead. I have Melzap .25 (prescribed to my father by a doctor). I do not want to take it without the expert's advice." }, { "from": "gpt", "value": "Hello. You are possibly describing palpitation (when you are able to feel your heartbeat). It may be related to excessive anxiety. It is not uncommon for stress and anxiety to increase when you are preparing for a competitive exam. You are already following the right approach- yoga, running, regular exercise helps. You can also try a progressive muscle relaxation exercise. It may take 5 to 10 minutes. You can try it twice a day during the exam period. Avoid too much coffee, tea, and soft drinks. It can make your anxiety worse. Ensure you drink enough water, eat regularly and sleep enough. Melzap .25 (Clonazepam) can be used for a short term used to manage anxiety. It should not be taken for a longer period. It can make you feel drowsy sometimes. So do not take it for the first time just before exam day. Try it earlier and see whether it helps. Do not use Melzap regularly. Also, you mentioned marginally increased thyroid. Is T3, T4 increased or TSH increased? It is better to get it checked since hyperthyroidism itself can cause palpitations." } ]
[ { "from": "human", "value": "Hello doctor, I am 24 years old. Two years back I grew some vision problem (myopia) because I think I used the phone a lot with full intensity at night. Till then my number has been increasing. Although now, I refrain from using gadgets at a high light intensity, till now I have visited the doctor about three times and every time, my number got increased. Right now my right eye's number is 2.00 and left eye's number is 1.75. I suffer from constant headache nad whether or not I wear glasses my eyes get stressed and then I grind my teeth. My questions are that with such decline in eyesight will I get blind? The last doctor I visit told me that at my age eyesight gets constant, so why mine is decreasing? What could be the cause of a headache around eyes? Why I have to apply stress to my eyes while reading or looking at far objects? Is there some exercise to cure myopia? How do you suggest LASIK treatment? Why people prefer lens rather than going for LASIK? Is LASIK harmful? What kind of food do I need to eat to cure myopia?" }, { "from": "gpt", "value": "Hello. I understand your concerns and please be reassured there is nothing to worry about. This kind of myopia will not cause any blindness. Even though most people's power stabilizes by 20 to 25, few may have progression all the way to 30, it is not usual but is still normal. There are numerous causes that can lead to a headache, but the amount of myopia you have is very small to actually cause a headache. My advice is to meet with a neurologist to get things clarified. If the power of your eyes is correct, there is actually no need for you to stress while you are reading. This can, however, happen in case you have been wrongly given an increased power while you actually had no change. There are no exercises to cure myopia. Regarding LASIK, it is an older surgery, but it is quite safe. SMILE is the newer procedure. But for either of them, your power needs to be stable for at least six months. We prefer lasik to lenses because lenses if worn throughout the day, cause damage to your corneas, sometimes this damage can be permanent. Myopia is not dependent on the food you eat, but the amount of near work you do. So to lessen the progress, avoid using your mobile for a longer duration and keep them at least 30 cm away while you are looking at it." } ]
[ { "from": "human", "value": "Hello doctor, I am six weeks pregnant. Before knowing that I was pregnant, I was treated for recurrent bacterial vaginosis with Metronidazole orally and Tergynan vaginally for a week approximately on weeks 4 to 5 of pregnancy. How it can harm my baby? Cause I heard that it is contraindicated in first trimester." }, { "from": "gpt", "value": "Hi. There are medications those can be advised in pregnancy as, during the antenatal period, many symptoms could occur that need to be treated. Metronidazole can be advised in pregnancy. So, do not worry and Tergynan is also antifungal antibiotic and it was advised locally, so acted locally. Actually, medications are better to avoid in the first trimester as basic organogenesis occurs. So now continue Folic acid 5 mg daily and do have scans at 13 weeks for nuchal translucency at 20 weeks for fetal detailed anomaly scan and at 22 weeks for cardiac outflow tract to be on safe side. Do not get stressed. Metronidazole is not contraindicated in pregnancy and Nystatin can be used locally." } ]
[ { "from": "human", "value": "Hi doctor, My age is 26 and I have an issue with my blood pressure. It keeps on variating. Sometimes, it is high (150/90, 140/85, 130/90) and sometimes, normal (120/80, 110/60). I want to ask that do I have to consult a doctor and have some test? If yes, can you recommend those tests? Or do you think it is fine to have this much BP?" }, { "from": "gpt", "value": "Hi. You need to test your blood pressure on a daily basis. The first thing in the morning and night time before you go to bed. You have to be resting for at least five minutes, and no food or drink for 30 minutes. Take the readings for one week. If it is, at the majority of times, above 140 then you need to consult a doctor. Otherwise, you need to have regular exercises, reduce salt, and caffeine." } ]
[ { "from": "human", "value": "Hi doctor, I am a 33-year-old obese male. About 1 and a half years ago, I had a painful folliculitis, right below the left nipple which was cured after taking some antibiotics. It had caused a tiny bump below the left nipple, which when touched hurt. Anyways, after taking antibiotics it got healed. The place, however, continued to have a bump, but it was hollow to touch. You could press it down and when released, it would pop back up again. There was no pain. About three weeks ago, I felt pain in the exact same spot where I had folliculitis and sure enough, it was back. It was painful to touch exactly like when I first got that. So I took antibiotics and the folliculitis got cured again, in the sense that there is no longer any pain to touch it. However, the bump of the folliculitis still remains. It does not pain at all to touch no matter how hard you touch it, and the size of the bump has also lessened. However, that bump remains and feel hard underneath, though it does not hurt to touch. What should I do?" }, { "from": "gpt", "value": "Hi. The description you have mentioned is quite classical for anetoderma. This condition arises whenever the skin's elastic and collagen fibers are damaged because of an infective or inflammatory condition. Due to the painful folliculitis, a few of these fibers in the affected area could have been damaged resulting in such condition. This can occur as a consequence of any skin disorder, it is totally benign, and if not causing any trouble best to leave it alone. However, in case you want to try something for it, you could use Tretinoin 0.025 % cream over the affected area for two hours daily." } ]
[ { "from": "human", "value": "Health Query : I have thalassemia minor in the blood and I would like to know if there is a final treatment for it and if not, then what would you advise me to improve my health? Symptoms : Paleness,Hair loss&Rapid Fatigue Medication : Folic Acid tablets & Vitamin D capsules (Would like to know how much IU vitamin D is suitable) Gender : Male Age : 20 Height : 172 cm Weight : 70 kg" }, { "from": "gpt", "value": "Hi Welcome to icliniq, Well according to your history and complaints I would like to ingorm you that a sure shot cure for this for thalassemia minor is not there at present but yes many treatments for major thalassemias are there which are not at all needed in minor forms. Yes symptomatic treatments and supportive therapy are adviced but nothing is sure shot. To improve your health it is recommended ypu must live a balanced life and acquire healthy habits like Adequate work and rest, adewuate balanced diet, mild exercise but with utmost care, be vigilant about any new or worsening signs of symptoms, I also recommend you to be in touch with your treating doctor and get yourself checked periodically incl. blood tests. RDA of Vit. D is minimum 600 IU/day for healthy individuals and minimum 1000 IU/ day eith ostroporosis. Although getting Vitamins B and D levels checked and then to discuss the amount with your doctor is advised. Take Care. Have a nice Day." } ]
[ { "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 had my tooth removed and a dental implant done five months ago. About three months ago it got infected. I went to my dentist, who cleaned out the infection and prescribed antibiotics. The infection did not go away, so I was prescribed antibiotics two more times. Once again, the infection is back. So over the past two months, I have gotten an infection four times and each time had been prescribed antibiotics, which seem to only temporarily fix the situation. I am at a bit of a loss for what to do because my dentist cannot seem to get rid of this infection." }, { "from": "gpt", "value": "Hi. That is hard that you got infected several times. If still infection persists, now your dentist must remove the implant and let the area heal. Maybe this foreign body is not accepted well by the immunity of your body so infection had occurred. Antibiotic coverage is enough once in a month, you are already given multiple times this means ultimately we have to remove the cause to get it right. Ask your dentist to do this removal work without much cost because five months is less period and comes under warranty period of time for an implant. Give me followup of your case in a week. Stay happy and blessed. Take care." } ]
[ { "from": "human", "value": "Hello doctor,For a person who has completed six chemotherapy sessions and month-long radiation for breast cancer treatment, how many HER2 injections are required after the above? ERPR/HER2 parameters are negative." }, { "from": "gpt", "value": "Hello. Can you give information regarding a few details? What was the stage? What was the histopathology report? What chemotherapy was received? If ER/PR and HER 2 was negative, then was FISH (fluorescence in-situ hybridization) done? If HER 2 is negative by FISH and histopathology, then HER 2 injection is not required. If HER 2 is positive, then if the disease is not metastatic then every three weekly injections for one year. If the disease is metastatic, then HER 2 injections are continued indefinitely till disease remains under control. I would be happy to help you if you have any further queries." } ]
[ { "from": "human", "value": "Hello doctor, I am a 44-year-old male with chronic sinusitis. I was exposed to lead and asbestos while serving in the shipyards about 20 years ago. I now draw disability for chronic sinusitis. Recently, my episodes have been turning into bronchitis and even pneumonia more and more frequently. Just this week, I was diagnosed with asthma. My question is can chronic sinusitis lead to asthma?" }, { "from": "gpt", "value": "Hi. I can understand your concern. Yes, chronic sinusitis can cause asthma. Recurrent respiratory tract infections including sinusitis can cause asthma especially adult onset asthma. But better to first get done spirometry study with bronchodilator reversibility. If spirometry is showing an obstructive defect with good bronchodilator reversibility, then asthma is likely. But, if spirometry is showing obstructive defect without bronchodilator reversibility then bronchitis is more likely. Please let me know that do you smoke? Do you have allergies? Please reply me with answers to these questions so that I can guide you better. I will be happy to help you further." } ]
[ { "from": "human", "value": "Hi doctor, Recently I had a mole that just felt funny. I went to my dermatologist and asked her to take a look. She was on the fence about it but decided to remove it given my history. I am blue-eyed, very fair, and my mother and maternal grandfather both had melanoma. She did a shave biopsy and the results came back as follows: junctional nevus with severe cytologic atypia and architectural disorder, inflamed pigmentary incontinence, a concerning melanocytic process with borderline qualities. It was recommended that the mole is excised with 5mm margins which I had done a few weeks later. I have two questions regarding this. First of all, my understanding is that melanoma can be tricky to diagnose in its earliest stages, so I am wondering if this could be melanoma. The word \"borderline\" in the path report has me the most concerned. My second question is whether or not I need anything else done regarding this mole. As I said, it was excised 5mm on all sides and the margins were clear. So, if it was an early melanoma, would there be any additional treatment?" }, { "from": "gpt", "value": "Hi. I have evaluated your concerns and I think that you need to be applauded for your alertness. The steps that you have taken to manage the \"funny\" mole have been in the desired direction. You are right that moles can be tricky to diagnose in early stages. It so happens that they tend to be taken lightly and by the time, an individual seeks medical consultation, sometimes they have already invaded more areas. The term \"borderline\" in pathological reports indicate that: However, the mention of atypia and pigmentary incontinence leave little scope for doubt concerning diagnosis. In my practice, I have seen that pathologists tend to be conservative in their opinion. You took the best step to get the lesions removed. Now you only have to remain a careful observer watching for any unexpected growth, similar lesion elsewhere and follow up as advised by your doctor." } ]
[ { "from": "human", "value": "Hi doctor, I have this sudden sore at the tip of my lips. I am wondering what could it be. I used to have frequent fat sacks, but this seems very different. I am attaching a close-up photo of it. Please advice." }, { "from": "gpt", "value": "Hi. I have gone through your complaint and have seen the attached photograph (attachment removed to protect patient identity). You are having herpes infection which is a viral infection. You should try taking a course of antiviral like tablet Acyclovir 400 mg thrice in a day for 5 days and apply a topical antibiotic like Mupirocin on the affected area twice daily. This will resolve the lesion within 4-5 days. This disease has a tendency to recur as the virus lives in the nerves of the host. Stress, ultraviolet radiation, surgery and infections can cause recurrence of the infection. This viral infection is caused by herpes virus. Herpes labialis The recurrence of herpes infection can be prevented or reduced in intensity by the use of a sunscreen lotion on the lips. So once the lesion heals, start applying sunscreen on your lips." } ]
[ { "from": "human", "value": "Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?" }, { "from": "gpt", "value": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have weight loss, cholesterol problem, and low vitamin D level. Please do check my attached blood reports and let me know if I have any other problem." }, { "from": "gpt", "value": "Hi. I have gone through your reports (attachment removed to protect patient identity). Based on your query, my opinion is as follows: Alcohol might be a cause for the liver related changes. Nothing major to worry for now. You will have to repeat the tests especially lipid profile and liver functions tests after 6 months to look for any changes. Avoiding alcohol should help." } ]
[ { "from": "human", "value": "Hello doctor, I had my wisdom tooth pulled two years ago and have not had any issues until yesterday. My gum where my wisdom tooth used to be is swollen and feels like it is pulling away from my gums. What could be the cause and how can I make the swelling go down at home?" }, { "from": "gpt", "value": "Hi. I had gone through your question. I can understand your concern. As per your history, it looks you are having retromolar area infection. It can be because of the left root stem or cavity in adjacent tooth. To get proper advice and safe diagnosis, you need to upload pictures of the involved area. There are chances of traumatic ulcer too because sometimes the hard food in missing tooth area gets accumulated and becomes infected. You can use Chlorhexidine mouthwash or normal saline gargles and continue the antibiotic medication for five days. Make sure to avoid drugs that may affect your infant in case you are a lactating mother." } ]
[ { "from": "human", "value": "Hello doctor, I have a confusion on pulling down an impacted left upper canine. One doctor said we can pull down left upper canine using bracket and braces other said no because roots are not yet formed." }, { "from": "gpt", "value": "Hi. Regarding the impacted left upper canine, I have looked at your CBCT and OPG (attachment removed to protect patient identity). A vital piece of information. The age of the patient is not available. However, according to the present data, the upper left canine is not completely formed and also has a bend in the root. It is also placed at a much deeper and more difficult location. It can be brought down into the arch with surgical exposure and braces. However, there are certain risks with such teeth. Somtimes the tooth is joint with bone compounded by the bend in the bone and so does not respond to the pressure. In such a case, it will have to be extracted. This happens in extremely less number of cases. So it is a risk worth taking for the canine tooth since it is a very important tooth. Younger the patient, better chances." } ]
[ { "from": "human", "value": "Hello doctor, I am 41, female, and sedentary. I am 100 lbs or more overweight 248 lbs at 5'4\". I started the gym today and I walked slowly for 15 minutes. My heart rate stayed around 120 bpm. Then I stopped moving to see how fast my heart rate would go down. It went up 10 beats to 130. I checked again a minute later, it had started going down again. Why did it jump up 10 beats after I stopped moving? I have had a phisicap less than a year ago. I was told I had a good pulse, great blood pressure. I also have panic attacks so once I thought I was having a heart attack and went to the ER. They did that tripolin test two times, EKG or ECG. They took an X-ray too. I had not had a heart attack and they said my heart did not look enlarged and no signs of a blockage. So I am still paranoid though. I just have never noticed heart rate going up briskly after stopping the activity." }, { "from": "gpt", "value": "Hi. Heart rate rises because of the unconditioning due to long term sedentary lifestyle. Do regular exercise, heart rate will slowly come down. The more one is fit, more heart rate will come down immediately after stopping exercise. A decrease of 20 or more in the first minute is normal, less than 12 is abnormal due to less fit heart. You need to lose weight, eat healthily, avoid addiction to be fit. Other causes are anxiety and dehydration. Do regular exercise to be fit and to lower heart rate after exercise. If you need more information, or guidance regarding weight loss, exercise, healthy food, etc., you can always ask anytime." } ]
[ { "from": "human", "value": "Hi doctor, I am 21 years old. I was wondering due to my shoulder being really bad and after doing surgery and still, even after that I am always dislocating it. I have been trying to tape it but I am not 100 % sure how to do that, so it will minimize the chances of it dislocating while snowboarding. I have been wondering whether the kino tape would be better or just a normal sports tape and if you could give me tips on how to tape my shoulder, it will be really helpful. I do exercises to try to stabilize shoulder but not with alot of progress." }, { "from": "gpt", "value": "Hi. I read your concern. In your case, taping can help you little in stabilizing the joint. However, Kinesio tape helps you to recruit or inhibit muscle and is of less help in providing stability to the joint. If you want to tape, then go for rigid tape. If you were my patient, I would honestly suggest you go to a good arthroscopic surgery and get your stabilization surgery properly and follow the proper rehabilitation protocol before attempting to start your sport. You have to first regain your stability range and strength before introducing to your sport again. If you are really keen only in taping, then tape your shoulder in that position which limits your sideways lifting and outward rotation of the shoulder which is actually a difficult position to limit. Stabilize your scapular muscles and can limit the scapular movement limiting the shoulder mobility. However, in a long run, this will not help you to make you independent. Just think about getting a good arthroscopic stabilization to your shoulder." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide." }, { "from": "gpt", "value": "Hi. For further doubts consult a sexologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I have done my C1 and C2 surgery with screw fixation. After three months, my head is little flexible to move down and backward but not left and right (the surgery moto is not to turn my head). But for the past one week, I am facing that my neck is very stiff and my right shoulder feels like very tight and weight (sometimes I get pain). Because of this, my total head feels like very tight and with this, I am not able to move my head down (but can move backward). After I consulted with my doctor and took an X-ray and checking that there is no fault in my screw fixation, that is perfect and he gave me some tablets too. But still, I am facing neck, right shoulder (starting from neck till shoulder knee) stiffness." }, { "from": "gpt", "value": "Hi. Your X-ray looks fine (attachment removed to protect patient identity). So, nothing to worry. Yes, you can travel but if you have pain and stiffness, then you need to use a soft cervical collar-size depending on your neck length, or it can be adjustable. If you do a sitting job, then you should get up once every 15 to 20 minutes and take a small walk for two minutes everytime. For the lower back, you need to do McKenzie back extension exercises (cautiously under the guidance of a physiotherapist, as the neck should not get a lot of strain while exercising)." } ]
[ { "from": "human", "value": "Hi doctor, My daughter is 15 months old, and it has been three weeks that she did not sleep at night. 1 to 2 hours at most and then she will cry waiting for me to bring her to the living room because she wants to play. She would not stop crying if I ignore her (I am trying to let her try to soothe herself), even if I try rocking her or put the pacifier. She will only stop crying once I brought her to the living room. I am working, so I sent her to a babysitter during the daytime. I thought she will sleep more during the daytime, but apparently, her sleep routine is just the same as before. Her babysitter said that she slept for 1 to 2 hours in the morning and the afternoon. She is healthy, so active, happy as usual and looks completely fine to me even though she does not sleep enough. Is this normal? Will this new habits affect my daughter's health or growth? What cause her sleep routine to suddenly change? (Previously she will sleep throughout the night, with 2 to 3 times milk feeding in between). What can I do to put her back to her previous sleeping habit? I really need advice." }, { "from": "gpt", "value": "Hi. Sleep habits of babies vary from one another. Your child is normal and there is no cause of concern. Most of the babies do this but become difficult to handle cause of working parents. She requires more patience. I really appreciate your concern. This will not affect her growth. Sleeping habits change because they become more active and locomotion takes priority over feeding. They like moving around. There is nothing anybody can do except handle with patience as you have been doing." } ]
[ { "from": "human", "value": "Hello doctor, I have a sore throat from last 15 days. Medications taken are Amoxicillin and Clavulanic acid taken for five days BD. The next course includes ZOCEF CV 500 BD for eight days. Levocetirizine 5 mg OD at night from the last 15 days and Betadine gargle thrice a day (both Levo and gargle, I stopped three days earlier)." }, { "from": "gpt", "value": "Hello. You may stop the Betadine gargle and start Benzydamine gargles diluted in water done twice daily after meals. Take a proton pump inhibitor which stops acid production twice daily before meals. Post meals, take an antacid syrup that neutralizes the acid produced. I would suggest you take an anti-inflammatory medicine to remove the congestion and edema inside the throat. The picture clearly shows granules in the posterior pharyngeal wall. If the condition does not improve, we may need to do a throat swab. If you need any further help do revert back. If there is any investigation that you have done please upload it so that we can have a look." } ]
[ { "from": "human", "value": "Hi doctor, My father had an angioplasty before two months. He is fine now. But, he is getting restless in eating by avoiding most of the food. Please instruct me the food items which my father can eat." }, { "from": "gpt", "value": "Hi. Thank you for the query. Your father can eat all fruits, dry fruits, vegetables, low-fat dairy products including milk without cream, one whole egg or two egg whites per day, fish, chicken, salad, pulses, lentils, and legumes. Limit red meat and salt to minimum. Spices can be taken to add flavor to food if low salt diet tastes unpalatable. Avoid processed foods, canned foods, sweets, and soft drinks even if not diabetic. Eat fish at least twice per week. If he has diabetes, then keep fasting sugar below 130, and random sugar below 200. Avoid sedentary behavior, do regular aerobic exercise, take all medicines, and follow-up your cardiologist regularly to adjust the dosage of drugs." } ]
[ { "from": "human", "value": "Hi doctor, I am 4 months pregnant. I had a TORCH test before two years as I met with miscarriage. The TORCH results were rubella IgG positive 19.56, rubella IgM non-reactive, CMV IgG reactive (738.65) and CMV IgM antibody non-reactive. I want to know whether I am at the risk of TORCH infection? Am I TORCH positive?" }, { "from": "gpt", "value": "Hi. I have gone through the query and images (attachment removed to protect patient identity)." } ]
[ { "from": "human", "value": "Hi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you." }, { "from": "gpt", "value": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness." } ]
[ { "from": "human", "value": "Hi doctor, I had irregular periods. All my other test reports are normal such as LH, FSH, AMH, thyroid and FBS. I had done pelvis transvaginal sonography three days back, but last period date was 28 days back. My report summary is as follows. Pelvis shows an anteverted, uterus with central endometrial canal. The uterus measures 56x29x34 mm. The endometrial thickness measures 5 mm. Both the ovaries were well visualized and appeared bulky with multiple small follicles noted in parenchyma. Right ovary measures 38x24x37 mm, volume measures 17.4 cu mm. Left ovary measures 40x22x33 mm, volume measures 14.7 cu mm. There is no free fluid in cul-de-sac. Is everything normal? Will I be able to get pregnant? I am 30 years old and married for 4 years. I have not been pregnant earlier and have been trying for baby since 3 months only. Currently, I am taking Folic acid and other vitamin supplements. Please advise." }, { "from": "gpt", "value": "Hello." } ]
[ { "from": "human", "value": "Hi doctor, I had unprotected intercourse on the 11th. My menses date was on 26th of the same month, but I missed my menses. I had a pregnancy test after eight days and it was positive. I took the first set of abortion pills on the same day at 6:30 PM. At 10:30 PM, I started to have bleeding and the cramps and pain continued till morning 6 AM. It bled and five to six blood clots were there. I took my second set of pills at 10 AM. After that bleeding was very less, but the cramps were there. Till now I have some bleeding and small spots with an interval. Is everything working well? I want to assure that the abortion is complete. Please suggest me." }, { "from": "gpt", "value": "Hello. Firstly, you have not mentioned the name of the pills or the pack that you have taken for medical abortion. From the set of pills, I understand that you have taken two pills at 6.30 PM and then a second set of Misoprostol pills at 10 AM after 16 hours. This is a wrong protocol to use just Misoprostol pills alone and also at such a gap of 16 hours. The bleeding experienced may just be an endometrial shed and the gestational sac may not have been aborted out at all, because cytotrophoblastic invasion has not been stopped by the first pill called Mifepristone. As the bleeding has stopped it is suggested that you should get a transvaginal ultrasound done tomorrow or today to see if the sac has been aborted or not as you saw fewer blood clots and no tissue like glistening lump. I feel that you have not aborted yet as the pills have been wrongly consumed. I want you to mention the name of the pack that you have used or the name of the pills that you have consumed. There are multiple packs available and the only concern in such early pregnancy of less than seven weeks is that Mifepristone is required 36 hours prior to Misoprostol intake and then completion success rates are higher. Nevertheless, get a transvaginal ultrasound done to check for completion and review with the report." } ]
[ { "from": "human", "value": "Hi doctor, I am a 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home?" }, { "from": "gpt", "value": "Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all." } ]
[ { "from": "human", "value": "Hi doctor, My mom had headaches and backpain. So recently, my mom went for an ultrasound scan and was diagnosed with a bulky uterus. The size of her uterus is 83x41x61 mm, and they also found an intramural fibroid sized 57x33x38 mm. Could you please help me understand what exactly this means and is there any complication?" }, { "from": "gpt", "value": "Hi. How are you doing? Let me start by saying that it is nothing to worry. Let me explain. Fibroids or myomas are benign or non-malignant masses arising from the muscles fibers of the uterus, usually in women with not many children (1 or 2). These masses are like stones and are hormone dependent. So, they grow till she has periods. Once periods stop, her hormone supply stops, and the fibroid starts shrinking. Intramural Fibroid never become malignant. If you randomly take scans of 100 ladies, 50 to 70% may have fibroids of different size. It is a dictum that, no asymptomatic fibroids need treatment. I would simulate it to, if you have a huge boil on the face, which does not interfere with food intake, just leave it alone. But even if you have a small boil on the inside of the mouth, it really hurts, then you may need treatment. Intramural Fibroids need treatment only if: If she has no symptoms, just leave it. It will shrink as her estrogen hormone is reduced. To further help in reducing the size and bleeding in periods, I suggest trying tablet Ormeloxifene (Sevista 60 mg or Novex DS), twice weekly. She can have it for a year or so and stop it after a scan. The fibroid would have shrunk. This medicine is cheap and has no side effects. If she is anxious or has any of the symptoms, then surgery and removal of the uterus with fibroids would be advised. Hope I have clarified your queries, do write back." } ]
[ { "from": "human", "value": "Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached." }, { "from": "gpt", "value": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->" } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, I have a case that was assigned to me in school, and I want to seek help from doctors. My case is about a girl who has schizophrenia and was diagnosed very early. She shows all the symptoms, like hallucinations, hearing voices, hurting other people and talking to people who are not there. My question are as follows. How can this person get counseled? Is CBT useful? If she does not seek help, what would happen to her? How can I help her if I was a counselor? What approaches can I use during our sessions and why? And lastly, what is the possible outcome?" }, { "from": "gpt", "value": "Hi. CBT is usually not useful in schizophrenia when the patient is having fulminant and active symptoms of schizophrenia such as delusions and hallucinations. The prerequisites for CBT (cognitive behavioral therapy) are, 1. The patient should be motivated for therapy.2. The patient should understand the therapeutic alliance between therapist and himself.3. The patient should have good frustration tolerance.4. The patient must realize that the symptoms are because of his/her maladaptive thoughts, feelings and behavior. So in your case, the treatment of choice is drug therapy along with supportive treatment. As far as the prognosis is concerned, it depends upon the following: 1. The response to treatment.2. Good family support.3. The age of onset, a very early start is a bad prognostic factor.4. Treatment compliance.5. Employment status.6. The family history of mental illnesses.7. Type of schizophrenia." } ]
[ { "from": "human", "value": "Hi, What should I do if I have taken seven 500 mg crocin tablets together?" }, { "from": "gpt", "value": "Hi. If you indeed took 7 x 500mg crocin tablets which on the GSK website are paracetamol tablets, your total dose is 7X500mg = 3500mg of Paracetamol. The answer would depend on how heavy you are. Most of the time, the toxic dose is 200mg per kilogram. For example, if you are 70kg, the toxic dose or dangerous dose is 200X70=14000mg. So if you indeed only took 3500mg paracetamol and your calculated dose is less than the toxic dose, then it should not be a problem. However, if you have liver problems or have taken an overdose of paracetamol before, or you took paracetamol recently as well in other forms/shapes/sizes or you take other medications then this is not the case and answer. Also, if you developed pain on your stomach on the right, started vomiting, or feel unwell then you should see your doctor. If you are still worried, you should see your doctor or go to the emergency department with your tablets or tablet boxes so that the doctors know what you have been taking. Overdoses of Paracetamol are dangerous and can cause death if taken over the recommended doses.Ultimately, you should not take so much paracetamol so often and in large amounts. An adult can only take a maximum of 1g of paracetamol every 6 hours." } ]
[ { "from": "human", "value": "Hi doctor, My periods started 14 days before and I had sex eight days back. Should I take pills after unsafe sex? If yes, what is the procedure to take I-pill?" }, { "from": "gpt", "value": "Hi. According to your cycle, it is the seventh day of your menstrual cycle and considered to be safe. If you have a regular 28 day cycle, then ovulation is less likely on day seven. But, if your cycles are irregular then it is difficult to predict the exact day of ovulation as to when the chance of conception will be there. So, to be on safer side, you should take a pill today only. It is known as morning-after pill or pill 72 (Levonorgestrel 150 mcg) to be taken within 72 hours of unprotected sex only once. Yes, you can get a withdrawal bleeding after taking these pills before your next due date. In case 72 hours have crossed after sexual intercourse, then also you can prevent pregnancy in this cycle by getting a copper-T (intrauterine device) inserted and that too within five days of unprotected sex." } ]
[ { "from": "human", "value": "Hi doctor, I have schizoaffective disorder. I take Abilify and Cymbalta. But most of the time my hands shake badly. Do you think it could be due to Abilify and Cymbalta or it could be more related to my disease? Does Abilify cause tremors as a side effect?" }, { "from": "gpt", "value": "Hello. How long have you had these tremors? Is it present all the time? Did you develop these tremors only after starting medication or did you have some form of shaking even before medication? Both Abilify (Aripiprazole) and Cymbalta (Duloxetine) are known to be associated with tremors. Have you discussed these tremors with your treating doctor or psychiatrist? You need to be assessed for signs of extrapyramidal side effects. Abilify (Aripiprazole) is a proper medication for your condition. Any medication can come with side effects. So after assessment, your doctor can either optimize the dose of the medication or if appropriate consider a medication like Pacitane (Trihexyphenidyl) to control these symptoms. Also try to practise progressive muscular relaxation and deep breathing exercises . It will help to calm your nerves as stress can exacerbate these symptoms. You are welcome to contact us if any further advice is needed." } ]
[ { "from": "human", "value": "Hello doctor, I am 19 years old. I took i-pill after four to five hours of having unprotected sex. I again had unprotected sex after 12 hours of taking the i-pill. I was very tensed and took another i-pill after 56 hours of the second incident. After seven days, I started bleeding. But, it was lighter than the normal periods and it lasted for five days. Then for six days, I had lower abdominal pain, back pain, small acne, and headaches. I took a home pregnancy test after 22 days of the second intercourse and it came back negative. I was normal after that with no pain. There was only a small acne present. Now, it has been exactly a month for the incident to have taken place and I am feeling bloated. I have weight gain and my breasts are a little sensitive. Is this because of the change in hormones? Or are my periods going to come? Or am I pregnant? I am very tensed. A detailed answer would be highly appreciated." }, { "from": "gpt", "value": "Hello. First of all, let me tell you that there is no chance of pregnancy. Usually, ovulation occurs between the 12th to the 16th day of periods or better said as 14 days before the periods. Life of egg is 24 hours and that of sperm is 72 hours. So, there was no chance of egg and sperm meeting on the 24th day of the period as the egg would never have been alive for that long. So there was need of a pill at all in the first instance. I-pill is a high dose of progesterone hormone. The same hormone which is produced in your body in the second half of the period after ovulation. This pill will suddenly increase the thickness of the inner lining of the uterus making it unfavorable for a possible pregnancy to implant. As it was a single dose, it had no strength to stand on, so it fell off and you got periods or bleeding from the increased thickness within seven to 10 days of taking the pill. This bleeding would have been thick, in fleshy pieces, dark red or brown, with slight lower abdominal pain until the bleeding is really reduced. So if you take one i-pill, it would make the endometrial lining unfavorable for an embryo to sit there, a second i-pill is never needed. Repeated use of i-pills in such short span will only disturb the hormonal balance and the subsequent periods. If at all the embryo had formed, which is not possible from the calculations you have given, then your urine would have been positive after 14 to 16 days of sex, which you said was negative. All the symptoms you have mentioned are due to the progesterone hormone. This is the i-pill and incidentally the same hormone that supports the pregnancy. So, just forget about it and relax. If you feel that the periods are getting irregular and different in amount then I suggest you just have any of the birth control pills like tablet Ovral-G (Norgestrel and Ethinyl Estradiol) or Dear 21 (Ethinyl Estradiol and Levonorgestrel) or Novelon (Ethinyl Estradiol and Desogestrel) or Duoluton-L (Ethinyl Estradiol and Levonorgestrel) or Intimacy plus 0.03 (Ethinyl Estradiol and Desogestrel) one tab at night for 21 days. I am advising it not for the contraceptive benefit but for its hormonal level correction. You can have it for 21 days and stop and then the next periods will be within four to seven days. Further cycles too will be regular. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. I suggest you can have the same pills cyclically for further contraception. Hope I have clarified your query and do write back if you have any more queries." } ]
[ { "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 am having major pain in the back bottom right side of my mouth where my wisdom tooth is pushing in. I can see the wisdom tooth. What can I do for pain since the earliest my dentist can see me is in a week?" }, { "from": "gpt", "value": "Hi. I had gone through your question I can understand your concern. You need to use Hydrogen peroxidase 3% mouth wash. Make sure the concentration must not be more than that. You can also use antibiotics only after consulting your dentist. You can also provide further details of your medical history or any drug allergy, including the pictures of erupting tooth so that I can offer you a better opinion and treatment plan. Wisdom tooth eruption. IOPAR x-ray. Impaction. Pericoronitis. Mouth wash and antibiotics. Avoid sticky foods." } ]
[ { "from": "human", "value": "Hello doctor, I am facing problem of missing periods from last month. Pregnancy test is negative. I have also taken tablets of Meprate. My last period was 62 days back. Please guide." }, { "from": "gpt", "value": "Hi. Period normally starts within a week of finishing Meprate (Medroxyprogesterone) tablets. Rarely it can take 15 days for period to start. If it has been more than 15 days since last dose, you need to visit gynecologist to get one ultrasound done, as Meprate will be effective only if your endometrial thickness is good, ≥ 7mm. If it has been less than 15 days since last dose, you can wait. If there is strong suspicion of pregnancy no harm will be done by repeating pregnancy test. Meprate will not induce period if you are pregnant." } ]
[ { "from": "human", "value": "Hi doctor, I have queries regarding my mom's health. She is suffering from some abdominal issues. When she had a CT scan, they found an impression with the liver. I attached her report and please tell me if there is a serious issue. Yesterday she got admitted with intolerable abdominal pain. Her doctor asked us whether she had any injuries on that area. But she never had any injuries. They prescribed some medicine and asked her to take an injection for two days. She was discharged home in the evening and last night she got severe abdomen pain. She is worrying a lot and crying all the time. She is getting pain while she coughs. She is unable to sleep and has constipation. I totally rely on you to get suggestion." }, { "from": "gpt", "value": "Hi. According to the CT scan report (attachment removed to protect patient identity), there are two problems. In the liver, there is hemangioma which is a benign tumor meaning it does not cause any harm. If it increases in size, then it is resected. The other problem is with the muscles of the abdominal wall in which a small amount of blood is accumulated which is causing pain. It can occur after some trauma or injury to the site. It will also resolve in a few days. So I think hopefully she will get fine in a few days. Take care." } ]
[ { "from": "human", "value": "Hello doctor, I have been experiencing pain in my left wrist for a month now. I had x-rays and a CT scan showing normal, but the pain continues. A few years back, I had ulnar nerve relocation surgery from a fall on ice in the same arm. Could the nerve be the reason I am having this wrist issue?" }, { "from": "gpt", "value": "Hello. You have mentioned pain in your wrist region for a month now. Also, you have mentioned previous ulnar nerve transposition surgery. Since your pain is localized to your wrist region, it seems unlikely that your ulnar nerve is involved because neuropathic pain is usually a radiating kind of pain in the distribution of the nerve. Also, there may be symptoms like numbness, paresthesias (abnormal electrical shock-like sensations) and weakness, which you have not mentioned. Also, no abnormalities in x-ray and CT scan means that the bones and joint alignment is all right and not a cause of pain. This also means that there is a soft tissue affection which is leading to your symptoms, so it could be due to ligaments around the wrist region, inflammation of tendons which we call as tendinitis, ganglion, etc., besides many others. Tendinitis or ligament sprain. MRI wrist (If no improvement in 3 weeks time or earlier if any worsening is present). 1) To wear a wrist brace for a period of 2-3 weeks. 2) Ice packs for local application. 3) Gentle anti-inflammatory medication like Ibuprofen or Paracetamol can be taken whichever suits your body. 4) Physical therapy We shall wait for 2-3 weeks to see the effect of this treatment protocol, also if you develop any swelling, or any other inflammation, kindly get back to an orthopedician and traumatologist online." } ]
[ { "from": "human", "value": "Hello doctor, I am experiencing tingling sensation of the scalp on left side of my head. The medications which I am taking are Zyprexa, Prozac Sonata, Neurontin, Tramadol and Metformin. Will any of these medications cause this tingling sensation?" }, { "from": "gpt", "value": "Hi. I want to assure you that everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. This is due to the side effect of medications you are on. It is relatively a minor side effect and is usually self limiting and not an issue of medical concerns. Many of my patients come with tremors of the eye muscles or facial muscle tremors too along with the scalp muscle tingling. All your medications are fine and nothing has to be changed because, this is just a temporary adverse reaction to them and will go away on its own. If I extrapolate my clinical expertise, I want to make sure you do not have the start of any neurological abnormality, as such kind of tremors may also be due to some associated neurologic disease. So, having said that, do you have some other neurological manifestations or any kind of disease symptoms other than this in any part of the body? Keep taking all the medicines. Your Metformin is least likely to cause such a side effect of muscle tingling. All others do have an impact of variable intensity. Avoid tea, coffee, diet or regular soda, energy drinks, alcohol, cigarette first hand and passive smoking, e-cigarette vaping, etc. Take plenty of water and keep a proper physical activity. Cardio exercises are best for you. It will raise the blood flow to the scalp vessels and will keep the emissary veins of the scalp well flushed and will help relieve the symptoms. Join any fitness club where sauna, swimming, steam bath, cardio exercises are available and follow the instructions of the instructor there. Your BMI (37.11) is high and it means you also have a higher fat content. And the drugs' fat distribution also contributes to side effects of drugs. Try to take your BMI down within the limit of 18-25. Proper rest and meditation is best treatment for you right now. Also try recreational and meditational activities with your family." } ]
[ { "from": "human", "value": "Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance." }, { "from": "gpt", "value": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?" }, { "from": "gpt", "value": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect." }, { "from": "gpt", "value": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->" } ]
[ { "from": "human", "value": "Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?" }, { "from": "gpt", "value": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?" }, { "from": "gpt", "value": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->" } ]
[ { "from": "human", "value": "Hi doctor, I am 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": "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, I got stung by a bee yesterday morning on my toe. When I woke up this morning, I started feeling itches here and there in my body. I also got two blisters on the top of my toe where the bee had stung." }, { "from": "gpt", "value": "Hello. With the conversation we had, I understand that you were bitten by a bee yesterday (insect bite) on your toe and today you have blisters, itching, and swelling. Based on the information you gave, I have suggested some measures as well as some medications. Please wash the toe with lukewarm water and see carefully if any part of the sting (sharp organ of the bee) is left in the toe where it stung. If so you must contact your local doctor who can do the needful steps to remove the sting. If not, then apply some antibacterial cream (like Mupirocin ointment or Betadine ointment) over the blisters. Apply the cream twice daily and wash off with lukewarm water before the next application. Wear comfortable footwear that does not rub over the affected part. Next, to get relief from itching, take an antihistaminic tablet. Antihistaminics that you may take are Levocetirizine 5 mg once a day (if effects wean off, then take twice a day) or Cetirizine 10 mg once a day. If there is pain take a painkiller (Paracetamol 650 mg) if needed. If there is severe swelling and that is increasing with days you need to consult with your doctor to see if it has caused an infection. Increasing pain, pus from the blisters, change of color of surrounding normal skin, fever are some other symptoms showing worsening of the condition or infection. If you are a diabetic with poor sugar control, you run an increased risk of developing an infection. In such a case depending on the severity of infection, anti-bacterial agents have to be instituted. Take rest and do not move the affected toe a lot. Eat plenty of nutritious food and take 4 liters of water per day (this should be the case normally). Especially so now because when you take medicines, the body needs abundant water to take care of metabolism." } ]

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