# migrations

dir: embeddings_queue
filename: 00001-embeddings.sqlite.sql
hash: d3755dfd232be8e8301f4d7fcfb3a486
sql:
CREATE TABLE embeddings_queue (
    seq_id INTEGER PRIMARY KEY,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    operation INTEGER NOT NULL,
    topic TEXT NOT NULL,
    id TEXT NOT NULL,
    vector BLOB,
    encoding TEXT,
    metadata TEXT
);


dir: sysdb
filename: 00001-collections.sqlite.sql
hash: 38352d725ad1c16074fac420b22b4633
sql:
CREATE TABLE collections (
    id TEXT PRIMARY KEY,
    name TEXT NOT NULL,
    topic TEXT NOT NULL,
    UNIQUE (name)
);

CREATE TABLE collection_metadata (
    collection_id TEXT REFERENCES collections(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (collection_id, key)
);


dir: sysdb
filename: 00002-segments.sqlite.sql
hash: 2913cb6a503055a95f625448037e8912
sql:
CREATE TABLE segments (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    topic TEXT,
    collection TEXT REFERENCES collection(id)
);

CREATE TABLE segment_metadata (
    segment_id TEXT  REFERENCES segments(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (segment_id, key)
);


dir: sysdb
filename: 00004-tenants-databases.sqlite.sql
hash: 048867ce8fcdefe4023c7110e4433591
sql:
CREATE TABLE IF NOT EXISTS tenants (
    id TEXT PRIMARY KEY,
    UNIQUE (id)
);

CREATE TABLE IF NOT EXISTS databases (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per tenant
    tenant_id TEXT NOT NULL REFERENCES tenants(id) ON DELETE CASCADE,
    UNIQUE (tenant_id, name) -- Ensure that a tenant has only one database with a given name
);

CREATE TABLE IF NOT EXISTS collections_tmp (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per database
    topic TEXT NOT NULL,
    dimension INTEGER,
    database_id TEXT NOT NULL REFERENCES databases(id) ON DELETE CASCADE,
    UNIQUE (name, database_id)
);

-- Create default tenant and database
INSERT OR REPLACE INTO tenants (id) VALUES ('default_tenant'); -- The default tenant id is 'default_tenant' others are UUIDs
INSERT OR REPLACE INTO databases (id, name, tenant_id) VALUES ('00000000-0000-0000-0000-000000000000', 'default_database', 'default_tenant');

INSERT OR REPLACE INTO collections_tmp (id, name, topic, dimension, database_id)
    SELECT id, name, topic, dimension, '00000000-0000-0000-0000-000000000000' FROM collections;
DROP TABLE collections;
ALTER TABLE collections_tmp RENAME TO collections;


dir: sysdb
filename: 00005-remove-topic.sqlite.sql
hash: b1367c826b8fba5f96f27befdc1d42d2
sql:
-- Remove the topic column from the Collections and Segments tables

ALTER TABLE collections DROP COLUMN topic;
ALTER TABLE segments DROP COLUMN topic;


dir: sysdb
filename: 00006-collection-segment-metadata.sqlite.sql
hash: 4eea7468935bf25d4604a0fed2366116
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE collection_metadata ADD COLUMN bool_value INTEGER;
ALTER TABLE segment_metadata ADD COLUMN bool_value INTEGER;


dir: sysdb
filename: 00007-collection-config.sqlite.sql
hash: 1c7e63bba346a42a18b6ab7f1c989bed
sql:
-- Stores collection configuration dictionaries.
ALTER TABLE collections ADD COLUMN config_json_str TEXT;


dir: sysdb
filename: 00008-maintenance-log.sqlite.sql
hash: 0a0e7e93111a01789addf64961c6127c
sql:
-- Records when database maintenance operations are performed.
-- At time of creation, this table is only used to record vacuum operations.
CREATE TABLE maintenance_log (
  id INT PRIMARY KEY,
  timestamp INT NOT NULL,
  operation TEXT NOT NULL
);


dir: sysdb
filename: 00009-segment-collection-not-null.sqlite.sql
hash: 054355aef9e63702bf54ea29e61563f1
sql:
-- This makes segments.collection non-nullable.
CREATE TABLE segments_temp (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    collection TEXT REFERENCES collection(id) NOT NULL
);

INSERT INTO segments_temp SELECT * FROM segments;
DROP TABLE segments;
ALTER TABLE segments_temp RENAME TO segments;


dir: metadb
filename: 00001-embedding-metadata.sqlite.sql
hash: 2b4cf52c4bb2676e21d6860a4409f856
sql:
CREATE TABLE embeddings (
    id INTEGER PRIMARY KEY,
    segment_id TEXT NOT NULL,
    embedding_id TEXT NOT NULL,
    seq_id BLOB NOT NULL,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    UNIQUE (segment_id, embedding_id)
);

CREATE TABLE embedding_metadata (
    id INTEGER REFERENCES embeddings(id),
    key TEXT NOT NULL,
    string_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (id, key)
);

CREATE TABLE max_seq_id (
    segment_id TEXT PRIMARY KEY,
    seq_id BLOB NOT NULL
);

CREATE VIRTUAL TABLE embedding_fulltext USING fts5(id, string_value);


dir: metadb
filename: 00002-embedding-metadata.sqlite.sql
hash: 12a570f7121b3a8ce750a2a7c36da20f
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE embedding_metadata ADD COLUMN bool_value INTEGER


dir: metadb
filename: 00003-full-text-tokenize.sqlite.sql
hash: f97ad6334aeaa8f419f01110b648b97a
sql:
CREATE VIRTUAL TABLE embedding_fulltext_search USING fts5(string_value, tokenize='trigram');
INSERT INTO embedding_fulltext_search (rowid, string_value) SELECT rowid, string_value FROM embedding_metadata;
DROP TABLE embedding_fulltext;


dir: metadb
filename: 00004-metadata-indices.sqlite.sql
hash: fb36603a45ee2cd0254cef3ef86585e8
sql:
CREATE INDEX IF NOT EXISTS embedding_metadata_int_value ON embedding_metadata (key, int_value) WHERE int_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_float_value ON embedding_metadata (key, float_value) WHERE float_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_string_value ON embedding_metadata (key, string_value) WHERE string_value IS NOT NULL;


# embeddings_queue

created_at: 2024-12-07 18:55:07
topic: persistent://default/default/1ec72250-5e6f-4315-a383-8352de23299b
id: 23743daf-c125-4dbc-a7d5-faea91957e67
encoding: FLOAT32
metadata:
{"Description": "Q. How long should my husband and I wait to try for a baby if we did cocaine?", "Patient": "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.", "chroma:document": "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 -->"}


# collections

id: 1ec72250-5e6f-4315-a383-8352de23299b
name: chroma_db
database_id: 00000000-0000-0000-0000-000000000000
config_json_str:
{"hnsw_configuration": {"space": "l2", "ef_construction": 100, "ef_search": 10, "num_threads": 2, "M": 16, "resize_factor": 1.2, "batch_size": 100, "sync_threshold": 1000, "_type": "HNSWConfigurationInternal"}, "_type": "CollectionConfigurationInternal"}


# embedding_metadata

key: Patient
string_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?


key: chroma:document
string_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 -->


key: Patient
string_value:
Hi doctor, I am a 22-year-old female who was diagnosed with hypothyroidism (genetic) when I was 12. Over the past five years, I have become around 50 pounds overweight and all of my attempts to lose have seemed to fail so I have given up, but my weight has stayed the same. There is so much information put there about losing weight with hypothyroidism but it all seems to conflict. I am so unsure as to what type of exercise and diet I should follow as a result but I still would like to lose weight, but most importantly have my body feel better. What can I do? I am currently on Levothyroxine, Buspar, and Benedryl.


key: chroma:document
string_value:
Hi. You have really done well with the hypothyroidism problem. Your levels are normal with less medications which are very good. As it is genetically induced, it is very difficult to lose weight. My advice to you is, you should focus on maintaining normal levels of TSH (thyroid-stimulating hormone) and try to remain active, having a positive outlook in life. Or else, it will become very difficult to balance your life with the symptoms of hypothyroidism. Even though your weight has not reduced, be very careful in not putting on weight here afterward. Everyday brisk walking for 1 hour. If you have body pain, alternate with exercises and walking. Avoid all kinds of junk foods, processed, bakery products, rich sweets, fatty foods, sodas, alcohol, and smoking. Avoid partying and binge eating. Follow the food timings properly. Have small frequent meals. In between snacks should be strictly fruits or any kind of low-calorie foods. Have unsalted nuts around five daily. It can give a glow to your dry skin. Everyday water intake should be around 1.5-2 liters. You can use flax seeds. Powder it and mix it in your food. It is a fiber which will give you fullness. Use turmeric, fenugreek seeds, or powder every day. It is a good antioxidant and fenugreek helps in reducing cholesterol levels. Include low-fat milk, curd every day. Egg white, lean chicken, or fish can be taken daily in moderation (anyone). Organ meats need to be avoided. Is your menstrual cycle normal? Please get back if you have any other complaints. Follow up after 15 days.


key: Patient
string_value:
Hi doctor! I used to have clear skin but since I moved to a new place, I started to have lots of acne on my face particularly on my forehead. I thought it would disappear once I went back home, but it only got worse. I did some research and assumed that it was caused by drinking too much cow's milk, but it has been since since I stopped and they would still not go away. I also noticed that I get deep acne whenever I'm nearing my period, along with the usual small red bumps. I bought an acne soap and have been using it for a month now but I'm not sure if it works. I hope you can help me because it has been affecting my mental state lately :((((


key: chroma:document
string_value:
Hi there Acne has multifactorial etiology. Only acne soap does not improve if ypu have grade 2 or more grade acne. You need to have oral and topical medications. This before writing medicines i need to confirm your grade of acne. For mild grade topical clindamycin or retenoic acud derivative would suffice whereas for higher grade acne you need oral medicines aluke doxycycline azithromycin or isotretinoin. Acne vulgaris Cleansing face with antiacne face wash


key: Patient
string_value:
Hello doctor,I am having an uncomfortable feeling in between the middle of my spine and left shoulder blade. It seems to get stiff, and my bones pop a lot around there, and it is very uncomfortable to sit in specific ways feels like my bones shift, well the other night it seemed as if my shoulder would pop out of place causing more stiffness after a while of dealing with it. I ended up feeling a popping sensation, where the stiffness was an instant relief. It was so shocking it put my anxiety through the roof. I thought I was going to die because my whole body was shaking and tingling. What am I dealing with? Right now I have no pain or tender near that area still relief but curious on what happened and why I got this shock and that popping feeling so loud it scared me half to death.


key: chroma:document
string_value:
Hello. The popping and discomfort what you felt is either because of improper scapulothoracic mobility or may be due to facet joint irritation in the neck with intervertebral hypermobility. Which could have caused due to stiffness in the chest muscles, shoulder stiffness, etc.  I would recommend you to do a lot of icing in the chest and back muscles. Maintain your neck and upper back posture by doing some back retraction work. Gently stretch your neck and chest. Gently massage your chest and shoulders to relieve tension in the muscles. I hope this is helpful for now. Kindly revert in case you need any help in this regard.


key: Patient
string_value:
Hello doctor,Before two years had sex with a call girl in a dark location for about 10 to15 min. I did not eject, and I am sure that she did not eject as well (not 100 % sure). Do not know if the condom broke (as it was dark) but had some liquid on my penis (maybe fluid in condom, not sure) After few days from then I had cold followed by itchy skin. I took medicine from the doctor and got it resolved.After a few weeks from then, I had fever 100 F, mild night sweats, mild sore throat, slight weight loss (around four to five kg). Also I feel tired most of times. After 50 days, I got an HIV blood test, which came out negative. Do not know the name of the test, they took blood from my fingertip, tested it using some chemical for 40 minutes, and gave a report. Doctor suggested me get the same test after three months. Now I took medicines for flu symptoms which are giving me relief. But, very worried about the situation. Will medicine I used for cold and itchy skin have impact on HIV. Was the test enough for diagnosis as I do not know the name like fourth-generation etc. Also I washed my penis after 20 minutes with water thoroughly. Please help.


key: chroma:document
string_value:
Hello. The HIV test uses a finger prick blood sample, with results given within 20 minutes, and is 99 % accurate at detecting any HIV exposure that may have occurred more than 12 weeks ago. However, it can potentially pick up HIV infection from as little as four weeks ago. There is nothing to worry nothing will happen, and please repeat your test after 12 weeks. If you want accurate results to get, it has done RNA PCR which will give actual results within 10days. Antigen detection like P24 gives best results with in two to four weeks. Probably your suffering from a simple viral upper respiratory infection. After 12 weeks, please consult your doctor he will examine and treat you accordingly.


key: Patient
string_value:
Hello doctor,I had an emergency surgery six months ago punched through a window right arm cut both arteries cut radial nerve with ulnar damage and cut bicep tendon nerves back now almost full thumbs up the only issue is bicep. My question is there something I can do to fix it like lengthening surgery, or am I stuck? I am a boxer supposed to go Olympics this year. My surgeon focused on the nerve and did not care help. PS pronator is still little and has not fully recovered.


key: chroma:document
string_value:
Hello. If you are saying it is already six months since the surgery and if you are doing regular physiotherapy, still has not gained much of the actions, then it is not worth waiting anymore. There are many muscle transfer surgeries which can give you the desired movements and help you in day today activities. But you have to remember that post such operations you will require time to train the brain and get the full use of such movements. That will take time. Do not want to demotivate you, but tremendous training and hard work might be required to reach the pre trauma stage of your boxing.


key: Patient
string_value:
Hello doctor, My culture from my gynecologist came back, showing that I have a yeast infection as well as Beta Strep. I was hoping for more information on Beta Strep. I have never heard of it, and there is a lot of information when I searched that is making me confused a little. I am not experiencing any symptoms, either. I feel perfectly fine.


key: chroma:document
string_value:
Hello. There are lots of bacteria and other organisms that colonize healthy skin. Yeast a fungus also is a commensal in our body. Just the presence of these organisms is of no significance. The colony count is needed, which is high, will need a course of antibiotics, which can be decided by culture and sensitivity. But after a surgery like what you had, or any significant stress or use of lots of antibiotics (as would have happened after surgery) or use of steroids or diabetes, all infections show an altered balance between good and bad bacteria. You do not need any treatment for this. Just wait for your body to develop those good bacteria, and gradually, all tests will come negative. If you have any symptoms, treat as per need. Avoid unnecessary antibiotics use. They will further delay the recovery. I hope I have clarified your query, do write back if any more questions.


key: Patient
string_value:
Hello doctor,I am 24 years old, and for the past nine years, I am facing hair fall problem nowadays my 60 % of hair is falling on my top and front of my head. I checked my thyroid and hemoglobin many times, but their reports are good. I use many home remedies and hair oils, but when I stop using it again, it starts falling. The allopathic doctor says use Minoxidil 5 %, Finasteride, and hair serum. But Finasteride has many side effects. Can you please tell me is any medicine available in homeopathy which stops hair fall and promotes hair growth if yes can you please tell me the name.


key: chroma:document
string_value:
Hello. I checked the attached photo (attachment removed to protect patient identity) and read your description. It seems you have been suffering from hair loss problem for a longtime. Do you eat healthy food like vegetables and fruits every day? Sometimes lack of nutrition is also the reason for hair loss. Do you know if your father also differed from hair loss issue at this young age? Did you suffer from severe health issues or chronic illnesses? If you do not think above mentioned is the cause for your hair fall, then the only reason I can think is that you have been going through severe stress which has taken a toll on your health. Homeopathy would be a good option in this case as it will cure our problem from the root cause, and there will be no side effects. So to prescribe you a correct homeopathic remedy I need to understand your mental, emotional, and physical state. He ce I need detail case history which can be done either through face to face consultation or online consultation. I would advise you to visit a good homeopath for consultation. For the time being, you can apply arnica hair oil twice a week on your hair. Just mix one spoon of Arnica oil with five spoons of coconut oil and apply all over your scalp. You can gently massage your ear with this mixture. Try this for 15 days and then let me know how you feel. I hope you start feeling better. Let me know if you have any questions.


key: Patient
string_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.


key: Patient
string_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.


key: chroma:document
string_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 -->


key: Patient
string_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.


key: chroma:document
string_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.


key: Patient
string_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.


key: Patient
string_value:
Age - 33 years Height - 164 cms Weight - 67 Kg I am suffering from sore throat so I took Augmentin 625 before 12-13 days back but found no improvement but I started suffering from Stomach pain and excessive gases. Now I am taking below medicines as per prescribed by ENT specialist that are 1.Allegra M tablet 2.Rinifol capsule 3.Esoz D 40 capsule 4.Acinil O surup for ten days.Two days remaning to finish course. Stomach pain and blown stomach due to gas is still there.


key: chroma:document
string_value:
Hello. I welcome you to icliniq. Well it is not uncommon to have Gastric upsets after a course of antibiotic. And antibiotic like augmentin are notorious to cause this. This occur secondary to effect of augmentin on decreasing the amount of lactobacillus microorganism which are normally present in the human gut and help digest the food. You should take yougurt, Kefir (fermented yougurt), Kefir. and there are certain diets with probiotic activity you can start taking it. Plus take Tab Ecotec twice daily for 4 weeks, and Tab Levosulpiride 75 mg once daily half hour before meals.for 2 weeks. You can continue with acinil O syp. while rest of your current medication can be stopped. I hope this will correct your microbiota and will bring the same healthiness as before. good day Antibiotic induced dysbiosis Small intestinal bacterial overgrowth Antibiotic induced dysbiosis Let me know in one week time how you respond to above regimen, if persistent of symptoms I would consider testing and giving some safe antibiotic therapy for 2 weeks.


key: Patient
string_value:
Hello doctor,Can I pull out hard teeth out no pain because I got a hole in my teeth? Whenever I use to eat something, it got stuck in it and caused severe pain. Kindly give me some advice about pulling it out without any pain.


key: chroma:document
string_value:
Hello. I had gone through your question, and I can understand your concern. If the pain occurs only when you eat food and it gets stuck into it, it is reversible pulpitis. For that, you do not need to get it extracted. You need to get it filled, and it will cost you less than that of pulling (extraction). Second, you will save your tooth too. My suggestion is to get dental filling done as soon as possible. If you want to get it removed, you need to visit a doctor (dentist), and there will be no pain because during extraction local anesthesia is given.


key: Patient
string_value:
Hello doctor, My reverse elbow armpits have developed a darker (my skin color is fair) pigmentation. This pigmentation has also affected the whole of my groin area. Some dots of such pigmentation have also come up under my extreme armpits. What should I do now? What is this condition? Can you diagnose the state conclusively?


key: chroma:document
string_value:
Hello. I understand your concern. The pictures are a bit hazy. But from the given images, it looks like a fungal infection by the name of pityriasis versicolor. I would also need to see your chest, upper back, and shoulders to be sure. Kindly send clear photos of the same to make a conclusive diagnosis. Meanwhile, you can start using the following medicines. 1. Tab Fluconazole 400 mg start and repeat once after a week. 2. 2 % Ketoconazole lotion apply for 5-7 mins and wash off once a day.


key: Patient
string_value:
Hello doctor, During rainy and winter season get frequent fevers. Most of the times I get it diagnosed, and every time doctors tell it is only viral fever. Fevers generally come twice a month. I take Paracetamol and Cefixime usually (on the advice of doctors). Generally, the illnesses go in 10 days. This has been happening from the last three years. Can you suggest any cure for it? I am a small time businessman, and this is affecting my financials. Regarding my medical history, I am a premature baby of seven months. As told by my mom and relatives, I remained alive on medicines with great difficulty. And also from childhood, I used to get skin diseases frequently, and for that, I think I was regularly administered antibiotics.


key: chroma:document
string_value:
Hello. I need to know a few things, 1. Do you feel feverish, or does the thermometer record a temperature? 2. What other symptoms do you get? Runny or blocked nose, sore throat, throat pain with swallowing, headaches, body pains, etc. 3. Does anyone else around you (family members, co-workers, etc.) develop similar symptoms before or after you do? 4. Do you get any tests done like blood tests or X-rays during those episodes? From your description, it appears that you are getting frequent viral upper respiratory tract infections. These are acquired from other patients through the air (coughing, sneezing, etc.). They are usually short-lived and last no more than five to seven days. Since more than 300 different viruses can cause similar symptoms, you can get infected multiple times each time with a different virus. The same virus cannot affect you again. Unfortunately, antibiotics do not work against viruses. They are meant for bacterial infections only. However, doctors continue to prescribe antibiotics unnecessarily, and this has led to the emergence of widespread bacterial resistance.  Other than symptomatic treatment, no medicine can cure or prevent these infections. They are self-limited, and you will get better even if you do not take any medication. The older you get, the less frequently you will get these infections as your body will be building up defenses with every disease. No household tips or vitamin supplements have been proven to work. Premature birth can lead to increased frequency of infections, but unless the infections are bacterial, not much can be done about them. Please get back to me with answers to the above questions and also attach any test reports you may have.


key: Patient
string_value:
Hi doctor, I am a 40 year old female. I got cottonmouth bite on the back of the left and right ankle. Three people saw and confirmed that as cottonmouth. I do not believe much venom was released. It happened under shallow water. I got immediate pain as if repeatedly the ankle and feet got hit with a bat and a burning swelling began quickly. I went to the ER. They monitored my blood for two hours and decided no antivenom. I was not given either a tetanus shot or any antibiotics. From the laboratory work, they said everything looks good, but I could not stand or walk. They sent me home with Ultram and Ibuprofen 800 mg. After two days, the swelling slightly increased instead of going down. My fiance took me to different hospitals. The swelling and the fang marks were evident. Again, the laboratory work came back as normal. I was still in pain and swollen ankles. They gave steroid IM injection and Prednisone pack and suggested antihistamine. It has been six days. Still, I cannot stand, walk or care for myself in any way. The swelling has not got down. I have kept it elevated and put some cool fabric packs on swollen areas. It seems to help with burning sensation. I have been drinking Echinacea tea, water and taking all medicines prescribed such as Ultram, Benadryl, Prednisone and Ibuprofen 800 mg. Back of my legs up to the thigh is swollen, entire legs hurt and tender to even minimal touch. Bruising has darkened and the swelling has not gone down. There are no red lines and no skin rotting. What shall I do now? I want the swelling to get relieved. I am scared. How to reduce the swelling? Please tell me what I need to do just to be able to stand briefly. The pain has subsided from 10 to 5, but if I try to stand by just keeping the foot down towards the floor, then the pain is excruciating. Please help.


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Hi doctor, My father is 71 years old. He had a fever for a week, and the temperature raised up to 104 during the night along with frequent urination. Two days ago, the fever came down to 98.4 for five hours but again increased to 102.3 despite taking the same antibiotics. He is taking tablet Gudcef-CV 200 for five days and injection Monocef, twice a day for four days. His TLC was 18,000 last week. Please give your opinion.


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Hi. I went through your post and investigation (attachment removed to protect patient identity). Regards. For further queries consult an internal medicine physician online -->


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Hi doctor, My 3 year old son was diagnosed with sepsis with SIRS, three days back. But, now his WBC and C-reactive protein are within limits. Will he have sepsis again? He frequently gets wheezing and allergic cough. He is currently taking Amclav.


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Hello doctor, I am facing bulging eye problem for a year. I am not able to sleep at night due to watery eyes. I went to the doctor, and he did an MRI and found that my eye muscles have enlarged. He gave the treatment for three months, but there was no benefit. He gave me Solu Medrol 500 mg then 250 mg injections for two months and some vitamin tablets. It is a severe problem. Please help me.


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Hello. The condition you have described is called proptosis. The most common cause of proptosis is thyroid abnormality (hyperthyroidism) and called thyroid eye disease (TED). In this condition, eye muscle gets enlarged due to GAG (glycosaminoglycans) material deposition. This condition usually resolves after active and quiet phase that takes up to five to seven years. During this time the actual cause is treated (hyperthyroidism) and for proptosis steroids may be given (that you have already taken). Enlarged muscles can compress the optic nerve and can cause permanent vision loss. So you need to consult an endocrinologist for the treatment of thyroid abnormality. Quit smoking (if you are a smoker) and keep follow your eye doctor to avoid complication that can cause permanent vision loss. You are welcome for any queries.


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Hello doctor, I am a 30 year old male, who weighs 200 lbs and 6 feet tall. I have been looking for my symptoms after watching a TV show. I know some things are not right with me, and I have been curious to find the cause. It could be one or more problems. Here is what is going on. I have cold hand and feet, sweaty hands and feet, many bumps in the arms, mainly right arm, sand paper hair since a young age, and my feet get numb and eventually very painful when walking. I have severe vitamin D deficiency, and my eyelids are always half closed. I have low metabolism, and I experience a lot of teeth problems. I might have osteoporosis. What is causing all this? Is it tumors or parasites or a neurological problem?


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Hello. Cold and sweaty hands and feet can happen in heart failure, anxiety, hyperthyroidism and shock. Numb feet, which are painful while walking can be due to neuropathy, nerve root compression at lumbosacral spine, or arterial occlusion in legs. The half closed eyelids can be ptosis, or something else. I suggest you get the following tests done: Since when you are having these problems? Do you have any impending doom, palpitation, breathlessness? I suggest you meet a neurologist in-person for proper clinical examination and better judgment. Revert with more information to a neurologist online -->


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Hi doctor, I have thyroid issues for the past three years. I got this when I was pregnant. I am taking Thyronorm 75 mcg tablet for the last three months. Recently, I have done the thyroid test and my T3 and T4 are normal and TSH is very low. It shows less than 0.01. What does it indicate? First, I was on 50 mcg and before three months I started 75 mcg as the TSH was approximately 6 at that time. Please explain.


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Hi doctor, I am a 35 year old woman. My height is 5'3" and weight is 147lbs. I do not have a child yet, but will be trying to conceive soon. I am a vegan and eat healthy. I workout five days a week and sometimes will go for a 5 km runs around two to three times a week as well. I went off my birth control pill about three months ago and have not had a period since. I was diagnosed with PCOS when I was 15, but after going vegan two years ago, doctor said it definitely helped with symptoms. I have been eating right and working out for the last three months, and my weight has not budged. In fact, it seems I have gained numbers on the scale. Three months ago, I was 139 lbs. Is there anything in my report that could be the reason for not being able to lose weight or abdominal fat? Is there anything in the infertility test portion that could indicate the issues in trying to conceive? I would like to get a professional advice on my blood work results. I am mainly looking to find out if anything on here can indicate infertility or difficulty in losing weight. Please help.


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Hello. I have gone through the reports (attachment removed to protect patient identity). For further information consult an obstetrician and gynaecologist online -->


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Dear Doctor, I am trying to figure out what is wrong with my 15 year old daughter. Her symptoms have developed most significantly over the past few months, and include depression, weakness, constant light-headedness, shortness of breath (even when sitting still), difficulty taking a deep breath (causes pain), episodes where breathing becomes especially difficult, a complete lack of energy, continual exhaustion, continual muscle soreness (especially in the calves), cold hands and feet (to the point of turning blue), intolerance to cold and heat especially, episodes of a racing heartbeat, and episodes of anxiety and disorientation. At first our focus was on her was depression but now our focus is shifting toward her problems with physical activity and breathing, especially as she has now come to the point where she can no longer participate in any sports. We have seen a psychiatrist for her depression who discovered the MTHFR Mutation, which has since been addressed with a megadose of methyl folate. After three weeks on the medication there has been no improvement. Her paediatrician tested her for asthma and the results were negative. We have put her on various vitamin B supplements and have made sure she is getting proper nutrition and rest. Again, nothing has helped. Other labwork, as well as some of her symptoms, has made us consider her thyroid. The thyroid results are as follows:  TSH: 0.059 ulU/ml. AntioTPO-Ab: 84.9 IU/mL. Anti-Thyroglobulin: 134 IU/mL. Total T3: 130 ng/dL. T4: 10.5 ug/dL. Other labs that were out of the normal range are as follows:  - Ferritin: 31 ng/mL (her other iron results were normal). - Differential (Audo Diff) Neutrophils: 66%. In spite of a low TSH we have been told that as long as the T4 level is within normal range there is no need for attention with the thyroid. Yet, I canno help but keep coming back to the thyroid and wonder if this is not where we should focus our efforts. Any thoughts please?


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Hi, It is really sad to know about your daughter. 1. As a matter of fact your daughter seems to have acute thyroiditis. Though the thyroid profile has not shown full blown thyrotoxic state, she has subclinical hyperthyroidism with TSH being suppressed. Since how long has she been like this? Thyroiditis might take 8-12 weeks to settle. How old are the reports? Thyroiditis might leave the patient hypothyroid. 2. Secondly she is 15, puberty is another phase of major hormonal and emotional change over. How are her periods? Has she put on weight? or lost some? You have supplemented with multivitamins, please see if B12 upto 1500 mcg is being given and Vitamin D 1000 IU daily or 60,000 IU once a week is going. Also supplement her with calcium and magnesium and check these levels as well. Treat her with Propranolol 10mg twice a day to beat the anxiety and palpitations. Get back to an endocrinologist online -->


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Hi doctor, I asked my doctor to do PSA test. The PSA came back normal at 1.0 ng/mL. However, he also did prostatic acid phosphatase test which was high at 4.5 ng/mL. My question is whether prostatic acid phosphatase test is valid for screening or not? Should I need to do these tests again? I had prostatitis symptoms in the past. Now, it seems to be fine.


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Hi. I have gone through your query. Prostatic acid phosphatase (PAP) has been replaced by PSA (prostate-specific antigen test). It is better in the detection of prostate cancer compared to PAP. The elevation of PAP levels alone is not a cause for concern. I hope your treating doctor has done a rectal exam to find out any prostate nodules. If it is normal, then it is not necessary to repeat the tests. Hope this helps you. Feel free to revert back with any questions. For more information consult an urologist online -->


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Hello doctor, 50 years old, 5.8 inches, 260 lbs. On blood pressure pills. My doctor is out of town for a few weeks. I reviewed PSA test results and apparently I have one abnormal reading out of three. PSA total 0.5, PSA free 0.1, PSA % free 20. The PSA % free 20 is in red indicating abnormal. What does this mean? What causes it to be abnormal?


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Hi. Free PSA should be more than 15 % to rule out prostate cancer. Free PSA is an additional tool used when PSA is above 2.5 and we want to check whether high PSA is due to benign prostate growth or due to prostate cancer. Some laboratories use 25 % cutoff, but most have 15 % cutoff value. Since your total PSA is quite low and free PSA is above 15 %, you should not worry. If in doubt, repeat after a few months.


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Hi doctor, I am 27 years old. I am worried about my prostate as my grandfather had prostate cancer and my father had an enlargement but was already cured. I had an ultrasound last year due to frequent urinating and result showed minimal calcification a year back. The Radiologist told me that the calcification has nothing to worry as it was not that serious and my doctor (internal medicine) also did not care about it. But I am still worried as what I have read is that even at a young age you can have prostate cancer. Though I am still experiencing frequent urination (I am now drinking a lot of water 2 to 3 liters a day) now, my creatinine is in normal level and KUB is all normal.


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Hi. I have gone through your query. It is extremely unlikely for you to develop prostate cancer at your age. Even in families with hereditary prostate cancer, the usual age people develop cancer is above 40 years of age at the lowest, though it is usually between 50 to 60 years. That said, in your case, it is too early to jump to conclusions of having prostate cancer in your family. The most likely explanation for your symptoms could be a mild urinary tract infection or even your increased fluid intake. Prostatic calcification is commonly seen and does not imply anything significant to worry now. If you are concerned, you can do a PSA (prostate-specific antigen) test and a prostate exam at 40 years. If normal, then you can repeat it after three years interval. For more information consult an urologist online -->


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Hello doctor, I am a 79 year old male. Excellent health, take no medications with the exception of an occasional Viagra. In a recent DRE, my urologist discovered two small nodules on my prostate. A PSA at the time was 6.3. Over the years, I have ranged in 2's and 3's. He suggested a biopsy of the prostate. I have read many negative things about this process. I have also read about nonevasive procedures to detect for cancer.


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Hi. I have gone through your query. I concur with your urologist in the need for a biopsy. Any PSA (prostate-specific antigen) more than 4 or abnormal findings on DRE (digital rectal examination) needs evaluation to rule out prostate cancer. None of the non-invasive techniques are sufficiently accurate as a biopsy at present. The closest is an MRI which, if positive, needs to be confirmed by a biopsy, and if negative does not exactly rule out a malignancy, you will need a biopsy nevertheless. Many blood tests are available but those are only if the DRE is normal and will not be applicable in your situation. Hope this was helpful, feel free to revert back with any other questions. For more information consult a urologist online -->


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Hi doctor, I have eye allergy for the past 1.7 years. I have consulted many doctors. I am using steroid eye drops too, but my eye allergy is still present. My eye irritates when it contact with blowing air, perfumes, air conditioner, strong odors, when I get cold and sometimes suddenly without any exposure. Occasionally, it causes pain in the eyes and head. I do not know what caused this. What is the permanent solution for this? Is there any other alternate remedy for this? When I take Cetirizine my irritation subsides in 30 minutes. Please help.


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Hello doctor, Presently I am on my 34 th weeks of pregnancy. LMP was before eight months. I had an IUD of more than 37 weeks before two years. Present medications are Clexane 20, and Ecosprin 75 daily. As per my doctor's planning, I should go for C-section between 36 to 37 weeks. Now when I should stop my Claxene and Ecospirin? This medication is given by my gynecologist after analyzing my boh panel report which states lupus anticoagulant by DRVTT is 45.50. No lupus-like anticoagulant present, APTT is 31.30 and PTT-LA is 98.80. Kindly advice.


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Hello.  I feel that it would be the best if you do not stop these medicines without the advice of your doctor who recommended these and made a plan for your pregnancy because self-treatment strategy will lead to no benefits. And both of these drugs are safe to use, so you do not have to worry. Furthermore, for your knowledge, aspirin is usually stopped at 35 to 36 weeks of pregnancy, and Clexane (Enoxaparin sodium) is being continued until delivery, and even after that. So I would again say that please take advice from your particular doctor before stopping any of these medications as your pregnancy is very precious. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


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Hi doctor, After 15 months of unprotected sex, I went for HIV test called Comb AIDS test but, the result came back negative for both HIV-1 and 2. Again after three months, I redid the test, but even this time, the result was negative. I was not satisfied, so I went for ELISA test, and again the results came back negative. I consulted two general physicians, who told me that I do not have HIV. But, I am still worried because of the symptoms that I have. I am a male, who weighs 62 kg, and I am 6 feet tall. The symptoms i'm having are:  severe weakness, ulcers in mouth and tongue, fatigue, pain in legs while sleeping, itching in the private part, occasional sore throat, occasional itching and pain in ears, and black spots on my back.  I remember having loose motions after a week of unprotected sex. At that time, the doctor told me that I have food poisoning, and I was alright after taking medicines. Are these HIV tests done by me reliable? Was the loose motion caused due to HIV? Is it possible that my immune system was so weak to detect antibodies during my HIV test? Should I go for another test such as PCR RNA test? Please help me, I am worried. Your kind response will be appreciated. Thank you.


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Hi. The test kits used to diagnose HIV are highly sensitive and specific and gives accurate results. The majority of the people who are infected with HIV (human immunodeficiency virus) develop antibodies by three months, and even in the rare instances of late seroconversions, they develop HIV antibodies by six months. You can rely on your HIV screening test results. If there had been no other exposure other than that, you do not require any further test. The symptoms which you mentioned could be due to various reasons and cannot be attributed to HIV. In fact, there are no specific symptoms or signs which can lead to the diagnosis of HIV. As per the above information, you are HIV negative. Just relax. Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime. Best wishes. For more information consult an HIV AIDS specialist online -->


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Hello doctor, I am a 22 year old male. I have problem of tight penis skin. Whenever I pull my penis skin back during erection it will be very hard to do. Then, my penis skin gets stuck behind the penis forehead and it is very painful to retract back. I generally use oil for this problem. Please suggest me what to do.


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Hello doctor, I am newly married. My husband is 26 years old and I am six months younger to him. My family members say that my husband is over-possessive and controlling. How can I know if my husband is over-possessive and controlling?


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Hi. Most of the persons who are over-possessive of their partner show certain kinds of behavior that is uncommon in the general population. They feel less secure and this sense of insecurity is the driving force for the over-possessive nature. Someone who is insecure may doubt their partner's dedication and may, therefore, try to control them. In short, they feel vulnerable and will do anything to make sure they are not hurt. The sense of insecurity can stem from a number of situations including parents leaving a child, a past romantic partner who was unfaithful and many more. To control the possessiveness: Consult a psychiatrist online in case of further assistance in overcoming this situation -->


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Hello doctor, I have pimples near my penis. I do not understand what problem I have. I am worried about that. Please explain my problem.


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Hi. It is very difficult to say what disease you have, because pimple does not come over penile area. It could be molluscum which looks like a pimple. If you can send me the photos, then I can definitely diagnose it. Explain the lesion properly like itching, pain, duration, pus filled, etc? Are you sexually active? Revert back with the photos to a dermatologist online -->


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Hi doctor, I am 18 weeks 2 days pregnant. My friend told me that I am supposed to add two weeks to those 18 weeks while counting. Is that true? Can I get pregnant if I had sex during period? My period was on the 28th and I had sex on the 5th. That time, my period was on, but not heavy. Could I have gotten pregnant that time? How long do sperm stay in the body? Please explain.


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Q. As I am having a history of miscarriages, will taking hCG injections help me to continue pregnancy?


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Hello doctor, My lmp was on five months ago. I was spotting for three days during my lmp and got a positive strip test after seven days. My beta hCG level on the day of a positive result was 126, and after two days, it was 125. I am being told that I will get periods in two weeks but told to continue folic acid and multivitamin and come for ultrasound in three weeks if no periods come. I have a history of miscarriages, and I am 35 years old. Can hCG injections help me or should I consult another doctor? Have I miscarried or there are still chances?


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Hello. Unfortunately what your doctor has said is right. Spotting in early pregnancy is normal. But a fall or no rise beta HCG is a poor sign. Beta hCG is a hormone produced from fetal tissue. At a level of 25 mIU/mL urine test is positive it doubles in 48 hours. So if the result of 7th is 125, then on 9th it should have been around 250 or more. Only healthy fetal tissue can produce an adequate amount of this hormone, so indirectly we get to know the health of the embryo even without seeing it. So it just means the fetal tissue is not growing. There can be lab errors, so to be on a safer side doctor has asked you to come for scan, to confirm.  If you are worried about the repeated miscarriages, have yourself and your partner checked for any problem. Causes like blood sugar levels, thyroid hormone problems, or prolactin hormone abnormalities, any structural problems in the uterus or any problem in semen. Do not lose hope, if you are getting pregnant without much help, no matter what the outcome is, then you will surely have babies. I hope I have clarified your query, do write back if any more questions.


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Hi doctor, I am 33 years old. My height is 176 cm and I weigh 77 kg. I started hitting gym a month back. I am into 1 hour daily workout, which include both aerobic and anaerobic exercises.  As per the BMI report, I was informed to keep my weight under 67-72 kg. Recently my gym trainer informed me about the pill Clenbuterol and it is safe to go for it. I went through a few websites and came to know it is more effective in burning fat, muscle build up and also used for treating asthma patients. My medical background is, I am an asthma patient. My recent medical checkup indicated that I have BP which is marginally little higher than regular and doctors indicated that it is not that much to be concerned about. I came to know, Clenbuterol is a steroid which has lots of other side effects like muscle cramp, dizziness, hand shaking, heart problems and effect on aorta. It has short and long-term effects too. It is completely banned in few countries and not available through prescription as well. Can you please inform me whether I have to go for it? Also, I want to reduce my weight without any side effects. As I am working as a software engineer, there might be a possibility that I will be traveling across countries and need to go for blood and urine tests for visa approval. I would like to know whether it will cause any problem in these cases as it is an illegal drug. Please let me know if any further details required from my side. Thank you in advance.


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Hello doctor, I am a 25 year old female. I am wondering whether Raw Bovine Ovary pills are safe to take. I am looking to gain weight in my thighs and breast. My thighs and boobs are skinny. Kindly explain.


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Hi doctor, I have been riding my bike a lot more recently and now I noticed that I am having numbness within the perineal region including scrotum and penile area. I have stopped riding since the onset of symptoms and it has been over a week now. Should these symptoms resolve with time if I quit riding? Please suggest.


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Hello doctor, I am 23 years old. I am obese and have a family history of cardiac arrest. My father got cardiac arrest at the age of 53. I have consulted the local cardiologist and gone through ECG, echo, TMT, lipid, hs-CRP and other blood tests. All the tests were normal except heart rate, which was 110 and also high BP. I am taking Rosufit 10, Nebistar 5 and Cilaheart 10. Currently, I am feeling warm in the left side of my chest for a short span of time. Sometimes, I have slight pain in my left hand and feels like a pinch type of pain in the center of the chest when I inhale and exhale. Is it normal?


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Hello. This kind of chest pain occurs during stress and anxiety only. We label them nonspecific cardiac chest pain. But, we should always keep in consideration cardiac chest pain and acid reflux. It is important to differentiate between the all. However, the cardiac chest pain is severe and crushing in nature. It increases on activity like walking and exercising. It also gets radiated to left arm. Since your ECG and other cardiac workup are normal, the pain is not due to cardiac issues. For acid reflux, I would advise you to take a combination of Pantoprazole and Domperidone once a day. Your increase in heart rate might be possibly because of anxiety only. For anxiety, try to do meditation and if no relief, you would be treated with anti-anxiety drugs like Etizolam. For further clarifications consult a cardiologist online -->


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Hi doctor, I just received my routine blood work for my cholesterol count and noticed that my absolute monocytes are low, 163. Other than this, all other blood results are within normal range. My total WBC is 5.1 and monocytes 3.2%. It there a reason to be concerned? I am currently healing from a terrible fall on my deck stairs, which resulted in a massive hematoma on my buttock. Would this have anything to do with the low absolute monocyte reading? I am currently on Lotrel and Lovastatin.


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Hi. Based on your query, my opinion is as follows (attachment removed to protect patient identity): For further information consult a hematologist online -->


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Hi doctor, I am a 22 years old male. I feel sexually attracted to my own mother. I had some mild feelings since childhood, but it became strong since teenage. I started feeling to be loved by mom as her son and sexually too. I sometimes feel guilty about it. But, I could not control myself. I saw my mother naked sometimes and this fed my lust towards her even more. I am getting dirty thoughts about her when I think about having love with her. I also watch porn especially incest. I want to express my love to her sexually. Please provide some way to overcome this. I am not under any medication. I am just trying to control myself mentally.


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Hello. I can understand your problem. Sexual feelings in an adult towards a female are considered as normal and acceptable. But, such feelings towards any female with blood relationship are not acceptable in any society and this result in significant blow to reputation and respect. The feelings you have described towards your own mother are wrong and should be controlled. In future this might result in relationship problem in your case especially towards your wife. This might result in difficulty in maintaining relationship with any other female. To overcome the problem you have to work hard. One thing is that stop watching porn completely. If that is not possible at this moment then watch videos only and avoid going to forums or reading stories of incest online. Such things increase the perversions. Avoid watching any material that relates to incest. I am not saying that you should stop masturbating but stop thinking about incest. You are having guilty after incest ideas, so most likely these are intrusive ideas and should be treated also. If possible visit a psychiatrist for help. Medicines like Paroxetine or Fluoxetine can help to control your intrusive ideas and you will feel better. These are safe medicines. Spend your time in outdoor activities. Gym and sports will help to vent out your energy and you will feel better. Avoid spending more time on computer and if your work permits then stop using computer or internet for some days. This will help you to overcome the addiction. Psychological conflicts. For further information consult a psychiatrist online.--->


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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?


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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 -->


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Hi doctor, When I had my third ultrasound, I was 24 weeks pregnant and it appeared like two faces in the ultrasound. I keep asking my obstetrician regarding my weight gain. I am gaining so much weight when I barely eat and my stomach so huge. I found that at 14 weeks on my first ultrasound I was having a boy and that was pretty early for me to find out a gender. I eat like two meals at once a day. I am now 34 weeks and 5 days pregnant. My obstetrician does not check my pelvis and not advised for another ultrasound. Can I send a picture of my third ultrasound to get a second opinion whether I am having twins?


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Hello doctor, I am an 18 year old, who dislikes visiting the dentist. Therefore, you can imagine my hygiene is very good. I had a brief period of gingivitis as a result of using braces for three years. Having removed my braces over a year ago, and lucky for me, I do not have wisdom teeth, the end of my dental pain seemed over. However, about five days ago all of a sudden, I woke up and the very back of my mouth around the last left molar is swollen. It is sore and irritable. I kept brushing and using salt water. There is no bleeding or pus, but it started to feel more irritable and tender as if it was an infection. It has not gotten worse in swelling or pain, but it has not gotten better either. My mother predicts a piece of food of some sort got wedged in the gum line, near my tongue. We have tried using Orajel to numb it enough so I could use floss or a toothpick to work around the gum, but it still is very painful to touch and it is very hard to reach that area. Sadly for me, I am starting my Invisalign treatment and I am going to get the impressions tomorrow. And I also have an appointment for a regular cleaning. I am petrified. Do you think a piece of food is the problem? Is there something I can do to remove the food before my appointment tomorrow? What will the dentist do tomorrow when I ask him to address the situation? What are the chances this is a bigger infection and is not food related, what will the dentist do then? Will I have to have surgery or procedure done or antibiotics will help?


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Hi doctor, I am a 24 year old female. I am a healthy and happy person. I eat well and exercise well. I have a lot of friends, cool hobbies, etc. But, I have a weird habit. Whenever I am alone I talk to myself standing in front of the mirror. I imagine a lot. I think so many things like I am in an interview and I try to venture out the best answers and framing smart answers. When I am practicing on my guitar, I imagine lots of people are watching me and appreciating me for playing so well. I imagine futuristic conversations with people where I ask a question and answer them. When I am alone, I keep imagining some stuff. Also, I pick up some topic and start talking to myself in front of the mirror. I personally feel this habit has improved my communication skills, confidence and vocabulary. I am not shy and I do not have stage fear. When I meet my friends or when I am giving presentations at college, I am the one who used to stay very confident. However, some days back, when I was talking to myself in front of the mirror, my mom questioned me. Until now I did not pay much attention to what I was doing. But, ever since my mom saw me doing that I have become conscious. I have stopped talking to myself for two to three days. But, I do not feel like I have been missing out on anything. I am still friendly and confident. But, I am just wondering if I have crossed the line of sanity. I searched about this on the internet and came across something called as schizophrenia. Is this disorder setting with my habit? Do I have schizophrenia or any other disorder? To be honest, after reading about this schizophrenia I am very scared. It sounds like a very serious disorder to me. Please help.


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Hi. I read your query with keen interest and understand your concerns. From the available description, I do not think you have crossed the limit of sanity or you developed schizophrenia. Schizophrenia is altogether very different disorder where people have abnormal perceptions such as hearing voices when no one is present and seeing objects when nothing is there. I do not see any of them with you. In my view, you need to put your worries at rest and do what your mind and heart considers right. It may be abnormal for your mother, but there is no pathology with this. If you feel more assistance is required or my answer to your query is far from setting down the worries, then it is better to see a psychiatrist in person. For further information consult a psychiatrist online -->


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Hello doctor, I have a wet feeling inside the anus for the past one year. I did a colonoscopy and sigmoidoscopy, and the doctor said that everything is fine. They said probably the wet feeling is due to sweat. Swab culture and sensitivity report showed up Klebsiella pneumoniae. I took Augmentin 625 and applied ointments. But I feel it is some liquid discharge from the anus skin. Can you suggest some medication?


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Hello. An anal leak is mostly due to underlying reasons, which need to be thoroughly investigated. Although we can together try reaching out on differential diagnosis. Regards. Revert with more information to a cosmetologist online -->


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Hi doctor, My sister is having some neurological problem. She is normal, but at times she feel uneasy and head spinning. We have consulted with a doctor since one year and a few days back for the same issue her doctor prescribed Metmax injection to be taken one per day for the next five days. But, after taking one injection, she is feeling very drowsy and not able to remember things and forgetting the past. I request you to kindly let me know the details of Metmax injection. Is it the right treatment?


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Hello doctor, I am a 31 year old male, and my query is regarding possible HIV exposure. Four months back, I had a sexual encounter with two female partners. I had insertive vaginal sex and received oral sex. Intercourse had lasted for about five minutes twice with each partner. Condoms were used throughout and were changed for every partner. I do not recall any of the condoms breaking or slipping off completely. About a week or so after the encounter, I experienced some health-related concerns, one after another.I got an eye stye, inside of the eyelid, which was little painful and irritating. It went away in a week. I got a boil, nearly an inch in diameter, in the lower abdomen, which subsided in a week. I also got a white area behind the wisdom tooth. This area was painful during the initial 3 to 4 days, then the pain subsided, and the white area started growing bigger. OPG and clinical examination suggested impacted wisdom tooth and trauma caused by friction of upper and lower wisdom teeth. So, I got both the wisdom teeth extracted. Now, it is normal.I also had a skin tag in the underarm area, which turned painful, hard, and dark purplish. One or two light reddish spots in the adjoining area. They resolved in 7 to 8 days. I have high blood pressure and triglycerides. My triglycerides were 292, which dropped to 195 after 10 days without medication. I got a severe headache one night, which went away next morning. I feel light-headed while walking, staring at the computer, etc., but not when lying down for 5 to 6 days. This happened concurrently with the diagnosis of high triglycerides and BP. I also have diarrhea type condition, that is, I have bowel movements thrice a day, which lasted for 9 to 10 days. My gastroenterologist remarked ‘no abnormalities detected.’ I took antibiotics and other medicines for the dental problem few days before this.I do not have a fever or any unusual skin rash. I do not have unusual body ache or weight loss or loss of appetite. I also do not have any apparent swollen glands. My creatinine and TSH test reports are normal. My LDL is normal, and HDL is little lower than normal. Assuming either of my partners was HIV positive, what is the chance of me contracting his? Does any of the above health concerns related to HIV? Does HIV symptoms, if any, appear together or can appear one after another? What is the most likely period after exposure when symptoms appear, if at all? In other words, is it likely for HIV symptoms to show after 5 to 6 weeks? I realize HIV infection can be confirmed only by a test. However, I sincerely request a prompt and clear response to the above queries, which will help me cut down the fear. Thank you.


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Hi. The answers to your queries are as follows: Hope your queries are answered, but please do not hesitate to ask or call anytime for any further query. Best wishes.


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Hello doctor, I am a 24 year old female. My period has been late by 13 days. I am sexually active. I took a home pregnancy test but that was negative. My period has been fairly regular in the past with them happening 4 days prior or after my date. I have taken emergency morning after pill in the past (thrice in the last 4 months). What could be the reason? Is there a possibility that I could still be pregnant after a negative test, though I have not had any other symptoms of pregnancy nor am I having any sought of discomfort?


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Hello. The striking point in your history is that you have taken morning after pill thrice in the last 4 months. It has to be understood that the most common side effect of an emergency contraceptive pill is delaying the next 2-3 menstrual cycles.  As your pregnancy test is negative even after 13 days post period, it clearly indicates that you are not pregnant . Hence, the delay in periods is likely to be due to ipill side effect. Or another possible reason for the delay could be stress induced hormonal imbalance during this menstrual cycle. Stress including emotional, psychological, physical or social disturbances, all have a bearing on the reproductive hormones and can easily delay your menses, once pregnancy is ruled out.  It is suggested that you can wait for another week to allow your menses to resume naturally , if not then you may opt for a withdrawal bleed with progesterone pills to resume your menses.  As pregnancy test is negative, you can rest assured and wait for another week safely. For further queries, consult an obstetrician and gynaecologist online -->


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Hi doctor, Yesterday night I did some rough masturbation. As a result two blisters appeared today at my penis. I have attached the picture. There is no itching and everything is normal except these blisters. How would they heal? Do I have to apply anything on them? Kindly guide.


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Hi doctor, I had oral sex, and my partner ejaculated his sperms inside my mouth, and I sipped the sperm that came out. After that he touched his penis, then he grabbed my pants near my vagina twice. After that, he used the same fingers inside my vagina. It was my first time with the oral sex and fingering. I do not know that there were sperms in his hand. We did not have sex. But, can I get pregnant in this situation? I missed my periods this month. What is the cause?


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Hi. In your case, there is a chance that semen might have entered into the vagina. As you have not done any sexual intercourse, there is less chance of getting pregnant. You have to rule out pregnancy by urine hCG (human chorionic gonadotropin) test. You can do this test at home. If pregnancy is not present, then thyroid problem and diabetes should be ruled out. Excess stress, obesity, prolonged fasting can also lead to a delayed period. You can consult a gynecologist for examination if needed. For more information consult a family physician online -->


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Hi doctor, I am a 55 year old male. I am suffering from inguinal lymphadenopathy. 2 years ago I have this on right side and now on left side. There is a square shallow knot present on the right side now. I have stiffness and rigidity especially in the left arm and occasional limited movements. Also I have discomfort in my legs and inguinal region. On ultrasound it was observed lipomatosis of inguinal lymphs. I have painful point in inguinal region, only if I press. I have noticeable weakness, but no weight loss. Occasionally I feel very low energy and could not maintain erection. I feel numbness in the shoulder or finger when wake from sleep. I have low sedimentation rate. There is no abnormal blood and urine finding. I had blood test and it is negative for all infectious diseases such as Lyme, cat scratch, AIDS, etc. Please help with some suggestion. Thank you.


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Hi. I assure you not to worry as all things may get settled with proper care and follow-up. 1. Inguinal lymph nodes usually get prominent due to some infection (that you say have been ruled out) or some primary pathology of the nodes themselves.  2. The knots you are talking about also warrants to rule out if that is a vein pathology or lymph nodes can be benign or cancerous changes. Biopsy of the nodes is mandatory especially when there we see changes on ultrasound.  3. Weakness can be due to hemoglobin or red blood cell deficiency. Other causes of weakness may be hypothyroidism or fluid and electrolyte imbalances.  4. Your low sedimentation rate may be due to red blood cell, white blood cell changes and protein abnormality. Sickle cell disease also may cause it. But clinical correlation is the key and for that your physician needs to go for physical examination and if suspicion arises, he may refer you to hematologist.  5. Pain in the lymphatic region can be due to lymph nodes being pressed on or it is possibly from lipomatous changes.  6. I also prefer you to get a detailed heart evaluation from cardiologist as weakness, shoulder and arm issues warrant that too. This kind of symptoms also needs screening for hypertension and diabetes mellitus. Your physician can help you for that too.  7. If you have got tested the above in past 8 weeks, you may upload the reports here for my review and diagnosis. If more than 8 weeks old, please go for repeat fresh tests. Biopsy and histopathology of the lymph nodes. Can be decided on investigations and diagnosis. Revert back with the investigation reports to an internal medicine physician online.--->


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Hello doctor, I had tonsillectomy about a month ago. I had been healing but I am concerned about my healing process. My uvula has gotten smaller and has strange color plus I see cobblestone at the back of throat and blue or dark red color surrounding soft palate. And there are visible blue or red blood vessels everywhere around the palate and arch.


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Hi. All these are normal after tonsillectomy surgery. I will suggest some steps to relieve some of the symptoms you are facing. Gargles with Benzydamine mouth wash diluted in water few times daily will help soothe the area and relieve pain. You may also take Tylenol for a few days for the pain relief. To relieve inflammation (the engorged blood vessels and cobblestone formation) you can take a combination of Trypsin Chymotrypsin Bromelain Rutopside. This medicine will relieve inflammatory cells and products from the area. Cobblestone formation is normal after the surgery. Regarding the reduced length of the uvula and the scarring on the palate, I would say, they are due to bad surgical technique. We carefully dissect the tonsil out of the pillars so that there is nil scarring of pillars and change to the uvula. We use a coblator for the purpose that minimizes bleeding and postoperative pain.


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Hi doctor, I had unprotected sex with my husband after five days of my last periods and took an i-pill immediately. I did not get my periods yet and my two home pregnancy tests were negative. My periods are always regular prior to this. I am under regular medication of Eltroxin 100 mcg. Please help me.


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Hello doctor, So I never had acne on the back, maybe one or two single, but after visiting this massage center, which I know was a big mistake, my lower back is full of acne. I tried a couple of ointments, did not work. Cortisone helped a little, but not really. I think I need oral back up, any suggestions?


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Hello. Apply Adapalene and Benzoyl peroxide 2.5 % combination gel at bedtime over the back. Do not apply Cortisone cream (steroid). It can lead to worsening of the condition. Clinical photographs would have helped. For more information consult a dermatologist online -->


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Hello doctor, I am afraid that my 10-year-old daughter might have Asperger's syndrome. She obsesses over spankings all day long. She watches videos of spankings all day long also, and she fantasizes of getting hit. She even spanks her brothers and sisters. I can tell it gives her some pleasure. She has no friends, and she wants to sit fantasizing about it if she does not have an iPad to look it up. She also obsesses a specific type of people. Does she have Asperger's? Is this a symptom of it or something?


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Hello. Your daughter is into the screen most of the time, and hence, it will be her primary advisor. She is just modeling what she sees and is quite common at this age. Try to minimize her interaction with the screen. She requires more human interaction. Put her in extracurricular activities to the maximum. Spend time with the child talking to her, and she will like it. Do not punish her, as it will have a negative impact, and the behavior can increase because of scolding. She will slowly get out of it. You can review with me for further follow-up.


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Hello doctor, Trying to get pregnant from last one year. All the tests for both of us are fine. The only problem is we are not very high on libido.


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Hello. By saying that all tests were normal, I hope you mean 1. Blood sugars, thyroid profile, and prolactin hormone levels. 2. Husband's semen analysis. 3. Wife's scan of uterus and ovaries. 4. Fallopian tube patency tested with HSG (hysterosalpingography) or laparoscopy. Now for loss of libido, the following reasons are to be addressed. 1. Above mentioned blood tests. 2. Kindly seriously think of shedding few kgs. Your expected body weight is 52 to 57 kgs. 3. Try to reduce any physical or mental stress. Diabetes has to be ruled out with HbA1c. If all these are normal, there is no reason for you to worry, and you will surely get pregnant. I hope I have clarified your query, do write back if any more questions.


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Hi doctor, My friend had his deamidated gliadin IgG antibody test done recently. The test result is 152. Does it mean that the person is having celiac disease?


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Hi. Deamidated gliadin IgG antibody level of more than 30 is diagnostic of celiac disease. Since the number mentioned by you is 152, it indicates that the person is having celiac disease.


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Hi doctor, I went to a chant few days back. There the loudspeaker was very loud. The very next day I noticed that there is ringing in my left ear. Now, it has been four days, but it has not gone. Can you help me? I am very scared. Has it caused any effect on my eardrum? Please see to it. Thank you.


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Hello. From your history of noise exposure and symptoms, it is suggestive of acoustic trauma. It occurs after a single exposure to very intense sound which cause damage to the organ of corti or damage the hair cells. Symptoms include ringing sensation in ear known as tinnitus and hearing loss. Treatment depends on severity of symptoms. If only tinnitus is present, protect the ear from further damage and also take some neuroprotective drugs. But, first you need to do a pure tone audiometry (PTA) to assess the severity. 1. PTA. 2. Tympanometry. Acoustic trauma. 1. Capsule Zincosule-4G (Multivitamin) once daily. 2. Tablet Defcort (Deflazacort) 12 mg once daily for seven days. Avoid loud sounds.


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Hi doctor, I am 32 years old female. I had unprotected intercourse 14 days back with no ejaculation from his end. I took an I-pill the next day at 8 PM for precaution. Those were my infertile days as my last period occurred 36 days ago. It has been more than a month; still I have not got my periods. Could you suggest some ways to get back my periods? Thank you.


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Hi. Please wait for a week for your period to start. If it does not start by then, you will have to do urine pregnancy test to rule out pregnancy. Period could have been delayed due to stress. Another rare possibility is that of pregnancy. Though you mentioned the days you had sex as your infertile days, sometimes occasionally ovulation could be delayed making the days fertile. Still you had taken emergency pill (though it is highly effective in preventing pregnancy, protection offered is not absolute). So, there can be little chance of pregnancy which you need to rule out first. If you want to rule out pregnancy earlier, you can do blood beta-hCG test, negative result of which will rule out pregnancy. Other option as I told is to wait for a week. If pregnancy test comes negative and still period does not start, you can induce period by taking tablet Medroxyprogesterone acetate 10 mg twice daily for five days. Period generally starts within a week of last dose of tablet. It will not induce period if you are pregnant.


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Hello doctor, I am 25 years old and had a pregnancy for five weeks. Four months back, I had used MTP kit. The problem is, even now I am having bleeding. Is this normal? How to sort this problem if it is not normal? Looking forward for your valuable feedback. Thank you.


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Hi. I understand your situation. This much of bleeding is considered unusual. Either the process of abortion has been incomplete, because of which the uterus is still trying to expel out the products of conception. Or you have some blood problem. Are you still passing clots? Or is it plain blood that is coming? Also, if you could tell me exactly how you proceeded to take the medicine it would give an idea of the cause of bleeding. For the time being, take tablet Tranexamic acid 500 mg, thrice a day. This will stop the bleeding, but not cure the problem. So, till the time we know exactly what is wrong, you can take this tablet. Incomplete abortion. Ultrasound pelvis for retained products of conception (RPOC) and CBC (complete blood count).


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Hello doctor, I have used Benzoyl peroxide gel for my acne and it has almost cleared. But, the acne left some red marks and blemishes on my cheek. I wanted to fade that redness on my skin. In the past, I used Epiduo gel. Please suggest me a product and guide me to remove that redness without laser treatment. Thank you.


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Hello doctor, I am 13 weeks pregnant. I have been diagnosed with subseptate uterus with the live fetus in the left horn. Baby is good, with heartbeat and growth. My doctor has advised me proper rest and some medicines. I want to know in detail about this subseptate uterus.


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Hello. Let me start with a few basic facts and further clinical correlates and effects. Every lady has two uterine tubes, which fuse at birth, and over time, the wall between the two tubes disappear. Now the uterus is converted into a single cavity uterus. The upper ends of tubes remain separate as two fallopian tubes. Sometimes the fusion is complete, but the partition does not disappear. If the tubes do not touch others or do not fuse at all, then you get bicornuate uterus. But if only the wall is partially removed, it forms subseptate uterus. If the wall does not disappear at all, then the septate uterus is formed. Now in both the last two conditions, the main problem is that the space inside the uterus is compromised. The best option was to have a hysteroscopic resection of septa then get pregnant. Having rest makes no difference. At 14 to 16 the week, she can undergo an elective cervical cerclage. Due to septa, uterus loses its polarity, and she is prone to cervical insufficiency. As space inside the uterus is compromised, she can have preterm pains, preterm labor. Due to septate, the baby presentation may not be head down. I hope I have clarified your query, do write back if any more questions.


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Hello doctor, My mother is 36 years old, and she is suffering from the respiratory problem from last two days, her hemoglobin count is 9.6, can you please tell what causes this problem?


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Hello. I have read through your question and would like to tell you that respiratory problems can be due to allergic or due to infection. Her Haemoglobin could be due to dietary deficiency. Give her iron-rich diet like dates, banana, and green leafy vegetables. If the respiratory problem is due to infection, then she may need an antibiotic course. For now, steam inhalation will help to relieve her. Steam inhalation with menthol twice daily. If her condition does not improve in two days, get her checked by a physician. If her Hemoglobin does not improve in one month, get a complete blood profile done to know the cause of anemia. I hope that answers your question. If you have any further questions, please feel free to write.


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Hello doctor, Today is my fourth day of braces, so I was just wondering when my blue fillings will be removed. The blue fillings purpose is to prevent me from biting down on the braces, but when will they get removed? Also, when will I feel comfortable biting down on my fillings, since my teeth are sore and it hurts, or when will I get actually to chew since I can only swallow?


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Hello. Blue fillings or bites are removed when your teeth are better aligned, and deep bite (if present) is improved or corrected enough to prevent interference of upper teeth to lower braces. It takes a while to get used to the blue bites, usually 7 to 14 days. However, chewing continues to be less effective for longer. It is advisable to eat soft foods and supplement with nutritious juices and smoothies.


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Hello doctor,My 24 years old daughter born without a thyroid and treated with Synthroid since birth has a TSH level of 23.980 uIU/mL and T4 Free of 1.57 mg/dl on the current dose of Synthroid 150 mcg. Her weight is 150 lbs and height 5' 4". Her endocrinologist increased her dose to 300 mcg, thinking her dose had been 250 mcg (incorrect). What is the correct dose to return to normal thyroid levels for this condition at her age and weight?


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Hello. It is better to increase the dose by 25 mcg, i.e. 175 mcg if she was using 150 mcg till date escalating the dose or thyroid medication will be like 25 to 50 mcg at a time. Not double the dose causes severe sickness. As you mentioned, she was Synthroid (Levothyroxine). It is better to continue the medication to maintain a normal thyroid level for a long time. After using this medication 175 mcg, it is better to repeat the thyroid profile after six weeks to check for that thyroid level.


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Hi doctor, I have beta thalassemia plus trait (AT+) and want to marry a man with sickle trait (AS). Please see the attached file of my beta thalassemia DNA genetics. Please give me the possibilities of our baby. I know there is a 25 % chance that the baby might have sickle beta plus thalassemia (ST+). But, will the symptoms be severe or mild or that of a carrier with very slight symptoms, that he/she will not need blood transfusions at all. What is your recommendation doctor? We love each other and want to be sure about our baby in the future. I am looking forward to your reply


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Hello. I have seen the reports (attachment removed to protect patient identity). Take care. Hope this will help you. For more information consult a hematologist online -->


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Hi doctor, I am an 18-year-old male. For the past four years, I have burning irritation in the middle portion of my penis after masturbation. The irritation gets relieved to some extent after I urinate. Please help me.


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Hi. Penile pain occurs due to infections or inflammation of the bladder or prostate. Trauma, persistent erection (priapism), cancers, and Peyronie's disease (the development of scar tissue within the penis) are the other causes. Sickle cell anemia may cause priapism due to blockage of small blood vessels in the penis. I suggest you consult a doctor for a physical investigation.


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Hello doctor, My fiance got sickle cell SD. He is 27 and does not suffer from anything else. He takes medication and changes blood every 4 to 6 months. My question is does it affect his life expectancy?


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Hello. Usually, in sickle cell anemia, blood transfusion is not needed. The prognosis depends on the severity of sickle cell. Dehydration, infection is a usual precipitant for sickle cell anemia. So it is better to avoid them and whenever having such incident, consult a doctor immediately. Sickle cell anemia patient's median age can be considered between 50 to 60 years but still, the exact specific prognosis cannot be predicted.


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Hello doctor, Sickle cell anemia is my problem. My age is 30 years, while dehydration time, I am getting pain. Is this issue dangerous?


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Hello. Yes, sickle cell anemia is a disease where RBC shape changes while dehydration and oxygen level goes down in body. Usually red blood cell will be round and plate shape. During dehydration and less oxygen time the shape of the red blood cell becomes sickle shape. Now RBC will stick together and block the blood vessels and produce ischemia. So to reduce the obstruction, you need fluids more. If obstruction is in lung, spleen, kidney or any organ, it is dangerous and severe painful. So avoid dehydration conditions, do not do severe exercise, avoid going to hill stations where oxygen is less. Drink adequate water.


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Hello doctor,I am suddenly feeling faint, weak, shaking, confused, and as if moving in slow motion. It has been going on for nearly 24 hours. Is this low blood sugar or stroke?


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Hello doctor, My dad is suffering from JE and both his thalamus are infected. Now, he is in coma. What is the prognosis of his condition?


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Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further doubts consult a neurologist online -->


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Hello doctor, At birth, my son was diagnosed with a seizure. Now he is 18 months old. I am fearing about DTwP booster dose side effect. Earlier three doses had reaction of muscle stiffness and fever.


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Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. Muscle stiffness and fever can occur after a DPT vaccination and is not a contraindication for vaccination. Contraindication for DPT vaccination are seizures, inconsolable crying, and central nervous system infection or encephalitis after giving DPT vaccination. If you want to be on safer side then go for acellular vaccine instead of whole cell vaccine. You should give DTaP vaccine instead of DwPT vaccine. Take care.


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Hello doctor, I am not able to conceive after trying for almost one year. I was diagnosed with pituitary microadenoma and I am on medication. My prolactin levels have now reached normal levels after two months taking medication. I suffer from hypothyroidism and on medication. I have had this for five years now and it is well within the limits as per my endocrinologist now. This is due to an autoimmune disease where my TPO (thyroid peroxidase) antibodies were high during the diagnosis five years ago. My husband and I would like to know how should we best prepare for pregnancy and what to look out for. We would have preferred to visit the clinic. Unfortunately, I am not in a position to visit the doctor due to travel restrictions. It would be great to get in touch with a specialist. I am currently on Euthrox 100 mcg, Cabergoline 0.25 mg once a week, and Folic acid 450 mg daily.


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Hello. I have gone through all your reports (attachment removed to protect patient identity) and your prolactin and thyroid levels are well in control. What is missing in the follicular monitoring profile of the dummy cycle and also your husband's semen analysis test? You have been following the correct protocol using LH kits for ovulation and post LH surge if a natural trial or timed intercourse did not work then husband's semen analysis becomes mandatory. Then when both male and female infertility causes are ruled out then comes mechanical causes where positions and version of uterus need to be considered and measures implemented. Anyways please send these two remaining reports before we can proceed further.


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Hi doctor,My son is very aggressive, sensitive, short temper, get panic, hyper and angry quickly. He could not listen to any good suggestions or guidance. He does not have a mental resistance. However, he is very sincere about his studies. He has got 83% marks in his studies. Now, he is preparing for the board exam. He tries a lot to study but gets pressure. He was suffered from brain fever at the age of 2.5 years. I have tried to give him ayurveda brain tonics like Shankhapushpi, anjeer, etc. But after taking those, he became more violent. There is no problem about sleeping. He plays cricket very well. He has good knowledge about computer, mobile, etc. How to reduce anger and increase the mind resistance of my son? I request you to guide me properly and suggest any medicine to solve his problem. Thank you.


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Hello doctor, I have been getting a swollen eye once a week, usually in the mornings. I feel a slight irritation beforehand, itchiness. Then my eyelid swells to the size of a golfball. The eye is not red, I can see perfectly, there is no sign of cuts or scrapes. No discharge, maybe a little dryness beforehand. Please help.


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Hello. You are describing an allergic reaction of the eye to some factor. If you are not also suffering from sneezing and dry cough at night then you can use antihistamine eye drops such as Pataday once daily or Patanol or Zyrtec twice daily for a period of 10 days. If you have started using any kind of new cream or make up around the eyes, change it into something hypoallergenic. Best of luck.


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Hello doctor,My mother-in-law 72 years old. She gets swelling in her toe on and off for the past year. Recently there was pus inside, and she is having pain. After soaking the toe in hot water and betadine, discharge came out, but it is relapsing again. She had antibiotic too. She has diabetes but under control with medication.


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Hello. She has an infection in the nail bed space. Need to focus on three things. 1. Her diabetics need better control. Better diet modification with medicines. HBA1c is too high. 2. The nail needs to be trimmed well regularly, and the area needs to be cared well daily. She may not have a proper sensation at the region due to diabetes. So regular inspection and care is mandatory. She should not walk barefoot, and slippers need to be correctly selected. 3. She needs control of infection. Visit a nearby surgeon (preferably podiatric) for the drainage of pus if present. Take an X-ray to rule out bone involvement and also need to check the blood supply to the region. I hope your queries have been cleared. Please review if any further questions.


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Hello doctor, I am an 18-year-old female, taking no medications, and I am 5'3" in height and 180 lbs weight. Since last night, I am having severe chest pains. I cannot sleep, and when I try to eat, my chest hurts more. It hurts all the time, but the severity comes and goes in spurts. I am not sure if this has anything to do with the chest pain, but just today, I was lying on my right side and moved to my left side, and I heard and felt a sloshing in my chest or upper abdomen area. What could it be?


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Hello. Thanks for providing clear and consistent history about your current medical condition. I can reflect on what you mentioned that it is related to Excedrin as it can cause gastric upset by increasing the secretion of HCl (hydrochloric acid) in the stomach. I suggest that you stop taking Excedrin for the coming period (at least a month), take some dietary precautions including avoiding caffeine, spicy food, dark chocolate, mint, fizzy drinks mainly cola containing ones, deeply fired, chili and spicy food. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) like Voltaren tablets and even injection and aspirin as well. Take the medication mentioned in the treatment part. In case, the condition continues, you need to visit your doctor (general physician or GIT specialist) for further evaluation. Gastritis, Peptic ulcer, and GERD(gastroesophageal reflux disease). Zantac (Ranitidine) 150 mg tablet one tablet two times a day for seven to ten days.


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Hello doctor,I am a 15-year-old male with a height of 148 cm and weight 44 kg. I am diagnosed with migraine, and I want a second opinion.


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Hello. Migraine is a diagnosis based on symptoms given by the patients. The symptoms are a severe headache, dizziness, vomiting some patients also get migraine by a loud sound, acidity, and excessive heat or cold. If you are having other symptoms like pain in the neck or back or shoulder, excessive acidity or deteriorating eyesight, then maybe the diagnosis of migraine can be challenged. If not Fepanil (Paracetamol) is good medicine, use it as advised by your doctor. If you have any other questions, please feel free to ask.


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Hello doctor,I have a dental abscess, and I am 33 weeks pregnant. It is so painful that I cannot eat, sleep, drink, or do anything. My dentist cannot do anything about it until next month. I was wondering if the emergency room can do something about it.


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Hello. You could ask your dentist or go to the emergency room to prescribe Antibiotics like Augmentin 625 mg thrice a day for five days along with Tylenol (paracetamol). This will help in pain relief and then go to the dentist to get the tooth extracted. Do not delay, as the pain and infection will affect your baby's growth as you would be avoiding normal diet and infection would not allow nutrition to pass onto your baby. It is okay to take during pregnancy if so much infection and pain are there.


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Hello, Welcome to the icliniq.com. Kindly answer the following questions to guide you further. 1. Do you have a fever, abdominal pain, nausea complaint? 2. What is the frequency of your motion? 3. Is there any blood in stool? 4. What is the duration of your symptoms? 5. Have you taken any treatment so far? You can revert with answers. Meanwhile, you can be prescribed antacid like Pantoprazole and Dimethicone (Polydimethylsiloxane) containing acid MPS syrup. I hope this will help you.


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Hello. After a tooth is extracted, it is advisable to keep the gauze in the site for 30 minutes, in the same position. After 30 minutes, do not spit, take the gauze through your hand and discard. This is to arrest bleeding and help in clot formation by pressure method, and spitting will lead to dislodgement of the clot. So, be careful with splitting (do not do it forcefully) for at least one day. I hope you have got the other instructions from your dentist.


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Hello doctor,I got my braces a year ago, and before that, I did not have any problem in my jaw articulation. Since my orthodontist gave me elastics to put I have TMJ disorder, my left articulation crack every time I open my mouth or eat or speak (I have decided not to put the elastics so that it does not get worse) and I am a bit worried. What causes this? Can this be fixed?


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Hello. Based on the given history, it can be due to the extra force you gave to open the mouth while on elastics. Based on your age, it can be due to an impacted wisdom tooth. Sometimes, this can be due to any muscle problem too (myofascial pain dysfunction syndrome), mostly due to physical stress in that area or emotional or mental stress. As for now, do not open your mouth very wide, like during yawning, etc. This is curable. Do not worry much. Do you have pain along with the click? I would suggest you talk to your orthodontist or general dentist or oral and maxillofacial surgeon to get a final diagnosis after a clinical examination done by them. If possible, send me your OPG (orthopantomogram) and lateral TMJ (open and closed mouth) X-rays to guide you further.


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Hello doctor,I am 22 weeks pregnant. Due date is after three months. I smoked marijuana for the first few months to help with severe morning sickness. I stopped smoking probably last month. I went to a gynecologist this month, and they took a urine sample in which they tested for drugs and marijuana was the only one I tested positive for.After two weeks of my appointment, I smoked once to help with a bout of morning sickness and have not since then. And I have planned not to do ever again during my pregnancy. My next appointment is after one week. Will I be threatened with CPS because of my positive urine from last time? And will they test my urine at my next visit? I am only 18, and I am very nervous. I am concerned because before I got pregnant, I smoked marijuana every day since I was 15. How long will it stay in my system? How can I safely detox it from my body?


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Hello. My advice to you that please stop taking marijuana, if you love your baby, then please stop it right now, because it affects your baby growth. And why you want your baby to suffer because of you, so please stop it and the other thing there is no safe antidote of marijuana. So better is to stop it, and yes, marijuana remains in your body system for up to three weeks. Please take medicine regularly and do USG (ultrasound) regularly and please for your child please stop to take marijuana.


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Hi doctor, I am a 21 year old female. I was bulimic for about a year. It happens once or twice a week. I never noticed any permanent changes in my eyes throughout my episodes. However, the last time I ever binged and purged three months ago, I vomited violently. A few weeks after this, I noticed that the vessels in my sclera are indefinitely more prominent than before. Did this happen because of the continuous pressure subjected to my eyes with vomiting? Or could it just be due to many hours of reading and laptop use? I have seen an ophthalmologist and he said that there is nothing wrong with my eyes and suspect a very mild case of blepharitis or bilateral dry eyes. I am using Optive comfort solution. I would like to know if my bulimic phase could have caused the prominent vessels in my eyes, as this has not been mentioned anywhere else online.


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Hello. I can understand your concern regarding your complaints. Revert back with the answers to the above questions to an eye care ophthalmologist online -->


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Hello doctor, I am a 38-year-old female. Trying for conception since eight years of marriage. Before three months I have been diagnosed with adenomyosis and both ovaries endometrioma I did laparoscopy and hysteroscopy for the same in the month of may and after that they put me on conjugated estrogen tablets and Decca peptide injection after 20 days of the operation but after a month of the operation during my periods I had severe pain and PMS. I had my BP raised severe palpitations along with severe bleeding and have painful periods like before operation I am concerned after operation why there are so many such problems. I asked my gynecologist about this, but he said show to your physician I went to my family physician he started bp medicines. He said it is a temporary increased. But I am concerned about my health now and wants to get rid of all this problem. My gynecologist said conception is the only remedy to solve adenomyosis and endometriosis. I want to have a normal life because I am on bed rest for three months. Please help.


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Hello. Let me start by saying that, as your doctor said, pregnancy is the best solution for all these problems. I do not see any need for bed rest. If BP reading is regular, try to reduce and gradually stop the medicine. Reports of infertility workup are missingHave your periods day three or fourth FSH (follicle stimulating hormone) and AMH (antimullerian hormone), to find what is your ovarian reserve. I hope your husband's semen report is normal. If everything is fine, please go ahead with ovulation induction with hormone IUI (intrauterine device). This would increase pregnancy chance by four times, thereby resolving other complaints. Do not waste time on other treatments. Try to get pregnant before you lose the benefits of surgery. I cannot comment on pain, as details of findings before surgery and surgical procedure is missing. I hope I have clarified your query, do write back if any more questions and for your feedback.


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Hello doctor, I had unprotected sex on my infertile day, but I was quite scared, so I took post-pill a week later I had another unprotected sex this time in my fertile days but did not receive the post-pill immediately next day I saw a slight spotting which prompted me into taking the emergency pill. Now a week later, I have been bleeding for two days. I hope this is not a sign of pregnancy. Please help me understand it better.


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Hello. Ideally, the emergency contraceptive pill is to be taken within 72 hours of last intercourse to be effective 99 %. It is of no importance if taken after a week. Nevertheless, the bleeding which you got mid cycle before you took the pill was likely to be an ovulation bleed as you had sex in your safe period, then you took the high dose progesterone emergency pill, which initiated a progesterone withdrawal after two days in the form of bleeding as expected. This rules out pregnancy as you had a withdrawal bleed, but it is always best in such cases to get a serum beta hCG test done to be conclusively sure.


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Hello doctor, My 3-year-old son had diarrhea for a week. He has thrown up a couple of times throughout the week as well. He was eating and drinking normally and has appetite. There does not seem to be any blood in the stool. And his belly ache goes away after each diarrhea episode which he has many each day. He is usually drinking as well. His doctors seem to believe that it is a viral infection and will go away in time. We just started a bland diet for him. Should I be overly worried? He is active and wants to eat and drink. So is this something more serious than we think or am I too worried?


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Hello. If there is no blood in stools, it is mostly viral. It usually gets settle in five days. Important here is maintaining hydration. Make sure you give him plenty of fluid, ORS (oral rehydration solution). If he is vomiting, you can ask your doctor to prescribe Ondansetron. Give him probiotics and keep a watch on urine output. If he is passing adequate urine, then there is no point of worry.


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Hello doctor, Looking for an opinion on tuberculosis skin test. Please answer if you have experience with PPD skin tests. I am 34 years old, former cigarette smoker. My friend got diagnosed with tuberculosis due to strong arthritis medications, and I have had some contact with him. I have attached images of my skin test below.


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Hi. Montoux test, PPD test is a very non-specific test and does not give you any confirmation for tuberculosis. It is used as an adjuvant test for diagnosis and never as sole test. It is read after 48 hours of injection. You have not mentioned the duration. You have to measure its diameter. It should be less then 10 x 10 mm. I cannot measure it online but apparently it is negative for tuberculosis (attachment removed to protect patient identity).


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Hello doctor, I am 18 years old, boy and I have a very tight foreskin and I have not even pulled it back. I tried to do it once using oil but it was of no use.


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Hello. The mentioned history is suggestive of phimosis in which foreskin cannot be retracted back over glans. Topical steroid cream can be beneficial in mild case. But, in severe case like in your case, if foreskin cannot be retracted, then circumcision like day care minor surgery can be done. So, I suggest you consult Urologist for your examination and operation.


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Hi doctor, I have experienced a problem in erection since last three months. I am a smoker. The testosterone level in my last routine medical checkup was 134. Please help.


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Hello doctor, I am having sugar addiction. I always eat candy non-stop and chips and soda, but I am so addicted that I failed the 30-day sugar free challenge in the first three hours itself. I need help, how can I stop this addiction if all my ways are failing everytime I keep trying.


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Hello. Sugar is not an illicit drug, but the brain acts in a similar manner to other substance abuse and addictions. Another reason you could be craving sugar regularly is due to how it makes you feel after consuming it. Generally, a sugary treat causes a rush of both glucose and endorphins in your blood. One of the best things you can do to fight your sugar addiction is to start by swapping sweet foods for healthy alternatives like vegetables. Yes, vegetables can be sweet, but the natural sugars you find in carrots, beets, sweet potatoes, and peas are so much lower than what you will find in treats such as gummies, cookies, or donuts. At the same time, they’ will satisfy your craving for sweetness and you can train yourself to eat these healthier choices over-addictive sugary desserts.  The last small tip for fighting your sugar addiction is to generate a plan for how you will eat. You can write this plan out, post it somewhere, or simply keep a mental note of it, but a plan can help you to succeed in various situations. For example, keep carrot sticks cut up in your fridge so that after work, you can plan to snack on those instead of cookies. Or if you are going out to brunch, decide that your plan is to order an omelet with vegetables so that pancakes (basically, a maple syrup delivery device) is not an option. The idea here is to have a plan for how you will succeed in various scenarios that typically create problems for you.


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Hello doctor, My daughter has a soft spot in the middle of her forehead for the past nine months but can only be noticed when she raises her eyebrows or if the lighting is right. When sliding a finger over it you cannot feel anything, the forehead feels normal even when she has her eyebrows raised. It looks like a soft slightly raised lump when you can notice it. I have taken her to the doctors but they could not see anything. I had to show them photos as sometimes it really stands out, other times you cannot see it. What should I do?


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Hello. Small spot in center of forehead is seen in some pictures (attachment removed to protect patient identity). As you know skull is made up of 16 small bones, these bones are attached with cartilages and get ossified with times. Due to some gaping, this swelling is seen. Give your kid Calcirol sachet once a week for five weeks, dissolve in two spoon water. Syrup Ostebon (Calcium) one teaspoon full twice a day. Feris drops 1 ml once a day. Zincovit drops one ml once a day. Vitanova drops 0.5 ml once a day. All the above for six months.


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Hello doctor, I recently took a women's health test to test my hormones. I just got my results back and my Progesterone level is extremely low where as my Estradiol level is in the normal range. I have dealt with many irregular periods since I was young and have not been able to conceive a child with my husband and now I think I know why. I was wondering if my results can be looked at by a doctor to give me anymore information on what is going on with my test results. I am only 25.


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Hello. The reports are fairly normal including the hormonal profile but the progesterone levels (attachment removed to protect patient identity). If these levels are from the proliferative phase then they can be considered normal, however, if from the luteal phase, then they are definitely low. Considering that LH was 11, this test may have been done around day 10 to 14 of your cycle, was it? In cases of progesterone deficiency, one tends to get anovulatory cycles and also shortened cycles with mid cycle bleeds and irregular shedding with often passage of clots, so if not so and if you are experiencing delayed irregular cycles then cause is likely PCOS and not progesterone per se. Also, important in any fertility evaluation is the the male fertility factor. It is important to learn if the semen analysis report of your partner is normal or not, whether the quality and quantity of his sperms are good or not, so please share his semen analysis report as well for review.


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Hello doctor,Over the past six years or so, my intraocular pressure (both eyes) has risen to 16, to 19, and now to 21. Will it continue to increase still? Kindly help.


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Hello. As you might have been informed, increased eye pressure is mainly associated with the disease called glaucoma. This chronic symptomless disease is very drastic to the optic nerve and might lead to irreversible damage, and in the end, cause blindness. However, this eye disease is never diagnosed or established based on eye pressure measurements and requires a detailed and comprehensive examination including many diagnostic tests like, visual fields, gonioscopy, OCT (optical coherence tomography), multiple measurements of eye pressure during at least three consecutive days and these tests might be repeated twice and even thrice in the first year and then every six months if the only suspicion remains. If you have not undergone these tests, please do, and if you require a second opinion, please upload the results of all these tests and I will gladly provide you with my opinion.


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Hello doctor, I think my right side bottom wisdom tooth is coming as there is a ball on the back side of my gum that is really swollen. It almost feels like a pimple and the area around it has white lines on the inner cheek wall. What should I do?


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Hello. If there is not much pain, it is better to let it grow fully. It may take a month or two to fully come out. If it does not, and the area gets painful then better to get an X-ray done for its exact position. Use warm salt water gargle twice a day for a week or two. Use a chewing gum on that side, it helps in faster growth of the tooth into occlusion.


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Hi doctor,My wife is 42 years old. She is feeling pain in the right wrist while moving the palm laterally outward. The movement gets somewhat obstructed slightly and it is not smooth. This has been started after an occasion when she tried to pull or carry one heavy bag a week ago. X-ray has been done on her right wrist which is enclosed herewith. Please comment on the severity of the wound and its medication. Thank you.


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Hello doctor, I had severe cough and mucus formation which was in yellow. The doctor had prescribed antibiotics, Salbutamol tablet and allergy tablets. Now that cough has reduced but I feel some heaviness at the back right hand side and when waking up in the morning. While I had visited the doctor they had adviced me to take an X-ray. Later they said there is slight pneumonia and to continue antibiotics (Azithromycin) for five days. Also, I have completed my antibiotics dose for four days, still left with one more day. Cough is not there currently and better. I am attaching X-ray that was taken for your advice. Would like to have a second opinion on the X-ray report.


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Hello. In attached X-ray report (attachment removed to protect patient identity), there is presence of slight consolidation in right side. So, it is suggestive of pneumonia like infection. For that, you need to complete antibiotic course. If clinically improved well, then no need for further work up.


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Hello doctor, I would like to know to weather the laser treatment is better than continuing specs for vision. What would be the drawbacks of laser treatment, is it very complicated?


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Hello. This is quite a common question youngsters ask. The best answer to this is it depends on you and your daily activities, profession, and lifestyle, etc. For example, if you want to take up professional sports, modeling, enjoy adventure sports, few jobs in the armed forces, getting a surgery done would be quite necessary.  On the other hand, if you want to pursue higher studies and professions where you work a lot with computers and work on fine parts like watchmaking, then surgery would put you at a slight disadvantage as it slightly reduces image quality and increases chances of getting dry eye diseases. Some surgeons also prefer wearing glasses as it protects against infection and blood spurts during operations.  With the latest equipment and techniques, laser refractive surgery is quite safe, and outcomes are good. The risk involved is very less. Although a power of - 5.0 is on the higher side, we can still expect good results given that your corneas are suitable for the surgery.  The main thing to consider is of course long term outcomes are, 1. As a woman, your power will naturally change during pregnancy and lactation, and this happens to all women. Some have more, others less. This is unpredictable. 2. Surgery only corrects you for distance vision. Another natural change in eyes is presbyopia. Here you need to wear reading glasses. So even if you were to get surgery now, you would only remain glasses free for up to around 40 years of age after which you need reading glasses. I hope this answers your doubts. In case you have any further questions please let me know.


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Hello doctor,I had an oral sex with a girl without protection, and I licked her vagina too, later I came to know she has PSV which she had undergone treatment and she was cured, I came to know risks of the STD's via oral sex and I was suggested to have test after four weeks, but they did not tell what test I have to go through in detail. My query is, what is the list of a test I have to go through? Please give me the names of the test in detail, so that I can approach a lab for testing.


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Hello. There are many tests, but the below mentioned are usually done to rule out the infection. These are a screening test.  1. Test for HIV. Tridot test. 2.Test for gonorrhea (urine or oral swab) and chlamydia. 3. Test for Hepatitis B (HBsAg) and C virus. 4. Test for syphilis such as VDRL (venereal disease research laboratory test) and if required RPR (rapid plasma reagin) test. 5. Test for HPV (human papilloma virus). Herpes virus test is usually not required if no symptoms are present or there is no outbreak of it. I hope this clarifies your concern. Ask again if anything unanswered,


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Hello doctor, My mother, is 76 years old, currently suffering from low, blurry vision (both near sight and far sight). Her BP, sugar, and thyroid are normal. A year before, she was critically suffered from urosepsis with AKI, DM II, pleural effusion, etc. but recovered. Though she has the first stage of renal failure and ventricular ectopic in ECG now. Recently she visited an eye hospital where she was told that her eye problem is mainly due to gradual damage of optical nerve, which is irreversible and the doctor cannot do much. In this respect, she was tested with digital fundus photography and OCT (Retina -Tessellated fundus in the right eye, FR dull in left eye). As per doctor's mention, I come to know that she has some cataract in the right eye (nuclear sclerosis grade II diagnosed in both eye) which need to operate soon for better vision, but I am not sure about it as it is not written in prescription as a diagnosis. She is advised to take a drop of Bimatoprost 0.01 % in both eyes every day to control optical damage. Now, I like to know is this medicine helpful if she complains with optical nerve damage without glaucoma or cataract. Is there any other solution to save her vision or further damage at least.


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Hello. I understand your concerns, and I am very sorry to hear about your mother's eye changes. I am afraid that the changes in the optic nerve are indeed irreversible and according to the reports is near total. This is known by the part of the reports that say CDR 0.9 in both eyes. To explain it in a very simple manner, the eye is like a camera, both have lenses, and just like the camera has a film, the eye has the retina. If there is a problem in both the lens and the film, simply changing the lens would not improve the quality of the picture as the film (retina) is also compromised. But in few cases may improve to a limited, yet unknown extent. The problem also gets compounded with her poor general condition with heart problems along with the recent sepsis. So operating on her cataract is quite risky. Regarding the eye drops, Brimonidine eye drops have been known to help in neuroprotection and may help in the preservation of whatever optic nerve function is left, theoretically. So this would be the thought process behind this plan of management given to the overall condition. As far as the next step in managing, it depends on the daily activities of your mother and if at all she feels her current vision is not enough for her to carry out the daily routine activities. In case you need more information, please let me know.


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Hello doctor,My father is recently diagnosed with papillary renal cell carcinoma type 1, and he has no BP or sugar. However, he had undergone bypass surgery ten years ago. Our doctor has suggested targeted therapy is better for him as there is another mass found in the lungs too. Our doctor has prescribed Sutent 37.5 mg, to begin with, and slowly increase it to 50 mg.However, due to our financial conditions, we cannot afford Sutent as it is pretty expensive for us. As we do not have any insurance. Is this the only drug available for this type of cancer, or do we have any other affordable and similar drugs with minimal side effects? We want to get your suggestion on this. Kindly help.


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Hello. As per history given above. Your father as metastatic renal cell carcinoma. I would have liked to have few additional markers like his general condition, report of CBC (complete blood count) and LFT (liver function test), RFT (renal function test) to look at his risk score. In metastatic RCC, in first-line settings we have three TKI (Tyrosine kinase inhibitor) that are approved and commonly used. Namely, Sunitinib, Pazopanib, and Cabozantinib. Sunitinib and pazopanib have almost the same progression-free and survival benefit. Cabozantinib has benefit in progression, but final overall survival was the same as sunitinib. Toxicities are bit different for Pazopanib with more chances of hepatitis, weight loss, and diarrhea. If you are not affording for Sunitinib, then I would say Pazopanib would be better as it is cheaper with similar benefits and slightly different toxicities. Cabozantinib is costlier and not yet available. I hope it helps. I would be happy to help you further if you have any more queries or questions regarding toxicities of these drugs. TKI.


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Hello doctor,I am going to get braces soon, and I am going to have a large gap, is there anything a dentist could make to hide my gap?


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Hello. Braces are placed to align your teeth more esthetically and camouflage the malpositioned teeth. From your question what I have understood is either you have a large gap already, and for that, you do not have to worry, braces will close it, or you are saying that during treatment you are going to have a gap because of the teeth removal. In that case, I want you to know that a few teeth are removed during orthodontic braces treatment to get space for the rest of the teeth to move and align themselves, and ultimately the gap will be closed. So, in both cases, the gap will be minimized or closed. You do not have to worry. Maintain proper oral hygiene, be careful with the brackets, do not break them, follow the advice of the orthodontist and do not miss any follow-ups as these minor steps will help the treatment to finish on time or maybe a little earlier too. Now, if you can elaborate on your question, I can answer more precisely. A picture of the gap will be helpful also.


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Hello doctor, The patient is 11 years old, and right from birth, he is suffering from type 1 and 2 diabetics. Initially, he was on injection and now on tablets every day. As per the doctor, his pancreas is not working from his birth. Can you please let me know if there is any treatment available for this? Also, can the bone marrow blood infusion technique help in treating this issue permanently?


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Hello. Yes, there is a procedure called pancreatic transplant. It must be taking place in your place as well. You can click on the individual hospital website and check if they have a pancreatic transplant facility, but it could be very expensive. But let me tell you one thing that even after any transplant, the patient has to take immunosuppressive medications all his life and compared to that the diabetes pills are still a better option.


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Hello. Theoretically, yes. But, practically I would not suggest you get it done as you will not be comfortable (mainly because of the water spray from the handpiece or drilling machine) and that will make it difficult for the dentist too. If it is an emergency or you do not have accompanying stuffed nose or difficulty in breathing through the nose, then you can go for filling. Depends on your comfort level and severity of your condition. I hope this has helped.


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Hello doctor,My son is having a fever of 102°. He is 5 years and 4 months old. Since last two days, his temperature is not reducing. We have given Ibuprofen plus paracetamol syrup. Tablet Zedocef (100) DT 1 tablet twice a daily for five days after food. Syprup Ondem 5 ml thrice daily 1/2 hour before food, syrup Ibuprofen, paracetamol 7.5 ml 6 hours once after food. We tested his blood, but there was no malaria or typhoid. But his TLC is 16700. He is not taking any food, but sometimes he drinks ORS. So suggest us what to do?


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Hello. You are already giving multiple antibiotics and antipyretics. The TLC (total leucocyte count) count in the report is on the higher side, which suggests some bacterial infection. Continue with the advised treatment. Some times fever may take three to four days to respond. Continue to give Ibugesic plus for each episode of fever for now. Cold sponging also helps to bring down the temperature. Get a repeat CBC (complete blood count) and Urine microscopy done. If fever is persisting and not responding to oral medication. The child may require admission for starting IV antibiotics. A complete clinical examination by the pediatrician to find out foci of infection is recommended.


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Hello. Yes, these are cherry angioma. What do you want to know specifically about these? These are harmless and will require electrocautery if you want them to get removed. No creams or oral medications are effective.


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Hello doctor, I have twins, a boy and a girl aged 2 years. I noticed that the girl advanced in skills than the boy. In the first few months of life, my son was faster than his sister in the growth and everything. And then, it was reversed. I am a graduate of psychology. I have a brother suffering from autism and frankly, I have a fear of this disease. I do not care and I do not want to surrender to delusions. But, mom and dad insist on reminding me of everything you see them that my son is also the possibility of getting hurt. I started since 10 months; I am watching my son very much. I blame him if he did not implement what I am asking. He says dad and mom. He loves to play, laugh and shake hands if I asked him to do so. He looks into my eyes when I talk, but I do not feel that he understands what I am saying to him always. For example, if I asked him to bring me cheesed off the table, he does not focus with me and ignore me. On the other hand, if he feels he is thirsty, then he will come to me and say a bottle of water. I know this is probably because the rate of a normal IQ and concentration varies from one to another child. I want a word from the doctor that makes me serenely scream in the face of all of the notes that my son is not normal and I tell them that my son safe and sound. The question is how completely I know that my son is not suffering from any problems in communicating diseases or behavior?


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Hi. I have gone through the query with keen interest and understand your concerns. Before making any opinions I need to inform you that take the things in objective manner and not on emotions I understand there is history of autism in the family and it does not mean your child suffers with autism. In a normal growing child there are many ups and downs and not responding on some occasions is not indicative of serious pathology like autism. We need to take notice that a child plays well with another child, responds to language on most occasions, cheerful, not having any abnormal repetitive stereotyped movements and communicates with the mother. Having said this I feel it will be appropriate to fill a simple questionnaire called Autism Spectrum Screening Questionnaire (ASSQ). This is a screening instrument for autism and you will know probably with sure that whether there is problem or not. If you still feel there is something abnormal, then you may contact the specialist doctor nearby for a physical evaluation. For further information consult a psychologist counsellor online -->


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Hello doctor,I took antibiotics about a month ago, and ever since the fourth day of antibiotic treatment, I have been suffering from diarrhea or loose stools. On the fourth day, I had bad cramps and loose stools that lasted from the fourth day to the seventh day. This then returned afterward with even worse pains, but this time, I had yellow stool followed by diarrhea. Ever since I have been having loose stools on and off that is foul smelling and mushy. Is this because of the antibiotics, or is it an infection?


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Hello. Your diarrhea could be a direct side effect of the antibiotic, in which case, it should resolve after stopping the antibiotic. It could also be due to a condition called Clostridium difficile infection (C. diff for short). C. diff is a bacterium typically found in the intestines of most people. But under certain circumstances (frequent exposure to antibiotics), a couple of strains of this bacteria can multiply and produce toxins (called C diff toxin A and B). This can provide diarrhea-sometimes bloody, with crampy abdominal pain. I suggest getting tested for C diff. You need to submit a stool sample for C diff toxin. If it is positive, there are treatments for it includes oral Vancomycin, Fidaxomicin, or Metronidazole. I hope this helps.


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Hello doctor, I have sore on my leg for a long time. More than a year, I did shave part of my leg at one point. It became like a sore, but I have a strong history of cancer.


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Hello. I have gone through your case. In my opinion, your lesion should be biopsied as early as possible as you have a long-standing history of cutaneous cancer, and I fear it could be slow-growing skin cancer. I have two to three differential diagnosis. 1. Nodular squamous cell carcinoma. 2. Nodular non melanocytic melanoma. 3. Basal cell carcinoma. 4. Keratoacanthoma. 1.Sun-exposed area. 2.White race and, 3 Past history of cancer Biopsy. Need excision as early as possible.


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Hello doctor,My son is 1 and a half years old. A few months ago we came to know that his Hb is 4.3 and Hb F is 92 percent and that he has beta thalassemia intermedia. He was immediately transfused once. Now he is taking vitamin C, and Hydroxy and Folic acid and his Hb are 10.2. Please suggest some diet for him to maintain his health.


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Hello. As your child is suffering from thalassemia intermedia, you should avoid giving iron rich food and food that leads to an increase in iron absorption.The foods which decrease its absorption are, (i) cereals and (ii) dairy products. The foods which increase the absorption are, (i) fruit and vegetables rich in vitamin C, (ii) meat, fish, shellfish and poultry and (iii) pickles, sauerkraut, soy sauce, vinegar, and alcohol. You can also supplement the child with folic acid 1 mg a day. Give nutritious diet and vegetarian protein sources, avoid meat and liver. Have a regular follow-up with your pediatrician for Hb level and iron overload.


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Hello doctor,I tried teeth cleaning, I avoided non-veg foods and beverage drinks, which produce gas, and I am eating a balanced diet. My bad breath problem is since for the past five years till now, so in this period I realize that I have a white layer on my tongue and when I smell my tongue then I feel very bad breath. Also, I have a hole on my throat back of the tongue, and something comes through that way like thick water and when I smell it so bad.Another is when I eat something, then that smell lasts for a long time. What to do? I have been spent more money to avoid bad breath, so give me a suggestion to get rid of it. Bad breath is the main reason for my unsuccessfulness. Sometimes thinking about this problem, I become depreciate. I needed your help.


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Hello. The white coating on your tongue is mostly due to bacteria and debris. And, it seems that you might have a dry mouth. All this must be causing bad breath. Clean or scrape your tongue regularly, maintain proper oral hygiene, drink a lot of water and even empty stomach will cause bad breath, so have food regularly on time. Do mouth rinse with lukewarm water and salt or lukewarm water and a bit of mouthwash diluted in the water. But, better to avoid continuous use of mouthwash as this itself can cause dry mouth sometimes, and discoloration of teeth. Get a consultation from a dentist regarding dry mouth, to rule it out. If you have dry mouth, a Sialogogue (to increase salivary flow) will be prescribed by the dentist. Do not worry. You will be fine. If possible, send me a picture of your tongue and teeth.


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Hi doctor, I have a 7 mm gallstone as seen in my ultrasound. They gave me Ranitidine, and I tried apple cider vinegar with fresh apples. Do I need surgery?


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Hi. Thanks for sharing your concern. Obesity. Cholelithiasis. Gallbladder surgery. For further information consult a general practitioner online.--->


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Hi doctor, My friend has been having left shoulder pain for months. For the last three weeks, he is also having the hoarseness in his voice (can barely speak) and little energy. He is eating well, but not gaining weight. He has no other symptoms. He is a carpenter and 50 years old. He smokes cigarettes, weed and crack cocaine. I think he has been doing this for 30 years. Today, his blood test and blood pressure are fine. His chest x-ray came back with a large mass on his left lung, it looked large to me. He was given a TB shot other than that they suggested a specialist. It was an ER visit so they did not say much other than it could be a cancer. What does this sound like to you? I deeply appreciate any of your help. Thanking you in advance.


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Hi. We are here to help you. I am really sorry to hear about his state. For further information consult an internal medicine physician online -->


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Hello doctor, I am 41 years old, male. I have symptoms of extreme nausea, acid reflux, fatigue, and weight loss. Ultrasound shows gallstone. I have enclosed the report. The doctor wants to do a HIDA scan and remove the gallbladder. Are my symptoms due to gallstone? Is there a substitute test for a HIDA scan? Should I go for surgery? Please advise diagnosis and treatment.


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Hello. First, gallstones in itself require treatment. The only treatment for 10 mm size stone is surgery. Medication will not reduce it. Untreated gallstone at your age may lead to complications. Your second query regarding whether symptoms of acid reflux are associated with gallstones are not. That is difficult to answer. There is an association of the two but difficult to directly link causation of acid reflux to gallstones. Hence, your symptoms may or may not rebate after surgery. Some patients although do show symptom relief. You should also undergo an upper GI endoscopy if your symptoms are persistent after discussion with a gastroenterologist.


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Hello doctor,I am 27 years old, height is 65 inches. Weight 56 kg now. Three months ago weight was 57.5. kg. Sleep 6 to 7 hours. About two years ago, weight was 58.5 kg. Blood pressure usually normal but sometimes low. I have a gas formation problem for about four years. Maximum time no pain but gas and heavy feeling in the abdomen. 11 months ago I did ultrasonography and got that gallbladder stones (3 to 4 stones larger size 0.6 cm). I am taking homeo medicine. Gallstone and constipation. Truly say in a month 12 days I feel good and 18 days I got gas problem but within last seven months sometimes I feel weak (tiredness). Within the last five months, my weight is not increasing and my hands are getting thin. Sometimes, I need to take Ranitidine tablet when much gas. I had a rheumatic fever at age 8 and took allopathic treatment till 20 years of age. Oracink tablet. Please, suggest me. Do I need to do any blood test? I will do an ultrasound after two months. I am taking Iron Vitamin capsule Zilvit according to the suggestion of relative. About four months ago I took Zilvit for 20 days and feel good. Homeo doctor said that he should not give other medicine for weakness.About 2 to 3 years ago I took Mazpro, Omeprazole tablet sometimes but most of the times it took time to remove the gas problem. Now I am taking homeo medicine for gallstones (eight months running) and took homeo medicine for constipation for four months from the same doctor. The allopathic doctor who did ultrasound suggests that there is no need to hurry to surgery and can wait for about one year.


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Hello. Your three main concern is the weakness, gallstone, and gas problem. For weakness following workup can be done: Investigate with above investigations as you have a weakness for many days. If still no cause for weakness found than EMG (electromyography) done. For gallstone, if no symptoms mean no abdominal pain present than surgery not needed. Ursodeoxycholic acid tablet 300 mg OD (once daily) can be prescribed for that. Avoid high fatty foods and reduce weight. For gas problem following measures can be taken: Take care. For more information consult an ayurveda specialist online -->


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Hello doctor, I was diagnosed with PCOS at 16, but have had successful pregnancies (other things I had zero breast change and less than once a day of milk production). We have never used any form of birth control yet our youngest is now almost 5. We have been actively trying for almost two years now. My periods during the last six months have been on time and consistent. I am 31. Why are we not able to get pregnant after two babies?


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Hello. As I have learned that your last pregnancy was five years back and that your menses have been regular since last six months and you have been trying for last two years without any use of contraceptive practices to conceive. This qualifies for secondary infertility treatment. Now the first thing which needs to be checked is to get your partner's semen analysis done to check for quantity and quality of sperms as of now. There are chances that the count may have gone down or the quality may have depreciated which can be treated accordingly. In middle age men, such male infertility is common and needs to be addressed first before a lady is subjected to tests and examinations for evaluation of secondary infertility. Hence, it is requested that you may please get his semen analysis and culture test done first and review with reports. In the meantime, you may send across any ultrasound pelvis reports or hormonal profile tests (from the last six months) that you may have undertaken for review (if the element of PCOS still persists or not). Semen analysis and culture for the male partner. Male infertility. Secondary infertility. As per reports (awaited).


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Hi doctor, I am 20 years old. I am a college student. Few weeks back, I was told that I have PCOS because of which I am facing difficulty in reducing weight. My weight is 65 kg and I am 5'4" height. It would be really helpful if you could suggest me a diet plan.


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Hi. I can give you some guidance which might help you reduce weight with PCOS (polycystic ovaries). For further information consult a dietician online -->


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Hello doctor,I am a 19-year-old male. Around two months back, I had a hiccup when dead-lifting and my lower back or lumbar spine area had a sharp pain. At the time, I did not think much of it and since then discontinued dead-lifts. Over time, I have developed some sciatica in my left hamstring area. I visited a chiropractor about two weeks ago and he took X-rays of my spine, revealing that my lumbar spine is curved to the right, canting my hips and therefore putting pressure on my sciatic nerve. I went in for three adjustments with him, over a one and half week span. I no longer have access to my chiropractor, being that I am overseas. My question is what can I do by myself in order to straighten out my lumbar spine and un-cant my hips so that my sciatic nerve can get some relief? Am I going to have to find another chiropractor and get more adjustments while I am over here? Note that the discomfort of sciatica only happens with a straight left leg when bending at the waist.


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Hi. Based on what you wrote, it sounds as though you may have scoliosis, a wedged vertebrae in the lumbar spine, a disc issue, or even lower cross syndrome. If there is any way to attach images of the X-rays, that would be ideal (though I know the current situation is not ideal). Assuming it is indeed a scoliosis curvature, I can tell you that you will not be able to straighten your spine (anatomically speaking). If it is a lower cross syndrome, your best bet while you are overseas is to work on core stabilization exercises. Bridge exercises, planks, and clams may all be beneficial to the lumbopelvic-hip-complex. All of these exercises can be found online, but essentially we want to strengthen the weak muscles and relax the overactive muscle. Please get the help of internet resources to have a knowledge of lower cross syndrome to get an idea of what muscles may be overactive and underactive. Without examining you myself, or seeing X-rays, this is about all of the information I can provide. When you return to your place, I would recommend continuing treatment with your chiropractor. For more information consult a chiropractor online.-->


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Hi doctor, I feel cramped, itching and lower abdomen pain during urination. I had intercourse with my partner last month and since then I have faced this problem. I went to meet a gynecologist and she prescribed some medicine and felt fine for 10 days. Then, again I am facing the same problem. Also, I have PCOD. Please help me.


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Hello. Urine for routine and microscopic examination as well as culture sensitivity. Revert back with the test reports to an obstetrician and gynaecologist online.--->


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Hi doctor, I am 20 years old. I have one kid and I am seven months pregnant. Since I started puberty, I got a lot of health problems. The left side of my underjaw is not fully grown. It feels like pieces are missing. You can also see the big difference between the left side of my chin and the right side. My cheekbones are also not fully grown. I have poor blood circulation and my face gets very very swollen. Mostly in the morning, my face looks quite normal and my skin color as well. Later, in the day, my face gets swollen and big and also when I eat and when I eat a lot and unhealthy it gets more swollen. When I lay down the swelling lessens. I also have mental stress and an anxiety and I have a scoliosis. I get tired quickly and my skin is very dry. I have dark or purple undereyes and dark patches on my ankles, knees, etc.


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Hello. I just read your query. See the issues like scoliosis, underjaw shape, and underdeveloped cheekbones are anatomical issues which are related to the natural structure of your body. They can not be corrected with the help of medication. You may take help from artificial modern techniques, which you can learn from a nearby physician. The poor blood circulation, swelling on face, stress and anxiety, tiredness can all be related to pregnancy. I advise you not to take any random treatment or any supplement without consulting your gynecologist. This is the crucial time of your pregnancy. So visit a nearby gynecologist and ask for the help for all the issues you are having.


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Hello doctor,I have mild scoliosis convex to the left and was wondering if a left knee arthroscopy can be the cause of my posture and/or pain issues. For example, sitting, standing. Also, having scoliosis, would that cause a blood clot (pulmonary embolism) after this surgery? With being a severe asthmatic.


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Hello. Scoliosis is a structural problem and knee pain will not cause this. Arthroscopy can rarely lead to a clot formation but is not necessarily a known risk factor for DVT (deep vein thrombosis) as you are likely to mobilize very quickly and the procedure is usually short. Scoliosis does not add to the risks either. For more information consult an orthopaedician and traumatologist online -->


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Hello doctor, There is white fungal ring infection on forehead of my daughter. Can you please suggest some oitnment?


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Hi. I have gone through your case. In my opinion, I have two diagnosis of your daighter's lesion. It could be fungus or eczema patch. For this, please mix Hydrocortisone and Clotrimazole creams in equal amount and apply two times a day for 14 days. Also apply any baby lotion at night. Within 14 days, it should heal. If in case, it does not heal, then please see your local dermatologist to evaluate her for other conditions. My second diagnosis is leprosy. Please consult your local dermatologist if the lesion does not heal.


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Hello doctor, I have been suffering with obsessive compulsive disorder- OCD, fear of germs, ordering things, obsessive thoughts. I also have anxiety while driving car at higher speeds. I have been diagnosed with Fibromyalgia which is lined to general stress, anxiety levels, which causes the muscles to be held tight. I have been able to accomplish most of the daily tasks and be successful in life. However, the anxiety while driving is troubling me. I need to reduce anxiety while driving, while also maintaining focus. Also, the general level of anxiety or stress is causing other physical ailments. Due to muscles being in constant state of tension. Currently, I do not take any medication. Only supplements 5-HTP (Seratonin) and one sleep aid (Melatonin).


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Hi. I understand you experience OCD symptoms, general anxiety symptoms and specific driving anxiety and some anxiety related physical problems. What is your current profession? Your job timings? Family members? For how many years you are having 0CD symptoms? GAD symptoms? Stress? Why? Exercise? Relaxation? Any therapy? Family support? Any other anxiety triggering factors than driving? Sleep? Physical intimacy? Please reply. Take care.


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Hello doctor,My youngest son is 2 and a half years old. Currently, he is crawling, and he is a delay in walking. I bought him for the child development clinic at the hospital. They have sent his blood sample to another country, and the result says that he has Duchenne Muscular Dystrophy. Kindly advise what should I do. My son can stand at the sofa, but he refrains from standing at the floor. He can lift his body. Is he able to walk?


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Hello. It is a genetic disorder. I am sorry to say this, as this disease has a poor prognosis. You need to visit a medical genetic specialist. Physical therapy, braces, etc. are common management. Along with that if you want to go for alternative treatment, then try Ayurvedic panchkarma therapy where Ayurvedic massage can be given to your son. It had good results in muscular dystrophy disorders. You need to visit a nearby Ayurveda physician or a panchkarma center. It can help you up to some extent. I hope you understand my point. For more queries, you can consult me.


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Hello doctor,People called me stupid and annoying it is not that I do not understand. It is that I cannot focus, I have a tough time focusing, and I would not deny I am annoying. I never sit still I am wandering around the house all the time I told my dad I would not sit still even if I was glued to the sit and he said I believe that. People complain about the fact I talk a lot, and I talk fast. I climbed a broken fence I love climbing fences when I was 12 I let my friend push me across the road in a shopping cart, and I let my friend push me around in a shopping cart on a bumpy ground I do not think before I act. I get very mad when people talk badly about me I get easily frustrated I get crazy if I cannot find something or if mess up on something I will pretty much get mad over anything I have a low tolerance when it comes to anger. ADHD runs in my family.


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Hello. You are reporting symptoms which are suggestive of ADHD (attention-deficit hyperactive disorder). How are you managing at school? Further assessment, including developmental history from parents, corroborative information from school will help to clarify the severity of your symptoms and also to rule out other conditions mimicking ADHD. Effective management of the underlying condition will help you to function better. I will advise discussing with your parents and consult your doctor locally who can refer you for further specialist assessment as needed. Depending on the evaluation, medication or behavioral support may be recommended.Meanwhile, you can try some strategies to improve your functioning. Exercise regularly, make a reminder list for essential weekly activities to avoid missing deadlines, minimize distractions by avoiding TV, mobile during your work hours, etc. I hope this helps.


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Hello doctor, I am 39 years old. Since more than a month I had a blister on my foreskin, and I noticed a reddish-sticky part in my foreskin. I saw this after sex because it was painful (but it was not hard sex at all). The blister went away, but the reddish-sticky part stayed. I had also burning and heat in the skin of my testicles. I went to the doctor, and he found an infection. I had antibiotics pills and fungal cream. After a week, everything was improved, but the reddish-sticky part was still there, but the doctor said everything was fine. But it is not. I went to another two doctors (a urologist and a dermatologist), and they said everything is fine. The dermatologist prescription was Vaseline, that was two weeks ago, and this stays. I am worrying about cancer, and I asked them a biopsy, but they refused. Since before five months I also had a red rash in the gland coming and going, but for more than a month, it has not happened again.


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Hello. I understand that you are concerned, but I can assure you that in the photographs there is no feature suggestive of any cancer. I understand that you had a blister after intercourse, that might be friction blister as other cause of blister in genitals include herpes, but that present as multiple tiny blisters. Recurrent glans rash can be candida, but right now, I cannot see any changes. It might feel sticky and thin after healing of a blister for some time, but there is nothing to worry. And certainly, there are no features of cancer. Just use some good moisturizer or use the following. 1. Cetaphil moisturizing cream.


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Hello doctor, My wife is currently on her sixth month of pregnancy. I am pretty much concerned about using Neomycin 0.5 % and Clobetasol 0.05 % ointment during the first month of our pregnancy. We had itching and burning sensation. We used approximately 4 g of ointment in total. She applied some ointment over her inguinal area and me over head of penis and we also had intercourse after that. This happened two times. Would this have caused vaginal absorption of Neomycin and damaged the fetus? Or as it was the month of conception would it have damaged the sperms, egg or the fertilized egg? I read some articles where topical Neomycin has caused ototoxicity, nephrotoxicity and reduced spermatogenesis in males. Should I have terminated the pregnancy earlier? Should I monitor the baby after birth for these toxicities? We did three scans so far dating scan, NT scan and anomaly scan which are normal.


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Hello. There are possibilities of absorption per vaginally and I agree there are reports of ototoxicity and nephrotoxicity but as she is six months pregnant now and all scans are normal so there are no morphological anomalies in the child but as far as ear hearing abnormalities are concerned, that cannot be detected by scans. Also, as on date after 20 weeks of gestation, pregnancy cannot be terminated by law unless gross abnormalities are evident in the foetus and permission would have to be sought by high court only.


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Hello doctor, My Hb is 8 to 9 always, and MCV is on the normal range, on CBC. I have enlarged spleen (moderate to severe) since childhood and chronic since then. I have a history of blood transfusions but had transfused only 6 to 7 times. My brother has the same problem with the same symptoms also. He is 31, and I am 34 years old. My mother is anemic with Hb 7.5 to 9.0 always, with normal MCV on CBC. She is 51 years old. Father has normal HB 14 always.


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Hello, Welcome to the icliniq.com. You have to rule out iron deficiency anemia and hemolytic anemia in your case. You need to investigate further as follow. You can revert with reports once done.If you have hemolytic anemia than hemoglobin level usually remains in the borderline range.If your above reports suggest towards iron deficiency anemia than iron tablet will recover your anemia completely. So revert with reports once done. Meanwhile, you can be prescribed ferrous ascorbate tablet for your anemia.I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor,I had sex with a prostitute last week. I used a condom, but I played her vagina with my hand. I came back home that night and had sex with my wife again. I also played her vagina with my hand. Next day, she had her periods and felt itchy at her vagina (I think genital herpes). So she scratched her vagina, and it became a damaged spot under the vagina. But it is better now and is about to heal. Is this STD or not?


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Hello. It may be normal, but I cannot deny from STD (sexually transmitted disease), and it may be herpes and vaginitis too. 1. Apply Betnovate-N locally up to deep in the vagina, after proper wash two times a day till required. 2. Ciplox TZ (Ciprofloxacin, Tinidazole) two times a day after food for three days. 3. Candid veginal tablet at night for six nights.It will be fine. And it means you believe in polygamy, which is one day become dangerous. Be loyal, and you can use her ten times a day. So she will remain healthy so as you. If she has vaginitis, you also can get the infection.


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Hi doctor, I am having an abscess on my balls. It is reddish and painful, but not much. I have jock itch right now. I saw terrific images on the internet, but it is not like that. Please help.


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Hi. Please put up two to three clear photos of the affected area for proper evaluation and guidance. Revert back with the photos to a dermatologist online -->


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Hello doctor, I am 33 years old. I have been trying to conceive for eight months from now. I have monthly periods and positive OPKs and BBT shifts, but periods are also very light, basically spotting. I had an Ultrasound which showed a few cysts, had mildly elevated testosterone, normal LH and FSH, normal estrogen, low progesterone. My PCP is not convinced. I have PCOS but I am wondering if that is still a possibility and what I should anticipate for treatment in the future (clomid vs. progesterone therapy, etc.)?


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Hello. The fact that you are getting positive OPKs each cycle indicates that you have an anovulatory cycle or in simple terms that you are ovulating regularly. PCOD (polycystic ovarian syndrome) cannot be diagnosed alone with just small cysts in ovaries, rather one should have around 10 to 12 multiple small subcenterimetric follicles lining the periphery of the ovary during midcycle scan, one should have featyres of clinical hyperandrogenism like acne, hirsutism (excessive facial and body hair), acanthosis and most importantly oligomenorrhoea or irregular menses. Testosterone alone does not justify the diagnosis. However, if o e needs to be sure, then AMH (ante Mullerian hormone) test can be done, which is more than four indicates PCOD. As mentioned that you are on thyroid medications, I believe your TSH levels are less than five. Please share your ultrasound and hormonal profile reports for review. Now, it would also be essential to check for your partner's semen analysis for quality and quantity of sperms. I am not sure if you have any kids before or not as you have not mentioned, but if you do not yet, then semen analysis of your partner would be mandatory, as your reports are relatively normal. Progesterone deficiency can be treated, and even Clomid can be contemplated only of the male infertility factor has been ruled out first.


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Hello doctor, I have tonsil stones, sore throat, swollen gums, and dry cough. Is this the symptoms of oral or throat cancer?


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Hello. A recurrent sore throat can occur in a number of pathologies. Most often it is as a result of some local pathology like Rhinosinusitis, nasopharyngitis, tonsillitis, GERD (gastroesophageal reflux disease), LPR (laryngopharyngeal reflux). Rather than relapsing and recurring course malignancies tend to have a progressive course. Further age is a crucial factor. Younger people usually do not have malignancies. Your doctor must have checked your throat, and he would for sure have picked something if there was any such thing. GERD and LPR are mainly known to cause recurrent sore throat. Malignancy is the last thing one would suspect at your age.


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Hello,I am a 28-year-old female. I always worried about her heart. I have GAD specifically focus on health anxiety and often experience heart attack symptoms so much so that I have gone to my doctor and the ER many times (always to be cleared). I continue to worry whenever the symptoms come back. I have been cleared so many times, but still, fear that something could go wrong or something might have been missed. Is there a chance that I could develop a risk of a heart attack without making any major changes?


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Hello. A heart attack usually occurs in those with risk factors for ischemic heart disease such as high BP, high sugar, high cholesterol, family history of a heart attack in young age, etc. Your tests are normal thats good. To estimate the lifetime risk of development of atherosclerotic diseases such as stroke and heart attack, have a fasting lipid profile done and send to me.


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Hello doctor,I have these rashes appearing in my inner thigh and body, and they started small and now has spread across 60 % of my body. I went to my local general physician and was given antibiotics, but that did not help. I was also given Dermol 500 lotion, Betnovate RD cream and Lyclear dermal cream to no avail. It is probably more comfortable if I send you the picture as it is very annoying. It is not painful, but it is spreading to my buttocks, inner thighs near my penis, both arms and body rib. What could it be?


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Hello. I understand your concern. I would have appreciated a bit clearer pictures with good light (attachment removed to protect patient identity). The distribution and morphology point towards a superficial fungal infection, which has been modified by topical steroids use? Has it been itchy at any point, any redness? Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Capsule Itraconazole 100 mg twice a day. 2. Tablet Levocetirizine 5 mg once at night. 3. Terbinafine cream apply twice a day. Do this for a week.


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Hello doctor, My cousin was diagnosed with genital herpes a few days back. She also has a sore throat currently that the doctor thought was strep throat but the strep test was negative. I shared a water bottle with her recently. Could I have contracted herpes from sharing the water bottle?


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Hello. The sharing of water bottle is not known to spread herpes. Genital herpes spread through sexual route. The viral infection also can cause sore throat like influenza infection. It will give streptococcus negative test.


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Hello doctor, I do not want to be sound like I am panicking, but I really do feel quite uneasy. Since I woke up I feel dizzy. My head is rolling and when I close my eyes, I feel like the world is rolling around in a full speed. It never happened with me any time before. I just had my lunch now, but I do not feel to eat any due to the same. Please advise what should I do? Thank you.


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Hi doctor, I take on a daily basic- 100 mg Ixel, 60 mg Paxet, 0.5 mg Clonazapem. My psychiatrist told me to take 5 mg of Zyprexa in cases of SOS. I do not have any psychotic symptoms. He told me it was meant to knock me down, so I could have relief from stress and I could sleep. I took this pill (first time ever) and I slept for 20 hours (I was awake for one hour in between). Then I was awake for three hours feeling really bad, dizzy, spaced out, tired. Then I slept for another nine hours. I still felt bad and restless for a day, but slowly I got less tired and more alert. I guess it is not normal. It was even quite scary. In the meanwhile, should I avoid this pill or maybe reduce it?


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Hello. I can understand your problem. You are on high dose of Paroxetine and are also taking Milnacipran, Clonazepam and if even with these medicines the symptoms are persisting, then there is no harm in adding a low dose antipsychotic drug like Olanzapine. Olanzapine in low dose has great efficacy in depressive symptoms, anxiety disorders and in resistant depression symptoms. The drug is associated with excessive sedation and this is the reason you slept for very long duration after taking this drug. In that case one option is to reduce the dose of the drug to 2.5 mg and give this a try. This should help you without causing unnecessary sedation. But, I am not sure if the drug will help much in anxiety if used in SOS basis. The drug should be used regularly after dinner and Clonazepam dose can be skipped which can be kept for use on SOS basis. You can have a talk with your psychiatrist for this.


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Hi doctor, I had LASIK done for my eyes two months back. My vision is all right but, I feel a burning sensation at the corners of the eyes (corners from where tear comes). After 20 days of LASIK, (back then) whenever I put any eye drops my eyes started burning. Due to the burning sensation, my eyes started watering. I had consulted many doctors, and they prescribed eye drops like Systane Ultra, L-Pred, and Eubri. But no eye drops help me. I do not know what to do. Sometimes I also get redness in the eyes. Is it dryness or something else?


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Hi. LASIK when it is done, corneal nerves will be cut. These corneal nerves take several months to regenerate. This can lead to continuous dryness and irritation in the eyes. Eyes also become hypersensitive. Systane ultra is artificial tear eye drops which is a substitute given for this dryness. But, the burning sensation in the corners can be due to an allergic reaction.  L-Pred may help that. Please avoid rubbing your eyes in case of irritation, as it may take a long time for healing the corneal flap; they create in LASIK. Sometimes, eye drops may themselves can cause an allergic reaction to your eye and can cause irritation. You can use different company drops of same content medicine to avoid this problem. Try Levocetirizine tablets. You can a send a picture of your eyes for a detailed evaluation.


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Hi doctor, I am a 33 year old male. I am from prickling, numbness, warm sensation in my feet and hands and tingling in my lips and mouth for the past two years. I had a severe cough for around two years and recently, it got resolved. My issue, initially started with prickling and burning sensations in feet and after that both palms. Now, it has increased above knee. I visited a neurologist, but the problem was not solved. Presently, I am suffering from numbness and tingling in the mouth on lip area, prickling, burning sensations and numbness in feet, legs and palms, getting tired after moving through staircase, feeling some discomfort in chest area like heaviness for some time, gas problem and recurrent mouth ulcer. My sugar test, BP, NCV, ANA profile, TMT and ECG are normal. ACE 69, HSV1 positive, vitamin D 17 deficient and uric acid 8.2. I am completely blank now; I am not getting any hope of good treatment for my problem. I had unprotected sex 9 years ago. My CMIA test and rapid HIV test came back negative that time. I had medicine for herpes simplex for a month, vitamin D3 60K once in a week for four weeks and then once a month for six months. But, my problem remains the same. I will be highly obliged to you. I am struggling because of my present health condition. Kindly advise the treatment.


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Hi. Your problem still could be due to a nerve problem, even though your NCV test is normal (nerve conduction velocity). Also, you might be having calcium deficiency, which is very common associated with vitamin D deficiency. I suggest you calcium supplements like tablet Shelcal HD daily once for three months. Apart from vitamin D and herpes medication, have you taken any medicines for your problem? Kindly let me know that. If not done, then kindly get serum vitamin B12 levels tested and revert back with the report. Revert back with the reports to an internal medicine physician online -->


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Hello doctor,My heart is normal, but I have ventricular ectopic beats. Could these cause cardiac arrest and kill me at the age of 23? I worry about it every day. Kindly advice.


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Hello. It is unusual for ventricular ectopics alone to cause cardiac arrest. Still, it depends on various factors like cause of ectopics, the morphology of ectopics, frequency of ectopics LV function on Echo. What symptoms do you have? Please provide your ECG and Echocardiography report. You have uploaded your photo as an attachment (attachment removed to protect patient identity).


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Hi doctor, I am 21 years old. My weight is 48 kg. I am 3 months 2 weeks pregnant. Now, I got chickenpox. I am very anxious about the adverse affect for my baby. I have visited a gynecologist and she suggested me to get abortion. Please clarify me the right step.


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Hi. Really this is a confusing state, but this does not mean you have to abort the fetus right now. When mother get infected with chickenpox, fetus carries a risk. But the risk is only 2% and in those cases the fetus might develop rarely some form of abnormality. Thus, straightaway recommendation of termination is not always a choice. Definitely there is no direct answer and it is upto you what to do. If you want to have the risk of 2%, which is very minimal and often equal to an incidence of congenital anomalies in low risk pregnancy, definitely you can continue it. In that case, just go for an anomaly scan from a very good center at the 18th to 19th week to confirm about the integrity of the fetus. For further information consult an obstetrician and gynaecologist online -->


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Hello doctor,My father, 74 years of age, has BPH. He had UTI four years ago and was diagnosed with BPH. PSA was 60 and last three years was on Urimax and past few months on Veltamplus. His PSA is 0.9 prostate size 45 cc and PVR is 70 ml. His symptoms have been the urinary frequency of every two hours all these four years. One doctor has asked to continue the medication. On a recent visit to the second doctor, the new doctor asked to stop the medication. So, I wanted a third opinion. What is the harm if we stop? What is the benefit of continuing it? The medication lowers blood pressure. So, it is down from the 70s to 50s.


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Hello. I would suggest you continue medicines as at present his flow (which is good) and postvoid (which is less, it should be less only) are because of medicines. I think if he stops the medicines then his urinary symptoms may get worse or postvoid may also increase. There is no harm in taking medicines. Veltam plus (Tamsulosin and Dutasteride) may cause postural hypotension. If he is suffering from severe postural hypotension then he can stop Veltam plus.  So harms of stopping are: His urinary symptoms may worsen. His postvoid may increase. He may develop UTI (urinary tract infection). Regarding frequency which is every two hours, I think at 74 years it is fine. Just continue as it is. Because apart from prostate there are many age-related changes in the bladder which cause these symptoms and which are inevitable and irreversible. Until and unless very bad frequency like every half an hour then only intervene. Make some lifestyle changes like drink less water at night before bed. Avoid or reduce drinks which cause diuresis like coffee and tea. For more information consult a urologist online -->


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Hello doctor, The top of my belly button, that is, the skin of my belly button is hard and firm, and the rest of my belly button is not. I feel as if there is something under the surface. I changed my diet, so I lost some weight. I was 168 lbs, and now I am 135 lbs. If I place two fingers over my belly button and do wide circles, I feel like there is something hard underneath. Is this a hernia or where my umbilical cord was? I do not have pain or symptoms, but I just feel it firm and hard. What is this?


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Hi doctor, I am a 34 year old female who is generally in good health. Yesterday, I went to dinner, ate a lot, felt very full after and felt I had strong gas. But, I was not in pain, just felt very full. What freaked me out was this pulsating feeling on the left side of my stomach above my belly button. It continued throughout the day on and off. I woke up with a feeling of no appetite. I was bloated and burping a lot but not nauseous and there was no diarrhea. I have been on Avaine birth control for about a year now and have never missed a pill, but am concerned I could be pregnant as the burping was an earlier sign when I was. Other than the burping, I do not feel any pregnancy symptoms. Is this something that will just pass or should I be concerned?


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Hi doctor, I am having issues with my feet. I feel that they are swollen and numb, but they are not swollen and also there is no discoloration. I do not have any chest pain, lightheadedness, dizziness, shortness of breath or any unusual pain and ache anywhere else. This usually happens while sitting down or lying down on the couch. It goes away when I stretch my toes out or walk. I play basketball twice a week. I am taking vitamins B12, C, E, potassium, garlic and fish oil on a daily basis. I have looked these symptoms up, but nothing matches completely with what is on the internet. I also have noticed a hard lump or knot in the middle or bottom towards my toes, where the numbness and swollen feeling starts. I think this might be something else. Please help.


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Hi doctor, Sometimes, my father used to get chest pain. Angiography showed that he has a LAD bridging and vessels are normal and clear. His echo is normal. His BP, blood sugar and cholesterol are normal. After the chest pain, he was given the following medicines for one year. They are Stator, Ismo, Clopidogrel, Aspirin, Cardace and Metoprolol. Now, after 1 year, his cardiologist has prescribed Ecosprin AV 150/20 (Aspirin and Atorvastatin) for lifelong. But, he does not have any pain now. So, is it necessary to take this tablet? Also, his cholesterol level is normal and he is not even having any blood clot as well. I read on the internet and beta blockers are given for LAD bridging, but this doctor have not given it now. He just gave Metoprolol and stopped. Please clear my doubts.


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Hi. I have noted all details of your father. Revert back with the reports to a cardiologist online -->


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Hello doctor, I have PCOS, and I missed my last two periods. Can I take Meprate or Deviry? In case I am pregnant, I want to keep the baby. Will these medicines cause abortion?


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Hi. How are you doing? You can definitely take either of the medicines, they both are the same. They are both Medroxyprogesterone acetate, and it is the same hormone which is released from your ovaries in the second half of periods after ovulation. In PCOD (polycystic ovary disease), as you are not ovulating, this hormone will be deficient. So, taking the pill meprate will cause bleeding, only if you are not pregnant. If there is pregnancy, this same progesterone hormone is produced by the ovary to support the fetus. So, these medicines will not cause abortion, but it will support it further. These medicines are very safe whether you are pregnant or not. It can never cause abortion. Hope I have clarified your doubt, do write back. All the best. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor,I am suffering from a heavy snoring issue. With this issue, I am not able to enjoy with my friends when going on trips and even when someone visits our apartment. Is there a solution? My snoring is very severe.


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Hi. Sure, there is a solution but firstly you have to detect the cause with the help of investigations and tests. You have to be examined by an otorhinolaryngologist to detect the nature of the soft palate, uvula, nasal septum, nasal turbinates, tongue base and to exclude any nasal polyps. The second step is CT scan for your nose and sinuses. The final step is the airway examination during sleep in a sleep laboratory. For more information consult an ENT otolaryngologist online -->


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Hello doctor, I have contacts on and they bother me so much. If I take them out I want to scratch so bad, my eye burns and itches.


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Hi. If you are having trouble with your contacts, you should discontinue wearing contacts and consult an ophthalmologist for an eye exam. Discomfort with contacts may be due to allergy to contacts or lens solution or it may be due to dry eyes (due to contacts) and in such cases contacts can make abrasions, ulcer on your cornea that would need a treatment. So, get your eyes evaluated from an eye specialist to diagnose the exact cause and get it treated appropriately. You are welcome for any queries.


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Hello doctor, I would like to get help reading knee MRI. Based on physical examination: Acute medial meniscus tear. Pain, clicking sound and cannot do activities.


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Hi. Please note the images are sub-optimal for giving a professional report as we need to see the images in detail at the workstation computer (attachment removed to protect patient identity). However, my observations after viewing the images sent by you are the following: Your MRI knee is showing a mild knee joint effusion and is the likely cause of your pain an discomfort. The medial meniscus shows a suspicious area of signal abnormality in in the anterior horn root area and is not a serious concern. The rest of the meniscus is looking normal. The anterior cruciate ligament is intact, however there can changes from a mild strain of the ligament.


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Hello doctor, I am having wisdom tooth pain and I am currently traveling. Can you please suggest some good pain relief medicine and once I am back home, I shall get it treated. Please find the attached X-ray.


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Hi. Do not worry. I checked your attachment (attachment removed to protect patient identity). Pain is due to impacted wisdom tooth which has also damaged adjacent tooth leading to caries. You may require disimpaction and restoration of adjacent tooth by root canal. Right now you take the following medicines: Ofloxacin 200 mg with Ornidazole 500 mg BD for five days. Tablet Acelofenac 100 mg with Paracetamol 325 mg, Serratidopeptidase 15 mg BD for five days after taking food. Tablet Pantoprazole 40 mg OD for five days. Mouthwash Hexidine three times daily for 30 seconds by rinsing oral cavity. You are also advised to maintain good oral hygiene.


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Hello doctor, I think I might have an yeast infection, I have thick white discharge, itching, and today the discharge is a little greenish. What should I do?


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Hi, Welcome to iclinq.com.  If its appearance is like curd, then probably it is yeast and you can take a single dose of tablet Canestein 150 mg to treat it.


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Hello doctor, Three weeks ago while descending on a moving escalator I fell down but I was holding the bannister and it only caused me to sit on the steps from where I got up and walked away upon reaching down. Next day, while sitting on a high chair with a very small base and seat, I slipped off but managed not to fall by holding on to a nearby support. For the previous three years, I have preferred to hold on to the railing while climbing or going down a flight of stairs. I consulted a neurologist who suggested an inner ear disorder and seeing an ENT speciialist. She told me to perform a brain MRI and consider a nerve conduction study. Can you shortlist the possible inner ear disorders? Then, please tell me the tests in sequence which I should do to identify the specific inner ear disorder.


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Hi. I understand your concern, you are probably suffering from imbalance. It is a type of vertigo. Such problems arises when vestibule of inner ear is not working properly. Balancing of moving body is managed by vestibule of inner ear. Sometimes inner ear gets diseased by viral infection, bacterial infection, metabolic dysfunction like hydrops. Diagnostic tools are good clinical examination by ENT doctor. Investigations like electronystagmography (ENG). My suggestion is to please consult your ENT doctor, certainly he or she will do same as above I said and will reach to correct diagnosis to manage your problem.


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Hello doctor, I have a problem in my eyes. My right eye is dry and left is normal. I use Systane Ultra eye drop from the last one year and Omega 3 capsule from last three months. No result was found. No improvement was found. Please suggest me how I can get relief in my right eye? I want to overcome dryness in my eyes.


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Hello. Unfortunately, dry eye is a chronic condition and does not go away. First of all, you should use the eye drop in both eyes and not only on the one you feel the dryness in, second of all, the minimal quantity of drops that might help you during the day is four times but there are no limits, you can even use it every hour. The other option is to have punctum plugs inserted and that might reduce the quantity of drops you have to use or to use the only available medication for this condition which is called Restasis. For a more detailed advice please provide me with more information such as schirmer test results atleast.


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Hi doctor, I have a yellow thick foul smelling discharge. It has been a while but it seems to be a problem. My partner also mentioned that I have extra smell compared to his previous partners. Why is this?


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Hello. You are suffering from bacterial vaginosis which is a bacterial infection. This can be confirmed with a high vaginal swab culture and shall require a course of antibiotics for a week with avoidance of intercourse during treatment. Try using alkaline vaginal washes to clean yourself and avoid chemical soaps. Meet your gynecologist for a local examination and prescription.


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Hello doctor,I have recurring BV and I do not know why. I have stopped taking baths, I do not douche, I never use any scented products. I am in a monogamous relationship. I just realized that my fiance washes his penis with shampoo, and we have unprotected sex. Could this be why I cannot seem to get rid of it?


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Hi. BV (bacterial vaginosis) is not a sexually transmitted disease. It is just an abnormal change in your normal bacterial flora. I would recommend using tablet Metronidazole 2000 mg once or you can use Clindamycin 5 % vaginal creams once for five days. That is available over the counter. Also, avoid using unnecessary antibiotics. Get your diabetes checked if you are gaining weight. Sometimes, use of probiotics is also helpful in some people. For more information consult an internal medicine physician online -->


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Hello doctor,Is there any way that I can treat BV while being 34 weeks pregnant? I had Metronidazole gel and suppositories and they did not work. The smell is pretty uncomfortable plus I have HPV. So, I do not know if that is associated with the smell too. BTW is BV contagious?


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Hi. BV (bacterial vaginosis) is not a sexually transmitted infection. You must be having associated fungal infections causing itching. Take tablet Metronidazole 400 mg three times daily for one week. Take capsule Clotrimazole vaginal pessary at bedtime for a week. Drink plenty of water.Keep your perineal area dry. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor,My daughter has just started kindergarten three weeks ago and came home today with a rash all over her arms, hands, and feet and one by her lip. She feels fine otherwise but they itch sometimes. Our 7-year-old neighbor just got over strep and impetigo and I am wondering if this could be that. It seems to look similar to the hand, foot, and mouth. She has already missed three days of school for a cold but I do not want to send her if she is contagious.


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Hi. I have seen your query and examined your given pictures (attachment removed to protect patient identity). It seems your son has a hand, foot, and mouth disease, and does not look like impetigo. HFMD (hand, foot, and mouth disease) is a viral infection caused by the coxsackie virus. It is a self-limiting disease and takes around 5 to 7 days to subside. Symptomatic treatment can be taken like topical Lactocalamine lotion local application twice daily and Orasep (Chlorhexidine gluconate) mouth gel local application twice for five days after consulting your gp or near by dermatologist,


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Hello. I think you are talking about hydrosalpinx. It is a temporary or permanent blockage of single or both fallopian tube. It is one of the major cause of infertility. It can be managed naturally through ayurvedic medicines and some specific Panchakarma procedure, Uttar Basti of medicated oil like Yavakshara oil. It helps to resolve blockage and open the fallopian tube. There are several causes to such conditions. Some of them are pelvic inflammatory disease, gonorrhoeal infection, etc. Ultrasonography, and hysterosalpingogram. PCOD (polycystic ovary disease), and hypothyroidism. Uttar basti with medicated oil like Yavakshara oil is the safe and successful treatment of hydrosalpinx. Avoid spicy and fried junk foods. Avoid cold drinks soft drinks ice-cream etc. Do regular kapalbhati Mandukasana and Ardha matsyendrasana as well as pranayana like anuloma viloma nadi shodhan and bhramari.


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Hi doctor, I am having a slightly upset stomach with bloating for the past four months. I thought I had a bug. Two weeks later, it seemed much better. However, my bowel movements did not return to normal. I had mostly constipation for about a month (even though my stomach did not feel as upset anymore). Then after that month, things flipped and now for the last four weeks at least, I have had movements that are almost diarrhea (very soft, formed only slightly). Colour does not seem abnormal and there is not a bad smell and I do not see oil drops in the toilet bowl. Every morning I have this. I also am having increasing stomach reactions. Every time I put food into my mouth, the gurgling starts. I am not feeling this is a food intolerance as it happens instantly no matter what I eat. I also get a lot of bloating due to the gas. I will, of course, be following up with my doctor, but wanted to ask here. I have a history of breast cancer, so I easily get concerned about cancers (I realize that breast cancer does not often spread to the bowels, but I am still worried about another cancer). I am not a person with a strong history of gastrointestinal upset. I did go through about 7 to 8 weeks of something about seven years ago and never really had a true explanation. Those symptoms accompanied many other symptoms such as nerve pain, twitching, cramping. I felt as though I was having an autoimmune type reaction and am now wondering if it was tied to hormonal changes as my periods changed at the very same time as I had those symptoms (perimenopause). I am currently on Letrozole for hormone positive breast cancer targeted therapy. I had my ovaries out two years ago. So my body is definitely experiencing a massive drop in estrogen over the past two years. I am wondering if you have any thoughts on what this could be? No blood in the stool.


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Hi. Your history fits into the acid peptic disease. I do not find any sign of cancer over here (attachment removed to protect patient identity). I would recommend you the following. A combination of Pantoprazole and Domperidone once daily for a few days. A good probiotic, to take a soft and bland diet, to walk after all meals. I would also recommend you to get your thyroid profile checked.


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Hello doctor, I have acne for around five years. Now I am using Cutein tablets. I suddenly got a burning sensation in my stomach. So, now I am using Pantoprazole tablets along with Cutein. Is that effective or injurious?


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Hi. Cutein tablet contains Iron as one of the ingredients, along with some other vitamins. The iron tablets can give increased acid in the stomach and indigestion. But, if you take both Cutein and Pantoprazole tablets together, the iron will not get absorbed. Therefore, first take Cutein tablet on empty stomach in the morning, and then 30 minutes later take Pantoprazole.


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Hello doctor,I am a 24-year-old female. I was engaged in some foreplay with someone last weekend. And they fingered me hard. Last night, I noticed a tiny bump on the inside of my vagina. It is a pea-sized right against the wall. It is completely painless, and I would not have even noticed it was there had I not put one of my fingers inside myself.Is it possible that this is just a cyst from the rough foreplay? It feels a bit smaller than it did last night, but I cannot tell. It almost feels like a pimple, But it is on the inside of my vagina, and I can only feel it by pressing my finger against it. What could this be?


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Hello.  Yes, probably it is due to injury caused by fingering. And if it is not painful and not causing any discomfort, then you only have to wait until it resolves spontaneously. And the other option is that after a few days say three to four days you can get yourself examined by your local doctor to make sure that there is nothing more than that and this swelling has been resolved entirely. I hope it has helped you should you require any further queries. Please do not hesitate to contact me.


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Hello doctor,My baby was 5.5 months old. One liter water bottle fallen in my baby's head, and that place became reddish. Already she was suffering from fever too. Kindly help.


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Hello. Please apply cold water bag to the reddish area. Also, you will need to start the child on drops crocin based on the current weight of the child (is it 2.72 kg? 2.72 kg is too less for a 5.5 months old child). Dose for 2.72 kg is 0.3 ml of drops crocin (100 mg/ml). Also please document the fever with a thermometer. If it is above 100 degrees Fahrenheit, it is advisable to get the child evaluated physically by a pediatrician. Also, if you feel the child is lethargic, has a convulsion or his refusal to feed, it is best to go to the nearest hospital.


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Hello doctor,I have some signs on my hand on the summer period. No doctor gives me any idea what it is or what causes it? Or how to fix it? Kindly help.


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Hello doctor, I used to masturbate regularly, and I do not care much for hygiene (I wore the same used underwears, cleaned my penis once in a while, etc.). Now from the last two months, I am unable to retract. The foreskin seems to have become tight and not allowing me to even pull it back a little. There is a kind of white patch formed at the tip of my penis as well. That is concerning. Could you please let me know what might be the issue?


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Hello. Let me tell you one thing, you need not worry about your condition, as it is widespread to have phimosis, which is the case with you. The foreskin is tight in your case, and hence, retraction is painful. The white patch you are referring to is nothing but color due to fibrosis. This has nothing to do with masturbation. You can undergo a simple procedure called circumcision, which will get rid of the foreskin and your problem with it, once for all. It is a minor procedure. Please address the issue of hygiene better. Though there will not be any serious health issues with cleanliness, absence of hygiene can result in fungal infection, which can be avoided by addressing the hygiene properly. Let me reassure you again, and you need not worry much, go for circumcision.


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Q. Please advice whether I can continue my same dosage of thyroid tablets after the variation of TSH levels.


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Hello doctor, I am under medication for thyroid from past one year. Initially, TSH was 15.5, and I was using 50 mcg later TSH came to 13 so increased dosage to 75 mcg. After which my TSH came to 8.8, and now with same 75 mcg TSH got risen to 11.11. Please advise do I need to continue with the same dosage or increase the dosage.


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Hello.  The goal of treatment in hypothyroidism is to normalize TSH (thyroid stimulating hormone) levels. The dose of thyroxine needs to be adjusted until this happens. The dose is weight related to some extent. The approximate dose of thyroid hormone is equal to weight in kg x 1.6. But ultimately, it is the TSH that guides the dosage. Here is what you need to do, 1. Increase the dose of Thyroxine to 100 mcg once a day. 2. Take the tablet on an empty stomach. Do not consume anything except water for one hour after taking Thyroxine. (No tea, coffee, milk, iron or calcium tablets, etc.). 3. Whenever the dose of Thyroxine is adjusted, recheck TSH after six to eight weeks. 4. No diet restrictions for hypothyroidism. Contrary to popular belief, it is fine to eat cabbage, cauliflower, broccoli, soybeans, etc. I hope this helps.


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Hello doctor,I have a lump under my skin on my arm, and it is slight my raised. It is not painful, and it is 5 mm in diameter. It has got a dark center that looks like a bruise. It has not grown in size either. What could it be?


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Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area.


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Hello doctor,I have chronic gastritis. I want to do snehapana at home with pure cow ghee. Can you please guide me?


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Hello. Ideally, you should have done it under the supervision of a nearby Ayurveda physician. Because this procedure also requires a close watch and some dietary restriction. Even if you are taking some medicine without guidance, it is not advisable to do it on your own. It can also cause some issues like nausea, vomiting, etc. in some cases, and it might be hard for you to manage it at home. The amount of ghee should be taken on various factors, and it requires a complete history and clinical examination. Also, the amount of ghee needs to be increased day by day for some days. After intake of ghee symptoms need to be watched for proper digestion. If the physician does not find appropriate digestive symptoms, then he can manage accordingly. After proper digestion of ghee, a particular dietary regimen and lifestyle have to be managed. So you should do it under supervision. I hope you understand my point that rather than doing it at home, it is better to do under the supervision of a nearby Ayurveda physician.


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Hello doctor, I am 29 years old male, with height 5' 10" and weight 75 kgCurrently, I am on 1. Clonazepam 2 mg one tablet during the night. 2. Trazine-S half tablet during night. I have been suffering from a borderline personality disorder (BPD) along with symptoms of anxiety, panic disorder, extreme irritability, anger, and so on. So for that, I have been prescribed with the above medicines for the past seven months. Came to know that Benzodiazepines like Clonazepam should not be consumed for more than a month, but in my case, I have been drinking it for more than seven months. The doctor is not tapering off the dosage either. So is it safe to continue? What shall I do? Kindly help.


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Hello. If it is the requirement of Benzodiazepines than you need to take for long periods. There is nothing wrong to take medication for a long time if you are stable on it. Theoretically and ideally, Benzodiazepine should be tapered off within four weeks, but in clinical practice, we have to give it for an extended period, depending upon the patient diseases. If you have no anxiety or sleep disturbance, then you can taper off your way. You can make it half of your tablet for two weeks then take half tablet alternate day for two weeks and then you can stop it.


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Hello doctor, My husband has been having head heaviness for a month now and I do not know what is causing this. He has had a cervical scan done and other tests were done and he was told there is nothing wrong. It been two months now since this started and is a sudden onset. Prior to this, he used to work out a lot at the gym but not now as he is having numbness and tingling sensation radiation from the lower back down his right leg with severe pains in the morning. There is a moderate pain with movement. He is currently having back pain issues before this head heaviness started. He has had a CT scan done and the report is as follows:  L1-L2 normal findings.   L2-L3 disc bulge with thecal indentation and irrelevant effect.   L3-L4 disc protrusion with caudal migration causing moderate canal stenosis and compression of the L4 nerve root at the lateral recess. Calcification of the disc noted posteriorly.   L4-L5 disc bulge with thecal indentation and contact to the L5 nerve roots at the lateral recess.  Impression: Essentially L3-L4 disc protrusion migration causing moderate canal stenosis and compression of the L4 nerve root at the lateral recess. I want to know what is actually happening. Some advice and recommendation and treatment options available in this situation.  Also, how can we treat the heaviness in the head as is causing difficulty in sleeping?   Are there any medications?   Also, does the head heaviness got anything to do with this situation?


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Hello. Your husband's lumbar spine CT (computed tomography)scan is indicative of a disk herniation, which is responsible for the pain in lower back and tingling sensations radiating in the right leg. It is not related to headaches. Considering these CT findings, I would recommend having some rest, avoiding prolonged standing up or sitting position and weightlifting. Physiotherapy and painkillers (Acetaminophen and Ibuprofen) coupled with a muscle relaxant like Flexeril. If the pain persists consulting with a spine surgeon. Regarding headaches, I would like to review his cervical spine CT scan report. It could be related to a wrong posture or a tension-type headache ( related to psychological or physical stress). For more information consult a neurologist online -->


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Hi doctor, I would like to get a summary of abortion options for someone 6 weeks pregnant. Please explain the risk statistics as in what percentage the patient have risks and what type of patients they typically are. The woman in question is an otherwise healthy 21 year old.


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Hello. For someone who is 6 weeks or 42 days pregnant as per the ultrasound and the pregnancy has been localized intrauterine, there are actually two options: In medical abortion the patient is given a set of medicines namely Mifepristone and Misoprostol in a set protocol. The aim is to disallow further growth of pregnancy by stopping the cytotrophoblastic invasion into the endometrium (through Mifepristone) and then initiating uterine contractions and placental separation (through Misoprostol). The procedure for drug protocol lasts till max 2000 mcg of Misoprostol has been given in a set protocol till the pregnancy has been aborted. The success rates are 93%-96%, but the disadvantage is that it may lead to prolong bleeding for up to two weeks before all the products of conception can be actually aborted. Sometimes, the bleeding just continues for long and one may have to resort to surgical curettage to remove the remaining decidua in utero. Surgical evacuation is a day care procedure where a suction canal is introduced inside the uterus through the cervix, with patient under anesthesia or a paracervical block and the products of conception are suctioned out completely. If the procedure is ultrasound guided, then the success rates are 100 percent and major advantage is, one can leave for work after 6 hours (till the anesthesia effect passes of if general anesthesia or after 2 hours in case of post paracervical block). The remote chances of Asherman syndrome or intrauterine adhesions have been documented in 1% of women who underwent surgical evacuation where adhesions were formed inside the uterus leading to secondary infertility. But, a controlled, ultrasound guided dilation and curettage under an experienced hand is safe. I would suggest her to opt for medical abortion if the pregnancy is unplanned or accidental as this would be a natural way of aborting and moreover pregnancy being less than 7 weeks, can be easily aborted. A repeat ultrasound pelvis to check for completion of abortion shall be necessary after the procedure is undertaken. The mild bleeding and discharge may or may not continue for long, it depends from woman to woman. If this fails, then of course you have a surgical option to look at. Pregnancy should be completely avoided for the next four months of post procedure as that is the time required by uterus and pelvic organs to return back to their pre-pregnant state.


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Hello doctor, I am a 27 year old female. My weight is 195 lbs and height is 5'8". I have hypothyroidism and I am on Synthroid. I am taking Amoxicillin for a lingering cold. Yesterday, I experienced a sharp pain on my left side, under my armpit, equal with my left breast. I had this episode of pain twice yesterday. On both the occasions, the pain lasted for about 5 to 10 minutes. When I put my hand on the area it felt as though something was passing through my ribs and once it passed the pain subsided and I was fine. There was a bit of tenderness in the region of pain. I am wondering whether this is due to gas from all the holiday food and carbonated drinks. Or is this something serious that I should get looked at? I wanted to wait and see if it happened again, but was looking for a second opinion on that. Both my grandparents passed away because of heart attack and so, I am worried. I am a mother of two kids and do not want there to be an issue.


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Hi. I understand your concern as your grandparents passed of a heart attack, the fear you have is genuine. But, just pain in your chest is not an indication of a heart attack. Since you gave a history of carbonated food and tablet Amoxicillin along with thyroid medication, these both can cause an acid reflux and that can cause heartburn and lead to such non-specific pain. However, if the pain was associated with sweating and stabbing character or constricting type with radiation to the left arm, then it is always better to get an ECG done to see if it is related to your heart. Heartburn. ECG. For further information consult an internal medicine physician online.--->


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Hello doctor, I am a 19 year old female with no past medical history. I experienced constipation for some days, and I saw blood in my stools. I found this small fleshy growth on the anus, which hurts after passing motion. The pain ceases after a few hours. This fleshy growth retracts inside when I contract the surrounding muscles, but it comes out when I relax. It does not cause any pain during other times. I am attaching a picture of this fleshy growth. Please help.


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Hi. I have seen your attached picture (attachment removed to protect patient identity). It shows old hemorrhoids called as skin tags. This picture, along with the pain that you are describing is suggestive of anal fissure. This is a tear in the wall of the anus, at the base of these skin tags. Here is what you need to do: To heal the fissure, do sitz bath. Take lukewarm water in a medium sized tub, put two teaspoons of ordinary salt per liter of water. Total 10 g salt per liter of water. Now sit in this water and try to push out on the anus. Try to make the water clean and sooth your anal region. Sit for around 15 minutes, 3 to 4 times every day for a month or so. Try to do this at least twice per day if you are working professional. It will decrease pain, itching, and help to heal the fissure. Do these for around 6 to 8 weeks. For pain relief during passing stools as well as healing of the fissure, I suggest the following or equivalent generic combinations for at least three weeks, after that only sitz bath should be enough: For constipation, I suggest you try the following: Curing constipation treats these and also prevents these from troubling again. Some people need surgical treatment for bleeding hemorrhoids, but only if dietary measures are not effective in controlling the problem. I hope that helps. Kindly leave feedback. Follow-up if you need any more information. For more information consult a surgical gastroenterologist online -->


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Hi doctor, Yesterday I used earphones which fit directly into ears for a very long-time. Today I am having extreme unbearable pain in back of head and ears. I have stopped using earphones now. Is there a fast fix for this unbearable back head pain? Can I take Disprin (I never take painkillers)? I use earphones on a daily basis under the prescribed volume limits. Though I have little pain sometime but not to this extent. Please suggest any medication.


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Hi. My understanding and inference is that the pain is not related to the earphones or sound level. This is because of loud noise which usually produces classical symptoms like giddiness, ringing sound in ear, hearing loss, intolerance to loud sounds and some pain in ear. Your symptoms are not very classical to diagnose. Please answer below questions for clear diagnosis. With the details available as of now, I infer that the pain is muscular most probably. For the same, I suggest you the following measures. To understand any occurrence of sound trauma to your ears we must do a pure tone audiometry. This is the definitive investigation to understand any damage to inner ear due to sound. I feel a strong pain killer like Aspirin is not required for these complaints. However, there is no reason to worry as of now. Muscle ache. Bad posture. Rigorous exercise. Pure tone audiometry (this investigation is usually present in speech centers and otolaryngology clinics). For further information consult an ENT otolaryngologist online.--->


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Hi doctor, I am 28 years old. Eight months ago, I got married. Now, I am trying to conceive. I am getting period like cramps 12 days before period, mainly on the right side of the lower abdomen. Pain ranges from mild to severe. My hormones are normal, but AMH is 7.01 ng/mL. My TVS before and after periods is normal. Please suggest what to do.


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Hi. I do understand your concern and due respect for that. For further information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am 56 years old. I have a feeling of trembling at heart since a month. Sometimes, I feel this trembling even while sleeping and hence, the sleep gets disturbed. During daytime, I also get uneasiness and shivering for hours after an episode of heart trembling. My BP after this feeling was a little bit high at 180/85 mmHg and then it came down to 135/85 mmHg. I went to a neurologist and took CT scan and Doppler of the neck to find for any blocks. Both the scans were normal. The doctor prescribed Rancil, a beta blocker 50 mg, Aspirin, sleeping pill 0.25 mg and Vertin. I hear some sounds in ears. I also had ear pain and giddiness due to ear fluid. The doctor told that such trembling feeling may be due to ear fluid imbalance or may be due to little blocks in blood vessels, which may not be seen in the CT scan. After I took the medicine for six to seven days, there was no such feeling. For the last three days, I stopped medicine, which was prescribed for 15 days. Yesterday night, I felt the same trembling at heart and the sleep was disturbed. Then, I took only beta blocker 25 mg (half of the original prescription), Aspirin and sleep pill and I had a good sleep. I am not a diabetic and have no BP so far. The BP in the last three to four days was normal at 125/80 mmHg even though I did not take the medicines. I walk for one hour on a daily basis regularly. I am also experiencing fainting like feeling, lack of concentration, losing of a sharp and normal vision sometimes. It takes about two to three hours to recover from these symptoms. When I take a beta blocker, Aspirin and sleep pills I find myself feeling better, but the BP gets lowered to about 95/60 mmHg. For the last two decades, I had vertigo. I used to get it once in every 12 to 15 months and I had got used to it. It normally go away in 15 to 20 days. But this time, in the last one month I doubt this is vertigo though I hear some ear sounds and have a little pain in the ears. Though I drive car and two-wheeler slowly, the feeling and unsteadiness makes me very uneasy. During night, sometimes I suddenly wake up after some vibration from the stomach and the chest portion and hence, sleep will be disturbed. I experienced trembling, three times in one month during daytime and felt uneasy in the hands and legs for five hours after that. In the morning, unsteadiness starts to occur and it has happened five times in one month. I am not able to concentrate and there is a fearful sensation in the body. This problem needs to be treated. I doubt whether taking Metoprolol and Rancil will lower the blood pressure. For the past 10 days, I am taking Metoprolol 50 mg, Rancil 20 mg at night, Aspirin at night, Vertin at night, sleep pill 0.25 mg at night and Pan 40 in the morning. Earlier, I was taking Vertin. Please help me.


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Hi. I read your query and understand your concerns. For further information consult your neurologist online -->


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Hi doctor, I am a 27 year old sexually active male. I have been with the same girl for the past 10 years and we are loyal in the relationship. I am having a ton of issues and pain in my lower region. The symptoms are lower back pain, pain in my pubic region, pain and tingling in my testicles, burning with and without urination and pain within the penis. I have been to three different walk-in clinics and had three different antibiotics, including Levaquin, Bactrim and Cipro. I went to a urologist and was told to have pelvic pain syndrome. I have had similar issues in the past. I dealt with a prostate infection a few years ago and that was treated with antibiotics. But, this time nothing is working. Most urine cultures show no bacteria. My thoughts are possibly pudendal neuralgia or interstitial cystitis, as my mom has IC. Do you advise sonogram or endoscopy or medications?


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Hi. Your symptoms do point towards chronic prostatitis. With negative culture and positive pus cells, it is likely that you are suffering from CPPS IIIA, which is non-bacterial inflammatory chronic prostatitis. Now, this is a difficult condition to manage and requires long-term therapy. I would suggest that you follow up with a urologist on a long term basis. Therapy takes some time and different medications work for different patients. IC (interstitial cystitis- painful bladder) is also a possible condition, but CPPS is more common in males than IC. You do not meet all criteria for IC as per the classic definitions. So, I would keep CPPS as the first differential. I am mentioning some tests that you may want to get done to clarify the situation in a better way. Recurrent infections. Urine anti-proliferative factor, EPS Culture (expressed prostatic secretions) after prostatic massage, uroflowmetry with post-void residual urine assessment and cystoscopy. 1. CPPS IIIA. 2. BPS (bladder pain syndrome) / IC. I suggest combination of Amitriptyline, alpha blockers, NSAIDS (nonsteroidal anti-inflammatory drugs) and Gabapentin. Dietary modifications will be necessary. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Stay away from spices, coffee and anything that you feel trigger the symptoms or aggravate them. Revert back with the reports to a urologist online.--->


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Hi doctor, What are some of the home remedies for burning sensation of the Anus? What is the reason for this burning sensation? It happens whenever I eat outside food. Though I did not eat more spicy food, why it is happening.


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Hi. The following are the causes for burning sensation in the anus. Here are some home remedies for curing the burning sensation of the anus.


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Hi doctor, I am a 33 year old female who has had meningomyelocele (spina bifida) since birth. I suffer from scoliosis of the spine, paralysis of the lower limbs and valgus of the feet. My bladder and bowel control had always been exceptionally good in spite of my condition. Before 12 days, I had sexual intercourse for the first time. Since that day, I have noticed that I urinate with extreme frequency for every 30 minutes. The urge to go is also very strong and holding it for more than 5 minutes has become impossible. I even wake up in the night to visit the bathroom. 12 days have passed and the symptoms have not abated yet. Is this a common symptom? Is it related to meningomyelocele? What is the solution? Please help.


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Hello. Please relax and do not worry. I will explain you everything in detail. 1. Urine routine. 2. Urine culture and sensitivity. 3. Ultrasound of abdomen and pelvis with post-void residual urine. 4. Hemogram. 5. Serum creatinine. Consult your specialist doctor, discuss with him or her and take the treatment below. 1. Tablet Norfloxacin 400 mg in the morning and evening for five days to be started after giving a urine sample for culture. 2. Tablet Pan 40 (Pantoprazole) in the morning for five days. 3. Syrup Cital 10 mL (Disodium hydrogen citrate) in glass of water in the morning and evening for seven days. Drink at least 2 liters of water daily. Revert back with the reports to a urologist online.--->


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Hello doctor, I am a 26 year old male. My height is 190 cm and weight is 85 kg. I do exercise with weights regularly. I have noticed that I have reduced feeling in the skin on my shaft. I cannot feel normal touch, but I can feel the pain if I pinch it with my nails. To best describe it; it feels like my penis is not there when the head was covered by foreskin. I just noticed it two weeks ago. Is this due to nerve impingement? I do not have any back pain or radiating pain down the legs. There is no trouble or pain with defecation or urinating. There is no tingling or pins and needles on the shaft. Rarely, I feel some burning or numbness feeling. I do not notice any discoloration or anatomical abnormalities. Is this a sign of diabetes? But, there are no symptoms such as polydipsia, polyuria, etc. I do not remember any trauma to the penis. I do not ride bicycles at all. I have been to a urologist and done an ultrasound of the penis and testicles along with a Doppler. But, there is no finding to be worried.My libido is very low. I get erections during the night or if I really concentrate on erotic thoughts. I have not tested testosterone levels, but I suspect them to be normal. I do not really mind the reduced feeling in the shaft. But, it would be nice to get it back. I am worried by thinking that it may spread or this is a start of a more serious disease. What is your opinion? Thanks in advance.


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Hi. This is a localized numbness that we are bothered with. Disease starting from this region without any other associated symptoms is quite rare and without them we may not think of a systemic pathology right away. Have you tried nerve tonics? I suggest back strengthening exercises and Pregabalin 75 mg once a day for two weeks. Vitamin B12 levels and HbA1c should be helpful. Consult a specialist doctor, discuss with him or her and take the medicine with consent. Lack of erections may suggest a more systemic disease, but we need to have more a detailed talk before we can attribute symptoms. For further information consult a urologist online -->


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Hello doctor, I am a 19 year old male. My right eye is smaller than my left eye. For this cause I am not able to see clearly with my right eye. Please help.


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Hi. I understand your concerns. The treatment options for you include: Consult an eye care ophthalmologist online for further follow up -->


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Hello doctor, I got my penis injured while having sex with my girlfriend. Now, I have what seems to be an inflamed rib or ridges on only one side of my penis. It hurts all day while walking or lifting too. I have a hard flaccid penis since this has happened. I have been taking anti-inflammatory drugs and icing it, but cannot get them to go away. Everything aggravates around night-time erections and all erections are painful on that side. I drive all day and just by pressing the brake, it hurts the whole day. I do not have peyronie's or a curved erection. Going to a urologist just blows me off. Has anyone ever heard of this situation? Is there any anti-inflammatory injection or drug that will make me not get erections until it heal? I never had these before the injury. I am attaching the picture. Please help.


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Hello. I had a look at the photo (attachment removed to protect patient identity). For further information consult a urologist online -->


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Hi doctor, I am a married guy of 32 years old. For the past two to three years, I am facing problem to get proper erection. I have already consulted a doctor and he asked me to get some tests done such as cholesterol, sugar and BP. We found that the triglyceride value is more than 350 mg/dL. He advised me to take tablet Lipicard 160 and Nano-Leo total sachet twice a day in milk for a week. He also advised me to do regular exercise and decrease the fatty or oily food. After a week, I found some difference in erection. It was better than before, but still I am not getting a triggering effect like I was having in my younger age. I had Sildenafil citrate in the past. Currently, I am taking Duralast 30 mg. In my teenage, erection used to happen even by thought. But, now I am getting it after struggling on bed. With my partner too the duration is very short. Please help.


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Hi. 1. Hyperlipidemia. 2. Dapoxetine. Erectile dysfunction. Exercise and dietary changes. For further information consult a sexologist online.--->


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Hello doctor, Thank you for giving us the first query free. I am 26 years old male suffering from asthma for the past 14 to 15 years. So, I feel shame for myself when I use an inhaler. I am not able to go on tour especially in winter because I do not want to share my worst condition in front of my known people. I do not need any sympathy faces. Sometimes, I do not feel shortness of breath but wheezing irritates me, and I am unable to focus on work. When people leave me alone, then I take inhaler. When I take a bath in winter, I feel shortness of breath. Right now I am taking Bresol (Himalaya tablet) two times a day for past two months with lukewarm water. This winter I am drinking lukewarm water every time. But the problem is still there. When I go to sleep, I feel wheezing and the same when I wake up. A pharmacist said to use Septilin (syrup) with Bresol and take Bresol thrice a day and Septilin twice, and nobody told me how long I have to take this. I know asthma is not curable. Please give me some good advice and names of medicines (ayurvedic) for long time relief. And also advise regarding Bresol and Septilin (especially how long I have to take this).


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Hello. Regarding the continuation of medicines, you may have to use the multivitamin tablet, Septilin (Tinospora) and Bresol (Turmeric, Vasaka, and Vaividang) for a long time till your allergic condition persists. These medicines are for helping your body develop good immunity against the respiratory problems. These medicines act slightly different than inhalers. Although, I would like to tell you that inhalers are scientific. Ayurvedic medicines may not help to get respite from an acute problem. Asthma is a manifestation of hypersensitivity. It is wise to find the cause of the hypersensitivity. We call the same allergy. Rhinitis asthma is different manifestations of allergy. Allergy is present in the genes, and we may not be able to cure allergy entirely. Allergen avoidance forms the mainstay of the treatment and management of allergy. You should be carefully noting down which areas and circumstances lead to the symptoms in you. Like going to gardens, smoking, pollution, dust, particular smells and fragrances, fumes, effluents, climate, etc. You should also note when the symptoms are more and when they are less. Whether there are any seasonal or diurnal variations. Once you have a detailed diary regarding this, you will be able to make some reasonable conclusions regarding when you have to be careful. Next method of finding out the allergen is allergy testing. The two methods available are skin prick testing and blood immunoCAP method. Both methods are easy and fast, but skin prick testing is more accurate. Once we find out the allergens causing the problem for you, we can give you specific advice on how to avoid these allergens and stay safe. The treatment of Septilin and Bresol that you are taking are to help your body stay healthy, improve immunity, provide all nutrients and micronutrient for the body to deal with offending agents. But these are not the definitive cure for the problem. Hence, it is not possible to say clearly till what time you will have to take the medicines. Additionally, if you get an asthma attack during the course of these medicines, you may still need inhalers or nebulization or medicines on an SOS basis. Do share with us your prescriptions and investigations reports so that we can help you better. Hope to see you healthy soon. For more information consult an allergy specialist online -->


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Hello doctor, I have had a red/pink rash on the side of my nose for about a year and a half now. It is on the bridge of my nose. It gets better at times, but most of the time it is prominent. It also usually gets better when I am in a cool environment and worse when I am in a hot climate or in sunlight. I used to take allergy pills every day for about two years and then I noticed the rash, so I stopped pretty much completely for about a month. It seemed to get worse and again I started taking them for another 3 months probably. It had no effect on the rash and I stopped completely and I have not taken a pill for almost three months. Does this sound like a reaction to the pill or is it something else? The rash also burns and so I know when it flares up. The rest of my face seems to have gotten a little more inflamed but it might be my imagination. I am a 22 year old male. My height is 5'11" and I weigh 160 lbs. I have tried everything to get rid of it. Please help.


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Hi. After carefully reading your history I came to a conclusion that there are two possibilities of your rash. Drug reaction: Photoallergic dermatitis: I would advise you take Prednisolone 40 mg in tapering doses and sunscreen with at least 50 spf, thrice daily at 8 AM,11 AM AND 2 PM, with 2.5 finger tip unit (one finger tip unit is the amount of ointment expelled from a tube with a nozzle of 5 mm diameter, from the skin crease that is closest to the end of the finger, to the tip of the index finger) for at least face. Consult a dermatologist online for further follow up -->


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Hi doctor, I have a yeast infection in my penis for the last two years. I have tried all natural medicines like coconut oil, yogurt, etc. Also, if apply Panderm plus or FourDerm or Candid cream daily, then I feel normal. Otherwise, I am getting inflammation and swelling of the penis. Kindly suggest a good medicine for permanent cure. Thank you.


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Hi. Always evaluate the cause of recurrent yeast infection. It can be any of the following reasons. Maintain good genital hygiene. Daily wash the genital area with soap and water and keep it dry. If you are uncircumcised, then clean under the foreskin. If it recurs after stopping the treatment, then continue the treatment once in a week regimen after consulting your dermatologist. If none of these works, then go for circumcision. For further information consult an internal medicine physician online -->


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Hello doctor, My mother is having melasma on face. Can she use Kojivit gel? If yes, please suggest whether it can be used at night time or otherwise?


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Hi. I have few questions for you to suggest the most appropriate treatment. Also, please get her hormonal tests done to ensure that it is not hormonal (FSH and LH). And please do follow the below suggestions: Avoid sun exposure - Use a sunscreen (UVA and B) minimum 30 SPF. (Neutrogena is good but you may use any as per your skin or requirement. Even shalaks pharmaceutical has a good sun cream- UV AVO) If she has to go out or even indoors, she must clean her face and then apply sunscreen.


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Hello doctor, I am a 49 year old fairly healthy male. My height is 6 feet and weight is 260. I am overweight and also have low testosterone. I have had a noticeable shrinkage in my testicles in recent years. I have embarrassing erectile issues, including premature ejaculation and often I am unable to maintain an erection. I am not on any regular medication. I do not drink alcohol or smoke. I have attached my photos for your reference. My skin is discolored with red circles on my inner side of the legs up to each side of the scrotum. It frequently itches especially after much walking. The red circles are also present just above my penis, but are obscured by my pubic hair. I am also concerned about a patch of darker skin on my scrotum. There is also a pimple or a tag of skin on my inner right leg; two smaller ones on the inner left leg and one at the top of my right leg where my pubic hair stops. They all sometimes hurt, especially when my innerwear rub against them. I have had these for years. I was in the hope that they would go away on their own, but now I have noticed a few small ones begins to develop in the same area. There is also a mole or pimple like growth between the base of my scrotum and anus. This hurts or itches when I sit or walk too long. I have not sought treatment to care of these issues before because of embarrassment. What treatment or medication might help? What do you suggest?


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Hello. At the onset I would like to tell you that though I understand your concern and situation, but there is nothing to be ashamed or apprehensive of yourself. It is a medical problem and can only be tackled by proper medical treatment and advice, and not by hiding your problem from doctors. It is great that you do not smoke as it may increase your problem. According to your weight and height your BMI is 35, which falls in borderline to moderately to severely obese. I advise you to visit or ask an endocrinologist regarding the shrinking of the testicles and erectile issues as these may be related to hormonal balance or even obesity. Red circles on the inner thighs (attachment removed to protect patient identity) are indicative of fungal infection known as tinea cruris. For this, a course of antifungals is advised. I would suggest the following treatment. Consult your specialist doctor, discuss with him or her and take the medicine with consent. The outgrowths of skin are skin tags and they are usually related to hyperlipidemia. They are not harmful and only have cosmetic concerns. They are best dealt with by simple office based surgery with cautery machine requiring only local anesthesia, which is a 5 minute superficial procedure. But, they will not go on their own. You may get your fasting serum lipid profile done, which will measure the levels of cholesterol, LDL (low-density lipoprotein), VLDL (very low density lipoprotein) and HDL (high-density lipoprotein). If any of these are abnormal suitable, then medicine can be started. Medicine is important as abnormal lipid profile increases one's risk of cardiac events in the future. One important thing on which I cannot emphasize enough would be decreasing your weight. If you can gradually decrease your weight even by a few pounds, you would see a lot of these medical problems would get better by themselves. You may follow up after two to three weeks. Revert back after three weeks to a dermatologist online -->


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Hi doctor, Around three months back, I started to hear a strange noise at night. We live in a village. Apart from the odd barking dog and passing car, it is silent, especially at night. However, I started to hear what sounded like a distant engine, but it never got any closer. It is almost like a droning sound, not a hum as such as seemed to almost vibrating through me. It did not particularly stop me sleeping, but was annoying. It was there for a couple of nights and I would go outside and could not hear it. I could hear it in other rooms of the house, although maybe not as loud as the bedroom. I could find no real explanation for it. Electric cables are going to the house but have been the same for years, and nothing has changed. Then a couple of weeks later, the noise was back and was really loud when I went to bed. I fell asleep but woke in the middle of the night, and it kept me awake. The next day I could still hear it everywhere in the house, also in the next door house, but not so much outside. It is like a constant distant aircraft noise or car engine that goes in and out, louder, quieter, louder, quieter and at times I almost feel it than hear it. It left me tired with a slight headache, and it was just pulsating through my body all the time. That was the worst day. Since then we moved to another house in an entirely different area, although still a quiet village location. There is a very little passing traffic as we are at the end of a lane. At first the noise seemed to have gone; however, I have begun to notice it again. I can hear it all the time, but in the day there are other noises and distractions. It is at night when it is very quiet I can hear a constant drone. It now seems mainly in my left ear, or I can hear it especially in that ear. If I put my finger in that ear, it stops. Also if I hold my nose and blow and keep the pressure up the noise cannot be heard. If I put my finger in my right ear, I can still hear it, although maybe not as loudly. For example, it was very distant this morning. If I put my left ear on the pillow and lie on my side, I can hear it just the same. It does not keep me awake and or cause me any real problems. I am just getting concerned it could be due to something nasty, like a brain tumour or something. I went to the pharmacist and got some cleaning spray. I have also had a consultation with an ENT specialist. I did not explain to him about the droning sound as it is difficult in another language, but he gave me a checkup and did not find anything out of the ordinary by looking in my ears, nose, throat, etc. I have recently been diagnosed with hypothyroidism although I can get no connection. If it is tinnitus, then I can live with it quickly enough at the moment. But, I am concerned that it could be the symptom of any serious underlying problem. I have had recent blood tests done, and they were all fine apart from my TSH levels for hypothyroidism, and my blood pressure is fine.


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Hi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.


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Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->


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Hello doctor, I am a 25 year old female. Two years back I had noticed a very thin black straight line on my nail in the right hand finger. This line is growing along as my nail grows. Though the line was thin initially, now it has increased in its width and thickness. When I searched in the net about the straight black line on my right hand forefinger, it is showing up as something related to skin cancer or melanoma. I am worried. Should I be concerned about this? I am not very dark, nor very fair. I have wheatish skin. Please advice me. I am attaching a snap of my finger with dark line for your reference. Also, I used to have three moles on my left hand which had been there since my childhood, but to my surprise two years back they went off easily. I got another very small new mole at a different place on the same hand and that too went away when I scratched it off. Is this something normal?


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Hi. I can understand your concern. I have gone through the attached picture (attachment removed to protect patient identity). Presence of linear pigmented lines on the nails can be due to multiple causes. In white people they are considered abnormal and require thorough assessment including biopsy. In dark skinned people it is a common variant. The most common cause of these lines is racial factors. Others being drugs, trauma, lichen planus, subungual nevi and malignant melanoma. You do not have to worry too much, but do keep a watch on the pigmentation. If you notice any variation within the pigmented line or pigmentation on the adjacent nail fold or finger pulp, then consult a dermatologist in person and get yourself evaluated. Regarding moles at other sites, it is sometimes possible that they can disappear. So you do not have to worry about that. For further queries, consult a dermatologist online -->


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Hi doctor, Please find my blood investigation report attached and provide me the required steps to take further. Thank you.


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Hi doctor, After sex, my girlfriend's face, chest and legs burn and itch. What is the cause? And what can we do for it?


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Hello doctor, I had C-section three years ago. My stomach started bulging, so I visited a doctor and had sonography. So came to know that I have mild umbilical hernia 0.7. If I do proper exercise and follow ayurvedic medicine suggested by you, then is this mild hernia curable? Please help me with this. Also, can I climb stairs in mild hernia?


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Hello. I understand your concern. Since you had C-section, you are likely to develop incisional hernia which is a common issue faced post C-sections if proper care is not taken during wound healing. It is not curable with only medicines but it can be preventable from reaching further stages. If you find and center close by which practices post partum care in Ayurveda then get the following done. Apply Dhanvantara taila followed by veshta bandhana (abdominal binder). Avoid lifting weights and too much physical exertion.


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Q. Increased intraocular pressure in both the eyes. Should I go for Laser Peripheral Iridotomy surgery(LPI)?


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Dear Doctor, I have abnormal pressure in my eyes. I believe it was 24 in one and 23 in the other. My doctor told me that he would not dilate my eyes because it would be dangerous and asked me to find someone to do Laser Peripheral Iridotomy surgery(LPI). I am 23 years old with no medical conditions. Need a second opinion.


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Hello, Thanks for posting your query at icliniq.com. Hence I advise you to consult an eyecare ophthalmologist online for treatment accordingly -->


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Hi doctor, I am 19 years old. I have pain in the corner of my left eye for the past one year. I went to the doctor, and he gave me Sterdex. I used it and felt better. My pain went away. After a few months, I started to have pain, but it was not so severe as the first time. I wear glasses and lenses, and I am treating my eye allergy with Chibro Cadron 5 ml, and for dry eyes, I use Fluidabak after taking the lens. Whenever I do my yearly eye checkup, my eyesight gets worse because of the pain in the corner, and I am scared about my sight. I do not know whether I use an appropriate medicine to my eye. Whenever I consult the doctor, he gives me the same medication. Please help me.


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Hi. Minimize the use of steroids as much as possible to avoid side effects such as an increase in eye pressure leading to glaucoma. Both Sterdex (Dexamethasone) and Chibro are steroids. They may relieve your symptoms in the short run but may harm your eyes if used for long term. Pain in the corner should not affect your eyesight. Just use appropriate glasses. For lubricant, you can start with Carboxymethylcellulose containing drops, and it can be changed later if more lubrication is needed. For allergies, Olopatadine containing drops can be used. Keep in touch with your doctor.


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Hello doctor, I am a 60-year-old female, who weighs 198 lb and 5.7 height. I was diagnosed with metastatic breast cancer 20 years ago. I am suffering from chemical depression due to chemotherapy, and so, I am on antidepressants for 20 years and on Celexa for the past three years with good results. Before five years, I was diagnosed with 90 % optic nerve damage in the right eye and 75 % damage in the left eye due to open-angle glaucoma. I am under Brimonidine Tartrate and Dorzolamide twice daily and Latanoprost once daily for the past five years with good control of glaucoma and proper visual fields. The recent visual field test showed a decrease in the visual field. Laser treatment was done again for open-angle glaucoma before a week.


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Hello. I am sorry to hear about what you are going through and wish all the health in the world. Fortunately, Celexa (Citalopram) is not significantly correlated with glaucoma as a side effect, and I doubt that the progression of your disease is related to your intake of the antidepressant. Glaucoma is a chronic disease that tends to progress regardless of all actions taken by the ophthalmologist slowly. Our main approach towards glaucoma is to keep it under control because we are not able to treat it and based on your history of ophthalmic care you seem to be in good hands, but you should be very punctual on your follow-up and doctor's recommendations. You can also add artificial tears four times daily at least to that list of eye drops that you are using. Dry eye is inevitable with all the medications that you are using.


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Hi doctor, My child, who is 2 years old, fell off while playing. She got hurt above the left eye with mild scar. Please suggest some medication. Thank you.


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Hello doctor, My father has been detected with glaucoma. The problem started about two months back. There is some irritation in eyes and vision is hampered in one eye. I wanted to get an opinion on how serious. What should be done? Do we need to take urgent action? Can we cure it completely?


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Hi. The thing with glaucoma is that it is a progressive condition and we can arrest its progress to a level that it does not cause further damage. The vision loss that has already been done by the disease is not reversible. Our goal here is to lower the pressure to such a level so that it does not cause further damage. The severity of damage is assessed: For the photographs, you have sent: For more information consult an eye care ophthalmologist online -->


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Hello doctor, My mom is a glaucoma patient for the last 10 years. She has been on medications like eye drops including Azopt, Ganfort, Alphagan, Vigamox, and prior to them Cosopt (which did not suit her). She has gone through retina eye laser and also has been injected in both her eyes almost 22 times for retinal leakage as well, has also gone through cataract eye surgery 16 years ago. At the moment her eye pressure remains between 21 to 24. The doctor says implants are necessary as she can see very less now. Given her eye condition is sensitive, a doctor has suggested that it is best to operate her with Ahmed valve implant, however, it has its own risks. I wanted to know if it is better to try the latest option, called MIGS (minimally invasive glaucoma surgery) like Xen Gel Stent and InnFocus Microshunt as it has near to no complications. I want to get an opinion about this before thinking about Ahmed valve.


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Hello. I am very sorry to hear about your mother's eyes. I suspect that she must have undergone the retina laser and the injections for a condition called as diabetic retinopathy. I feel that most likely it is a complication of diabetic retinopathy that might have caused a high pressure in her eyes. Xen gel stent is currently FDA approved for refractory glaucoma not caused by diabetic neovascularization and Inn focus micro shunt is currently being tested for long term side effects and usefulness in such situations. I must be clear in letting you know that neovascular glaucoma is a very adamant disease to treat and the treatment may not be straightforward and may require multiple procedures and reviews with the treating doctor, yet the most often agreed upon surgery, across most hospitals in the world is currently Ahmed glaucoma valve, along with of course the laser and injections. In case you need further clarification or if your mother is not a diabetic, please send a scanned copy of all her doctors records and prescriptions. I will do my best in helping you understand the situation.


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Hello doctor, I am suffering from asthma since last three years. I am using Formonide 200 two puffs two times daily. I am also suffering from GERD for the past seven years. Now I only take Pantacid 40 as and when required. It is my question. Is it a perfect prescription for me?


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Hello. A Formamide inhaler is a good medicine for asthma. Is that dose right for you or not depends on your level of asthma control? If it is well controlled, it can be continued. However, if over the last three months of your symptoms were well controlled may be able to attend come down with the inhaler dose. I would suggest you be in touch with your pulmonologist for this. If your GERD (gastroesophageal reflux disease) symptoms are only occasional taking Pantacid as and when needed shall suffice.


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Hi doctor, I am 21 years old now. I am suffering from asthma for more than 17 years. It was horrible until my 15 years of age. It was pretty bad. But the severity has reduced now. It usually occurs at night time. Sometimes it happens in the daytime too. Wheezing is present, and there is chest tightness. I am taking Foracort 400 Rotacap during breathlessness. I am taking the tablet for the past four to five years.


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Hi. Having night symptoms mean that your asthma is not well controlled and upgrading the treatment is required. Foracort Inhaler 400 mg is a right combination that is used daily. I recommend you take Singulair 4 mg tablet (Montelukast) once daily in the evening. Use blue inhaler during the time of exacerbation every five minutes till 20 minutes. If there is no improvement, you should visit the nearest ER (emergency). Also, let me know if you have a PEFR (peak expiratory flow rate) chart.


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Hello. As you said correctly that asthma patients should always take care of their diets as some food ingredients may cause a severe asthma attack. Grossly we cannot avoid all food types because there is person to person variability to the food allergy. So you should strictly avoid food that is causing some difficulty in breathing or attack. To find out exactly we can do skin prick allergy test or blood allergy test so that you definitely know what food you are allergic to. After that, you must avoid those food items. Processed foods, some bakery items containing eggs, chilled drinks, food colorants, should be strictly avoided. Always check ready-made foods or processed foods for ingredients. Sometimes butter, cheese, yogurt, and milk also needs to be avoided in some cases of diagnosed allergy. Otherwise, you can enjoy fresh fruits and vegetables in your diet.


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Hi doctor, I am 20 years old. My hair is getting thin. As my father is bald,  I fear that I will also get bald. Also, I want to improve my skin texture. Please help.


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Hello doctor,I am 29 years old now. I have allergic asthma for last 6 to 7 years but in very mild form (mild suffocation and coughing for 2 to 3 days, once in three months). It used to get triggered by an old house (old book or newspaper dust) or distemper and paints or orange flavored drinks. But since last one month, frequency and magnitude both have increased. Yesterday, for no possible reason known to me, it got triggered. My query is can such allergic asthma turn into permanent asthma? I want to avoid any long-term course until extremely important. What is my option to tackle or control and reduce above symptoms, with mostly home remedies, diet control exercise and minimum synthetic medicines? Nose bleeding in childhood, frequent nasal blockage till the age of 21.


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Hi. As per your symptoms, you are suffering from bronchial asthma with allergic rhinitis, but you need to confirm this by doing a spirometry with reversibility test. Asthma is a disease related to hypersensitivity of our respiratory system to some allergens which cause triggering, inflammation in the respiratory mucosa. Undoubtedly you need to take medications else symptoms will get worse as your age advances. So visit a chest physician. I am a practicing chest specialist so I know the pros and cons of the disease. See this asthma is a genetic disease acquired during childhood, and any genetic disease means in genes and currently we in our medical field we are under research for a permanent cure like answers in this genetic diseases field, so my opinion would be visiting a pulmonologist or a chest physician for proper work up and guidance. Chest physician can do a spirometry and total serum IgE levels and as per your need will prescribe you some inhaled medications like long-acting beta 2 agonists and inhaled corticosteroids and maybe some oral steroids as per need which can help you with minimum side effects. Maybe you will need those medications for some duration like three months a year at maybe long or on changing seasons. For more information consult a pulmonologist online -->


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Hello doctor, I am 35 years old, 5 feet 11 inches tall and weight 79 kg. Vegetarian diet. Before two years, due to stomach disturbance and pain and some popup and cracker sound occurred in my knee joints. I visited the doctor and he suggested me for a laboratory test of liver function test and all reports were in normal range except sugar which was 138 at that time and gave me some medicines and referred to orthopedic for joint pain. I have visited an orthopedic specialist. He took an X-ray of both leg, knee, and told that it is an early stage of osteoarthritis of the knee and he suggested for MRI and I got my MRI done. In the MRI report, it is mentioned that left knee has been affected with osteoarthritis. After that, he gave some medicine for 10 days and referred to a physiotherapist for exercise and weight loss. I have visited as he told and now I have reduced my weight and now there is very little pain remaining in my left knee but now my other joints like the left hand thumb, finger, and both hand and knee have popup sound during movement. Kindly diagnose my problem and suggest the treatment for the same.


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Hi. I went through all the history details and reports. It shows mild osteoarthritis which is not reversible. But if you maintain your weight and exercise, it will halt. Please do quadriceps exercise for knees and for shoulder, bench press. Take a lot of fruits and vegetables. The cracking noise is normal and you need not worry. I hope I have answered your questions. Please feel free to ask me if there is any doubt in this regard.


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Hello doctor, I have pain in my left leg which moves around. First in my knee, then in the lower leg, upper leg, etc. I previously had pain in my left arm. An urgent care doctor told me it was osteoarthritis. An X-ray of my knee was done. I was prescribed an anti-inflammation medication.


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Hello. Osteoarthritis is a possibility. However, it is associated with pain and swelling of the knee joint and pain is predominantly while walking, especially going upstairs. NSAIDs (nonsteroidal anti-inflammatory drugs) may help. However, physiotherapy and weight reduction are important. It would have been better if you had uploaded a snapshot of the X-ray. For more information consult a rheumatologist online -->


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Q. Suffering from osteopenia and osteoarthritis. Taking AcuCal and FreeFlex. Is it safe to take SAM(S Adenosyl Methionine) to enhance mobility?


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Dear Doctor, My mother is 66 years old. She is having Trigeminal Neuralgia and for which she is taking Lyrica 75mg, Tegritol CR 400 and Symbal 30. And other medication details as below: For Cholesetrol -> Storfib -10mg. For BP -> seloken xl 100mg and amlodac 5mg. For Urinary Incontinence -> tropan 5mg and cranpac. Her bone mineral density revealed to scores of Osteopenia, and also Osteoarthritis. She is taking AcuCal calcium tablet and FreeFlex Forte. But her mobility is still very much restricted. So I want to know whether she can take SAM (S Adenosyl Methionine), and is it safe? Also If she can take SAM, what will be the dosage and duration. I am asking whether she can take this as a supportive to enhance her mobility. She is a pure vegetarian and on fat free diet. Her weight is 70kg, height is 5.1 feet. Please give your suggestion.


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Hi, Welcome to icliniq and thanks for the query. She can take SAM or MSM (Any one of them). SAM is a safe medication. It is a cartilage protective drug and will help her improve some of the pain in osteoarthritis. For osteoarthritis: you have to remember that these medications like free flex, collagen peptides, SAM and MSM are like to help to nourish cartilage and provide some relief. They do not actually replenish the cartilage. I normally advise to take these cartilage supplements for a period of 3 months and gap of 6 months and again restart them. Just check the medication freeflex might contain MSM. Regarding osteopenia, I advise her to continue calcium and consult local orthopaedic surgeon if he can help her with some medications that can build up calcium. If her mobility is restricted, then better to get an x-ray and check the current stage of osteoarthritis and depending on it, we can suggest further treatment. Consult an orthopaedician online -->


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Hi doctor, I am a 24 year old female. My BMI is normal. I am fairly active on my feet all day because of work and I used to walk instead of transport. I was a lot more active when I was younger. I used to dance for roughly 20 hours a week and swim five hours a week. Since I have got older and due to injury, I dance for 2 hours a week and swim when I get a chance. I was diagnosed with Osgood-Schlatters in both knees when I was 16 and had physio for a year. They used to swell drastically and I still have prominent bony lumps just below both the kneecaps. The only thing that really seemed to help is drastically cutting down exercise as they would become so painful that I could barely walk. The pain comes and goes after an active day at work such as cycling, swimming, driving a long distance or sitting for a long period of time as I am 5'10", it is regular. I have also noticed recently that I have been getting neck and lower back pain as well as regularly feeling like I have strained my right shoulder. I have tried to pass it off as just pain, but it is becoming too often to be a coincidence and cannot help thinking it is linked. I have looked online and read a bit about osteoarthritis and this seems to fit what I have been finding. But, I do not want to jump into conclusion. Do you have any idea what this could be and whether it is linked? Is there anything that I can do prevent it other than cold compression? Thanks in advance.


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Hello. 1. Osteoarthritis. 2. Overuse injury. 3. Rheumatological diseases (less likely). 1. Complete blood count (CBC). 2. Antinuclear antibody (ANA). 3. X-ray of the shoulder with Y-view and x-ray of the cervical and lumbar region. 1. Most likely degenerative joint disease (DJD). 2. Osteoarthritis of cervical and lumbar vertebrae and shoulder joint. 3. Less likely rotator cuff injury for shoulder and nerve impingement of the lumbar (lower back) area. 1. Ibuprofen 400-600 mg every 8 hours as needed for pain. Should take the tablet with food and do not take it empty stomach. 2. Muscle relaxant like Cyclobenzaprine 10 mg every 12 hours on as needed basis. You should not drive while taking it. 3. Physiotherapy would be very helpful. 1. Minimize your exercise to three times a week and strengthening exercise encouraged. 2. Use braces (knee brace and back support). Revert back with the reports to an orthopaedician and traumatologist online.--->


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Hello doctor,I am 34 years male. I have skin tags in underarms and neck. I have a skin tag in the shaft of the penis for the past four months. I consulted a doctor here in my town, and they said it is a skin tag. I want to re confirm it again. Please help.


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Hello doctor,I was suffering from minor Achilles tendinopathy and visited a physiotherapist today to get it checked. During the session, he performed some deep tissue massage on the calf (which was very tight) to relax it, which was very painful. After the massage, I experienced sharp pains while walking (which was not there beforehand), and when I brought this up with the physio, he said it was normal because it was the first time I had gotten deep tissue massage on that area.I have been icing the calf and resting, and while it has gotten a little better, it still hurts to walk. I have my exams tomorrow which I have to get to and other events on the weekend where I have to be (and will involve walking). I am worried about how I can see as I cannot walk at all. Is it normal to experience such pain after deep tissue massage to tight calf muscles, or did I sustain some injury (say a muscle strain or something similar) and need to get it checked out?


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Hello. I read your concern. Sometimes, usually, they try to break the trigger points, and it would have caused discomfort. The technique itself is pro-inflammatory techniques and will induce some more inflammation so that healing happens.  So do not worry. Now, I request you to ice your calf frequently like once in two hours for 15 minutes as of now and stretch it properly things should settle down fast. Tomorrow morning you might feel a lot of stiffness in the calf, do not worry as you have to stretch your calf gently and roll your calf over a foam roller or if have somebody ask them to massage it for few seconds. Things will be fine. You can walk without pain. I hope this is helpful to you. Kindly revert in case you need any further information in this regard.


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Hello doctor, I am 27 years old, and I have 1.6 months old baby. After my delivery, I am getting scared for everything. If something bad had happened to anyone, I am scared to talk with that people am thinking that it will happen to me also. If I love to buy any product while taking am thinking that if I take some bad will happen to me like that I am thinking.


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Hello. Please do not worry. After delivery, for any woman, it is common to have a hormonal imbalance which could cause anxiety and depression symptoms. More over, the trauma associated with the childbirth also could trigger anxiety and depression. But both of the anxiety and depression conditions are normal and they are for a short time. Your symptoms should clear within three months.


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Hello doctor, I had intercourse yesterday. In the beginning, the condom was not there, can say for one to two minutes for three to four penetration. After that condom was there and semen came after masturbating for 10 minutes. Can I get pregnant with precum?


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Hello. The chances of getting pregnant with precum are very low. It also depends on the time of your cycles. If you are not in the middle of your cycles say day 13, 14 or 15 of the monthly periods, it should be a safe time.


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Hi doctor, This is really nerve racking but I noticed these growth on my shaft (fold area) that are very small and round. They tend to itch quite often especially when touched. I can attach an picture.


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Hi. I see that the growth over the shaft of your penis has been disconcerting to you. It has a scabies look, which is caused by a small mite. For confirming the diagnosis, I need to know how long are you having this? Do you have itching over any other area in your body? Do any other people in your home have any recent itchy lesions over their body? Are you sexually active, and if so, does your partner have any genital lesions like white discharge, etc.? Please get back with the details, so that I can zero in on a diagnosis and prescribe the appropriate medicine for you.


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Hi doctor, What health implications have been observed with a unilateral paralysis of the diaphragm? I have had a plication performed, but it failed and is back to the original issue. Currently, I am suffering from shortness of breath, chest pain with dizzy spells and increased heart rate. I am on Propranolol for the heart rate issue. Please help.


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Hi. Traumatic or some cancer causing nerve compression. MRI Scan and spirometry. Unilateral diaphragmatic paralysis. For further information consult a pulmonologist online.--->


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Hello doctor, My doctor prescribed Diflucan (14 days / 200 mg) to treat urinary candidiasis. I just took day 6 of Diflucan. I am feeling a little better but still have achiness in pelvic area, bladder. My question is how much longer until I get full relief? Is this normal?


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Hi. I suppose you have urine culture proven urinary candida infection for which this tablet Diflucan was started. Usually for urinary tract infection, it is given for 1 to 2 weeks depending on patient symptoms. You can continue till two weeks till sypmtoms subside and then repeat the urine culture test for documentation of complete resolution. You should also check for your blood sugar as these infections are common in diabetic person and high sugar can lead to recurring infection. Burning sensation in urine or achiness as you described is most probably due to infection. A sonography of abdomen and pelvis is advised to rule out other causes such as stone disease as cause of infection.


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Hello doctor,I have non-alcoholic fatty liver grade 2, bilirubin 1.7, and creatinine is 1.2. How to reduce cholesterol and bring back to normal liver function?


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Hello. Your fasting glucose is high so that you might also have diabetes. Should treat it adequately, apart from diet and lifestyle changes. Cholesterol is fine, and if you follow the changes in diet and lifestyle regimen, cholesterol will get normalized too. Excessive sleeping and always feeling tired is due to alcoholic fatty liver damages. Should stop drinking alcohol and increase water intake. Stinging nettle supplement will help detox your liver. Keep following up with gastroenterologist regularly.


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Hello doctor, I am suffering from right side chest pain and right arm and also have fever and vomiting. What should I do? Is it symptoms of something big?


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Hello. You have mentioned that you have diabetes. Patients with diabetes need not always be present with typical chest pain in case of any sudden cardiac event; symptoms like right sided pain, and persistent vomiting should not be taken lightly. And also you did not mention about history of any 1) cough, 2) abdominal pain, and 3) burning urination In addition to a coronary cardiac event, your symptoms also suggest the possibility of any lung infection as it can lead to fever chest pain and even vomitings sometimes.And as people with diabetes have a predisposition to infections, patients with fever and vomitings should be evaluated for urinary infection also if other symptoms are present. You need to get 1) ECG. 2) Chest X-ray. 3) Complete blood picture. 4) Complete urine examination is done. Without any delay and also chest and abdomen needs to be examined for any infection. You can contact me any further queries.


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Hello doctor, I have recently been diagnosed with adult ADD. My psychiatrist prescribed 20 mg Adderall every morning. I took it for a few days (it worked) and then took a break of two days as I found I was not able to sleep on it. I thought I would get a good night sleep and then resume the meds to see if they were active. After the break, I have been taking them consistently every day and find they do not have any effect on me anymore. My psychiatrist now prescribed 75 mg of Wellbutrin. I also told him that I was having crashes in the evenings when I was taking Adderall. Why would the Adderall stop working so soon? What effect will the Wellbutrin have?


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Hello. It usually takes a few attempts to optimize your ADHD (attention-deficit hyperactivity disorder) medication regimen. It can be somewhat frustrating, but your experience is not uncommon. Your doctor will titrate the dose of Adderall (Dextroamphetamine, Amphetamine) according to your clinical response and tolerability. There is some evidence to show that Wellbutrin (Bupropion) is helpful in adult ADHD, especially if you also have any low mood and anxiety symptoms. So continue having regular reviews with your doctor who will monitor your response. Follow proper sleep hygiene measures and try to exercise regularly. It will have a beneficial effect.


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Hello doctor,I am a 19-year-old female with 170 Ibs, currently on 30 mg of Cymbalta. I have been diagnosed with major depressive disorder, generalized anxiety disorder, and insomnia. I have had three major depressive episodes in the past two years, and I feel like I am on the verge of another one. I had an appendectomy eight days ago and was prescribed Hydrocodone to manage the pain. I am still taking all of my regular medications, but I stopped the Hydrocodone four days ago. I feel hollow, incredibly sad, and very lonely (even though I am not alone). I am also having disturbing and very vivid dreams, which only increase the feelings of isolation and sadness. I eat healthily, exercise lightly, and manage my stress well. What can I do to fight off this impending depressive episode?


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Hello. You have undergone appendectomy recently, and it is normal to develop mood disturbance after any surgery. You are already on the major depressive disorder, and this is the reason you are feeling bad, isolated, sad, and lonely. Wait for few more days and see if spontaneous improvement occurs. If the mood gets worsened, then the dose of Cymbalta can be increased. For sleep, any good Benzodiazepine can be taken, which will help in calming you.


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Hello doctor, I am a 34-year-old male. I am experiencing pain in my right side of the stomach, about 7 inches right of my navel (in line with my navel). When I sit or lay down I do not feel pain as long as I do not move. I feel pain whenever I take deep breathe, cough, and move my torso. My stool and urine look normal and I do not have difficulty in passing stool and urine. I started feeling this pain for the past four days. I just noticed that my right stomach looks bigger than my left. It seems that it is inflamed. Please help.


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Hello. Are you diabetic? Do you feel any pain after food intake? I have seen the images that you attached with your query (attachment removed to protect patient identity). Possible causes are: 1. This is the area for gallbladder possibility of cholecystitis. 2. Right ureteric stone may present pain in this right para umbilical/ right hypochondrium area. 3. Fatty liver. 4. Colon infection (ascending colon). 5. Gall stones may also present like pain in this region. So use the tablet Cyclopam (Dicyclomine and Paracetamol) twice a day for five days, Ofloxacin and Ornidazole twice a day for five days after food, tablet Pantoprazole before breakfast for one week. Drink plenty of liquids. Avoid fatty foods. If symptoms not improved please get it done ultrasound abdomen and post me.


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Hi doctor,I have some white spot on my tongue. I researched on the internet and it looks like white oral cancer lesion. Any of your thoughts will be appreciable. I have attached the pictures for your reference. Please help.


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Hello doctor,I am suffering from diarrhea for the past 10 months and having treatment at the hospital. I want to know about the diets I should have. The doctor says no for milk, but fine to have curd or lassi. I want to confirm if I can have curd and lassi?


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Hello. Probably your diarrhea comes when consuming milk containing food, which means your intestines are intolerant to lactose, which is the sugar that is present in milk. We call such situation as lactose intolerant enteritis. Curd and lassi you can take because their lactose content has been degraded by fermentation and so you can have both.


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Hi doctor, I am having trouble in my relationship, my partner has not been contacting me for the past one month and it is affecting me a lot. I am talking to myself considering that I am talking to him, I am making up stories of why he is doing this, sometimes the story is against him and somtimes it is supporting him. I am scared of waking up in the morning thinking that I have to now go throught one more day suffoctaing and crying for the same reason. I am even scared to lock my doors because I feel totally all alone like if there is noone for me, even though I stay with my parents and dog. Please help me to get out of this situation. I seriously need your help.


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Hello. This will last for some more weeks and you will then get adjusted to new change in your life. If he is not contacting you and is totally ignoring you then in that case there is no benefit in thinking about him. If he is so stubborn that he has no contact with you for the last one month then he should get the reply in the method he deserves. You should focus on yourself, whenever you have thoughts about him you should call your friends or your family members. Try to distract your mind. You can go for shopping to distract yourself. One month has passed already so I think you have developed good strength. Try to consolidate your strength. This is the age at which you should focus on your studies and career. He should be ignored totally. If you will ignore him, you will get more strength.


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Hi doctor, I am a 67 year old male. I am overweight, mildly diabetic and have high BP. I have pain on backside of my left heel. It increases in the evening. I think I have Achilles tendinitis. Please help.


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Hello. 1. Recent blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and serum uric acid. 2. X-ray ankle - lateral view. 3. A clinical picture showing exact site of pain and inflammation, so that the pathology can be estimated. 1. Achilles tendonitis (Achilles tendinitis). 2. Plantar Fasciitis. 3. Bony spurs. Follow up with investigations to an orthopaedician and traumatologist online.--->


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Hello doctor, I am a 40 year old man. I have a foot pain which was diagnosed a few years ago as plantar fasciitis. I use shoes with special support, insoles, and cushion on the socks. I also have a pain in my right knee, especially on the inner side. I want to know if there are any exercises or stretches I can do to improve the condition. Also, can you suggest any other home treatment options for the knee and the feet? I am giving you some more details about the presenting complaint. Regarding the foot pain, I feel it early in the morning after walking or after sitting for a long period of time. And the knee pain is usually while walking. However, the condition gets worse if I walk after sitting for long periods of time as well. I have been going to the Chiropractor for a few months. The knee pain has gotten better. They have recommended hamstring stretches, quadriceps stretches, wall stretches for the calf, foot stretches and bridge exercises. For the knee pain, they have diagnosed sore muscles in the inner thigh, right above the knee and it is responding well to such treatment. Also, based on the tests they suggest my gluteal muscles are not activating fully due to prolonged sitting.


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Hello. The protocol followed by you is good. You should follow that regularly for the next one month. For the plantar fasciitis, I suggest the following: For the knee pain, I suggest the following: This will help ease your pain. Happy recovery. For more information consult a physiotherapist online -->


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Hello, I am 60 years old. I have plantar fasciitis from one year and two months. It is getting better, but I wanted a second opinion on my MRI done two months ago. Also, since the past two weeks, I have hip pain from the groin to the outer part of the hip in a semi-circle. It is painful to get in and out of a car or climb stairs. I have been doing Cross-fit gym for the past three years.


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Hello. I have gone through your reports (attachment removed to protect patient identity). Revert with reports to a fitness expert online -->


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Hi doctor, My uric acid in blood shoots up to 7.9. I do not have the problem or gout or kidney stones. How to reduce it? I have already started to drink lemon water the whole day. I have attached the photographs. I have only knee pain, which is at the backside of the knee while climbing up and down stairs for the last two years. Also, my left leg thigh muscle has localized numbness for the past five years. Numbness did not hurt, but bothers sometime. Numbness is not heavy if i use nail on it or scratch on it, I sense it well. How to cure this numbness? Is this serious?


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Hi doctor, Is it normal to be treated for epilepsy without an epilepsy diagnosis and all brain tests came back clear? I had three generalised seizures, each of which lasted around a minute in the beginning of this year and none since. CT, MRI and EEG all came back clear. I have recently been diagnosed as B12 deficient and read that this can cause seizures and believe this may have been what caused mine. My aunt also had seizures all in the same day 20 years ago, all tests came back clear. They said it must have been viral. She refused to take medication when leaving hospital as they had told her it was viral, and never had a seizure since. She was then also diagnosed as B12 deficient. My neurologist still expects me to take epilepsy tablets. I am told that epilepsy is the working diagnosis. I never had any health problems in my life until I had these seizures. I took myself off the medication over two months ago due to side effects including that they were making me forgetful, not just forgetting to do something but my mind would be totally blank which really freaked me out as it is not like me at all. My memory is always 100 %. Since coming off them I feel so much better, and my only symptoms at the minute are from B12 deficiency and I am being treated for that with injections. I am 38 years old and female.


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Hello. I read carefully your question and would explain that a normal EEG does not exclude seizures. Anyways, there are many other causes that may trigger seizures even in healthy persons like insomnia, alcohol or drugs, thyroid gland dysfunction, electrolytes imbalances, anemia, head trauma, etc. Epilepsy is a disease which leads to repeated seizures in the absence of the above triggering factors or other medical disorders. Coming to this point, as you have stopped medication and you are feeling great, I would recommend just wait and see if you will have any seizures while free of AED. If this happens, I would recommend starting another AED like Levetiracetam in low dose. In the meantime, I would recommend following a regular sleep hygiene, eating a balanced diet, avoiding caffeine, alcohol or smoking. I would also recommend avoiding driving in the next months as we can not predict if seizures will reoccur or not.


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Hello doctor, I am 31 years old 5ft 11" in height and weight 24 stone. I have been getting lower right side abdomen pain for the past few months, and it usually starts after walking or standing for a long time. Today the pain has got worse, and I also have lower back pain. I suffered from Crohn's disease and had a bowel resection seven years ago, but currently, I remission and my Crohn's consultant does not think this problem is related. I also have a problem with passing urine, as it takes me ages to go and have to strain or sometimes rock and also will sometimes stop mid flow and have to strain to continue. I am worried as the pain become worse this evening.


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Hello. Your history suggests the relationship between Crohn's disease and lower right abdominal pain. Gut resection causes this kind of symptom as the overall function is compromised. A post-surgical follow-up visit to the surgeon would be helpful to see whether urinary bladder or ureters were involved. I will suggest you make a post-surgical follow-up with the surgeon and a gastroenterologist for Crohn's disease follow-up. Consult with an orthopedic doctor for osteoarthritis and calcium, and vitamin D supplements. Bone pains in osteoarthritis occur due to condition itself and also due to calcium and vitamin D insufficiency.If any X-ray of abdomen and neck you have, please send me.


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Hello doctor, My 6 year old daughter was born with tyrosinemia type 1. She had diarrhea and bloody stools for 10 days, a month back. She was tested for many things, and everything came back normal, except her calprotectin level was 1250 while she had loose and bloody stools. She was admitted and had a cleanse and got an endoscopy done, and it showed lots of inflammation. She was put on a high dosage of steroids and Sulfasalazine for five weeks. The bleeding has stopped, and we weaned off the steroids. The biopsy results said it was IBD. Two weeks ago, she had her calprotectin level checked again, and it was in the 200. This week, we checked it again, and it was 39. I will include pictures of the biopsy results and pictures of the endoscopy. Her doctor said that the reports are not 100 % fine, and it is either UC or Crohn's. The doctor said that further down the line, we would be able to know which one she has. I would love to get a second opinion on what it could be.


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Hi. I have seen all the attached reports (attachment removed to protect patient identity). Have a nice day. Revert with more information to paediatrician online -->


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Hi doctor, I had severe abdominal pain with diarrhea a month back. The next day pain subsided, but slight discomfort was there for two weeks. Then, I went to see the doctor who prescribed Flagyl and Rifamixin. The lower abdominal discomfort did not disappear and the stool has not formed yet. Then recently, last week I had more investigations and as per investigations, the doctor says that I have Crohn's disease. Is it really Crohn's or could be something else?


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Hello. I went through your report (attachment removed to protect patient identity) and post, the thing which is favoring Crohn's disease is normal biopsy colonoscopy. You need to do ASCA (anti-saccharomyces cerevisiae antibodies) and a CT enterography. Your CRP (C-reactive protein) and calciprotein are high. So, Crohn's is a strong possibility which will be confirmed by CT enterography and antibody test. For more information consult an internal medicine physician online -->


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Hi, I am a crohn's disease patient and now my ESR level is 70 and CRP positive. I am taking pentasa 1g twice (morning and evening) and also 150mg of azoran (immunity suppressant tablet) in the morning alone. Today I visited an ayurvedic doctor to start ayurvedic treatment and he gave me medicine indukantham kashayam and septilin and both seems to boost the immunity of the body. I want to know is it good to have both medicines like pentasa/azoran with ayurvedic medicines as mentioned above.My ayurvedic doctor has said that I can continue both for some time and then review after a week and check if ESR levels have fallen. Please advise.


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Hi. Crohn's disease is an autoimmune disease, in which our own immune system tries to act against our body tissues. With this concept, allopathy physicians give drugs to suppress immunity, thus no action against our body tissue. This is the way of allopathy treatment. These immunosuppresants have their own side effects over a long period of time.  Revert back to an ayurveda specialist online after two weeks for further follow up -->


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Hello doctor, My one year old daughter had a fever for four days, with one episode of seizure on the fourth day which lasted less than a minute. There was no post ictal confusion or drowsiness. At first, the doctors started with Ceftriaxone and Amikacin for four days, then a lumbar puncture was done showing leucocytes. The report said 135 with 80 % lymphocytes and 20 % monocytes. The day before lumbar puncture, she was started on Vancomycin. The blood culture done before starting Ceftriaxone showed Staphylococcus growth with 50 thousand colonies. They said it may be contaminated. Urine culture showed enterococcus faecium, but repeat test came negative. All subsequent tests came negative. Now the child is doing well, without fever for four days. They stopped both Vancomycin and Amikacin and told to continue Ceftriaxone for two weeks. I am awaiting the CSF culture reports. My concern is whether it is alright not to give Vancomycin.


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Hello. I can understand your concerns. I hope this helps. Take care. For more information consult a child health specialist online -->


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Hi doctor, What could be causing the extreme pains in my lymph nodes under my neck and tingling the in head? Should I see a doctor in person? I had a sinus infection a month ago when the neck pains suddenly appeared. I was given antibiotics. It got rid of my other sinus symptoms, but not the lymph node pain. Recently, I was found to have an abscessed wisdom tooth and an abscessed crowned tooth. I had both pulled and was given Clindamycin for 10 days. Still, I have neck pains.I have been on a ton of antibiotics so not sure if bacteria are even responsive anymore. Should I be concerned about meningitis or that the infection has spread to lymph nodes? It has been about a month or two that neck pain has continued. Would blood work or an ultrasound be a better way to see what is going on? Is there anything I can do to treat this at home?


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Hello doctor, I had meningitis fever when I was 7 years old because of which my hearing capacity was lost. I use hearing aids and I can hear from hearing aid, but it is hard to listen. One of the doctors said that I have bones issues, and I need to consult with a rheumatologist. But it is hard for me to understand.


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Hello. The main problem with meningitis is that it is an infection which causes irreversible damage. As far as knowledge goes, there are not many cases who benefitted with the hearing. The cochlea is the hearing organ of the human body. It has three partitions filled with fluid. When hearing loss is caused by meningitis, the cochlea begins to ossify (the canals in cochlea start turning into bone). Thus the sound vibrations are not able to reach the auditory nerve. Usually, the loss is permanent. If you already wear hearing aids and now having a problem with understanding the speech, you need to see an audiologist and recheck your hearing as it might have progressed. If the loss has increased, please reprogram your hearing aids. If it has not changed, then you need to practice communication perception techniques. A speech therapist can help you with the techniques to improve communication. There are few techniques for better communication, but as you have not mentioned, I am not familiar with what method you use. I feel you should have discussed the problem in detail so that I could have helped you more with techniques. Do not hesitate to contact me.


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Hi doctor, My brother has fungal meningitis and is in a coma. Initially, he responded to the commands, but after him having a tracheostomy and a feeding tube put in him; he is not responding to our words. What do you think? Is there a possibility of recovery? Will he wake up?


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Respected doctor, My 63 year old mother was diagnosed with tuberculosis meningitis (TBM) 10 months ago when she complained of a severe headache. She has undergone CSF study and the report of the study is attached. She has been taking ATT medicines since then. The list of all the medicines she is taking is also attached. The medicines had come down to only one tablet (R-Cinex) in the last 10 months. But, now for the last two months, she started having back pain in the spine area and is now suspected to have a TB infection in the spine. She has a history of L3-L4 collapse four years ago, but that was due to osteoporosis. Her BMD score was -3.2. The spine has been severely infected from L1 to L5.  The MRI revealed an abscess with a pus collection in it (report attached). The doctor says it could be Pott's spine and may be because of a drug resistance (MDR), and they wanted to perform a USG aspiration for Xpert plus SRL, culture and sensitivity of pus. But, the test did not happen because the location of the pus was very deep in the muscle and could not be extracted. So, they extracted some tissues near by the infection area and sent for a small biopsy. The report of the histopathology (small biopsy) is also attached. It says mild nonspecific chronic inflammation. Since no strong evidence of drug resistance could be found in the small biopsy, the doctor has restarted the medicine of AKT-4 plus STM 0.75, and they want to see whether this reduces the problem or not. They said we cannot start DR/MDR treatment without any strong evidence of drug resistance. The current OPD card is also attached in which the medicine has been restarted. Now please guide us about what should be the treatment plan of the disease based on the information submitted. Can anything can be done to get a strong evidence of drug resistance since the ATT medicine is very heavy and the doctor has restarted this medicine only on the basis of his opinion? How can we assess the recovery from the disease apart from relying only on the reduction of pain? Does she require any further MRI or any test after some time?


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Hello. I went through your post which has nicely described the events. Also, I reviewed her reports (attachment removed to protect patient identity).  For more information consult an internal medicine physician online -->


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Hi doctor, My 3 year old daughter has had three nosebleeds in about 3 hours. During the nosebleeds, she said her cheek bone area close to her nose hurts. What to do?


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Hello doctor, My wife has nausea, vomting episodes that are not related to conditions, for example she can eat and feel nauseated or vomit after an hour or two or not feel anything. Then a few days later it can happen again. It comes and goes and is not stable, or triggered by certain conditions. It is totally random mostly. She gave birth to twins with a CS and was on Prontogest supplement for 7.5 months.


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Hi.  She may have repeated biliary colics or recurrent attacks of gastritis or may have urinary tract infections. So, she needs urine routine test, liver function test for further comments.


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Hello doctor, I cannot grow beards on my cheeks but moustache and beard near chin grow properly, what can be done to grow full beard? Please help.


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Hello,  Welcome to icliniq.com. This is very common not to have full grown beard. As you have mentioned you have hair on chin and moustache but not on cheeks, you can consider meeting an endocrinologist and get your hormones laboratory test done. This is just to ensure that you do not have any hormonal issues. If everything is normal, you can consider beared transplant surgery. It is safe and permanent solution to your problem.


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Hello doctor, How accurate are skin prick tests for predicting positive reactions? My family is interested in a pet and I have had negative skin prick and blood work tests for dander. Before we bring a pet in and before my kids become bonded, is it reasonable to assume negative tests will translate in no reactions. Occasionally, when I interact with animals, I have a reaction but it is difficult to determine whether it is actually the pollen which I am highly allergic to.


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Hi. Skin prick allergy testing is one of the most accurate ways of diagnosing the allergen, one is sensitive to. It is definitely more accurate than blood immunoCAP testing (blood allergy testing). Skin prick testing checks your sensitivity to the protein in question. Even if sensitive, it need not mean you are allergic. Whereby, a positive result need not always mean you will get allergy with the protein. It means that your immune system is sensitised to that allergen and that an allergy can occur in subsequent exposures to the allergen. A negative in skin prick testing will mean that you are not sensitive to that protein and that you will not end with an allergy upon its exposure. This is true. But it is specific for the particular type of allergen. What all animal danders were included in your profile and what was the response to each? Is there a photograph or record of the wheal or flare that developed after each prick? Was the test read by a clinical allergist or immunologist and were you provided a report as to that you are not allergic to any animal dander? Were you diagnosed with pollen allergy or sensitivity? Have you observed any symptoms of allergy while in gardens or bushy areas? Or in any particular season? Does any one else in your family have allergies?


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Hi doctor, I am an 18-year-old girl. It had been quite noticeable for some time that I have had excessive hair loss, especially in my hairline. I am a ballet dancer and have been putting my hair in buns ever since I was little. Two years ago, I started training a full time course which meant I needed to put my hair in a bun every day with hairspray, and a lot of times I got home too late to wash it out. Now I am taking more caution but I have lost a lot of hair and my hairline has receded a lot. Is there anything I can do to reverse or help it?


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Hello. From your description, it seems like it is traction alopecia that occurs due to excessive pressure on hair roots due to hair bun, etc. First thing is to make sure to relieve pressure from your hair roots. Use Minoxidil spray BD over the frontal area. Take biotin supplements BD for atleast three months. Follow up at one month.


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Hello doctor,I am a 44-year-old male with 5ft 4" in height and 69 kgs weight. My TSH (9.83) value is high, but T3 total (104.6) and T4 total (8.5) are normal. No medications are other than Uprise-D3 60 K capsule, which I take weekly. I have no particular symptoms but no weight loss in spite of very active sports and workouts daily and cholesterol borderline high in spite of a very balanced low-fat diet. My report says, Cholesterol 201, LDL Cholesterol 135, HDL Cholesterol 42, Non-HDL Cholesterol 159.00, and Triglycerides 118.


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Hello. I can understand your concern. I have gone through the reports you have attached. In my opinion, you should get done repeat test after a month.No need to start thyroid medicines. Do regular aerobic exercise like running, cycling, swimming, or walking. I hope I have solved your query. I will be happy to help you further.


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Hi doctor, I had a tooth extraction and a temporary bridge on my back upper teeth. The temporary bridge broke and I got another one. After this, I started to have some soreness in my left cheek and left side of my tongue. My cheek feels swollen and sore. I noticed two white bumps on the inner side of my cheek today. Is this from the dental work or something else?


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Hello doctor, I was diagnosed with candidal balanitis and wanted a second opinion. I have itchy red and pink rash. No open sores or lesions. I had this a month ago and after Diflucan for 14 days it went away but came back this weekend.


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Hello.  I understand your concern.  1. It certainly looks like candidal balanoposthitis (attachment removed to protect patient identity), though I would appreciate a photo without flash to see the lesional morphology better. 2. Besides the fact that it can spread via sexual contact and one is advised to get their partner also treated, other precipitating factors like blood sugar should be ruled out. Treatment remains the same as you are already taking it. Get other relevant investigations done to rule out any associated STDs. Take care.


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Hello doctor, I was diagnosed with balanitis about three weeks ago. I got antibiotics and was told by the doctor to keep the area clean and apply an anti-fungal cream. At first, it was super itchy and could not use anything tight. Right now I do not feel it but I can see as you see in the pictures, it is healing. It was my fault to get this so bad because at the beginning it was just red and I thought it was a simple rash because of my sensitive skin but then the rash was so bad that was burning my penis. I just want this to be over, right now. I want to be back to normal but is healing so slow that I am getting desperate. I am using Menaderm Clio, Emuaidmax, Gelmicin, and Cortisone. Not sure if this sensitive area is normal to heal slowly or maybe I am using the wrong medication. They already tested for any infection. Usually, I am very sensitive and I think because I did not pay attention to the initial redness and kept doing a lot of things without taking care developed the severe rash.


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Hi. Looking at the picture, features are consistent with candidal balanoposthitis. It is quite severe. Please stop using Menaderm, Cortisone, both are steroid cream, that makes the infection grow rather healing it. Gelmicin has steroid along with anti-fungal medicine. Any history of unprotected sexual intercourse before this rash appeared? Clean the area with lukewarm water, use a mild soap. Apply Clotrimazole 1 % gel or cream twice a day for 3 to 4 weeks. Avoid sexual contact till it heals. You need oral antifungal capsule. Do you know if you have any allergy to any medication? You need Itraconazole 200 mg, one pill twice a day for just one day. It is a single day treatment. Buy two capsules of Itraconazole 200, take one pill in the morning after breakfast and one pill at night after dinner. Please do not take Itraconazole if you are allergic to it. Since it is severe, you may need to repeat the Itraconazole capsules after one month.


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Hi doctor, I am a 40 year male. Since last one month, I have been suffering from irritation of foreskin. The skin has become tight and cannot be pulled back. There has been a whitish discharge from the penis and constant irritation. I have tried using Candid B cream but there has been no improvement. There has been a little pain around the penis head. I am not a diabetic and there are no other ailments. I have a problem of high BP and have been prescribed Eritel 40 mg. Please advise.


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Hello. You might be suffering from candidal balanoposthitis. Please send good quality photographs of the lesion taken in a natural light for confirmation of diagnosis and treatment. Regards. For more information consult a dermatologist online -->


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Hello. If a person is suffering from PTSD (posttraumatic stress disorder), depression and anxiety, they will probably need a combination of medication and psychological therapy to manage their condition. Lexapro (Escitalopram) is a good antidepressant that can be helpful in this situation. Based on more clinical information and formulation, psychological therapy can be considered. CBT (cognitive behavioral therapy) will be helpful in addressing depression and anxiety. If PTSD is the predominant primary condition, trauma-focused CBT or EMDR can be considered. Kindly discuss with your doctor locally. Also ensure, you follow the necessary self-help measures like healthy eating, adequate sleep, regular exercise, avoiding alcohol, etc. You can contact again if any further advice is needed.


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Hello doctor, I am looking forward to have advice about the outcome or prognosis of nerve regeneration and repair for my son. Before 13 days, my 10 years old son fell with a bottle in his right-hand palm and had his palm triangle open. As we were in another place, the local surgeon cleaned the injury, and I took him to another place where he undertook a surgery before 10 days of nerve repair of the proper ulnar digital nerve of the median nerve. I do not know if it is the exact term, but the nerve cut was the one at the root of the index, and that goes on the inner side (facing the 3rd). Would you please advice me about the outcome of this surgery? Is this nerve responsible for some functional disabilities of the Index? Is it only sensitive? Can he flex his index and use it usually afterward? No other tissues were cut, like tendon.


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Hello. I have read your concern. Can you give me more of the details of the surgery if you can still remember? How was it repaired as what you have told by your doctor? How is the finger at this moment (can he flex? can he feel anything at the tip of the finger?) I am hoping for your reply.


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Hi doctor, When I look towards my left, I can use either left eye or right eye. I am unable to focus both the eyes on a single point. Also, When I move my eyes towards left, my left eyeball goes little upward than the right. Please help.


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Hello doctor, I am taking Welbutrin for the first time and I have questions about the physical and mental side effects. Also, I have depression coupled with suicide and self-harming thoughts. In the past, I have been on Lexapro. I want to inquire if I am improperly diagnosed?


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Hello. You are suffering from depressive features and hence the low self-esteem and self-harming thoughts. I suggest you take Zosert (Sertraline) 50 mg twice daily along with tablet Lonazep (Clonazepam) 0.5 mg at night for a period of two weeks. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to focus on a new hobby. Give time for physical fitness.You can review with me for further followup. For more information consult a psychiatrist online -->


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Hello doctor, I have depression, feeling of failure in life, no more attraction to live life. Sad, anxious, or empty mood. Loss of interest or pleasure in activities. Thoughts of death or suicide, including suicide attempts.


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Hello. I understand what you must be feeling right now. Depression is a serious but treatment illness. I can see you have thoughts of suicide and suicide attempts are also there which indicates that your depression worsened now. But do not worry, there are various treatment options available, with which your condition can be improved. Depression is a biological illness just like diabetes. It is neither your fault nor your wish to be in the pain that you are in right now and you cannot overcome these feelings and thoughts. Every disease needs appropriate treatment. I would advise you to consult a psychiatrist online or offline as soon as possible. Remember help is there please avail it. I would require more details about your problem. Thyroid function test, serum B12. May require inpatient care, medicines, therapy.


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Hi doctor, I am 79 years old. I have depression for over ten years. I usually take 10 ml alcohol every evening. I had been taking Prozac 20 mg for many years. I suffer from insomnia. I am taking Mirtazapine 15 mg, Valium 5 mg, and Phenergan 25 mg. These give me sleep for 12 hours. Before three days, I increased the dosage of Prozac to 30 mg as I was more depressed and extremely fatigued for many months. After taking it, it worsened my insomnia. I had no improvement in fatigue. A few months back, I took Mirtazapine 30 mg. It also worsened my insomnia. Then I reverted to 15 mg. Please help me.


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Hi. Please use Prozac in the morning as it can worsen sleep when used at night. You can take Prozac 40 mg. Do not increase the dose of Mirtazapine as higher doses of Mirtazapine cause insomnia whereas low dose help in sleep. Mirtazapine 15 mg is sufficient. Do not take Phenergan and Valium at the same time. Please continue to choose only one drug, and the dose is adequate. I would also advise you get an MRI brain (magnetic resonance imaging) done. Along with the medicines, engage yourself in social activities and do exercise frequently. You can consider starting therapy for depression and alcohol dependence.


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Hello doctor, Do I have depression? I need to know because I think it will be a whole lot easier if I know and admit it myself. Last night I was crying without reason, it has been like this for five years now. I can go on not going out of my room for a week without eating and every time I worry too much, I cannot concentrate. I want to be good at studying but there are days when it is too much and I cannot seem to focus. One day I feel fine and positive and really motivated but then after a few hours I hit that feeling of uselessness again and I cannot do anything.


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Hi. Depression can be normal and can be a disease. Depression is diagnosed when a person has low or depressed mood for most of the day every day at least two weeks, lack of interest and pleasure in daily activities, other symptoms are sleep disturbances, appetite changes, poor concentration, pessimistic thoughts, feeling guilty, hopelessness, thoughts of ending life. It is multifactorial. Your history is suggestive of depression as you have mentioned that these symptoms were in the past also, try to find out what is causing your depression. Any current issues or any past life event? Tablet Escitalopram 10 mg at night, tablet Alprazolam 0.5 mg at night if sleep issues, lifestyle modification (go for walk daily, meet with your friends, share your problem with whom you trust), psychotherapy sessions.


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Hello doctor,My 5 years old girl has been having eczema since she was 3 months old. She was scratchy all the time (at least every 3 to 4 hours). Even though we have applied moisturizers such as Aveeno, it was not helping her. When doctors prescribed topical steroids, we used it and she felt better. But as soon we stopped steroids she got the eczema back. As the doctors told we believed that as age progress eczema will subside. But she has even now and in fact it is little worse than before. We stopped steroids about six months back and trying to manage without it. One thing we noticed recently is that when we did not apply any oil or moisturizer (coconut oil or moisturizer never really helped) she did not scratch in the day time. But in the night between 12 AM and 2 AM she has been scratching all the time without sleep and sleep again. We are really worried if she will carry this lifelong and we are stressed. Also, we do not want to use steroid and would like your opinion on that if there is any complication if we avoid steroid completely and just leave her in this routine in the hope of getting better (we do not want her body to get used to steroid).After reading the above points please advise on how we should handle her without much medicine, if possible?Should we avoid moisturizer and oil as she is not scratching in daytime (rough patches still exist though)?When will she get better or at least have less and manageable eczema? Will it be at least at her teenage?


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Hello. You have put your query with nice description but I think you have uploaded wrong images. So, if possible share correct images. From your description, it seems atopic eczema. It is endogenous eczema which may have several aggravating factors. Predisposition may come from the hereditary mechanism. Other first or second degree relatives may have features of some kind of allergy or atopy. Seasonal changes may also affect disease course. Some food like groundnut, cow milk, an egg may cause the problem. It starts with dry skin. Then some tiny lesions, sometimes oozing, scaling, crusting. They may coalesce to form large plaques. So we have to put first check on dry skin by use of plenty of moisturizers. It is best to use just after taking bath, tap the water with towel softly then apply moisturizer within 3 to 5 minutes of the bath. And have to apply 3 to 4 times a day as per requirement of skin to combat dryness. The dry or cracked skin may produce stinging sensation: burning sensation initially but it will go on its own. Or you can try a different moisturizer, even a good vaseline or coconut is also perfect. Topical steroids are useful during exacerbation of disease. It comes in different potency, and I hope your doctor had prescribed low-mid potency one. Like Hydrocortisone, Desonide, Flucinolone or Fluticasone. Among these, Desonide is best according to efficacy and safety. There is nothing like being habitual. You can stop anytime. But try to stop in tapering way like initially daily, then alternate day then weekends then stop. Your baby is 5 years old so you have one more option to replace steroids. Topical Tacrolimus 0.03 % ointment. Once lesions are clear by use of steroid then you can shift to Tacrolimus. Or on the face, it is alone sufficient. No need to use steroids on the face. How to manage with minimum medicine: Can moisturiser be avoided? No. Apply with a soft hand, do not massage vigorously. When will she get better? Usually, 80 % child become better by age of 12 to 13 years. But it depends on several factors like family history, exposure to aggravating factors, management of exacerbations. You have to pamper skin of your baby, care during cleaning, tapping, applying moisturizer all needed. There are several another way to treat exacerbation so you should not be worried. For more information consult a dermatologist online -->


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Hi doctor, I am a 23 year old female who has developed dry fingertips. The skin flakes off to leave smooth raw skin that has pins and needles when touched. It started with the index finger of my left hand. I asked a pharmacist for an opinion, and he thought it was nerve damage and recommended steroid cream. Over the last six months, it has spread to fingers of both hands. During this period, I also developed an itchy rash on the inside of my elbows. When I went to the doctor, she said it as eczema and prescribed me Dermol, Doublebase cream, and steroid cream. My fingers have not improved over the past month, but my arms have. Could you please give me your opinion on the supposed eczema on my fingertips? I am not convinced on what it is. Thank you.


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Hi. Continue the same treatment. 1. Avoid excessive wet work and direct contact wit soaps and detergents. 2. Avoid direct hair dye application. 3. Reduce gardening activities if any. For further information consult a dermatologist online.--->


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Hello doctor, Eczema or fungus on right thumb and index, it looks like it is expanding and it leaves apparently dead skin behind which peels off. I have pictures for a better understanding. It itches none to moderately, it hurts slightly when applied pressure on. I am a driver.


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Hi. From your pictures (attachment removed to protect patient identity), it is more in favor of eczema but infected one. Do you use gloves while holding steering? It is not a fungal infection clinically. You have to apply combination ointment containing Betamethasone and Neomycin. The most important thing for eczema is to maintain moisture and hydration of the skin. For that you have to use Vaseline (petroleum jelly) 4 to 5 times a day. Take non-sedating antihistamine. You will get better. Eczema. Apply a combination of Betamethasone plus Neomycin ointment, Vaseline 4 to 5 times a day, take non-sedating antihistamine tablet. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants, use cotton gloves.


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Hello doctor, Small skin warts are spreading on my face and neck drastically. Can you please suggest the cure for this kind of a virus infection? It started one and a half months back. But, I only recently realized that it is multiplying.


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Hello doctor,I had receptive oral sex (received fellation) with an escort girl three weeks ago. Since then, I have got urethritis three days after. I have been treated with Levofloxacin for 10 days. The urethritis got cured, but I kept getting some strange burning sensations in my scrotum and the top of my buttock, but no lesions or bumps were visible. Only redness.The symptoms then disappeared then for four days, I got ticklings on my back, arms, chests, but again nothing visible on my skin. Since two days I have got paresthesia on my left foot, left arm and left hand that does not seems to stop (sometimes I feel it more or less) and sometimes some cramps in my leg or arm. I got a 4th generation HIV test at three weeks, which was negative. Do you think I have a chance to have HIV? Do I need to retest at four weeks or six weeks? If you do not think I have a chance of getting HIV, what options should I look for?


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Hello. Oral sex is least related to HIV. Symptoms are very bizarre and mostly by oral sex HSV, and STI is common. The tickling sensation is different as such, may be seen in vitamin B 12 deficiency, and anxiety. Symptoms come but goes in a particular time. You can still go for the HSV test. And STD panel test. No signs you had related to both. Till then you can take, Tablet Mecobalamin (Methylcobalamin) 1500 mg one at night for one month. If you feel better, you can continue for another a month if at all required. Tablet Escitalopram 10 mg (esitelop10) one at night for ten to fifteen days if at all needed. It is not at all HIV. I hope you have understood.


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Hi doctor, I am 25 years old and my penis size is 2.2 inch in flaccid state and 5 inch in erect state. I would like to know that, is it a good size because I have read somewhere that 6 inch is normal size. My penis size is smaller than the standard size. What to do now? Do girls think about penis size? I also have a small testicle and read that a small testicle cannot produce enough sperm, is it right? I am noticing one thing in the morning. When I get up, my penis is in erect state. Is there any problem about that? Please give me some advice because I am planning for marriage soon. Kindly clear my doubts. Thank you.


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Hello. Thanks for choosing this platform. 2 to 5 inch of the penis size is normal. The average size of penis is 3-5 inch while erect and 1-3 inch while flaccid. Having said this I like to inform you that penis size does not make things different during sex as only one third of the female vagina is sensitive. So, even 3 inch of penis in erect state provides equal pleasure to both partners. In regard to penis size your fear of small penis is baseless and you can get this idea out of your mind now. Girl may or may not think about the size as it is their domain, but as I said it dose not matter on bed. What you read in pornographic magazines is distorted presentation and does not hold any truth. I do not understand what do you mean by small testicle and low sperm count. It is the number of seminiferous tubules in the testis that matters. Other than that if you are having doubt you can get report of semen analysis which will reveal true sperm count in your semen. Having morning time erection is completely normal and there is nothing to worry about that. If you do not get morning erection that may be a sign of problem. For further information consult a sexologist online -->


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Hi doctor, My son is 2.6 years old. His weight is 12 kg. He is a healthy and active child. But, he is getting coughs and cold at least once in a month for the past three months. Currently, he has a fever for the past two days (101 degree) and cold from today morning. I am giving him Cetirizine and Ambroxol for cough and cold, Meftal for high fever of above 102 degree Fahrenheit and Crocin for normal fever. Other than these, I am giving him Zincovit. I guess that the cold, which he has gotten subsided once he take antibiotic and cough syrup. Whenever he coughs too much, he will then vomit the phlegm out. Other than this, the phlegm is not coming out either in the nose or through the stools. Please get me some solution to make the cold come out. Thank you.


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Hello. Viral fever. Complete blood count, CRP (C-reactive protein), parasite F and V test, CUE (complete urine examination) and chest x-ray. Viral pyrexia. I suggest the following medicines. Consult your specialist doctor, discuss with him or her and take the medicine with consent. 1. Syrup Cetirizine 5 mL, once daily at night. 2. Continue Crocin (Acetaminophen) and Meftal (Mefenamic acid). 3. Nebulization with 3% Nacl (Sodium chloride), twice daily for three days. 4. Syrup Ascoril LS (combination of Ambroxol and Salbutamol) 4 mL, three times a day for three days. Revert back after three days to a paediatrician online.--->


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Hello doctor, I am 26 years old and my weight is 70 Kg. I got married 6 months back and I am having PCOD. I had sinusitis few years back and I got treated for the same. For about a year, I have been facing frequent cold issues and sneezing issues. Every day I sneeze at least 10 to 15 times. I have done a few tests showing less vitamin D and serum iron and also with absolute eosinophilia. I am facing heavy hair loss and my TSH is normal. Please advice.


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Hi. I reviewed your reports (attachment removed to protect patient identity). I advise you following: Revert back after 2 weeks to a general medicine physician online -->


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Hi doctor, I am 17 years old and getting white hairs. They are white near the scalp and black in the tip. What to do?


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Hello. As you are only 17 years old, the primary cause behind it might be genetic as your parents or grand parents may have white hairs at an early stage. The other possible causes might include poor nutrition, improper lifestyle, stress, etc. White hairs mean lack of melanin, the coloring pigment in hairs. Once the hair that grows white, there are fewer chances to revert them back to normal black color. But, you can stop further graying of hairs. First of all add foods like figs, curry leaves, raisins, fresh fruits, and vegetables in your diet. Avoid excessive caffeinated drinks, spicy and junk food. Quit smoking and drinking if you do. Sleep adequately at least for 6 to 8 hours a day. Try to go to bed before midnight. Avoid taking too much stress. As far as medicine is concerned, I suggest tablet Asthiposhak two tablets twice a day with water for six weeks. Apply Bhringraj oil on your hairs two to three times a week one night before washing hairs. Wash your hairs with a mild herbal shampoo. Have one glass of lukewarm milk and add a pinch of black pepper and turmeric in it and take it before sleeping. Try all these things, and you will soon feel positive results. 1. Genetics. 2. Poor nutrition. 3. Stress. Revert after a month to an ayurveda specialist online.--->


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Hi doctor, Whenever I eat spicy food, I feel some kind of irritation, burning sensation and pain in my gums. I do not have any cavity in my teeth. I got scaling done 2 years back. Once I stop eating spicy food, the pain fades away in few minutes. I would like to know the reason behind it. Please advice me the preventive measures as well.


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Hi. Hurting of gums while taking spicy food might be due to the following causes: 1. Gingivitis (swelling and inflammation of the gums) - Swollen gums may be painful and may cause burning sensation and pain while taking hot and spicy food. Gingivitis occurs due to either plaque or other debris accumulating around the teeth and gums. Also hormonal changes occurring during menstrual cycle can cause swollen and painful gums. Any medicines taken for medical issues like hypertension, epilepsy, etc., also cause gum changes and swelling. 2. Any ulcers in the mouth will get hurt while taking hot and spicy food. Ulcers might occur due to faulty tooth brushing techniques, usage of toothbrushes with hard bristles, stress, sharp tooth hurting the tissues, any dental appliances or ill-fitting dentures. 3. Any abscess related to infected tooth might also hurt while taking spicy food. But, you have mentioned that you do not have any cavities or teeth issues. Have you been examined by a dentist regarding this? 4. Any impacted tooth (teeth that remain unerupted due to inadequate space inside the mouth or remain inside the bone itself) may develop swelling of gums around it. When the opposing teeth impinges on this swollen tissue while taking spicy food it gets hurt. 5. Hypersensitivity reactions may occur to certain foods. This might cause swelling, reddening and burning sensation of the mouth. This may occur due to some food additives. 6. Habits like smoking and usage of tobacco products may also cause burning sensation while consuming spicy and hot food. 7. Dental procedures like scaling (cleaning of teeth) might cause minor tissue injuries. These hurt and cause burning sensation while taking hot and spicy food. But, this heals in 4-5 days after cleaning. In your case, this might not be the reason, as you have undergone scaling before 2-3 years. 1. Get dental scaling done, if you have any plaque or calculus deposits causing swollen gums. 2. Get your oral cavity examined by your dentist, for any ulcers, abscesses, infected teeth and impacted teeth. 3. Also get checked for any sharp teeth and any dental appliances or ill-fitting dentures. If found, sharp teeth have to be trimmed and reduced, and ill-fitting dentures and dental appliances have to be corrected immediately. 1. Kindly make a note if you develop any gum swelling, redness or bleeding gums during your periods. 2. Use toothbrushes with soft bristles for brushing your teeth. Also follow the proper brushing technique for brushing your teeth. 3. Make a note whenever your gum hurts and what foods hurt your gums. Check if any food causes the same issue repeatedly. In case, if that food contains some additive that causes hypersensitive reaction, then you may have to avoid that particular food in future. 4.Quit habits like smoking or usage of other tobacco products (in case you do). For further information consult a dentist online.--->


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Hi doctor,My blood group is B positive. I am going to marry a person with B negative blood group. Is there any problem?


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Hi. I can understand your concern. From history, I hope you are telling that you (male) is B positive and your fiance (female) is B negative. It will not cause a problem in first pregnancy but in second pregnancy severe hemolytic disease of the newborn can occur. So, we have to prevent this sensitization when she will be pregnant. So, just keep this in mind and in first pregnancy of your wife (she is having a negative group as per history), she should be given Rh(D) immunoglobulin injections in the antenatal period at 28 week of gestation. In addition, before marriage, you both should be investigated for thalassemia minor status. For further information consult a hematologist online -->


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Hi doctor, I am a 34 year old female, and I had my right ovary and tube removed during C-section, due to a 4.5 cm dermoid cyst. The cyst was found during an ultrasound scan, five years back. The surgeon said a cystectomy was no possible because the cyst had completely replaced the ovary. Could you please confirm if the attached histopathology report says anything about the ovarian tissue? I had no symptoms, no pain, no torsion, and the right ovary was functioning in spite of the cyst. I became pregnant twice due to ovulation from the right ovary. What is the medical condition due to which the entire ovary is replaced by a dermoid cyst? Thank you.


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Hi. I have gone through your attached reports (attachment removed to protect patient identity). Take care. Hope your concern is solved. For more information consult a pathologist online -->


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Hi. I am afraid the answer is not so simple. However you can avoid sex in the unsafe period. The unsafe period is the period roughly between 10th to 20th day in a woman having a 30 days menstrual cycle. This period roughly corresponds to the most fertile period in a woman's menstrual cycle. You can also try the withdrawal method where you need to withdraw just before ejaculation, but it needs lots of mental strength on your part. Your partner can also use certain female condom or spermicides also. Use emergency contraceptive methods to prevent pregnancy after having an unprotected sex. But please keep in mind that, all these are never 100% to prevent a pregnancy. Revert back to an obstetrician and gynaecologist online -->


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Hello doctor, I have bad faeces smell coming from my nose when I breathe. What could be all possible causes? Nobody around me feels that smell and that is how I got to know that it is from my nose itself. Please advice.


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Hello. Bad smell during breathing could be due to various reasons. Let us see those one by one. Malignancy: an intranasal (inside the nose) or intraoral (inside the mouth) malignancy can produce foul smell, that can be perceived as faeces smell by the nose. Malignancy can be painless and without any symptoms. Malignancies of paranasal air sinuses also produce foul odor. Dental infection: a tooth decay can produce bad smell. Dental infection usually produces significant pain. Food particles get collected inside the decayed tooth and hence cause the bad smell. Sinusitis: Chronic sinusitis can cause constant post nasal drip and purulent discharge (pus discharge). This results in foul odor. Maxillary sinusitis commonly produces foul odor. Sinusitis will have other symptoms like headache, facial pain, nasal blockage, post nasal drip, etc. Foreign body inside nose: A foreign body which has got stuck inside nose without being removed for many days will produce purulent discharge and smell. The discharge will be from one side of the nose. It is common among kids. Foreign body produces nasal block. Atrophic rhinitis: It is a disease where the normal space inside the nose gets increased due to destruction of the anatomy. Also the condition causes merciless anosmia (loss of sensation of smell). The sufferer cannot perceive any smell but the people around him can get the extreme foul odor emanating from the patients nose. Atrophic rhinitis also presents with crusting inside nose and nose block. Maggots in nose: Maggots are larval stage of fly (chrysomia). Maggots usually occur in association with atrophic rhinitis. Fly lays its eggs inside nose leading to maggots inside nose. They are attracted to the foul odor and they themselves aggravate the odor. Tonsillitis: Pus accumulated over the tonsil can cause bad smell. Tonsillar enlargement with infection and consequent foul breath is common in many children. Other symptoms of tonsillitis include fever, throat pain, enlarged lymph nodes of neck, difficulty and pain while swallowing. Nasal diphtheria can produce foul odor. Diphtheria produces a membrane over the affected mucosa. Rhinitis caseosa: it is a destructive disease producing foul odor. It was thought to be a fungal disease, exact etiology is still not clear. Tuberculosis: TB of nasal mucosa produces granulomatous inflammation and caseating necrosis, consequent death of tissues and foul smell. Hope I have cleared your query. Further evaluation and clinical examination is required. For further follow up, consult an ENT otolaryngologist online.--->


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Hello doctor, Recently I have been experiencing a slight burning sensation on the tip of my penis. When I pee, it stings a bit. The stinging sensation is subtle, but there is always a slight urge to pee. It feels like something is streaming down, but I can only feel it when it reaches close to the head of my penis. I am uncircumcised and I notice a white substance that seems to be, what I feel is, dripping down. I have not had sex in a while and if I did, it was always protected. I thought it might be due to lack of hydration. So, I have started to drink more water. I was told that cranberry juice works, which I started drinking today. My pee stream is slightly weaker, but the color is normal. Any advice? I thought it might be an infection but I do not want to jump to conclusions yet.


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Hello doctor, How many times can I masturbate a day? I am a 14 year old boy going through puberty and hence such doubts.


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Hello. It is one of its kind and the most interesting question that I have come across. It is good to see that how an adolescent can be so inquisitive about his sexual development. For any other sexual health related queries, feel free to consult a sexologist online -->


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Hello doctor, I had a seizure for the first time in my life when I was about 19 years old. The emergency room physician did not do any tests before he put me on Keppra. After I had been put on Keppra, I went to a neurologist who did an MRI and a sleep study. Nothing showed up on either test, but he wants to keep me on the medication. The issue that I have is I think the medication is causing more problems than helping. Why would he keep me on the medication when I was not diagnosed with anything? But I was told that even if I do not need the medication and I still stopped it cold turkey, it could cause seizures. Is it true?


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Hi. I read your query and understand your concern. I hope this answers you. If you have more questions feel free to write back to me. For more information consult a neurologist online -->


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Hello doctor, I have enlarged circumvallate papillae from the last 45 days. How do I get rid of it? What medicines are suggested?


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Hello. Normally, circumvallate papillae are enlarged structures at the base of the tongue. So it is normal to have enlarged papillae and it does not need any treatment especially if you do not have any symptoms like pain, swallowing difficulty, etc. Also, there is unlikely to be any abnormalities in them as it is unchanged since last 45 days. You upload the picture of those papillae so that I can confirm. However, with a sore throat, it may appear bulky and slightly enlarged but it settles down after it is treated, and you already took Amoxicillin for that. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->


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Hello doctor,Why do I have this bad smell coming from my nose? It is embarrassing. People around me smell it all the time. I do not have my mouth open and people smell it soon as I walk in the room. What is it?


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Hi. The first thing that comes to my mind is a disease called atrophic rhinitis. Here, the mucous membrane and structures inside the nose shrink and the nasal cavity is filled with crusts, which get infected and smell. In this condition, the patient has decreased sense of smell, but others can feel bad smell coming out from the patient's nose. A diagnostic nasal endoscopy is sufficient to diagnose the condition. It can specify whether it is atrophic rhinitis or something else. If it is at all atrophic rhinitis, the treatment is frequent saline nasal washes and mechanical removal of the crusts by an ENT specialist. Rarely surgery is needed. For more information consult an ENT otolaryngologist online -->


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Hello doctor, I had two menstrual cycles in one month, two weeks apart. I have not had an intercourse for two months. Should I be concerned?


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Hello doctor, I have a BB sized lump where my preauricular lymph node is, right outside my right ear. My dermatologist, who is treating me for melanoma in situ, is sending me to an ENT this week to check it out, but said melanoma in situ cannot spread. I have no other symptoms. It is not tender and he described it as rubbery and movable. I discovered it a few weeks ago incidentally because my jaw hurt a little one day, so who knows how long it has been there. It has not changed in the two to three weeks I have known about it. What are the possible things it could be (your differential)? Should I have it biopsied, and does it sound like cancer?


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Hello. For swelling in the pre-auricular area, my differentials are: Since it is rubbery and movable, I feel it is more like a node only. Nevertheless, we need to investigate it. A fine needle aspiration cytological (FNAC) study will be required, but since the area is close to the branching of the facial nerve, we need to very careful with this investigation. An ultrasonogram of the swelling will be very useful for this. It demonstrates the likely contents of the swelling and indicates a diagnosis.The likelihood of cancer is there but not more than other possible differentials. Parotid tumors can occur in young individuals like you. They are not uncommon. Please revert back with details and we shall help you. Revert with more information to an ENT otolaryngologist online -->


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Hi doctor, I got married before seven years and living happily with my wife. A week ago, I had a very enthusiastic sex session in the shower. During which I slipped out and missed going back in and had a substantial impact. At that time I believe I had a frenulum tear and the skin was split. After initial redness and swelling, now it has a small scab. How long will it take to heal? And is going to a doctor worth my time?


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Hi. It is quite common to get a frenulum tear while having coitus. It will heal within four to five days and pain will subside in a day or two. However, if you still continue to have pain, you can seek an opinion. Avoid coitus for few days for a quick recovery. For further information consult a sexologist online -->


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Hello doctor, Just as of today my nipples have got swollen and my boobs are tender to touch. It started less than an hour ago. I had headache all day. As far as I am aware, I am not sure what is going on? I never had this issue before. Please help.


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Hello. A swollen nipple as well as tender breasts can occur if you are just before your cycle. If so, it is quite normal. It is due to the temporary hormonal fluctuation inside you. Otherwise, taking hormonal contraceptive pills could be a reason. Hard sex with rough handling of your breasts is another issue. Just apply some hot compress over your breasts and put them in tight undergarments all the time. If the pain is more, you can avail Paracetamol 500 mg tablets as and when necessary basis. For further doubts consult an obstetrician and gynaecologist online -->


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Hi doctor, My sister is 20 years old. She does not feel bladder emptying and she was diagnosed to have a weak bladder. She has frequent urination problem and undergoing allopathy treatment for the past one year. Still, there is no significant improvement. Is there any treatment for frequent urination in ayurveda?


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Hi doctor, I am a 21 year old virgin. My foreskin is tight which has not gone down. I had sexual intercourse with my girlfriend yesterday, were my foreskin came far down the penis head that was really paining and hurting me. Now, my foreskin is still back and not going up. My exposed penis is very much sensitive, like even my pants touch them also it is very much incredible for me to bear. The foreskin which has come beyond the penis head is not going back and I do have some scar wounds reddish on my foreskin. The other problem is, if I get erection it is paining for me, I do not really feel comfortable like before. I am also getting some smell around my penis, can it be smegma? What should I do? Is this a serious issue? Why is my foreskin not getting above my penis head and covering my penis like before? Is this normal? Should I go consult a doctor? I am so much confused. Please help.


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Hello doctor, I am a 25 year old male. I am 181 cm tall and I weigh 70 kg. All the members in my family are tall, but I am not that big when compared to my father and brother. I am mentally depressed since my childhood. It is all about my body. I was a female looking boy with very soft body, less energy and not interested in sports. Since that time my arms and legs are very long. But arms are very lean as girls. My puberty was too late at around 18 years of age. But after puberty, I have hair on face, but till now it is not much as my brother had in that age. Facial hair is also thin and not uniform everywhere. I feel my bones are like females and not very strong, arms and fingers are not as big as males. My muscles are less too. I went for gym and built up a little muscle, but forearm and fingers are still feminine. I feel my waist is a little wide. Did I have any genetic problem or hormonal imbalance at puberty stage? I am totally exhausted. I am always worried about that. Please help me.


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Hi. I totally understand your anxiety. Based on the description which you have given, there could be a possibility of Klinefelter syndrome. This condition can be seen in about one in 600 boys. A normal male will have a chromosomal pattern of XY. However, in case of Klinefelter syndrome, there would be an extra X chromosome which would have happened randomly during the formation of the egg or sperm, or after the baby boy had conceived.  The extra chromosome is not inherited. So, this condition does not run in families. The adult male body may not be able to produce enough testosterone, the hormone responsible for the development of male characteristics. There may be low energy and sex drive, lack of muscle and too much body fat around the waist. Most men with this condition lead normal lives and also have normal relationships. A few boys with condition may feel shy and may have low levels of self confidence. They may grow quickly than usual and may become taller than other family members. The testicles may be smaller than normal and may not produce enough of the sex hormone testosterone. This may lead to features such as: This condition can be diagnosed by: It is advisable to get treat early in order to avoid further fertility issues. Treatment options available are: A definitive diagnosis can be made only after a complete physical examination and after performing laboratory tests. Visiting an endocrinologist at the earliest would be advisable. Consult an endocrinologist online for further follow up -->


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Hi doctor, I am a 33 year old male. My height is 5'10" and I weigh 81 kg. I am suffering from anxiety and somatization (as described by my medical report) more than a year. I was under allopathy medical treatment without any remarkable benefit with many doctors as general physician and cardiologist. I was also suffering from some side effects of these medicines. One day suddenly I came to know about the Arjunarishta, then I left all allopathy medicines and started this ayurveda medicine and felt relax within a week. I have been taking Arjunarishta since two months approximately but I still have some problems on and off as 1-3 times in a day. They are congestive pain in chest and neck, irregular heartbeat, hard and pounding heartbeat, pain in left arm, pain in jaw, hot and cold flashes, rarely feeling suffocation or dizziness or vertigo (not together) for 2-5 seconds, feeling relax at morning or when I sleep if feeling any problem. I am feeling one or two symptoms together; I have many normal ECG and blood test when I was under allopathy medical treatment. Am I suffering these current problems because of Arjunarishta? Even I do not want to leave Arjunarishta. Even my parents have also started Arjunarishta. My mother who is 55 years has left anterior fascicular block as in ECG. Is it fine to continue Arjunarishta for whole life?


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Hi. Arjuna tree bark has many benefits in the cardiac patients. I suggest you to continue arjuna bark medicines. In your case, the Arjunarishta contains minimal alcohol. So, continuous consumption may cause some gastritis. If the symptoms appear within 2 hours of the consumption of Arjunarishta, then it might be due to the medicine. If the symptoms appear after 3 hours of consumption of Arjunarishta, then it means; it is due the disease itself. Only first 3 hours, the Arjunarishta will control the disease. So, you can consume the arjuna tree bark in different method, such as tablets or powder. This will avoid the bad effect of alcohol in Arjunarishta. For further information consult an ayurveda specialist online -->


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Hello doctor, I am an 18 year old female. For the past two years, I have had this waxy buildup only on the roots of my hair. It feels sticky, oily and stiff. None of the shampoo I have tried has fixed it. The problem goes away a couple of days after I dye my roots. I am wondering if there may be a problem with my scalp. Please help.


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Hi. I have seen your query and concern. Oily skin and excess sebum secretion. 1. Seborrheic capitis. 2. Tinea capitis. Seborrheic capitis. I would suggest you Sebowash (Fluocinolone) shampoo twice weekly. It has to be applied on scalp and left for 15 minutes before you wash. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You should not apply hair oil. You can use conditioner and shampooing regularly rest of the day. Revert back after a month to a dermatologist online.--->


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Hi doctor, I am 44 years old. For the past one year, I have noticed dark spots on the fingers and near knuckles on the left hand. They do not hurt, but look like a burn. I also noticed numbness in the tip of my left middle finger. I have allergies, asthma and sleep apnea. I am also suffering from herpes 1 and 2. My current medications are Adipex, Zyrtec, Oxybutynin multivitamin, Valtrex (only when I have a flare-up) and Ventolin inhaler. Please suggest some advice.


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Hello. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. You are most probably suffering from hand eczema or lichen simplex. Numbness in your finger does not seem to be related to this, however, it may be seen in case of certain orthopedic such as nerve compression or medical conditions like diabetes. For the dark patches, I suggest steroid ointment containing Clobetasol twice a day for two weeks. Consult your doctor, discuss with him or her and take the medicine with consent. 1. Avoid excessive use of soap. 2. I suggest apply an emollient or a moisturizing cream to your hand frequently during the daytime. Revert back after two weeks to a dermatologist online.--->


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Hello doctor,One week ago and five days, I hit a school clock off the wall and on the left side of my nose. I went to the E.R., and they said it was not broken, and it was only swollen and bruised. The swelling went down, but it is still hurting, and it has been stuff since then. I used a flashlight to look into my nose, and in the left nostril, I saw to things like deep into that was red and kind of swollen, and when I looked into the right nostril, I saw the same thing, but they were pink and not swollen. But when I breathe in hard, my left nostril makes a weird nose like a motor that was not before the injury. Please help.


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Hello. Nasal trauma and consequent inflammation can cause symptoms like you are complaining. Epistaxis and stuffiness can be present. Since you have been examined at ER and they did not find any signs of fracture, there is nothing much to worry. The swelling you saw deep into your nose is turbinate, and they need not be necessarily identical on two sides. Since there was trauma, it is likely to be congested. There is no reason to be worried too much. Use decongestant drops for a while, and it will be fine.


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Hello doctor, The last week two weeks I have been getting peeling in my mouth like on my cheeks. And I wanted to know if that is from loose fitting dentures or if I have not been cleaning them properly.


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Hello. Usually, vitamin B complex deficiency causes such peeling of the oral mucosa. If you are using dentures for a long time, then it may be the reason for this.Take a multivitamin once a day and eat a good healthy wholesome diet.


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Hello doctor, Please, can you help me to analyze this result. I need a specialist who can help me to investigate this result and can a person with such a result father a child? If no, what is the remedy or treatment for it?


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Hello. The two semen analyses reports show entirely different semen characteristics (attachment removed to protect patient identity). The first report is entirely normal, and the person can father a child as long as his female partner is normal. The second report shows no sperms, hence the person cannot father a child. But there are few clarifications needed, 1. Whether both reports are from one person only? 2. What were the collection methods? 3. What was the time gap between two reports if both are from one person? 4. What is the fructose value in the second report? 5. What is the serum FSH (follicle stimulating hormone) value in person with the second report? 6 . what does transrectal and scrotal ultrasound show in both? If you can clarify these points, I shall be able to give still a detailed answer.


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Hello doctor, I went for five root canals on front teeth. Which type of caps are advisable single or joined?


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Hello. Yes, caps are advisable but single is best. Joined or bridge has a drawback. If any side of the joined cap is loose or any damage comes, then the whole bridge is removed. In single if one particular tooth or cap has any problem or any damage, then the single cap will be repaired and removed.


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Hello doctor,My mother is 59 years old and had undergone mitral valve replacement operation 15 days back. Now she is having breathing difficulty sometimes. SpO2 after exertion is 87 to 89 (without 02), the respiratory rate is around 28 to 30. I have attached the CT contrast thorax. There is no fever and wheezing. The echo shows only mild MR, and TR. No pulmonary hypertension and pleural effusion. She cannot take Duolin nebulization because she is a patient of atrial fibrillation, it increases her heart rate. But atrial fibrillation is under control by medicine. Please suggest the treatment.


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Hello. I have gone through all the history you provided here. Your mother is currently suffering from two different problems. Mitral valve replacement followed by mild MR and TR as well as atrial fibrillation, are distinct cardiac problems. And according to you, she is taking prescribed medicines regularly.After going through the CT scans images (attachment removed to protect patient identity), it looks like she is suffering from some infective lesions in the lungs, most probably pulmonary tuberculosis (PTB). She is having breathing difficulty with low oxygen saturation, probably due to underlying lung infection. To confirm the diagnosis, further sputum tests are advised for sputum AFB (acid-fast bacilli) and culture tests. If no sputum sample is available, then induce sputum by nebulization with saline solution or perform a bronchoscopy. You are advised to consult pulmonologist doctor who will evaluate history and will advise recommended tests and medicines if required. Currently, symptomatic management includes oxygen supplementation with a high protein diet. Continue all cardiac medicines as advised. Depending upon the sputum AFB report, further treatment can be planned. I hope I have cleared all your doubts. In case you have any questions please do not hesitate to contact me again. Infection with PTB. Sputum AFB and Bactec AFB Culture. Depending upon sputum AFB report may require antitubercular treatment. Strictly use a mask while coughing and talking.


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Hello doctor,I was diagnosed with bipolar 2 and panic disorder. I currently take Zoloft and Klonopin. My psychologist believes I am functioning normally, but sometimes I worry that I may be in psychosis, or displaying symptoms. My only concern is that recently, I have been having paranoid thoughts. Nothing extremely delusional, but sometimes I feel like my parents think I am crazy or that they are lying to me. I also had a paranoid thought that my boyfriend was lying to me. The thoughts do not happen very often, but is this normal for bipolar type 2?


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Hello. It is common to have some paranoid thoughts, especially when you are feeling stressed, anxious, and feeling low in confidence. From the way you have described your symptoms, psychosis appears very unlikely. You can recognize the paranoid nature of your thinking, and your thoughts do not seem to have delusional thinking. Your report says that you are functioning normally and so I think your psychologist is right. Continue with your psychological therapy to manage your mood and anxiety symptoms and challenge your distorted thinking pattern. I will recommend having regular follow-up with your prescribing doctor to monitor your mental state and seek review if you experience any new symptoms.


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Hello doctor,I did the blood test a few days ago, and the reports state that,1) Monocytes 0.19.2) Red cell distribution width 46.7.3) Platelet distribution width 21.4) Mean platelet volume 13.4.5) Platelet to large cell ratio 50.5.Kindly advice.


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Hello. The test is not specific. You need to specify why it was done and what your symptoms are. The test indicates macrocytosis larger platelet than usual, red cell distribution width is higher than normal (11.5 to 14.5). This indicates that your bone marrow which produces all the blood cells such as red blood cells, platelets and granulocyte white blood cells (neutrophils, eosinophils, basophils) and monocyte is not getting enough vitamin B 12 (cyanocobalamin) and folic acid. I do not know are you anemic since there is no indication of red blood cell count there. The cause can be from not getting enough folic acid and vitamin B 12 in your diet, or your intestine does not absorb enough B 12 vitamin, a condition called pernicious anemia from lack of intrinsic factor needed for their absorption. You may be a vegetarian because if you eat enough meat, you would not be having folate and B 12 deficiency.You may have vitamin B12 and folic acid tablets.


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Hello doctor, I am a 25-year-old male. I am suffering from urticaria for a long time. I did not remember exactly how long but it has been approximately four months since I am suffering from this issue. My father and brother also had suffered from this, but only once or twice, but for me, this is a normal thing. My skin has become so much sensitive that even soft rubbing can cause redness, itching, and swelling. I had not taken any treatment yet because I was told that this would be cured automatically within a short span of time. But in my case, it is getting worse day by day.


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Hello. You have new-onset urticaria. Since it has gone on for longer than six weeks, it is now considered chronic urticaria. It is a common condition. Most people will experience at least one episode of urticaria during their lifetimes. There are many causes of urticaria such as 1. Infections-viruses, bacteria, and parasites 2. Drug allergies. 3. Food allergies. 4. Insect bites or stings. 5. Physical causes like exposure to cold. The exact cause cannot be identified in about 50 % of the cases. Please try to see if you have changed any cosmetics (hair dye, creams, powders, soaps, shampoos, deodorants, etc.). Have you started any new medicine or supplements (including herbal, over-the-counter, etc.)? Any recent change in your occupation, use of latex, etc. Any urine infection-burning urine etc. Any use of food colors?If no answer can be obtained, I suggest checking a complete urine examination. Also, I would try a course of de-worming treatment. Albendazole chewable tablets (brand name Zentel) 400 mg. Take it in two doses. The first and second dose should be separated by a week. Take after food, only two doses are required. For symptom relief, try antihistamines. I suggest a non-sedating anti-histamine taken once a day in the morning.If this alone helps, fine, if not, take a different antihistamine at night. Take them daily for a few weeks and then start cutting back slowly and observe. If your itching and urticaria do not respond to anti-histamines, you may need to take corticosteroids.


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Q. I get throbbing headache in the morning after long working hours and late night sleep. Please help.


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Hello doctor, I woke up with a throbbing headache. Previously I was alright before going to sleep which was around 2 AM. Lately, I have been sleeping very late due to working at home for long hours. Please help.


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Hello. I can understand your concern. According to your statement, you have been suffering from throbbing headaches during waking up. Headache which is throbbing in nature may result from the dilation of blood vessels from increased blood flow. Headache is very common in everyone life. Strenuous work, stressful life, dehydration, anxieties, tension, common cold, allergies, low glucose sugar level, etc., can cause headaches. Throbbing headaches may result from some health conditions such as migraines. Throbbing headache occurs at the top of head, Cluster headache occurs as throbbing headache behind the eyes, Occipital neuralgia presents as throbbing headache at the back of headache, Temporal arteritis occurs as throbbing headache in temples, Hemicrania continua occurs as throbbing headache on one side. Treatment depends on the causes. You should undergo some investigations like CBC (complete blood count), x-ray PNS (paranasal sinus) can detect the cause which is responsible for your sufferings and then treat them accordingly. You can take for your headache as follows. Tablet Inderal (Propronolol) (40mg) 0+0+1 for 15 days, Naprosyn (Naproxen) (500 mg) 1+0+1 for 10 days, Prevacid (Lansoprazole) (30 mg) 1+0+0 for 15 days. In case of allergy or cold take tablet Allegra (Fexofenadine) (120 mg) 0+0+1 for 10 days. In case of any other query knock me.


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Hello doctor, I am 23 years old. I have been diagnosed in the past with (SAD) separation anxiety disorder, autism spectrum as well as ADHD. Lately, I have been harming myself and having trouble controlling my emotions. I sometimes feel as if the whole world hates my guts. Then I feel good again a little while later, sometimes soon, sometimes not even until the next day. As well as some delusions towards those closest to me. Now that I have told you a little about my self. The question is, can separation anxiety develop into borderline personality? Can the fact that I have smoked weed almost daily for the past two to three years and occasionally from age 16 cause borderline. Or can substances like LSD, dmt, and ecstasy trigger the borderline as well? I am having a hard time believing how extreme my emotions are. Kindly advice.


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Hello. Yes, separation anxiety disorder might develop in borderline personality disorder (BPD). But based upon the information you provided I am not sure if you have SAD. Smoking weed might increase anxiety, which could worsen the symptoms in BPD. Smoking weed can lead to precipitation of acute psychosis, which can prove dangerous. LSD (lysergic acid diethylamide) or any hallucinogen can increase psychotic symptoms.


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Hello doctor, I recently have had tests done after I was with someone that I do not trust after the fact. The only thing I have come up positive for is the common HSV 1. I remember having one outbreak when I was young and no outbreaks after. I have IgG antibodies present in my blood. I fear that the person I was with carried HSV 1 and reinfected me. I hope that my antibodies reacted and destroyed the second infection. I had a blister present on my skin after being with this friend. But it healed up immediately, more than a regular blister. Is there a chance that my IgG antibodies took care of the second infection? I told this person that I had perfect sexual health, and it was essential to me and the love of my life, which I am hoping to find. So it has hurt me at a phenomenal rate. I think of it daily. I need to know if I had IgG antibodies built up before reinfection, can it destroy the reinfection if symptoms are present? My symptom was present one day before it started healing. On the upside, a doctor that looked at it said it was nothing. Other doctors said it was probably nothing. It has cost thousands of dollars to find an answer. I am looking for a true love to live life out with and this is very important to me. Please let me know if IgG antibodies could kill reinfection if a symptom were only present for a day. It has been about nine months, and I have not had any symptoms. If you can help me, it would mean the universe to me.


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Hello. I understand your concern. Please follow the following facts.  1. Once you get infected with HSV-1 (herpes simplex virus), as you had been in childhood, IgG antibodies remain there in the blood indefinitely or life long. 2. They help in containing further episodes, so subsequent episodes of herpes are always less in severity than the primary one. 3. Usually, herpes secondary episodes last for a few days, can heal in a couple of days also if it is minimal. 4. You are getting worried too much, and please relax, it has been nine months, there is no need to panic now. 5. You did not mention the site of blisters or any photographs you have taken, and it might not even be herpes. 6. There is no sign of HSV IgG in blood, and it just indicates you had an infection anywhere in the past.


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Hello. Have you done the X-ray of the sinusitis? Sinusitis is inflammation of the paranasal sinuses which are like air pockets found within the cheeks, frontal part of the skull and inside the anterior skull bases. Obstruction to the draining channels of those sinuses lead to blockage and accumulation of secretions which becomes infected and the problem begins. Or there can also be a congenital deficiency in the ciliary cells that beats to drain the secretions into the meatus. You will have to use antibiotics such as Augmentin, use Actifed tablet one tds. Also, you can use nasal drop to help open the ostium so that the mucus clogging it can go out. There is also a surgical procedure, e.g., antrostomy to drain out the maxillary antrum sinuses.


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Hello doctor, I am 25 years old male. My problem is redness of the genitals. It has been two months now. It first started from my penis head with four or five red bumps like spots. Then I consulted a dermatologist. He gave me Candid-B cream to apply and some anti-fungal tablets. But I mistakenly use liquid Dettol in water to wash my penis, and it spread badly to my scrotum area. Whole red no itching and no pain just a little red nerves beneath. I have used creams like Onabet, Dermiford k5 prescribed by doctors. And have done 25 days course of Itraconazole 200 mg two times per day. And that with Onabet cream and glycerin lotion. The last cream I used was Betnovate gm, which damaged my penis and gave me a burning sensation on scrotum and foreskin. Now I am applying no cream, only keeping ice pack, and I consulted another doctor. He said after seeing pictures that there is no fungus just irritant contact dermatitis. Please help.


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Hello. According to the history given by you, it could be irritant contact dermatitis followed by application of dettol. Since you have used most of the creams and few of it containing steroids, your skin has got thinned, and that is why you could see red colored vessels. It is advisable that you should not apply any cream which contains steroids it could worsen your lesions. Apply coconut oil before taking a bath, no soap on the affected area during bath. Please share pictures of it so that we could start with the treatment. You might need to take oral steroids to improve your condition, but no topical cream. You can take tablet Levocetirizine 5 mg at night time for five days. This is to reduce the itching or burning part but not going to cure it. It is advisable to consult a dermatologist.


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Hello doctor, The problem is with my second elder sister who is unmarried and aged 62 years. She was a school teacher and has retired from service. She is 160 cms in height and weighs 60 kg. She falls under the category lean to good health except for a bulging tummy. Main problems are, 1. Pain in both the legs with more pain in the right leg from thigh to the knee. 2. Sometimes a feeling of being pushed from behind when standing. a. Apart from these, she is also suffering from, When lying down to sleep or sitting for some time, 1. Feeling as if the veins inside the legs are getting loose with pricking pain on both feet. 2. Biting pain on both feet even when one foot is pressed with another foot 3. Sometimes a feeling of scratching with a sharp instrument. 4. Pain in toes and nails. 5. Pain in the bottom of the feet 6. Burning sensation in feet, especially when the saree edge touches the feet. 7. Feeling of standing on a carpet while standing on the ground without slippers. 8. Tips of the toes are getting rough even though creams are applied. 9. The sudden jerk of hand enough to break sleep. 10. Pain in the legs are spreading from the feet upwards towards the knee. b. While standing 1. Need for placing hands on nearby objects like a wall, chair, table to get better support. 2. Pain just on the right side of the right knee (the place where the knees fold) and a feeling as if the bone will break c. When walking 1. A feeling of getting pushed from the back 2. Unable to walk at a stretch for even half a kilometer 3. The feeling of forceful dragging of legs 4. Feeling of breathlessness d. Hands are unable to work with both sides together (e.g., holding utensils with both hands for placing them on a gas oven, holding the utensil with one hand while stirring the contents with the other) even though there is no problem when working with one hand alone. She has some relief when washing legs with cold water I am attaching herewith copies of all the doctor's prescriptions, the test reports including latest scan and MRI report of the spine, the medicines she has taken for your kind perusal, please. Please go through the details and kindly advise us what to do and what medications to take to make the pain bearable, if not eradicate the same.


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Hello. Went through your queries and the files attached (attachment removed to protect patient identity). This clinical scenario is possible in two cases. 1) Compression of the spinal cord at the cervical level or lumbar level or both. 2) Peripheral neuropathy is affecting all four limbs. She has been extensively investigated. Treatment for peripheral neuropathy has been tried in the form of pregabalin, gabapentin, nor tryptiline, etc. which do not seem to have afforded any improvement to her. So I suggest we may try a course of the following medications for a week. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1) Tablet Medrol 4 mg 1-0-1 after food (Methylprednisolone). 2) Tablet Pan 40 1-0-1 before food (Pantoprazole). 3). Tablet Phlogam 1-1-1 before food (Trypsin, Bromelain, Rutoside). 4). Tablet Nurokind LC 1-0-1 after food (Vitamin B12, Levocarnitine). 5). Tablet Nervijen-NP 1-0-1 after food (Nortryptiline, Pregabalin). 6). Tablet Alsody 1-0-1 after food (Alpha lipoic acid, Superoxide dismutase). Cervical stenosis, lumbar stenosis or peripheral neuropathy.


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Hello doctor,I get bruising easily. My blood reports are fine, and the bruise gets clear with vitamin C and K tablets but occurs again when I stop the medicine. Why?


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Hello. Kindly mention since how long you have such problem? And mention the duration of the treatment. In such easy bruising case, the causes like liver disease, low platelet count, and coagulation abnormality have to be ruled out. You have investigated for that, and all the parameters are within the range. So if your problem is since a few days, then you can continue oral vitamin C that is Limcee and topical vitamin K. If the problem continues, then consult nearby hematologist for detailed evaluation. Hematologist might evaluate further in the form of fibrinogen estimation and full coagulation profile testing. I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor,I have some health issues that I would like to address. I have depression, fatigue, low energy, tiredness, and red eyes when I wake up, and I feel exhausted after masturbation. I have a history of masturbating for eight to nine years since I was 12 years old. The first few years, I was continually masturbating with lots of pornography. I am now masturbating one to two times a week yet still feel exhausted and fatigued daily and even watch porn one to two times a week. I have trouble with morning wood maybe once a week. What can Homeopathy offer me to heal from masturbation and get back to being healthy?


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Hello. I understand that you are concerned about various health issues, and it seems most of the symptoms are related to over masturbation. Masturbation at the teenage is prevalent. Homeopathy has a vast number of remedies to heal this issue. However remember that masturbation was is not bad, but overuse is something that causes health issues, twice or thrice a week is not bad.Homeopathic remedies will help you to deal with this habit, and you would be able to concentrate more on other things in life like a career or job, etc. Homeopathic remedies are prescribed after taking your mental, emotional and physical health in to the consideration. Based on the little information you provided here you can start Lycopodium 30c four pills once a day for five days. Then begin with Kali Phos 6x two tablets twice a day for 15 days.These pills and tablets usually dissolve as soon as you keep them over the tongue. Hence there is no need to swallow these with water or anything liquid. Kindly report back on15 days. I hope you start feeling better. Let me know if you have any questions. I would be happy to answer.


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Hello doctor, 1. I took ECP during withdrawal bleeding (as I stopped contraceptives). Will it work? 2. Will this affect my menstrual cycle as I have not got my periods in my due date. I am freaking out. 3. When should I go for pregnancy test to clear my doubt?


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Hello. 1. Usually the possibility of ovulation is less during withdrawal bleeding, so the need for emergency contraception is less. But as you took the pill already, if at all there is any possibility of pregnancy, it can help. 2. Because of high dose of hormone in it, it can affect your periods. Sometimes after taking emergency contraceptive pill, you may see withdrawal bleeding after 7 to 10 days. 3. For accurate result better to test three weeks after having unprotected intercourse.


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Hello doctor,The stomach blossoms without food, even in the morning. It is felt more in the upper part of the stomach.


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Hello, Welcome to the icliniq.com. You can have a gas problem due to functional indigestion. I suggest you take gelusil MPS like syrup before bedtime for one week. It is advisable to take Rabeprazole like antacid for the week also. If there is no improvement than USG abdomen scan should be done for further workup, meanwhile avoid gas forming foods like cabbage, cauliflower, etc. Carbonated drinks should be restricted. I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor,My tongue hurts and bleeds when brushed. White spot on uvula area and white and small red dots on the roof of my mouth. Also, a yellowish color is seen on the roof of my mouth.


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Hello. The condition is called aphthous stomatitis. It usually follows a brief period of stress to be emotional or physical, as a febrile sickness. You need to take a short course of antibiotics, topical analgesics, anesthetics. Multivitamin supplements and antacids can be taken. It is usually self-limiting, and the treatment is aimed at symptom relief.


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Hi doctor, A person used Abilify and drank alcohol heavily on Abilify. Then switched medications and quit drinking for years. Can that person go back to Abilify again? Will it work? Or does drinking alcohol make the medication never work again? Please explain.


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Hello doctor,I finally withdrew from the drug called Seroquel. But now my penis has no sensation at all. I have much more arousal meaning my sex drive is back. But it is as though 90 % of the sensation is gone. While on Seroquel, I had more, but I stopped the medicine due to many bad side effects. It has been two weeks since my last dose.


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Hello. Seroquel is Quetiapine, and the drug is an antipsychotic and mood stabilizer drug. In high doses in some individuals the drug is known to result in side effects like reduced libido, sometimes delayed ejaculation, difficulty in orgasm, etc. But Quetiapine is one of the safer antipsychotics if we compare this drug with other antipsychotic drugs.  The possible explanation of reduced sensation on the penis could be mild withdrawal, which might result in numbness like symptoms, and this may present with symptoms like reduced sensation around the penis. But the dose you were taking that is 50 mg is not a very high dose. Stopping this would not result in much withdrawal except mild insomnia. If we link this with sexual side effects of Quetiapine or Seroquel, then this will reverse by own in coming days. In most cases, sexual side effects go by own in less than four weeks of stopping the offending drug. You were not on a very high dose so that the recovery would be earlier. Prolactin levels increase seen with antipsychotic use (in high doses for a long duration, but some individuals even in low dosage). The standards will normalize in some days, and this will result in an improvement of sensation on the penis. No need to worry, and at this point nothing should be done because your erection is relatively better now, this means libido is improving.


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Hello doctor, I have a skin infection on my right arm and would like to know what I need to get better.


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Hello. How long has it been there? What are the symptoms in it? And any other family member affected?


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Hello doctor,I am gurgling when breathing in and out, especially when laying down. In the beginning, I had a fever with strong cough and wheezing sound when breathing in and out, after a few days, I am back to normal, but this wheezing turned into gurgle till now.


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Hello. Take syrup Bromhexine two tablespoon thrice daily for a week. It will produce a cough. Please excrete it out. Also, do steam inhalation thrice a day for a week.


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Hello doctor, I am a 33-year-old male, and my height is 5 ft and 8 inches. I am currently on medication of Soltus 75 mg, which was earlier Soltus 100 mg. I am on medication for one year and a half. I was having delusions. I want to know till how long do I need to continue this medication as I am gaining wait and my mental alertness has also reduced. What could it be?


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Hello. Soltus (Amisulpride) is an antipsychotic medication given to manage symptoms like delusions, hallucinations, thought disturbances, etc. These symptoms can occur in different situations like extreme stress, psychosis, etc. Discuss with your prescribing psychiatrist regarding the diagnosis as he will have a complete history. This medication needs to be continued for at least a year, possibly longer depending on the nature of your symptoms, previous history, etc. So again, kindly discuss with your prescribing doctor. If you are stable, your doctor may consider decreasing the dose to soltus 50 mg daily. But any dose reduction needs to be done under medical supervision. Weight gain can be an issue with this medication. It can be managed by eating healthily (avoid fast foods, high-calorie snacks, etc.) and having regular exercise.


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Hi doctor, I am aware that I have eczema. But, everything I try does not work. I have been having severe eczema since I was 8. I am about to be 19 now. I have tried using unscented lotions, dermatology approved lotions, organic oils and even all of the ointments doctors prescribe me with. The only thing that the lotions and ointments do is calm the irritation. Over the years, I have learnt to resist the urge to scratch unless it becomes unbearable. But, I always find myself sleep scratching. Yeah, I said it sleep scratching. I wake up with tingling legs and can see how hard I have scratched in the middle of the night. I moisturize all the time. Yet nothing works. I am getting to the point where it is starting to interfere with my life. I am young. I want to wear shorts and sundresses whenever I want. But I cannot because of the ugly scarring I have on my legs. I forgot to mention that my eczema is only active on my legs. Occasionally it occurs in my hands and rarely on my arms. Sometimes I even get it on my face. I have tried keeping my nails short so I do not have gross scratch scars but it does not work. I get my nails done because it does not leave scratch scars but it leaves bruises. And do not get me wrong the ointment is the best thing that works but I do not want to have to be wearing that ointment as a lotion. I have to leave to the ladies room about every hour so I can moisturize my legs to prevent the itching from happening but honestly who wants to live a life like that? It has begun to affect my life emotionally and I do not know how much more I can take of it.


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Hi. I can understand your concern. Being a dermatologist observes in day-to-day activity few diseases have bad impact on lifestyle, out of which eczema is one of them. But, with your descriptions it seems to be atopic dermatitis, which becomes better as age progress. In adults, it involves the flexural surface eventually localizing to the front of elbows and behind the knees. You need not have to worry that much. Besides medicine, you should do some yoga exercises, which will help you much. Few general measures you have to follow are: In case of oozing, avoid ointment or cream, corticosteroids in lotion form may be used. When there is no oozing or in dry eczemas, corticosteroid cream is to be applied locally twice a day. Local antibiotic cream with or without corticosteroid is helpful where bacterial infection is present. Skin biopsy needs to be done to confirm the diagnosis. Atopic dermatitis. Revert back for regular follow up to a dermatologist online.--->


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Hello doctor, I am 18 (unmarried) and I have missed my periods on first two days and I suppose I might be pregnant (unplanned) as I am not having any symptoms of my monthly periods. Me and my fiance had a pullout in 6-10 seconds after he inserted the penis in vagina but there was just a pre-cum which he had already wipped away and there was no ejaculation taken place (sure). Is it a sign of pregnancy? Can I consult a Gynecologist alone without parents or guardian? Can I terminate the pregnancy by medication as it has been only 6 days? What should I expect? Please help, I am stressed.


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Hello. Please do not get worried or panicked. Get a beta hCG test done. It is a blood test to confirm pregnancy. A value less than 5 means you are not pregnant. Even if it is positive, you do not need to worry. You can get it terminated by medicines (You will need to get an USG done first). You can visit a gynecologist without parents and your privacy will be respected. Please make sure you visit a qualified gynecologist and do not visit quack out of social fear. Gynecologists are professional and will not meddle in your private life and will help you get rid of pregnancy without risk to your life.


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Hi doctor, I have two small white spots on the lower portion of my front tooth. Can it be removed by microabrasion? Is the procedure worth? Please guide.


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Hi. There are several reasons for the white spots on your teeth. Usually, white spots appear when the mineral content in the outer part of the teeth (enamel) is less. White spots could also occur due to high fluoride level in the drinking water or nutritional deficiency during teeth development and infections to name a few. Are the white spots only on the front teeth? Or do you have them on other teeth as well? Microabrasion certainly does not help whatever the cause of the white spots may be. It just makes the surface of the teeth rough and gives rise to other problems. You could consult your dentist and ask whether bleaching can be done. There are other options like placing a veneer on the surface of the teeth. However, a small part of the tooth surface needs to be abraded to place the veneer.


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Hello doctor, I recently got married and I knew my partner for long before marriage. My query is I am finding it hard to have intercourse. I am very active while doing foreplay, but when I am about to insert somehow I end up ejaculating outside. We as a couple are planning for pregnancy at the earliest. Please guide us. Thank you.


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Hello. As per your history, you seem to be suffering from erectile dysfunction (difficulty in sustaining erection) after marriage. The commonest cause of erectile dysfunction after marriage is performance anxiety. If you are worried about erection and your performance during sexual intercourse, it could cause problems with erection. To overcome this, you can try the following techniques. You can take these tablets on alternate days if needed as the effect of these medicines will last for 2 days. If you are taking any other medicine for blood pressure or cardiac condition, ask your doctor if it is fine to take these medicines along with the other medicines. You will not need these medicines for more than 15 to 20 days because you will develop confidence when you have sex successfully for a few times. As you are recently married, do not worry about pregnancy so soon. You will have plenty of time and opportunity for planning a baby. This added pressure of getting pregnant could also adversely affect your erection. Performance anxiety. Erectile dysfunction. 1. Relaxation techniques. 2. Tablet Forzest and Rivotril.


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Hi doctor, I do not used to sleep a lot from early age. Daily to the maximum I will sleep for 6-7 hours. Now, these days I find scary researches about how sleep deprivation can damage brain permanently. I want to know whether my condition too is also related to sleep deprivation. Will it cause any permanent subtle changes to my brain? Please help me.


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Hi. Yes, the research has gained a lot of attention and we do consider the facts. But, what has been done cannot be reversed. However, if we go with clinical experience, usually people who modify back there lifestyle do not get any ill effects in life. In fact, I would advice in such case that you should stop thinking that what is reversible and what is not. Start living your life normally and take help with a psychiatrist if there is great difficulty in sleeping. One can be treated easily with hypnotic drugs which help in controlling these issues.


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Hi doctor, Recently my child seems to have developed phobia for terrorist. She is just 4 years old. I did not know how really she even came to know about the word terrorist. Now, she remains afraid for most of the day and night. She thinks that they are going to come to her. She does not like to go outside the flat and visit public area. I think it may be that one of the movies seen recently has left a deep impact on her. We tried our level best to convince her that movies show false things, but somehow the word terrorist has got deep inside her. She keeps talking about them throughout the day. We do not really know how to get this out of her. These things have started very recently and becoming more intense. Kindly help.


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Hello. Child's mind is very delicate and easily moldable. Subtle things can cause drastic and unexpected effect on them, which we cannot even predict at times. In your case, it is quite easily observable to you. It is good that you could recognize this change in her behavior so early and decided to take an opinion for the same without wasting further time. Violence and rage have very severe effect on a child's mind. This is what happened with your daughter. The violence depicted in the movie and the reactions caused by that violence in the movie characters have made a deep impact on her mind. The fear caused by that violence had got imprinted on her mind. This can be the beginning of development of an underlying anxiety illness in her. So, it is very important for you as a parent to help her overcome this. You have to gradually make her aware that though the terrorist are the ones who spread violence and chaos, but on the other hand there are good people also who stop them. To begin with storytelling is a good way to inculcate things. Then play therapy can help. You can get her into play activities where you can strengthen her faith that there is no need to be afraid of bad guys and there are always good guys to help with. Gradually start taking her out and expose her to the people in neighborhood. Tell her about different kind of people living nearby. Familiarize her with the surroundings. Besides this, you should avoid watching content depicting violence and rage in front of your daughter. Child's age is a tender part of their life, they learn very quickly. So, use this as a therapy to manage her fear.


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Hello doctor,I am a 32-year-old woman. The one with whom I am in love sometimes behave rudely to me. He remains silent whenever he dislikes anything that I say. I am a bit outspoken, and I am unable to control this. His silence kills me. I find it difficult to do routine work. I feel so sad and shattered. He will not answer my messages and will not pick up my call even if I had called 50 times a day. I feel like hurting myself. I suffer from depression since childhood, and I am taking Amitriptyline since the last 13-14 years. How can I divert my mind and focus on my work during those times? It happens almost twice a month. We are together for five years now.


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Hello. It looks like you and your partner have different personality styles and deal with conflicts differently. For example, if you are an extrovert, you would like to talk your way through issues. But if your partner is an introvert, he may have an aversion to conflict and arguments and may withdraw during stressful periods. This is a natural way of responding to some people and not to be taken personally.  If your partner is otherwise fine and treats you well, it may be helpful to have an open and honest discussion with him when both of you are calm. Write down your thoughts if direct talking can be difficult and ask your partner to reply. Both of you have to respect each other and learn to form your ways of dealing with conflict as a couple. It is natural for all couples to have disagreements, try not to overthink in such situations. Try relaxation techniques and carry on with your usual routines. If needed, you can try counseling or couples therapy. Also, look after your emotional health. Consult your doctor to review your mental health and the need for continuing anti-depressants. I hope this helps.


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Hi doctor, I am blessed with a baby boy (3 months 10 days). I am sharing with you his vaccination card. All vaccines are almost due because of the Corona Pandemic. Most of the clinics are almost closed. Will you please suggest, whether these vaccines can be delayed a bit till the suspension of lockdown, or do I need to arrange it ASAP. Really tensed about this unexpected and unfortunate situation.


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Hello.  I understand your concern for your child. I would say you can wait for some more time till the end of this month as probably after this month lockdown restrictions will be over. I believe you should go according to your pediatrician as he would understand the situation best at your place. Till then, best hygiene measures should be taken for your child. Use hand rub or wash hands properly before touching your child. Avoid giving bottle feeds. If you maintain this, there should be no problem. All vaccines can be given at a later date.


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Hello doctor, I am a 26-year-old female. I am nervous most of the time and cry a lot because my dad passed away a month ago. I feel like there is no reason for life now, have no goals and moments without happiness. I thought about suicide several times, so I need some pills to relax me during the day time without sleeping effect. What should I do? I will never see my father again, which drives me crazy.


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Hello. It is always painful to lose a loved one. Your symptoms are suggestive of an acute grief reaction to the loss of your dad. Grief causes significant emotional distress for some weeks, but usually, you will heal gradually with support from family and friends. To clarify, did you experience any emotional problems or mental health issues before your dad passed away? In that case, the grief can be more intense, prolonged, and you may need professional support like bereavement counseling.  Usually, pills are not recommended for normal grief. But if you have any other underlying emotional problems, kindly consult your doctor who can assess and prescribe according to the need. I will advise not to isolate yourself during this period. Try to go out regularly even if you do not feel like it. Open up and talk to trusted family and friends, tell them how you feel. Try to eat daily and sleep well. Go for short walks and try to do your regular activities.


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Q. I am suffering from burning sensation and inflammation in anus after intercourse. Will this be HPV?


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Hello doctor, I am a 24-year-old bisexual male. 10 months ago a friend stroked his penis between my thighs, and suddenly his penis slipped and entered my anus for merely an inches, and he pulled out then we stopped performing it. And after four months I got constipation and hard stools, and then day by day I started to feel inflammation and burning sensation throughout my anus sometimes this burning pain moves to my perianal area and maybe in the rectum. As I read about the HPV infection, I got very scared, and I am in a deep depression. I do not know what this HPV or piles are? Kindly tell me what to do as I am in deep agony, pain, and depression. Please help.


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Hello. HPV (Human papillomavirus), usually HPV infection does not cause any noticeable symptoms or health problems. Some time produce genital warts.For your complaints, constipation and burning sensation may be due to piles or anal fissure. So better go for the rectal exam and proctoscopy examination to rule it out. For piles and fissure try these medicines. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Tablet Pilex 1 t.i.d (three times a day) for 20 days. 2. Tablet Dulcolax (Bisacodyl) one or two for constipation. 3. Proctosedyl ointment use, as per instructions are given in box for 20 days.


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Hello doctor, My wife is around 18 weeks pregnant and, she started to spray pesticides inside our home. I am concerned that this might harm our developing baby. Please advise.


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Hello. I understand your concern. Definitely pesticides of any category are harmful. If it can damage the pests, then that will be harmful to the baby. But we humans are bigger in size and damage is not significant, unless sprayed daily for many days, for a long time and directly onto the face. By 18 weeks, the baby is fully formed, so there cannot be any significant damage or long term effects on the baby. To be on a safer side better to avoid your exposure to pesticides. Do not worry, and your baby will be ok now. I hope I have clarified your query, do write back if any more questions and for your feedback.


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Hello doctor, I am a 42-year-old male. When I was 15 years old, I started to suffer from depression and had to undergo psychiatric treatment. I was prescribed Trazonil for a sleep disorder and Flunil for depression and anxiety. I was under this medication for nearly seven years. In the meanwhile, I got hooked to alcohol and smoking before 20 years. I took an overdose and consumed almost 90 tablets of Trazonil in an attempt to end my life. However I survived, but I have felt that it really damaged my brain especially my memory and till today I remember most of the things which took place prior to this incident as well as things I learned, but in my daily life after that I became very forgetful and had trouble remembering things, events or new things which I try to learn. So my question is that is there any way which I can reverse this ill effect or lessen to a high degree so that I can remember things better or have a better memory. I have been drinking for the past 20 years, and since last three years after moving to another place my frequency and dosage of alcohol has increased, and I know it also plays a significant role in diminishing memory. I quit taking medicines almost 14 years back.


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Hello. It is good to know that you are insightful about the problems caused by excessive alcohol intake. Have you contemplated cutting down on alcohol? Alcohol may be playing a significant part affecting your memory and also have a negative impact on your emotional health. Your memory difficulties may be more related to a history of depression and concurrent alcohol abuse. It is less likely to be a long term effect of Trazonil (Trazodone) overdose. You may know that alcohol has a depressant effect on the brain (despite the initial euphoric effect). With your history of depression, it is essential and can be tackled at the earliest. You appear to have experienced significant depression, including a risky overdose. You seem to be resilient in your way but are you still depressed? Are you using alcohol as a coping mechanism to manage everyday stressors? I will recommend consulting a doctor to review your mental state and proceed accordingly. You can consider counseling or talking therapy to address issues related to excessive alcohol use. Try reading books. Also make sure you take care of the basics like eat healthily, sleep enough, and exercise regularly. Try yoga or meditation if available locally.


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Hello doctor, My girlfriend has been taking Microgynon 30 for two months, with two packages back to back. She took Microgynon for suppressing severe PMS. The medicine successfully suppressed the PMS, but there seem to be some side effects. She experienced some spotting for a week, and the other doctor told me that it is normal for a microgynon-taker. Her actual period started the very next day after stoppage of spotting (which is late for two weeks), and it has been lasting for 18 days. In the beginning, the volume is lower than average, but red blood is visible. In recent days, the volume keeps increasing, and it gets me worried about whether some issues are occurring. Should I take her to a gynecologist for a check-up or it is entirely reasonable for a microgynon-taker? We did not have any sexual intercourse before and in the case for an extremely rare accident, she took a pregnancy test, the result was negative. Therefore, pregnancy could be eliminated. She finished her second package of Microgynon around 6/4, and the next day, the blood volume started to increase. One more question, she has a third package of Microgynon and the gynecologist we saw said that she should begin the third package when the second period stops. Is this correct?


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Hello. Your doctor is right in saying that this is normal with the medicine you are taking. Microgynon is progesterone. It is a hormone which builds up and helps in the growth of the inner layer or lining of the uterus called endometrium. Due to overgrowth sometimes the endometrium sheds off and appears as vaginal bleeding or periods. The drug is otherwise safe just that continuous bleeding is a nuisance and may lead to anemia. She must take some iron supplements and wear a panty liner. For PMS (premenstrual syndrome), she can try a few things after the course of medicine is finished. She must stop taking tea and coffee. Minimize her salt intake and less water for a week before her expected periods. Also, PMS is a broad term, and treatment depends on what symptoms bother her more.


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Hello doctor,My husband is mostly sad and depressed. He cannot listen a word against him or his family(mom, dad & sister). He gets mad and behaves very rudely with everyone if they do not agree to what he says. He fought with his boss in his company for silly reasons. He abuses me emotionally and mentally. He hides from colleagues and friends about his marital status, to some he says he is not married and to some, he says he is married, and his wife stays with his family and works in a bank (but I live with him and work in MNC). He always uses to tell a lie to me in small things also, he is never ready to accept his fault. Even if it is evident that it is his fault, he will never agree. He was flirting with some girl and went to meet her, and I got to know this when I checked his phone when I confronted him, he got mad at me. He is not ready to accept that he is at fault. He never answers my questions, always diverts the discussion. He does not have any plan. He hates my family for no reason and always say abusive things against them. He says he loves me but never let me live happily. In short, he is still right. Is he mentally ill?


