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Hello. I can understand your concern. Considering the history of the symptoms you have mentioned, there are few possibilities. One is some underlying mood disturbance which could part of bipolar disorder. This should be appropriately evaluated to make a diagnosis. Repetitive mood swings, keeping grudges, anger outbursts, repetitive lying, etc., are seen commonly.  Such symptoms can occur as part of some personality disturbance. Anger, irritation, etc., could be related to personality issues. Please talk to him and if possible, consult a psychiatrist. Mood stabilizers can be used to control his anger and mood swings.


key: Patient
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Hello doctor, It has been around four years that I am always scared to sleep. It usually happens if there is an accident I am scared that it will happen to me too, and I would not sleep for about a week. I am so scared of earthquakes, and many nights, I will not sleep thinking that our building will fall. If there is any news like killing people, I will lock all the doors and windows thinking that I will be killed too. And another thing is supposed I eat at 1 pm for the next two hours I will be full and suddenly I feel so hungry, and in a minute I started feeling so weak and start to shiver. This happens whenever I am feeling hungry.


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Hello. Your symptoms are suggestive of an anxiety disorder, which is making you excessively worried about things happening around you. It can be tiring and emotionally exhausting to experience high levels of anxiety all the time. Try relaxation exercises to help manage stress and related anxiety levels. Deep breathing techniques and progressive muscle relaxation exercises will be beneficial. If possible, try yoga as well, and counseling or talking therapy will be helpful. If symptoms are severe and persistent, you will benefit by consulting a psychiatrist for a full assessment and consider medication options as well.


key: Patient
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Hello doctor,I had a seven-day monitor, and I have attached my reports. Nothing has been added about whether I need medication, etc. This sounds dangerous. should I be worried?


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Hello. Can you upload the report again? I did not get the part narrow complex 5 qrs hr etc. Do you have any chest pain or discomfort heaviness on exertion, or shortness on exertion? These are ectopics or extra beats. These are usually benign and not life-threatening. These are frequently associated with MVP (mitral valve prolapse), caffeine, alcohol, thyroid problems may aggravate these. But, considering your age, we should rule out ischemia in you. You should also get a thyroid test done. So should get a stress test like stress thallium or TMT (treadmill test) done. You will need beta blockers like Metoprolol to keep these under control. If there is any evidence of ischemia, then you can opt for antiplatelets and Statin. I hope this helps you and get back if you have any questions.


key: Patient
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Hello doctor,I am an 18-year-old male, and for over two years, I have been dealing with a lot of chest acne. I have been told it is folliculitis. I have gone to three different derms who have just prescribed me Benzoyl peroxide washes, sodium washes, Doxycycline, and a bunch of different creams but nothing helped.It has impacted the quality of my life, and I am not sure what else to do anymore. I have been doing a lot of research on fungal acne, and I feel like this is the problem I have. Even though I mentioned this to my dermatologist, she said she thinks it is more bacterial and said to see if it would improve by prescribing me new creams, and that I would maybe have a culture test done later on to see if it is fungal acne. Do you have any tips or recommendations on what I can do to solve my problem? Or does this look like fungal acne?


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Hello. I understand your concern. It looks to me like Pityrosporum folliculitis. Some people call that fungal acne too. Does it itch? Please take the following medications for three weeks. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Capsule Itraconazole 100 mg after dinner once a day. 2. Ketoconazole, 2 % Cream, apply twice a day. 1. Capsule Itraconazole 100 mg once a day after dinner 2. Ketoconazole 2% Cream apply twice a day  For 3 weeks


key: Patient
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Hello doctor,I have started taking Aripiprazole 5 mg tablets, after which I started getting spontaneous rashes. My question is, is this effect worrisome (should I go to urgent care)?


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Hello. Aripiprazole can induce skin rashes though it is not commonly reported. It will be safer to get yourself checked to rule out any systemic involvement, especially if you have any fever, pain, signs of the exfoliating rash. Are you on any other medication that can increase the chances of drug-induced rashes? Most rashes are simple and transient, but a few rashes need more urgent attention. So you need to be examined. Depending on the nature and severity of the rashes, you will be advised either to stop or discontinue Aripiprazole. So consult your primary doctor at the earliest.


key: Patient
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Hello doctor, My friend had accidentally swallowed tooth crown an hour ago, she is not facing any problem till now, what should she do, kindly advise.


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Hello. I understand your concern but I think as so much time has already passed and by God's grace everything is fine then I think it has not gone into the airway, problem erupts only when it gets stuck in the airway, it might have gone down through the digestive tract and shall pass out normally through faeces. The biggest question is whether it went inside along with breath or food? That will surely subside the confusion and the one who swallowed most probably can feel this. I would surely want to know which number tooth it belonged to in order to know whether it was bigger or smaller in size. Anyway, an X-ray is always advisable for safety if your area is now open for the same. Be careful and look for the engulfed crown in your passed out fecal matter that will also relax you if you find it sooner. It mostly passes out in 24-48 hours. You can have banana so as to help it pass digestive tract smoothly.


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Hello doctor,I am 21 years old. Today I noticed a small black spot on my toenail, I did a little research and found out that it might be a melanoma cancer, but also it could be a fungus infection. After a bit more research, I noticed that an unusual cystic pimple between my chest that I have had for two months now might also sign of melanoma. I spend little to no time in the sun. Do I have melanoma? The black spot on my toenail might be because of the tight shoes I have been wearing lately, my toe also hurts a little bit from those shoes. The red pimple between my chest appeared five to six month ago, then disappeared and reappeared multiple times, I squeezed it, and blood and fluid came out of it.


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Hello. I understand your concern. The thing on the chest looks more of a sebaceous cyst, (attachment removed to protect patient identity) which comes and goes even if you pop out the contents as it needs to be excised completely to prevent the recurrence. For the toenail spot, I am not sure that it is melanoma, it can be other things like a subungual traumatic hematoma, or pseudomonas nail infection. Nonetheless, you need to keep observing it for any color or size changes. The two conditions you mentioned do not seem to be related, though. Use the following medication for two weeks, and if it is because of infection it will improve 1. Tablet Ciprofloxacin 500 mg twice a day for two weeks. And avoid tight footwear.


key: Patient
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Hello doctor,My son is four and a half years old, and he is suffering from reactive airway disease (enclosing the reports and prescription). Kindly suggest based on the above medication that till how long we can safely go ahead with Montair LC Kid. Is there any upper limit of giving this. I am very skeptical about continuing it in the long run. He is completely fine with this medicine, but if I skip a single dose, he starts coughing just anyways and ends up vomiting everything he had. So I keep on giving him a daily dose of MLC kid. Also, he is a bit aggressive and impatient. I do not know whether these are the emotional changes associated with this medicine. Please tell me that is he losing his natural immunity due to this.


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Hello. Please note that the medications prescribed are to the best of my knowledge. Montelukast has been prescribed for patients for prolonged periods extending up to even two years without any problems. It uses has shown reduced requirements of admission and improving the quality of life in patients suffering from hyperreactive airway disease. However, it would be good if we can omit the LC (Levocetirizine) content by just giving Montelukast alone in the form of tablet Montair 4 mg daily at 8 pm instead of Montair LC syrup (Levocetirizine, Montelukast). The Levocetirizine component may cause dry mouth, sleepiness consequent irritable behavior in very few children if given for prolonged periods. The tablet (Montair) can be crushed in a small cup of water, and the child can consume the paste or solution. Most of such cases usually get alright as age advances with complete remission by the age of six to eight years. Very rarely this may persist till 10 years. If it continues until the age of 10 to 12 years, it may progress into asthma in adulthood.


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Hello doctor, I am concerned about my friends medical diagnosis about paranoid schizophrenia is fabricated by him and resulting in unnecessary medication. Kindly advice.


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Hello. The diagnosis of paranoid schizophrenia is not easy. Proper evaluation by a psychiatrist is needed to make the final diagnosis. The individuals with schizophrenia show symptoms like hearing voices talking or voices are giving commentary, suspiciousness against anyone or even family members, ideas of prosecution, ideas of reference, etc. These should be present persistently, and in usual cases, there is no insight about the symptoms. It is the family and friends who take the patient for evaluation and not the patient he or herself visits the doctor for a diagnosis. Yes, depression or anxiety can be the possibilities, but these too should be evaluated. Symptoms of depression like low mood, anhedonia, reduced energy, fatigue, negative thoughts, bad thoughts, lack of surety about future, feelings of helplessness, worthlessness or hopelessness, etc. are seen.If he has doubts about his symptoms, he should be evaluated by a psychiatrist.


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Hello doctor, Since I was around 8 years old, I have experienced mood fluctuations but not in the normal bipolar way (which I am being tested for). I do not feel like my mood sways between depression and mania. It is always some level of mania but without depression. I also experience tactile hallucinations such as something grabbing my leg, ants or bugs crawling up my legs as well as something breathing on and grabbing my arm. Tension headaches are also common, and intrusive thoughts pretty much ruin my life. Another common occurrence is I notice I have trouble talking, not in a word salad kind of way, but a slurred sometimes mumbled speech. My Psychiatrist says it is likely bipolar, but I do not think that that is the only possible diagnosis. To me, it seems more closely related to schizophrenia or schizoaffective disorder. All I want to know is that is there a possibility that I am correct? Could it be a schizophrenic related disorder? In the past, they gave me Citalopram for anxiety.


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Hello. Yes, your psychiatrist is correct. Bipolar is a more likely diagnosis. Bipolar disorder need not be present with depression and mania both. Recurrent mania also comes under the category of bipolar disorder. In mania, our sensitivity to stimulation increases like colors appear more bright, music appears more appealing and smoothing, also hallucinations are common in mania too. Schizophrenia and schizoaffective disorder diagnosis are made only when there are criterias of disease which get full filled. You can refer ICD 10 bluebook for detailed criteria. To me also, the diagnosis of schizoaffective disorder and schizophrenia is less likely.


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Hello doctor, My son aged 32 years is suffering from schizophrenia for the last six months and not accepting any treatment and since the last 10 days his symptoms got worsened and became violent and today he tried to get injured and he is suspicious on everybody thinking everyone is talking about him and plotting to harm him and asking us to kill him by giving poison and today he became very violent and after consulting a psychiatrist doctor today we gave him Risdone liquid 2 ml by mixing with fruit juice. Now he is sleeping calmly tonight. Please help us for further treatment.


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Hello. I can understand your concern. A lot of patients of schizophrenia or other psychotic disorder refuse to take medicines and this becomes difficult in treatment. Risperidone liquid is tasteless and odorless and can be given without knowledge to the patient. But keep one thing in mind that he should not become suspicious that he is being given medicine by mixing with food. Most of the patients come to know about this. You will have to remain alert for this. This should be followed strictly. In coming days he will become ready to take medicines by own. Till then you can give him Risperidone liquid. He is on 2 mg per day and if needed, the dose can be increased to 3 mg per day. The second option in his case if he refuses to take even food or juices from you is long-acting injectables. Long-acting injections of Haloperidol or Fluphenazine or Risperidone or Paliperidone are available. These have actions for around 15 days and can be given to him if he refuses to take medicines. This can make treatment easy for him. You can discuss with his doctor for this treatment option.


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Hi doctor, I have had a bad cold sore 8 weeks ago on my top lip and a bit of the skin above it. I used Zovirax externally 2 weeks course and Acyclovir 2 weeks course to treat it. The actual sore improved, the blister stopped weeping, the scab formed and flaked off within 3 weeks but the redness is still lingering. I rung the doctors that put me through a pharmacist who told me to use Hydrocortisone 1 % cream. I used it for a week as he recommended but it still did not go away. That was two weeks ago. I also had a new flare up three days ago. Also on the top of my lip symmetrical on both sides. It looks different to a cold sore in that it was some redness and skin flaking. Home remedies I have tried so far: Aloe vera (not much help), Tea tree oil (irritated it), Manuka oil (helps healing where the sore is but seem to irritate the new flare up), Coconut oil (irritated it), Almond oil (seems to soothening it at the moment). I am worried if this is still unresolved herpes/cold sore and can be transmitted to my partner who does not have herpes. Is it contagious and am I able to kiss my partner?


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Hello. As per the current picture sent by you, it does not look like a cold sore as of now (attachment removed to protect patient identity). Also, I would advise to stop all ongoing treatment (including the Hydrocortisone) and just leave it alone for a week. Apply Dologel only. It contains Cholinesalicylate along with certain other ingredients that help to heal. No application of any lipstick or any other ointments or creams to the region. I would not advise kissing for 2 more weeks atleast till things resolve to prevent spread. Also, limit alcohol intake if you are currently consuming alcohol. Avoid spicy foods too to promote healing.


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Hello doctor, I am looking for an appointment with you firstly for reassurance I suppose and then CBT rather than waiting for the NHS. I have had OCD since I was a teen (intrusive thoughts and having to touch wood, say prayers, etc.). This seemed to subside until I had my daughter but then flared up again after and I was misdiagnosed with postnatal and placed on Citalopram. After a couple of years, I came off the tablets and was extremely stressed. Then suffered what I now see as an OCD relapse. I was petrified. I was losing my mind. Researched schizophrenia and almost gave myself all symptoms, suffered depersonalization on the commute home from work and spiraled into an anxious mess. I took myself to a doctor and was adamant I was psychotic. I was screened and told that I had bad anxiety and OCD. From here, I was put on Fluoxetine and things got a lot better. Five years later, I am going through a lot of stress and I stupidly did not take the tablets every day for a period of time. I am now again riddled with OCD thoughts and feelings around schizophrenia. I am my own worst enemy as I know if I had schizophrenia I would not query it. I would believe irrational things. So in turn, my OCD tried to confuse me and I do believe the thoughts. I do not want to carry on like this please help. I am a working mother.


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Hi. I understand you must be going through a tough time. First of all, please do not stress yourself so much with whether it is OCD or schizophrenia or what not. You are much more than a diagnosis. It is important you are at peace and have some relief from the distress. Coming to your symptoms, you have said you have intrusive thoughts but what kind of intrusive thoughts do you have? And apart from saying prayers and touching wood is there anything else that you do? From your history, it does seem that you are having severe OCD which is causing a lot of anxiety. If Prozac has helped you in the past, you can reconsider the same medication but you will have to take it for longer duration like two years or more and at a higher dose like 60 mg. Consider tablet Clomipramine 20 mg along with Prozac for an augmentation effect. For acute anxiety, you can consider tablet Etizolam on SOS basis. As for psychotherapy, rather than CBT, exposure and response prevention seems to be a more helpful option for you but we can explore more on that only when we know the exact nature of your intrusive thoughts. Please look up progressive muscle relaxation techniques. These will help you gain some control over your anxiety symptoms.


key: Patient
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Hello doctor, I have a few and little genital warts in my vagina. I can send you a picture if you want, I am very worried that it could be VPH. Please help me.


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Hello. It seems to be HPV (human papilloma virus) warts only. But need to be confirmed. Are you sexually active? If yes then does your partner also has similar lesions?


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Hello doctor, My daughter is a premature baby. Her birth weight was 1.7, and now she is 2 months old and weights 3.1. Our doctor suggested dexolac special care. She is suffering from constipation, and gas problem after having it. The doctor suggested medicines, but there were no changes. One to two days she was fine, and the next day the same problem started again. She is mostly crying at night and not sleeping. Can I change formula powder? What powder is the best for my baby? Please advice.


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Hello. Please note that children below the age of 6 months pass stools either once in two to three days or 10 to 15 times per day. It is normal, and it is not labeled as loose motions or constipation. If you are labeling it as constipation because of hard pellet like stools, then I would advise you to increase the water content of the top feeds and see. As far as the gas problem is concerned, it is also normal. Nothing is to be done. Almost all babies have gas just like a normal adult. There is no medicine for the same because it is normal. You can calm down a crying baby by either singing (light tones), suckling (allowing baby to suckle), swaddling (wrapping the baby in cloth), swinging (putting the baby in a small too and fro motion). You can also tap slowly on the stomach to reduce discomfort as and when required.


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Hello doctor, I am suffering from depression. It has been four years. I am always demotivated. I was average student but then I became a failure. I cannot concentrate on studies. I feel like god is talking to me and orders me certain things which I must do. I always feel like third person is ordering me and I get tired answering them. I feel like I have become a small child of second grade.


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Hi. The symptoms like someone is talking to you, talking to God or hearing voices which others cannot hear could be occurring due to some psychotic issue. Such kind of symptoms are not generally seen in depression. Since such symptoms have resulted in loss of performance in studies, poor concentration in studies, so please visit a psychiatrist for help and evaluation. Drugs like Amisulpride, Olanzapine, Quetiapine, etc., can help you in coming out of depression and psychosis.


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Hello doctor, I recently got married but when I started having sex with my wife, I started noticing that my penis is not becoming hard enough to have sexual intercourse. Also, sexual arousal is also not happening. I believe I am suffering from erectile dysfunction. Kindly advice what I should do.


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Hi. Erectile dysfunction can occur because of many factors like diabetes, hypertension, thyroid disorder and also due to stress and psychological problems. So, visit a nearby psychiatrist to find the exact cause and then act accordingly. If there is no physical or medical condition then, Sildenafil or Tadalafil will help in erection and these drugs can only be used after discussing with your doctor. Meanwhile, spend enough time on foreplay. You can take few days for only foreplay and proceed to sexual intercourse only when you feel that you are fully erect. Avoid any substance abuse like alcohol or tobacco. Take adequate sleep. Do regular exercise like morning walk for 45 minutes daily. Do exercises of pelvic muscle like kegels exercises.


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Hi doctor, I took Benzodiazepine Alprazolam for insomnia for 2 months for a total dose of 30 mg, while stupidly attending college parties and binge drinking once a week during the period (I have never taken the pill on the day I was drinking). I did not take the drug every day and after roughly two months I quit the drug altogether, the withdrawal, that I did not recognize at the time, kicked in (Extreme tinnitus, sweating, heart racing, heightened anxiety). I went to ENT doctor and she gave me two Dexamethasone injections in 3 days (I think 8 mg). I developed during these 3 days a major loss of short term and then long term memory, trouble finding words, trouble learning in general. The physical symptoms of the steroids and benzo withdrawal went away in 2 weeks. It has now been a month since I feel physically fine, but the cognitive issues persist and they do not get better at all. I have been to a psychiatrist because I felt overwhelmed that Iam not going to be able to finish school in such a state and she gave me Escitalopram thinking it could be psychological, but there is no improvement in cognition after a months use. Does that combination have that drastic side-effects and could it caused a chemical or structural problem in brain? What can I do to return somewhere close to my old self? I am 24 years old.


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Hi. People taking Alprazolam should not combine it with alcohol and avoid combining it with other medications, such as narcotic pain relievers, that cause drowsiness. Doing so can cause additive drowsiness and reduced breathing as well as other side effects, which can be dangerous and possibly fatal. Alprazolam may be habit-forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (more than one month), do not stop taking the medication without speaking with your doctor. A gradual reduction in dose is recommended when stopping this medication to avoid withdrawal symptoms.  Escitalopram works by blocking the reuptake of serotonin so that there is an increased level in the brain. Serotonin is an important neurotransmitter responsible for mood and well being. It is usually taken once daily and may take a few weeks to months reach maximum therapeutic potential. So continue taking Escitalopram until you see significant improvements in your memory.


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Hello doctor, I hit my forehead against a wall and had a small cut on my forehead and now it has healed and it looks like a scar. Will I have a permanent scar?


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Hi. First, you need to understand that scar treatment depends on its depth and lenght. Whether your scar is permanent or not, it is very important to evaluate it. Mostly scar lightens and becomes equal to the surrounding skin with passage of time. However, scars which are deep becomes permanent. Such scar will not go away with any creams or gels. Best treatment for permanent scar is reversal by plastic surgery or it could recover to some extent with C02 laser.


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Hello doctor, I am six weeks pregnant and there is a stone of 3 to 4 mm in gallbladder. Can I get operated for the same?


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Hello. I understand that you are worried about gallstones and it can be stressful whilst undergoing pregnancy. However, let me assure you that most gallstones do not cause any symptoms. Seeing as they are small in size, they can be easily left alone until after the mother has delivered the baby. The risk of miscarriage is always present whenever a pregnant women undergoes any procedure. Are there any symptoms that are bothering the mother? Like jaundice, uncontrollable pain, etc.? I would also request you to share the investigation reports as it will help us make a better decision. LFT, Ultrasonography Pain medication - Tablet Paracetamol 500mg SOS if having pain Avoid spicy and oily food


key: Patient
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Hello doctor, I have lump at the base of chin in the middle, where it meets the curve of neck. The size is a little smaller than a dime. Only you can feel that but not see. I was having discomfort for a month on the left side like I have to move my neck but has stopped now. Then noticed the round lump about four days ago. It does not hurt.


key: Patient
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Hello doctor,As of now, I experience abdominal pain with cramps in the lower right of my abdomen. What could be the problem?


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Hello. This could be as simple as digestive problems with gaseous distention. It requires medications for indigestion or gaseous distention like Charcoal tablets, passing by symptoms of gastroenteritis. If diarrhea and vomiting develop, food poisoning is one of the reasons as well. Also, it can be a kidney or ureter problem (stone or salts). This site can suggest acute appendicitis as well, which should be dealt with as an emergency. In all circumstances, I recommend a visit to your general physician or internal medicine specialist for further history taking, clinical examination, and evaluation. Visit your doctor for further evaluation.


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Hello doctor,I have a burning sensation on the feet for three days. I am currently under Clonazepam.


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Hello. Causes of burning feet include peripheral neuropathy and plantar fasciitis. I suggest you use footwear even at home and take over-the-counter pain medications to alleviate pain. You may also use Diclofenac gel for local application. If the symptoms do not subside over one month, please get electroneuromyography of the lower limbs to look for nerve involvement.


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Hi doctor, My father has a round inhomogeneous opacity in the right middle of the lung. He is taking Ceftum 600. How to treat him?


key: Patient
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Hello doctor, How can I improve my immunity for pneumonia since I already had it five times? Once when I was a kid, thrice in high school and currently at college. Please help.


key: Patient
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Hello doctor,My father is in the hospital fighting pneumonia and has COPD. His latest X-ray has shown some improvement. The X-ray shows he has an extensive airspace and interstitial opacities in the left lung and patchy opacity in the right lower lung. The plan is to do a bronchoscopy and use a tube to assist in getting him oxygen.


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Hello. I have gone through the history of your father's illness you have provided (attachment removed to protect patient identity). The X-ray reports are suggestive of pneumonia. At this stage, on initial antibiotics and supportive treatment, if he has not improved, bronchoscopy may be essential to isolate the organism that has caused pneumonia. This will help to guide antibiotic therapy. By tube to assist oxygen, they are possibly implying putting him on a ventilator? That may be necessary if he is not able to breathe on his own adequately to maintain oxygen in his body. For more information consult a pulmonologist online -->


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Hi doctor, I am having fever for about a month now. So, I have done a master health checkup and the report shows raised PLBS 184, SGPT 121, LDL 112 and fatty liver. My chest x-ray PA view shows right lower zone soft tissue opacity. Because of the soft tissue opacity fever pack, thyroid profile, blood culture and sensitivity, sputum AFB, sputum culture and sensitivity and sputum gram stain tests were done. The results were normal except the gram stain test results. The gram stain sputum culture conventional showed pus cells and epithelial cells occasionally, bacteria - gram positive cocci, gram negative rods. Sputum culture and sensitivity showed pus cell - occasional, epithelial cells - occasional, bacteria - gram positive cocci and gram negative rods and growth observed - normal flora. So, kindly explain the above results and advise me. My past medical history includes fistula-in-ano, hypertension and vitamin D deficiency. Currently, I am taking Telma 40 mg and Lumia 60k.


key: Patient
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Hi doctor, I went to the emergency room with fast heartbeats. The doctor did an EKG and chest x-ray, and he said I had pneumonia. But, my QT was slightly prolonged. He repeated the EKG after a week later and said it was fine. Should I be concerned about the prolonged QT? Can pneumonia have caused it?


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Hello. Hope this helps you and get back if you have any doubts. For further queries consult a cardiologist online -->


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Hi doctor, My father was previosuly diagnosed with renal tubular acidosis and diabetes mellitus, was maintained on Potassium citrate and Gliclazide OD. Currently he had an infected insect bite on the left anterior lateral aspect of the leg. He was started on CO-Amoxiclav BID. Currently on its 4th day, I had his labs taken which revealed HbA1c: 8.5, FBS: 7.57, Crea: 2.79 mg/dl, BUN: 3.67 mg/dl, Hgb:195, Hct: .58 wbc:13.2, plt: 157 with normal lipid profile and uric acid. Should I start CKD medicines already? Should I step up with the DM medicines? Thank you.


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Hi. High creatinine suggests a CKD picture for a long term diabetes particularly uncontrolled DM. Your fathers HbA1c is high which shows his diabetic status is not under control. High potassium levels is one of the complications of CKD, in this picture taking Potassium citrate is not advisable as it may increase its levels. And diabetic drugs also need to be modified when a person lands up in CKD, most oral medicines cannot be given. It is safe to shift the treatment with Insulin. You need to visit a Nephrologist for alterations in your medications and appropriate advice for CKD. serum potassium, sodium, phosphorus urine routine USG abdomen DM, CKD


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Hi doctor, I am 40 years old male. I am suffering from fatty liver. I have high cholesterol, and thyroid level is also high. I am not taking any medication.


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Hi. I have gone through the attachment (attachment removed to protect patient identity). You have a high cholesterol level which is the cause of the fatty liver rather than weight. A lipid-lowering medication is required. Regarding your thyroid, the hormone levels are within normal. There is no need to worry about them, unless if you have significant symptoms. I suggest a medication take Atorvastatin 10 mg tablet once daily before dinner and repeat the lipid profile after six weeks. Liver enzymes should be done after one month as a precaution. For more information consult a family physician online -->


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Hello doctor, All my reports are normal except one. They told me that I have a grade-1 fatty liver. What does this mean?


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Hi doctor, I have a fatty liver for a year. I gained a lot of weight. After regular exercises, walking, and maintaining my diet, I am unable to lose weight. Can I take Lycopodium along with Calcera carbonica? And I also have a lot of dandruff problems. I am taking Himalaya liv 52 ds.


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Hello. The fatty liver is due to obesity. You have to check your blood pressure and sugar levels as well. Check serum cholesterol, serum triglyceride. Regular active one hour exercise is needed for you and a strict diet restriction has to be followed. Fatty foods should be taken less. Fruits to be taken more. The Ursodeoxycholic acid tablet can be used for fatty liver. Dieting is needed along with exercise to reduce weight. Check hypothyroidism by serum TSH (thyroid-stimulating hormone) estimation. For more information consult a family physician online -->


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Hi doctor, I had diarrhea for about 20 days. After I got recovered, my doctor advised me to do an MRI of the abdomen. These were the results shown. There was a mild signal drop noted in the liver on the T2 fat sequence suggesting a fatty infiltration. My pancreatic head and uncinate appeared normal. Distal body and tail showed a fatty replacement. Kindly advise.


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Hi. You have a fatty liver on MRI (magnetic resonance imaging). It is very common. Please say about the habits you have. Please mention your medical history. Please tell about your BMI (body mass index). Fatty liver can lead to liver damage and cirrhosis after a long period. I advise you check your liver function tests, sugar, and lipid profile. Follow a regular exercise and diet. Try to lose your weight. Have healthy food. Revert me with the blood reports. There is no need to take medicines for fatty liver. They will disappear after a lifestyle modification.


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Hello doctor, Hemoglobin: 14.3, platelets: 174000, SGOT: 38.9, SGPT: 65.0 and vitamin D: 23.6. All other reports are normal.


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Hello. You seem to be suffering from non-alcoholic fatty liver disease (NAFLD). This does not require any special treatment. I suggest you avoid painkillers, alcohol, and reduce weight if you are obese. I would also recommend you testing for hepatitis B and C. I hope it helps you. For more information consult a medical gastroenterologist online -->


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Hello doctor, I am addicted to codeine for the past 4 years. After my marriage, my wife had conceived but that time we did not want it. So, we aborted and it has been 2 years. Now we are trying to conceive but it is not happening.


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Hi, Welcome to icliiq.com.  I read your query and understand your concerns. First of all I would like to inform you that Codeine can be stopped in gradual manner. Scientifically speaking you can go for 10% reduction of original dose every week leading to complete abstinence at the end of 2-3 months. In case this is not possible or you are not able to tolerate the lower dose of Codeine you can get yourself treated form local psychiatrist. We often recommend Clonidine for this purpose which helps in the withdrawal symptoms of Codeine. The medication dose is decided depending on the dose of Codeine, age of the patient, duration of abuse and blood pressure. I mean to say that this is high time to say "NO TP ADDICTION" and take this opportunity to come out of this addiction without delay. I understand that your concern is not addiction but inability of your wife to get pregnant despite repeated efforts. But we need to understand that addiction and infertility are related to some extent and removal of one risk factor might pave for fathering a child. In addition it is also important to get semen analysis done for yourself and follicular study for your wife to rule out other causes.


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Hello doctor,I want to share my aunt case and seek advice regarding this case. My aunt is about 54 years old, and her husband is around 63 years old.After the death of my aunt's father, a behavioral change occurred in my aunt. She started to blame her husband and try to make her husband stay away from all young girls.She got extra possessive about her husband. She blamed three to four girls and stopped them to come close to her husband even she blamed her daughter in law to stay away from her husband. We do not know why she is doing this? She always thinks that all girls and aunties trying to get interact and come close to her husband. Please advice.


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Hello. She should consult a psychiatrist. The symptoms like possessiveness, ideas, or even delusional beliefs about the fidelity of husband, blaming husband, etc. cannot be ignored. She might be suffering from some mood disorder most likely depression with psychotic symptoms. This could be some psychosis too. Individuals with psychosis show paranoid delusions, delusional beliefs, and become suspicious. Considering her age and late onset, the chances of depression with psychosis are more. She might refuse to visit a psychiatrist and will try to evade the visit. Drugs like Olanzapine or Quetiapine can be used to reduce her psychotic symptoms, and she will come out of depression.


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Hello doctor, I would like to ask about my symptoms. It started with aweful headache for two days. The following week had pain in muscles and bones. Then that went followed by extreme anxiety attacks, burning on neck, tingling in head and face. I was in and out of hospital for three days. Started on Lexapro and Rivotril. Three weeks after having the medicines had muscle pain and twitchingsome muscle weekness. It is been five weeks now, and the anxiety is better but still have muscle twitching and some muscle discomfort.


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Hello. I will be happy to help you out here, and I need a little more history.  1. Do you have any flu-like symptoms? 2. Any nausea, vomiting, or diarrhea? 3. Have you been taking any over-the-counter supplements?


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Hello doctor, I just want to know what kind of mental illness my fiance has. When she was 11, her mom's fiance shot her in front of my fiance and when he turned the shot gun on himself he told her to look. I just want to know if that could be a reason for why she acts a little weird and off sometimes. She talked about her mother a lot too. She misses her.


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Hello. Yes, if she has witnessed such life threatening trauma in her young age, she might act weird sometimes. But that does not mean that she has any psychiatric illness. You should focus on your relationship with her and give her proper time and she will come out of her psychological trauma. But symptoms like hearing things which others cannot hear, or talking to her mom, fear, etc., should be evaluated by a psychiatrist. This could be due to excessive stress or some psychotic issue. This should be ruled out.


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Hello doctor, I am a 41-year-old male with 5'11" height and weight 214 pounds. Multiple sclerosis and bipolar disorder are co-morbid conditions. I was recently admitted for a heart catheterization to check for any potential blockage after an abnormal ECG, chest and chin pain, months of breathlessness, and a very strong family history of cardiovascular disease. Fortunately, no blockages were found. However, my cardiologist informed me that I had diastolic heart failure. To be clear, he did not say diastolic dysfunction, and he said heart failure. My high blood pressure has always been controlled. My reports say,  1. Moderate tortuosity of epicardial vessels consistent with hypertension. 2. Hyperdynamic left ventricular ejection fraction of 75 to 80 %. 3. Moderate to severely elevated left ventricle end-diastolic pressure 24 mm Hg. My cardiologist never gave me a prognosis. He told me to eat a low sodium diet and to get checked for sleep apnea (which I will do), but he never gave me a prognosis. I have dealt with health problems for a very long time. It is essential for me to know what a diastolic heart failure diagnosis means for my lifespan. I am married and have five children, and it would be nice to know what I am looking at. Kindly advice.


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Hello. I am sorry to hear that you did not receive any detailed explanation of your condition. Diastolic dysfunction is the inability of the heart to relax, which can be diagnosed with echocardiogram or with evidence of high pressures inside your heart chambers, as evidenced by the increase LVEDP (Left ventricular end-diastolic pressure) in your cardiac cath (it was 24 mmHg, and normal is considered less than 15 or 18 mmHg). The term diastolic heart failure is used when we have evidence of diastolic dysfunction as above in addition to symptoms of heart failure (the shortness of breath you described). There is some belief that diastolic heart failure is more benign than systolic heart failure, but in reality, that is not the case. They have similar prognosis when compared in general. However, patients with advanced systolic heart failure have a worse prognosis than those with diastolic heart failure. The complicating aspect is that there are no many proven therapies that work for diastolic heart failure, other than low sodium diet, diuretics, exercise, proper eating, and lifestyle modification. To provide a more precise diagnosis, it would be essential to understand how is your exercise tolerance, however that can be challenging with your multiple sclerosis. I hope this information helps. I do not want you to feel discouraged but instead focus on lifestyle modification. Eating well, stress reduction (mindfulness or mediation can help) and practice physical activity. Hypertension, and obesity. Possibly an exercise stress test to objectively assess your exercise capacity, sleep study, and probably a Holter or event monitor (to assess for arrhythmias or atrial fibrillation).


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Q. My husband gets frequent sharp cramps in right lower abdomen lasting for a minute. What could this be?


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Hi doctor, My husband gets sharp cramping in the lower right side of the abdomen over a period of two months. It happens once or twice a week and lasts for a minute. We checked for appendicitis and kidney stones and all the reports are negative. We did a CT scan of the abdomen and it came normal but with a finding of stage 1 fatty liver. Can you please help me understand what is his issue?


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Hello. I will definitely help you. Right lower abdomen pain has many reasons including appendicitis and kidney stones. There are some other reasons like indigestion of food, infection of the small intestine, or worm infestation. This may be functional also in which no cause is identified. The main reasons are indigestion and irritable bowel syndrome in which all investigation were normal. So if a CT scan is normal and there are no other complaints like vomiting, bloody stool, urinary complaint, constipation then it must be functional due to indigestion. Avoid fatty and spicy food and lots of water have to be taken Give two-hour gap between dinner and going to bed. Please get back to me if any of the above symptoms are there and attach an investigation report also for better help.


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Hello doctor, I have started to notice something about my eating habits. I noticed that I have gained a lot of weight this year. And I have even been eating food that I do not like. I get hungry so many times during the day, even though I already ate. Last year, I would not say I was on a diet. But, I hardly ate much. I was wondering if that is the reason why I am gaining this new eating habit. If you starve yourself for a long period of time, will it trigger you to want to eat more? This is a serious concern of mine, because I have never been such a big eater.


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Hello. If you starve for a long time, your body demands for more carbohydrates to complete its metabolism. If the starvation continues for a long time, the body starts accumulating energy for the period of starvation, hence you feel to eat more. The best way is to provide lots of fluids and fibres so that you feel full and avoid carbohydrates and junk. Decide your meals to 5 to 6 meal pattern, increase protein fibre, you will maintain weight. If gained, start with exercises for good result.


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Hi doctor, I realize I have IBS symptoms and they seem to be related to SIBO. I need your advice on how to treat it effectively. Here are some symptoms and test results. Leaky gut or intestinal permeability with multiple food intolerances. Seems to have hydrogen sulfide based SIBO, severe farting with a foul smell of eating foods like cabbage, broccoli, cauliflower, high protein foods. I may have an overgrowth of sulfate-reducing bacteria. Rifaximin seems to help with SIBO but it is temporary. I have to eat rice as I cannot eat gluten or wheat. Some experts on SIBO say that MMC or vagal nerve dysfunction is the root cause of SIBO. I have heard a lot of patients get better when they increase gut motility. So I wanted to ask if taking prokinetic or cholinergic support will help SIBO from reccuring.


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Hi. The best is to avoid eating foods that cause trouble. Secondly, for SIBO (small intestinal bacterial overgrowth), it is better to use a combination of Tetracyclines plus Metronidazole for two weeks. Effective probiotic will also help. Take the following medications: 1. Tablet Tetracycline 500 mg thrice a day two weeks. 2. Tablet Metronidazole 400 mg thrice a day for two weeks. 3. Take a good probiotic for two weeks at the end of the previous two drugs. 4. Take fresh homemade yogurt twice daily in a small bowel.


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Hello doctor, I have severe bad breath problem after taking fever medications for a week. Does it come from my stomach? Please help me, as I am embarrassed.


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Hi. Bad breath is due to the destruction of good bacteria in the intestine by antibiotics. I suggest you try probiotics, such as Lactobacilli, thrice daily for two weeks. You will feel better.


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Hi doctor, I had probiotics for two days as I was having issues with constipation and it helped me. Later, I got side effects of nausea, headache, cold and hot sweats, sleepiness, loss of appetite and going to the bathroom more often for the past three days. I discontinued probiotics. Should I seek medical help?


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Hello. Thank you for providing a precise history. Revert back with the answers to the above questions to an internal medicine physician online -->


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Hello doctor, I would like to know a few details of the tablets which I have been taking for my scalp psoriasis. Winolap 5mg once in a while when itching is too high (without doctor's prescription). Isotretinoin drugs/other drugs (with doctor's prescription). I have been taking these medicines on a regular basis and were very effective. But only till I take them. If I stop the medication, I have to visit my doctor again and start medications again to get some relief from itching in scalp. I want to know if these medicines will cause harm/side-effects in future? Can these be taken continuously?


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Hello. Isotretinoin is a potentially dangerous drug and in many countries there are very strict guidelines over its use. It basically contains retinoids which in simple language is a derivative of vitamin A. It is primarily used to treat severe cystic acne and I fail to understand why your doctor has prescribed it to you for psoriasis. Its side effects include: Well, I need some more information: 1) For how long have you been suffering from scalp psoriasis? 2) Exact name and exact dose of the medicines which you are taking? 3) For how long have you been taking each medicine (in detail)? 4) Any medicine which you had taken in the past but not taking now? 5) Do you feel any side effects which I have mentioned above? 6) How much relief have you got in your scalp psoriasis from these medicines or no effect at all yet? 7) Do you have psoriatic lesions anywhere else on the body or just on scalp? Kindly provide these information, so that we can evaluate your case in detail and prescribe you with the best possible treatment. Revert back to a dermatologist online for further follow up -->


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Hi doctor, I am suffering from psoriasis for the past 24 years. I have tried a lot of ointments already. I heard one of the reasons is lack of vitamin D. Is it true? I am 54 years old now.


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Hi. Psoriasis is a T-cell mediated autoimmune disorder. What you have heard about lack of Vitamin D as its cause is a myth among patients because nowadays there is a new class of topical drugs available which are analogues of Vitamin D. These reduce the excessive cell proliferation and differentiation seen in the skin cells of a psoriasis patient. A few of these drugs are Calcipotriol, Calcitriol, and Tacalcitol. Their pros are that they do not cause skin atrophy, but they are useful only for stable and moderate psoriasis. To help you better, I need photographs plus a detailed history with a previous medication you had taken.


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Hello doctor, For a couple of months, I have had a red area between my butt cheeks (not anus, further up where butt cheeks meet). This developed on the right side as a large area of redness which now feels scaly and a bit raised. At times it may feel moist, watery, not quite bleedy though. I tried an athlete's foot antifungal spray which I think helps a little bit, but it comes back again. Is it psoriasis or fungal infection or just irritation? I am a runner and sweat a lot due to heavy exercising every day. I took a picture, and I have attached it. Please advise.


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Hi. After carefully reading your complaints and looking at your photographs, there seem to be three possibilities (attachment removed to protect patient identity). For making a clear cut diagnosis, I need the answers for a few questions: Looking forward to your response in order to help you.


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Hi doctor, I have been suffering from psoriasis in my palm. When I was 12 years old, I had this disease for the first time. After taking some medicines it disappeared. But, it used to come on and off. In the past one year, I have faced this problem quite often. In between, I had homeopathy. As it cannot be cured, I shifted to allopathy again. A local doctor prescribed me some medicines for psoriasis and I want a second opinion about the prescription.


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Hi. Yes, your treatment is right. But, do not take Folitrax for long duration (Methotrexate) as it can adversely affect your liver and immunity. For further information consult a dermatologist online -->


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Hello doctor, My SGPT and SGOT are increased. Diabetes is also not under control. Cholesterol levels have also increased.


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Hi. Regarding your SGOT and SGPT, it is elevated because of liver tissue strain due to diabetes and hyperlipidemia. But other liver enzymes are under control. Avoid spicy and fatty food and if you are alcoholic or smoker, stop. Regarding diabetes, you are on right medications but HbA1C is 7.1. ABG is 157, care for diet and mild exercise, we can bring it down. Renal uric acid and urea and creatine are not increased, so renal condition is fine. Continue the treatment, diet and exercise. Monitor BP. Do ECG, US abdomen and review. Diabetes and lipoma. BP, ECG, echo, ultrasound abdomen. Cirrhosis of liver. Liver disease, DM, hyperlipidema. He can continue the same treatment with diet and exercise. 1. Roseday A75, once, 2. Istamet 50/1000 twice, 3. Glimepride 2 twice 4. Febutrix40once and, 5. Remylin D once. Liv 52 two tablets twice daily. Avoid fatty and spicy food, no alcohol and smoking.


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Hello doctor, I am a 27 year old lady. I started having a sore throat two months back. I just thought it was a flu coming. But then, when I noticed that it had been on for two weeks, I decided to take Amoxicillin. I took it but did not finish the course on the last day. I had traveled and forgotten them at home. The sore throat went away but came back a few days later. I took another full course of Amoxicillin and during the course, the sore throat went away. I finished the full course but a few days later, the sore throat came back again. I went to the clinic and the nurse noticed that my throat was inflamed and prescribed Erythromycin. I took it but the sore throat kept on coming back. The nurse then prescribed Ciprofloxacin. I took the full course but still the sore throat did not go away. When I went back to the clinic, the nurse said it was no longer inflamed but I could feel it, but only that the discomfort seemed to be going deep down the throat. It is like each day I can feel it is moving down. It is not a very painful sore throat. I do not take any painkillers. My body temperature and blood pressure are normal and have been normal throughout the period. Right now, I can feel discomfort in my upper part of the chest. Another thing is that the first episode of sore throat occured after I visited my sister who from time to time gets swollen glands (below the ear). What could it be and how can I get well again?


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Hello. I have gone through your complaints. Repeated attacks of a low-grade sore throat suggest that it could be chronic pharyngitis. The other common causes of chronic sore throat are due to acidity and gastroesophageal reflux. That means stomach acids pop into esophagus silently and burn the throat in the nights. You should undergo upper GI esophagoscopy and a throat swab to rule out infection. Try taking antacids for a week. Do not take antibiotics. I think this would suffice. For more information consult an ENT otolaryngologist online -->


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Hello doctor, I am a 33-year-old male. I have not had any previous health problems, non-smoker, and non-drinker. Generally, I am feeling fine. For the past six months, I have produced bloody semen with blood clots and producing more recently. I have also recently started feeling mild pain behind my right testicle. Occasionally, my left testicles seem to change in size slightly and seem to almost disappear and the right testicle becomes quite tender and firm. I had an ultrasound scan about six years ago and there was found some cyst but little concern. About a week ago, I sensed a small lump rising above my right testicle to my lower abdomen, it was uncomfortable but I slept and the discomfort eventually went away. I see little blood-colored spots appearing on my arms and torso perhaps resembling perhaps petechiae and have an area of this rash on my torso that I am not sure may be related to my concern? I have been taking Azithromycin since yesterday incase it may be a virus or something bacterial but it does not seem to be helping the problem. I had a blood test in January 2020, but have not been able to make a follow-up blood test yet. Not sure why it might be necessary. What does the problem sound like to you?


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Hello. Hematospermia (blood in semen), is fairly common. Generally it is not considered as a sinister sign. There are whole list of possibilities for this theoretically, but once we ensure it is not due to sinister cause and rule out treatable causes say like infections we do not beyond that as it will not affect the management. Sinister causes mainly prostate and testicular cancers. At your age prostate cancer is extremely unlikely but need to ensure no testicular problem. With your symptoms with testes, you need another scan to be on safe side as the scope for examination to be conclusive. I suspect you have epidydimal cysts which are very common and can cause pain, etc. So if the scan does not show anything other than this, I would not worry about it at all. I think the rash is completely unrelated to this or any of your urological problems. Nor the rash or hematospermia is related to old history of chlamydia. Since you have not had any other urinary symptom, I would not worry much about other tests related to urinary tract. However, I would also recommend sending semen for culture to see any infection in it. Lastly about prostate cancer virtually unheard in your age. Finger examination of prostate, PSA blood test and MRI scans of prostate are the screening tests in general. But not something I would recommend if testes scan comes back normal and if you are still worried an MRI then will be helpful as last resort. Idiopathic. Testicular pathology. Ultrasound scan of testes. Ideally an examination of genitals including prostate by a clinician. Semen culture. Idiopathic. Hematospermia. With reports.


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Hi doctor, I am having skin problems for the two months where pimples are like faint and after it disappears that spot becomes black. Please help.


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Hello. I will help you with your problem. You are having acne vulgaris which is the most common skin condition of your age. Generally, the eruptions on healing leave a mild dark spot. If the eruptions are manipulated by picking them or squeezing them, they leave darker spots on healing. In your case, if you are having oily skin, you should use Ahaglow S facewash four to five times a day. This will prevent oily skin which is one of the main causes of the acne. For the treatment of the eruptions, you should use Deriva CMS gel on the eruptions at night daily. Also take tablet Azithromycin 500 mg three days a week for 1 month (3 days daily dose, then 4 days gap, then repeat). The dark spots, if persist after the course of treatment, can be treated by other creams then. Acne vulgaris. As mentioned above.


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Hi doctor, My 15 year old daughter always gets sick. When I take her to the doctor, every time he used to say it as viral infection. This is the fifth time in a year she has been sick with the same symptoms. Her symptoms are cough, low fever, sore throat and yellowish white colored mucus covering her tonsils and back of throat. Are these the signs of tonsil infection? Should her tonsils get removed?


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Hi. Let me first enlighten you about tonsils. 1. Eating more chocolates or ice creams. 2. Dental and oral hygiene. Throat swab and culture or RADT (rapid antigen detecting test). URTI (upper respiratory tract infection). If culture is positive then I suggest Tablet Amoxicillin 625 mg twice daily or tablet Amoxicillin 500 mg thrice daily for 10 days. Consult your specialist doctor, discuss with him or her and take the medicine with consent. 1. Repeated salt water gargling. 2. Maintain oral hygiene. 3. No high carb diets like ice creams and chocolates. For further information consult an internal medicine physician online.--->


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Hi doctor, I am 24 years old. I have had a sore throat every day for almost a month. I had antibiotics already, but it did not work. What could be wrong with me? It is chronic and I have been more tired with this. Sometimes, I am getting a fever and belly pain. My laboratory test showed strep test positive. What to do now? Please help.


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Hello. I understand that you have done strep test, which is a rapid test to find out whether the pharyngitis has bacterial origin. The strep test is positive and this means most probably the Streptococcus pyogenes detected in your throat is the causative organism for the pharyngitis. The strep throat infection has to be treated with appropriate antibiotics. I suggest you take a course of Amoxicillin and Clavulanic acid (625 mg) twice daily after food. Take supportive treatment in the form of salt water gargling of the throat, anti-inflammatory and pain killer tablets. Also avoid spicy, oily and masala-rich foods, which aggravate the throat irritation. As a painkiller, I suggest tablet Paracetamol 650 mg twice a day. Anti-inflammatory tablets are combinations of trypsin-chymotrypsin enzymes. If you do not get relieved with this antibiotic, then I suggest you go ahead with a throat swab culture and sensitivity. That will tell us about the details of the antibiotics to which the organism is susceptible and resistant. With your blood pressure values, I see that they are towards the higher side. However, if it was measured using a digital BP apparatus, it is bound to be erroneous. Kindly visit your GP and get your BP checked. Manual measurement of BP is the preferred method. At your age, it is unlikely that you have this high BP. For further information consult an ENT otolaryngologist online -->


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Hi doctor, The issue is from 39 years ago. When I was 13 years old, I was considered for the possibility of poisoning. I was admitted to hospital for 8 days and the diagnoses were cervical adenitis and viral syndrome. I had a fever of 103 degrees for several days before going to hospital. My throat culture grew Strep. On admission to hospital, CBC showed WBC 12,900 (normal range), Hb 13.2, Hct 38.7, 36 lymphocytes, 9 monocytes, 7 eosinophils and the platelets were adequate. The almond size lymph node on the left cervical chain and the right side lymph was golf ball size. The neck was supple, no rigidity and some restriction of movement. There is no mass or thyroid palpable. The rest of the physical examination is within normal limits. Total bilirubin 0.4, ALT or SGPT was 714 initially and on discharge it was 215. SGOT or AST was 426 initially and 202 on discharge. LDH was 297 and then 217 on the day of discharge and albumin 3.8.  I am trying to figure out why my liver enzymes were so high initially and 8 days later they came down. I was treated with Keflex IV antibiotic, which cured the infection. Mono spot was negative. Urine and blood cultures are negative. From what I read, the liver cause could be toxic. But, at the of 13, I neither drink, nor had hepatitis.


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Hello. Revert back with the answer to the above questions to an internal medicine physician online -->


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Hello doctor, 1 year and 10 months old boy got injured by boiling water, the doctor pricked some of the blisters. The hospital could not say which degree of burn it is, so we are concerned and want to get a second opinion since he is crying a lot and is in pain, the doctor did not advise anything further. He is around 10 kg. The genital parts also have some blisters. Picture has been attached. The white area on the picture is Flammazine cream that the doctor prescribed. Should we find another hospital, is it serious?


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Hi. This qualifies for approximately 9 percent burns (attachment removed to protect patient identity). The child will need to take some painkiller medications like syrup Crocin DS (250 mg/5 ml), 2.5 ml thrice a day for 3 to 5 days to reduce the pain. As regarding the cream, it is good, please continue using it. Unfortunately, I will not be able to judge from the picture if the child needs Bactigrass application or no to the burn site. This can only be assessed by a surgeon. Hence, it is advisable to get the child physically evaluated by a surgeon as early as possible. If required, the surgeon will clean up the wound and debride or leave the skin as it is and can assess if the child needs Bactigrass sheet application or no.


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Hello doctor,I am 61 years old. I have some weird swelling on my left ankle, and I took photos of it to send to my son. He is worried it is related to a Renflexis infusion I had last week. I have had RA since I was 39.


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Hello, Welcome to the icliniq.com. The edema due to renflexis is an uncommon side effect. If you have leg edema, then it is advisable to investigate as follow. 1. Serum protein estimation to rule out hypoproteinemia. 2. Sgpt (serum glutamate-pyruvate transaminase) to exclude liver disease. 3. Urea, creatinine estimation to rule out kidney disease. 4. Serum TSH estimation to rule out hypothyroidism. Echocardiography to exclude cardiac cause and finally local ankle joint X-ray if needed. If edema leg more than diuretic like Furosemide can be prescribed after consultation with your doctor. I suggest you consult nearby physician for a detailed discussion of all these. I hope I have answered your question.


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Hello doctor,I feel stress, tension, and anxiety for even little things. Due to tension, I have the urge to pass stool frequently. My digestive system has been distributed. Some times I ​suffer from constipation, and loose motion, but mostly from loose motion. Gas also forms in the stomach. I always feel less stamina, loss of strength, weakness, fatigue, tiredness, with low immunity​ associated with tightness, aches, and pain in both hands and legs. Kindly advice.


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Hello. It seems you have developed severe anxiety towards something. You may try Argentum nitricum 30c one dose (four pills) once a day in the evening for five days. After five days start taking Kali phos two tablets twice a day for 15 days. These remedies should help to reduce your anxiety to some extent. Please do not take these remedies for a longer duration than the recommended period. Let me know if you have any other questions. I would be happy to answer your queries.


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Hi doctor, I am a 38 year old male, and I have been feeling twitches in my arm. I started feeling this constant twitch about six weeks ago. I did not experience any weakness in that arm or anywhere else in the body. The twitches lasted for about a week and then went away. The twitches have now appeared four weeks later in the same area (upper arm). Again, there is no apparent weakness, which I have tested by lifting weights at the gym and both my upper and lower body strength seems to be fine. What is worrying me to death is, could these twitches be an early sign of ALS? Is it possible that weakness will follow even though I do not have it now? Do ALS twitches go away for four weeks at a time and reappear? If I started to experience constant twitches six weeks ago, if this was ALS should not I have experienced some weakness by now? Is the fact that the twitches are localized to the same place a bad thing?


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Hello. I have read your query and understand your concerns. First of all, I will suggest you consider other possibilities before jumping to conclusions. There are a number of conditions which can present with twitches without any disease, and ALS (amyotrophic lateral sclerosis) is one of the remotest possibility for a 38 year old young male. The commonest cause for twitches is simple worry or anxiety. I know at least 100 individuals with anxiety, who presented with simple twitches and no other symptoms. In my opinion, you need to see whether these twitches have any relationship with your anxiety level. The another common conditions which present with twitches is endocrine abnormalities, such as thyroid and parathyroid disorders. In case the stress level is not able to explain the twitches, an evaluation for endocrine abnormality is indicated. The list may go on in a similar fashion. Find the answers to your questions below: I hope this helps you. If you have more questions, feel free to write back. For further queries consult a neurologist online -->


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Hello doctor, I am a female, and I have an issue with my upper teeth. I lost the right canine tooth when I was young, which made my upper front teeth to move to the side. And my front two teeth are a little big. I consulted a local dentist, who said the solution is to take out one normal tooth, that is, the tooth after my left canine. Then he will put braces to align the other teeth, and he said he will bring my teeth back in the center. I just want to know if there are any other options to correct my teeth. I do not want to loose a good tooth. Can you help me?


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Hi. Without any clinical pictures, it is hard to comment on the situation. However, I will give you some basic facts. For more information consult an orthodontist online -->


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Hi doctor, I am a 29 year old male. I have some enlarged bumps and white lesion on the back of my tongue. I thought that I had a gum problem because my saliva was often brownish and I had a funny taste in my mouth. Now, I believe that I have some fungus infection. It looks exactly like on the picture I have attached, but only in the back of my tongue. What kind of treatment should I need?


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Hello. I had gone through all the data posted. For further information consult an internal medicine physician online -->


key: Patient
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Hi doctor, I had unprotected intercourse with my fiance during the first week of last month. Same week, within few days she complained about vomiting sensation but had no vomiting. Immediately the next day she had a little discharge from vagina and a little menstrual cramp. Her last menstrual period was in the last week, two months back. The local gynecologist told it is because of gas and gave an antibiotic tablet, multivitamin syrup and gas related tablet. The following day, early morning she felt headache and a body ache. Is it something to be worried about? Is she pregnant? When do the earliest symptoms of pregnancy come up?


key: chroma:document
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Hello. These are not pregnancy symptoms, but rather they are symptoms of ovulation with mild abdominal ache, nausea, headache, bloating and thin mucus discharge from vagina. As her last menstrual period (LMP) was in the last week, two months back. So, it is day16 today. Hence in a 30 day cycle, this is the time for ovulation. As you had sex in the first week the following month, still she can be considered in her fertile period and hence an emergency contraceptive is advisable to be taken in 72 hours in your case to prevent pregnancy. However, the earliest you can detect pregnancy would be after 7 days post-intercourse with a serum beta-hCG test. If it shows the level of hCG more than 5 ng/dL then shall confirm pregnancy. Otherwise, she would be pregnancy safe. But, at present these are ovulation signs. Revert back after the test to an obstetrician and gynaecologist online -->


key: Patient
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Hi doctor, I have been getting pubic hair with a white coating under the testicle area. It almost looks like the hair is coated with white conditioner. I have also noticed that the area seems to be sticky when I sweat. I shave the pubic hair off, but it comes right back. I have been checked for STDs and I have none. Is this from my partner since it keeps coming back? Or is that it is deeper than shaving the hair off? Is there any creams I can use?


key: Patient
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Hi doctor, In my kidney ultrasound, my left kidney shows mild dilatation of calyces with dilated extrarenal pelvis of approximately 39 mm. What does it mean?


key: Patient
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Hello doctor,  I am a 29 year old male. My height is 5'9" and I weigh 95 kg.   I got married in January 2014. My wife is 2 years younger than me. She comes from a very simple family and she has had no relationship before marriage.   I am the first guy in her life. She is also the first woman in my life and both of us have never had physical relationship ever before.   Now since January 2014, we are trying to have intercourse but unable to.   We are wanting to have a baby now, but are really worried with the situation. My wife is very shy and does not know much about sex.   I masturbate every day in the morning before bath on my bed with the stomach position.   I have never masturbated with tool in hand position and I have even tried but I am not able to. I cannot ejaculate in that manner.   The moment I lay down on stomach, I ejaculate in less than 20 seconds. I am very worried.   My masturbation has become even more regular since I am unable to have sex with my wife.   Also my wife is very sensitive when I touch her vagina.   Recently she has started enjoying fingering but she resists a lot if I do it with two fingers.   I wonder how I will ever penetrate her with such small space.   Also we tried penetration a lot of times but the moment I come close to her I lose erection.   We are very frustrated and are dying to have a baby.   I am very uncomfortable with my foreskin rolled down.   I know for penetration the head of the penis needs to be inserted but the head is very very sensitive and that is why I prefer masturbating in laying on stomach position.  Please help us. We want to have a baby now and before that we want to be sexually happy.


key: Patient
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Hello doctor,I am 36 years old. I have genetic hair loss, is there something I can do to grow more hair? I use Minoxidil, but it is not working.


key: chroma:document
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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 assess the condition and to suggest you the appropriate diagnosis and treatment. I need to see it to help you further.


key: Patient
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Hello doctor,I had a strange ECG from my watch. No one else looks like mine, and my primary doctor said that it is anxiety.


key: chroma:document
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Hello. I have thoroughly gone through the ECG results there are no specific changes that would indicate any pathological change. ECG results might show different shapes and morphology, but it does not necessarily mean it is abnormal. I have to ask what are you doing about your weight? You are overweight, and it puts you at risk for cardiovascular disease. I hope you have put in measures to help reduce your excess weight like dieting and exercise.


key: Patient
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Hello doctor,My right eye is red and puffy. It hurts when I blink by the top of my iris. It also tears up a lot when it hurts, and when under the light. I use contact lenses that I can use for a week straight, and it started on day three. When it started, it only hurt when I blinked, and the eye would tear up a bit, the next day it was red, puffy and it reacted to light. I immediately removed the contact lenses. What is wrong with my right eye?


key: chroma:document
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Hello. First of all, I would like to tell you my point of view as an ophthalmologist in and against any contact lens that stays in the eye for more than 12 hours. The puffiness is most probably related to an allergic reaction that your eyes are experiencing, and you should discontinue using these contacts. The redness, the light sensitivity, and even the tearing are all signs of dry eye for which you should start using artificial tears at least four to six times daily, especially if you plan on using contact lenses again. Regardless of what any manufacturer says, you should not sleep with your contact lenses, and I would advise you to use daily from now on. You can use artificial tears while wearing glasses.


key: chroma:document
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Hello. Stammering or stuttering is not very uncommon in this age group. Most children do stammer at this age, and with time over a few months, it gets resolved usually. I believe that the delivery of this child was smooth, and she had no history of admissions for any illness. Also, her milestones are normal and not delayed. Now here, the family has to play an important role. Your child has started developing speech, and this is quite normal to happen. So, first of all, you stop worrying. And even if you worry because I know it can be alarming for parents, please do not pass on your anxiety to your kid. Just do not let her feel that it is abnormal. Whenever she speaks, to listen to her and never try to correct her or scold her for this. Pay attention to what she is saying and look at her, and eye contact should be there. When you talk to her, talk slowly so that she can grasp every word. Kids always try to imitate us. She will also start speaking slowly, which will help her say words correctly and with ease. Never criticize or scold, also tell everyone at your home and even school teachers. Encourage her to speak. Do not pass your anxiety to your kid is most important because if a child gets anxious, it will get more pronounced. Slowly and gradually, you will see that your kid has outgrown this. If still, you feel that there is no improvement after one to two months, speech therapy may be done. Speech therapy should be started before four to five years. I hope this advice would be helpful to you. I would be there for any help.


key: Patient
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Hi doctor, I am a 28 year old male. I have itchy scalp and hair fall with tiny white ball all over the head and also in shoulder. The balls are attached to the skin and coming out in nails with pressure. I have attached the photos along with this query. I am using anti-dandruff shampoo, which cures the itch for one or two days. But, the white balls are still coming out. I am facing this problem over a year. Now, my hair fall has seriously increased. I have oily skin. Advice me some medicine which is easily available and some technique to care my hair.


key: chroma:document
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Hi. According to your history and from the photos (attachment removed to protect patient identity), you are suffering from acute dandruff with folliculitis. For further information consult a dermatologist online -->


key: Patient
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Hello doctor, I got married three months back. And since then, I am not able to have sex with my wife. I am not able to retract my foreskin when erect, and the head of the penis is not visible. I can only retract it less than 1 cm. The foreskin on the penis is very soft, and I cannot roll it back. When I try to penetrate, it pains and my erection is not very strong to penetrate. I tried taking tablets for improving my erection, but it has not helped. My erection is better now, but I am not able to penetrate. Please help me. Is it compulsory that the foreskin has to retract during sex? Please help me as soon as possible


key: Patient
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Hello doctor,I have blisters on the head of my penis due to masturbation without proper lubricant. I thought that it would heal by itself in a few days but now the blister popped and the skin is very tender and hurts to the touch. Also, another blister of sort, developed on the tip. It cannot be an STI because I have not had sex for several months now. How should I go about with the treatment?


key: chroma:document
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Hello. There are a few conditions which cause painful blisters even without a sexual contact, like genital herpes, primary syphilis, impetigo among others. Please provide more details: The treatment would vary according to the details you provide. If you underwent any investigations, please attach that during the follow-up. For more information consult a general medicine physician online -->


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Hi. I have read through your query in detail. Please find my observations below. Severe pain in abdomen radiating to the back might be due to many conditions which require evaluation. Problems that might cause the stomach and back pain, all the possible reasons, For spasmodic pain you can take antispasmodic medicine like Spasmonil plus (Dicyclomine hydrochloride and Mefenamic acid). This has to be taken twice daily for pain that might be a spasm. This should reduce any spasmodic pain that you are having. Once pain is stable then please consult your doctor and get examined clinically. If required the doctor might ask for an ultrasound scan abdomen to be done to know the cause. Above mentioned causes are the commonest and there are many other conditions which might cause a similar pain. Clinical examination and investigations are important.


key: Patient
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Hi doctor, I had a very bad habit of excessive masturbation. I started it when I was 14 and now I am 27. I masturbate around two to three times per day. I was not aware of the side effects of the masturbation. Now, my penis is totally shrunk. It is looking wired. I visited a doctor. He gave Nano Leo capsules. It has been three weeks and I am not finding any change at all. Is there any hope for me? Will it cure my side effects? Please help me. I had the habit of smoking and drinking habit as well. Now, I stopped everything before three weeks. Can I get my normal old life?


key: Patient
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Hello doctor, I am 17 years old and mostly healthy. I had an EEG and an MRI several months back; both came back fine. I suffer from OCD related tension headaches. On the 15th, I was in my father's office looking for something. It was too dark and so I decided to turn on my dad's lamp. It is an archaic thing, built in the 1930's by my grandfather's sister and it is mostly copper. I grasped for the light switch, instead I accidentally touched the copper beam of the lamp. The moment I touched it my hand gripped it. Around four to five seconds passed till I realized that my hand was shaking and got an electric shock. I quickly pulled away. Then, I felt sick, extremely anxious and in a daze. The next morning, I woke up extremely anxious and a tad bit confused. I felt as if I was confused. My parents brushed it off as anxiety and stress. Later that day, I had what seemed to be an allergic reaction to my lunch. I had red blotches all over my chest and neck. My face felt hot. Then, I received a 50 mg Benadryl shot. Almost instantly I felt as if the space around me shifted. I felt taller soon after I got tired, confused and disorientated. By the time I got into the car, I fell asleep, although I was not really asleep. I felt like I was slipping in and out of consciousness the entire way home. It was as if half of my brain had shut off. My muscles were limp and I was thinking strange things as if my mind was thinking by itself and I had no control on it. I then managed to walk into my room without falling and sleep. It was a dreamless sleep. When I woke up, I was irritated. Every voice in the house made me angry and I ended up cursing my brother and mom. I engaged in short nonsense conversations on and off. I would talk about something that did not make any sense and then I forget and ask what I was talking about. My head and neck vibrated. My muscles were weak and my body felt jittery. I wanted to sleep, but I could not. The space around me was fluctuating. Then, I had a large panic attack that lasted till 12 AM and I woke up the next morning around 10 AM with severe confusion and deorientation. I was thinking nonsense and could not construct a sentence. My muscles were weak again and I could not focus on reality and my head was vibrating. Fear sets in again. I do not cry even when terrible things happen as I usually cope, but I could not control my mind and cried a lot. We called the doctor who gave the injection. He told me that I was having some kind of allergic reaction and that I should take Zantac to help the Benadryl move through my system. Later in the day, it seemed to dissipate slightly. But, now (7 PM) it is back and almost as bad as it was this morning. I took another Zantac, but it has not done anything yet. I feel the vibrations most in my teeth and nose. Also, I have a rapid heartbeat. Is this being caused by the electric shock? And if so, will it go away over time? Am I in long term issue? Or is this caused by the Benadryl? It has been over 30 hours and I believe it is only since I was injected. Did this trigger long-term side effects? Do stress headaches have anything with this? Or is this caused by a combination of all three things? I just need help. Please I need to know what is going on. I really do not want to live with this. I am having a very hard time writing this. Thank you so much for your time. Also, my dad got shocked three times by that lamp.


key: chroma:document
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Hi. I understand your symptoms with chronological order. For further information consult a neurologist online -->


key: Patient
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Hi doctor, I got my arm trapped between a metal pole and an electrically controlled door. The blood flow was cut off for around 30 seconds to a minute. My arm is quite painful and swollen. It has some blood spots and my wrist hurts when I bend my hand and fingers. Do I need to see a doctor? Is it sprained? What should I do?


key: Patient
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Hello doctor,I have ankylosing spondylitis (HLA B27 positive) for the past 12 years and with pulmonary tuberculosis the very next year. And took medicine for nine months, and now I am daily taking Saaz, and I am going to plan for Biologics. The doctor suggested Etanercept 50 mg, but I am afraid of side effects as I was already affected by TB before 11 years. Shall I go for biologic Etanercept 50 mg, and what precautions I have to take during biologics? (I have enclosed the report)


key: chroma:document
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Hello.  You need to do Mantoux test and interferon gamma level before starting biologics because they can cause reactivation of tuberculosis if there is doubt you should receive the two drug ATT regimen (anti-tubercular treatment) before starting biologics that is recommended if either Montoux or interferon gamma is positive.


key: Patient
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Hello doctor, After every erection without orgasm, my testicles start hurting along with abdominal pain. Kindly advice.


key: chroma:document
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Hello. Testicular pain after erection may be a signal that you are having epidydymo orchitis because the epididymis and testicles are the organs where your sperms are stored and produced respectively. So if the pain comes when there is a history of trying to ejaculate that may suggest inflammation somewhere in these organs was there a previous history of STI (sexually transmitted disease) before this incident, pain from the testes is usually referred to the lower abdomen. We also need to be mindful of testicular torsion.I advise you to do urine MCS (microscopy, culture, and sensitivity), semen analysis MCS then scrotal scan to see the testicles anatomically for any scarification.


key: Description
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Q. Kindly suggest the alternative medicine for the hormone blocking injections in the treatment of breast cancer?


key: Patient
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Hello doctor,My mother was diagnosed with breast cancer early this year. She underwent MRM surgery and now undergoing chemotherapy. Her age is 57, and the doctor advised for eight cycles of chemotherapy. Now she completed five cycles, and now the doctor had advised 17 more injections for hormone blocking. We find 17 more injections are too much and will be highly stressful for my mother. Could you please suggest an alternative treatment.I have attached a few essential reports for your reference. Please let me know if you need any more details.


key: chroma:document
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Hello. Her cancer will be her 2 neu positive, in this scenario, it is mandatory to give 17 injections of Trastuzumab, otherwise chances of recurrence are high. As far as cost is concern, you can get some other way, like hospital cost is very inflated, get it administered at a small center, you can get injections from wholesale yourself, and you can go for generic drug.


key: Patient
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Hello doctor, Last month I had I-pill (within 48hours of intercourse) after 18 days of onset of my periods. I did not have any side effects like withdrawal bleeding, nausea, etc., after taking the I-pill. I got my periods on the 1st of this month. I am unsure if this is my normal period or bleeding due to the side effect of I-pill? Please help me to clarify this. If it is my regular periods, then there is no delay in it (a week before or week after than expected date). Is it normal? Is there a need to take a test or any chances of pregnancy? If yes, when to take the test?


key: chroma:document
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Hello. Let me start by assuring you that you are not pregnant and need not worry. If you have had your periods 18 days before taking I-pill, your ovulation would have been around 13 to 15 days after that. Life of egg is only one day. So there is no chance of an egg being alive on that day of sex. I-pill or emergency contraception pill is a high dose of progesterone hormone. After ovulation, your ovary also will be producing the same hormone. As you have taken it after the ovulation date, the thickness of the inner uterine lining would have increased further. But would not have shed. Usually, if you take it before ovulation, your bleeding will start within a few days. So you should have had your regular periods, slightly thicker or more than usual. If you had bleeding almost like regular periods, then the inner lining of the uterus has been shed. There is no chance of pregnancy if at all, to catch inside the uterus. So do not worry, your next period will be one month from this period. I hope I have clarified your query, do write back if any more questions and for your feedback.


key: Patient
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Hi doctor, I have a milk tooth in the bottom row middle, which is moving and needs to be removed. And I got irregular teeth in the top and bottom which needs correction. Is it possible to close the gap after removing the bottom milk teeth, the gap would be about the width of a 5 rupee coin.


key: chroma:document
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Hi. Yes, could be done in clinic after removal of mobile tooth assessment of available space and space management criterion and space maintainance methods implemented such as Maryland bridge. As your age is 30, I suggest you undergo orthodontic treatment sooner as bone elasticity for pressure tension decreases with age.


key: Patient
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Hi doctor, A month ago I was at an outside chlorinated hot springs but it was really cold and windy. I remember saying my ear is so cold like freezing so we went inside. Ever since that day it feels like water is in my ear. Sometimes worse than ever. Then I got a head cold and both my ears felt clogged. But the ear that got super cold still feels like water is in it even after the cold has mostly cleared up. I went to my family doctor and they said it was red in my ear canal but they do not see an infection or water in it. What do you think? If for some reason it is compacted, could that be seen?


key: chroma:document
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Hi. Do you have pain or decreased hearing? Did he rule out wax and outer ear infection? Could he see the ear drum?


key: Patient
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Hello doctor, Since four years I am taking Sizodon LS medicine from a trusted doctor. Nowadays I feel sufficient response. But after consulting my same doctor, he is avoiding to stop that medicine. As per his opinion, if I stop this tablet, again I will face problem after a month. Now, I request you, is it true or false?


key: chroma:document
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Hi. As you are on Sizodon LS (Risperidone) for last four years and now alright. Stopping the drugs depends upon many factors like your diagnosis, family support, etc. It is true that if you are suffering from schizophrenia or related diseases, then it is advised that you continue the medicine for many years or possibly life long otherwise relapse (symptoms re-appear) can occur. So, continue your treatment according to the advise of your psychiatrist.


key: Patient
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Hello doctor, I am 37 weeks pregnant. I have sharp pain in lower left side that is coming every couple minutes but does not last long. Is this the start of labor? I am also possibly leaking amniotic fluid but I am not entirely sure since there is not a lot.


key: chroma:document
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Hi. How are you doing today? As you said most probably it is the beginning of labor pain. Usually cervix, the mouth of uterus is slightly to the left. Pain usually lasts for a few seconds only, but reappears. Do not worry. Minimal vaginal discharge with this pain indicates that cervix is gradually opening. To confirm about the pain, just feel the top of uterus, trying to indent your fingers. When no pain, you can feel the baby parts. When you get the pain, uterus contracts and becomes stony hard, you will not feel baby parts. Just having pain is not an emergency.  Just note four points:  1. Movement- you should have atleast four movements after each meal. 2. Pain- if it is frequent and lasts longer. 3. Leak- you will feel thick water just wetting your clothes. Not minimal discharge. 4. Bleeding- obvious red colour.  You will need medical help in all these situations. Do not panic, if this is your first pregnancy, it takes about 12 hours for baby to come out after true labor pain and 6 to 8 hours, if second. All the best.


key: Patient
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Hello doctor, For the past two months, I have been experiencing a minor rash on the crown of my penis. I have have been using antibacterial cream since then but it does not seem to recover. The rash occurred a month after I had an unprotected sex. No itch, no discharge, no pain while urinating or anything just a few rashes that do not seem to go away. Could this be a sign of STDs? No other symptoms are present. I also had an HIV test a month after I had sex and it was non-reactive but I have a very high cholesterol level. Could you please tell me what is going on? I use Brulidine cream (antiseptic and antibacterial cream).


key: chroma:document
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Hi. I saw your clinical pictures (attachment removed to protect patient identity), genitals look normal clinically, skin is little dry, I do not see any rash, blister or ulcer which are the manifestation of STD. In the first picture, those white tiny bumps below the glans (tip of the penis) are the harmless ones, they are called pearly penile papules. Are you referring to them? Herpes will have painful blisters in a group with redness at the base. Syphilis, chancroid will have ulcers. Gonorrhea presents with pus from the urethra, pain while urinating. At present, with your history and clinical pictures, I do not see any symptoms or signs of any STD.


key: Patient
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Hello doctor,I had a road accident and fractured my right thumb. It happened three weeks back and was administered a spica cast the next day of injury. After an X-ray, the doctor suggested that the cast can be removed in a few days. I want to understand, how long before I can resume my normal activities like driving or riding a motorcycle, etc. Also, I was strength training regularly before the accident, when is it advisable to lift heavy weights again?


key: chroma:document
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Hello. It is a bony mallet injury. You need to wear the splint on for eight weeks totally, a mallet thumb splint. Do not remove the splint for eight weeks. Repeat X-rays after eight weeks of injury and splint application. And then after eight weeks, you will require physiotherapy for mobilization as you are expected to have the stiffness of that joint. Driving can be about three months after the date of injury. Heavy weight lifting can be done after six months of the date of injury. Can you send me the other view of the X-ray also, if you have so that I can see the fracture better in the other view of X-ray also? For more information consult an orthopedician and traumatologist online -->


key: Patient
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Hello doctor,My recent CBC showed 1+ anisocytosis and 1+ anisocytosis. My hemoglobin is 12.9. The lowest hemoglobin I ever had was I believe post my C-section. I do take multivitamin/ or prenatal almost on daily basis even now. I am concerned with these results: I know in previous blood test it showed some anisocytosis but not +1. My physician did not say anything about this. I found out because I read my tests. I am going back to see him and question these results. Any suggestions?


key: chroma:document
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Hello. Anisocytosis means a difference in the size of the red blood cells. This could mean that you have a mild iron deficiency. Anisocytosis of 1+ is a very mild variation in the size of the RBCs. Your hemoglobin levels are towards the lower end of the normal range and it is possible that your iron stores are depleted. This can be determined by testing serum ferritin levels. I would suggest that you continue taking the iron and folic acid tablets for another two to three months to bring up your hemoglobin levels and replenish your iron stores. There is no need for you to worry. For more information consult a hematologist online -->


key: Patient
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Hi doctor, I am a 41-year-old male. My blood and urine tests are normal. I am experiencing tender muscles all over the body. I have pain in legs and arms, and I have tried various treatments to treat them. I have done physical therapy, chiropractic, and massage. I am concerned that it can be an overall systemic issue. I am having this problem for about ten years. I have sensitive spots all over the arms and legs. More recently, I had joint pain. I have moderate anxiety (OCD) and mild sadness or depression. I also have dust allergies. Please help me.


key: chroma:document
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Hi. I have gone through your history and blood reports (attachment removed to protect patient identity). Your test results are normal. The pain experienced all over the body looks like a different condition known as fibromyalgia. I want to ask you some questions to confirm it. Please say whether you had any history of mouth ulcer or excessive hair fall, history of difficulty in combing hair or had a problem in getting up from a toilet seat or had any mood changes when you got angry, any recent history of forgetfulness, any history of frequent headaches or bowel upset. Please explain your condition in detail.


key: Patient
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Hello doctor, My right leg is weak and toes also numb. Last year I had the same problem in my left leg. I can no longer control and use my left hand. I had same problem with my right hand before two years. I am very concerned because I can feel my left leg getting weaker and numb and my right hand is going numb again. Kindly advice.


key: chroma:document
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Hello. As mentioned in your history you have (attachment removed to protect patient identity), 1. Atrial Fibrillation. 2. TIA (transient ischemic attack). 3. Hyperlipidemia. 4. Migraine. 5. Fibromyalgia. Atrial fibrillation is possibly not found last time, and so it might be you have paroxysmal atrial fibrillation. Most of your test including MRI brain, CT angiography of neck vessels, 2D echocardiography, and MRI spine did not show any specific abnormality. Also documented are anxiety and depression. I would like to know some detailed information about your symptoms and medications, 1. What exactly happened to you now? Since when weakness in right leg started and did it happen suddenly or slowly? 2. In toe numbness, do you feel tingling, pins, and needle sensations? Or you have less feeling of touch at toes? Had it also start along with weakness, or there was a time lag between weakness and numbness? 3. Do this numbness and weakness persistent or is it intermittent in the whole day? 4. Have you noticed any particular factor, which increases weakness and numbness (like walking or laying in the bed or forward bending or stressful situation or sleeplessness etc.)? 5. How is your usual mood in day-to-day activities? 6. How are your sleep and appetite? 7. Have you been gone through nerve conduction studies? If yes, please send that report too. Revert me with above mentioned information for better understanding and further judgement.


key: Description
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Q. I have pain,extreme fatigue,unsteadiness and muscle twitching. I do not know if all these symptoms are related to one issue or more.


key: Patient
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Hello doctor, I have had this problem for 8 years with no proper solutions. Please help. Strange sensations, tiredness, feeling of heaviness in the arms and legs. Hands and feet become warm. I have an electrical shock like feeling in face. I have extreme fatigue, unsteadiness and muscle twitching in the arms and legs and my eye often twitches. Now my feet and hands itch like crazy. Feet are worse than the hands. I take Cymbalta, Lyrica and Levothyroxin. I have had MRIs of the spine and brain, nerve conductivity test, and many blood tests including heavy metals, HIV, syphilis, drug test, vitamin levels test, Lyme disease test, ANA and so many others. The doctors are not able to figure out what is wrong. I had about 25 hours of sleep only this whole week, because I have so much pain. When I do sleep I thrash all over the bed. Going this long without getting much sleep is not normal for me. I usually do get more sleep than this. When all this first started I got very sick, lost weight (about 40 lbs in two months) and laid on the couch for a year missing out on life because I was too exhausted and sick. I do not know if all these symptoms are related to one issue or more. The doctors thought I had MS, but no lesions. Please help me. Thank you!


key: chroma:document
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Hi. I read your query and understand your concerns. If your age and other description does not match with the above narration or if you have more questions feel free to write back to us. Consult a neurologist online for further help -->


key: Patient
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Hello doctor, I have a stiffness of neck and pain which continues to the back further. This often happens when a stressful situation arises, which also raises my BP. Worries related to health and other life concerns keep bothering me. Please suggest.


key: chroma:document
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Hello. From your symptoms, it seems like fibromyalgia with anxiety. Whenever we are anxious, our autonomic nervous system plays a role, and hence increases the blood flow to various organs by pumping more blood at higher rates, and thus heartbeats can be felt by us. Also, when we are subjected to constant stress, those muscles become stiff. And thus, due to constant tension in them, they hurt after some time because of lactic acid accumulation. Your BP (blood pressure) is also because of stress and not medical hypertension. I would like to know more about your symptoms. Let me know about the details so that I can help you further. Take care. Revert with more information to a psychiatrist online -->


key: Patient
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Hi doctor, For several years my father is suffering from stomach pain. His problem includes blood in stool and pain in left side abdomen area. He has taken ayurveda, homeopathy as well as allopathy medicines, but nothing has benefitted. We did test like endoscopy, but some doctors said it is due to piles. But, no medicine was effective till date. Kindly guide us.


key: Patient
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Hi. I am 20 years old, and a student. I am currently having obsessive thoughts and I find it hard to control the thoughts. I have fears and getting anxious that something might happen to me yet, I am trying to convince myself to not to. But then again, i've been seeking for help from psychiatrists that offer free consultations because, as I said I am just a student wanting to know more about my condition. I hope someone could help me. I have ear problems and mitral valve prolapse. I for now, have medical prescriptions for mitral valve prolapse and haven't checked up for this ear problems of mine. I am currently taking Propanolol.


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hello, I can understand that you are suffering from obsessive compulsive disorder and having distressing obsessive thoughts. OCD is quite resistant illness which involve serotonin a kind of chemical in the brain. we generally prescribe antidepressants to increase level of serotonin in the brain. antidepressant require in higher amount because you know oCD symptoms are very resistant more than depression. there is also a talk therapy which is called as exposure and response prevention it's a kind of cognitive behaviour therapy . I would suggest you to visit your psychiatrist again and ask for this talk therapy. this will definitely help you hope my answer help you thank you kind regards feel free to ask further


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Hello doctor,I started the combined pill 12 days ago. I vomited on the 6th day after 14 hours of taking medicine. I also vomited on the 9th day after 12 hours of taking the pill. Am I still protected?


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Hello. Yes, still you are protected,  1)If you vomit more than two hours after taking your pill, you are always protected from pregnancy. 2) If you vomit within two hours of taking your pill, take another medicine right away. 3)If you do not take a replacement pill within three hours of your normal time, use a backup method for the next 48 hours.


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Hello doctor,I am having cough and chest congestion for the last three days. Also getting a mild fever again and again. I also have a chest X-ray done today only. Please suggest is it pneumonia and if yes how severe is it?


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Hello. Your chest x-ray appears normal. There is no pneumonia. What you have is an upper respiratory tract infection (URTI), mostly caused by viruses. This is a self-limited disease and usually clears up within seven days on its own. Sometimes, cough can persist a while longer and is called post-viral cough. Antibiotics are useless against viruses. They should only be used against bacterial infections. Viruses cause the vast majority of URTIs. These infections spread through the air (when you cough or sneeze) or through contact. They are not transmitted through food. Treatment for viral URTI is symptomatic. Fever medicines like Paracetamol, Ibuprofen, or Naproxen can be used. Nasal decongestants for the congested nose. If cough persists beyond a week, then a corticosteroid inhaler can help.


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Hello doctor, I am a 20-year-old female. I got used to masturbating to porn for seven years now, and I never had an orgasm by myself only, maybe twice my whole life before my relationship. And now I am in a lesbian relationship, and we are living together. The whole six months, I have never had an orgasm with her except when we masturbate together. I have started to worry, sometimes I almost reach but never totally reached, and sometimes I return without an orgasm. Is it because of my porn history? I do not know where the problem is?


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Hello. Orgasm is not traceable to your masturbation or porn history. Some people experience it a few times in their sex life. Even in a heterosexual relationship, most times the man cums even when the lady is yet to cum. On many occasion, she never cums. So it is body differences. Has nothing to do with your masturbation experience. Some ladies cum faster when oral sex is done on them. So there is nothing wrong with you. You are fine.


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Hello doctor, There is abdomen pain since three days. Pain is not continous but really painful. Little loose motion, light headache when gets out of bed, little fever on day 1 and 2.


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Hi. Such pain in abdomen with stool discomfort can happen as a result of stomach infection. Important here is clinical examination to know the site of the pain. So it is advisable to see your doctor. If he would feel suspicious, he would send you for an ultrasound abdomen. If all normal, you would be treated with antibiotics like Ofloxacin. Till you get medical help, you may take a combination of Pantoprazole and Domperidone that would reduce your acidity and pain. Take light food and drink plenty of fluids. Stomach infection. Ultrasound abdomen. Colic. Stomach infection. Light food. Review with ultrasound.


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Hello doctor,Yesterday I consulted an orthodontist, and I was told, that to keep the changes that braces will acquire, they will have to pull out four of my healthy teeth, without including the wisdom teeth. Those are going to be four premorals, two on the upper jaw, and two on the bottom jaw. I heard that it is the only way because of my severe jaw defect. I was wondering if it can be true because nobody wants to get rid of healthy teeth.


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Hello. I can tell you about treatment in the broader sense. In case of the shorter lower jaw, either a surgical and orthodontic treatment is done (in case of poor esthetics, both jaws and teeth are corrected) or orthodontic correction of only teeth. Since your question is about the second treatment plan and pertains to extractions I will answer that. Extractions are relatively common in orthodontic treatment to create space. In cases with smaller lower jaws with space requirement, upper arch extractions are mandatory. Lower arch extractions are also advised if there is space requirement or extractions needed for bite improvement or maintenance of normal bite. So it is reasonable to advise the extraction of four teeth. You can send pictures of your teeth and X-rays to confirm whether this fits your case.


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Hello ! Can you please review my blood test? My concern are low level of ferritin, high level of B12 and Urine WBC is very high.


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Hi, Welcome to the icliniq Following is my opinion for your asked question. The low ferritn , Low Mcv could be suggestive of early iron deficiency anemia. The common cause for high B12 include supplement intake , Liver disease or Kidney disease. Your liver & kidney profile reports are normal.So don't worry about that. If you have any history of supplement intake than mention it.B12 excreted by urine , so might need not to worry about that.High Non Veg food also sometime can cause elevated B12. For low ferritin no need of any treatment.Repeat your serum ferritin & serum iron after few days. The WBC in urine could be due to urinary tract infection.For that investigate further with urine culture report.Meanwhile take more water & cranberry juice extract tablet.Attach the urine culture report once done. Hope this will help you Regards


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Hello doctor,My age is 28, and I think I am suffering from sexual weakness like premature ejaculation and erectile dysfunction. I want my young days back. I think it is just sexual weakness. Can I take Damia drops? What is the dosage and till when I have to take for six months or a year?


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Hello. I suggest you have Agnus castus 200 three times a day at every eight hourly for at least 10 days. This medicine will help with both premature ejaculation and erectile dysfunction problems. Please also inform me if you have diabetes, high blood pressure, or any other diseases, so I will help us to do more and appreciate the treatment. I would also like to suggest you do some physical exercise daily in the morning for at least 30 minutes.


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Hello doctor,I am 27 years old, weighing 57.1 kg and about 1.45 in length. I was busy cleaning this morning when my heartbeat felt very strange. Like it was vibrating inside my chest, it lasted for about 30 seconds and stopped. After that, I feel very tired, a little out of breath, and a heavy weight on my shoulders. Should I be concerned?


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Hello. You probably had a transient arrhythmia (abnormal heart rhythm). The most common type of abnormal heart rhythm at your age (assuming you do not have any pre-existing heart conditions) is supraventricular tachycardia. This can produce symptoms like palpitations, lightheadedness, and a strange feeling in the chest. An ECG, if done during the actual episode, can provide a diagnosis. But at least, you should get a baseline ECG. So, I suggest seeing your general physician within the next few days. Other things that are pertinent when you have fast heart rhythms are: 1. Excess production of thyroid hormone (a thyroid test TSH would be appropriate).2. Excessive consumption of caffeine.3. Any recreational drug use like cocaine.4. Electrolyte imbalance.If you get these episodes frequently, you should see a cardiologist who can order some tests.


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Hello. Yes, Zoloft (Sertraline) may cause muscle cramps, tingling by disturbing blood sodium chloride levels. Zoloft is an SSRI (selective serotonin reuptake inhibitor), which may cause a disturbance in these ions (sodium and chloride) hence may cause it. Get the blood test done serum sodium and serum chloride, or you may try increasing salt intake in your diet. Which if improves your problem then it is undoubtedly due to low sodium and chloride.


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Hi doctor, I am suffering from acidity, GERD, IBS from the last five years. I am just taking Pantop DSR or Rabekind DSR from the last three years but no result. I have high BP, stage 1 BP varies from 140 to 150 and 90 to 110. I feel bloated mostly. Sometimes breathlessness, pressure in eyes and head. I have fat in my stomach around 2 to 3 inches. I have visited many gastroenterologist but no result.


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Hello. You have several symptoms related to the gastrointestinal tract: 1. GERD.  2. Irritable bowels.  3. Bloating.  You also seem to have abdominal obesity and high blood pressure. Proton pump inhibitors like Pantoprazole and Rabeprazole do not seem to have helped you. I suggest a dietary approach that will reduce your weight and also can get rid of the bloating, acid reflux and irritable bowel symptoms. That diet is the low carbohydrate, high fat diet (LCHF diet) or ketogenic diet. This involves cutting down your carbohydrate intake and increasing the intake of healthy fats. In my experience, nearly all people who followed this diet got rid of the acid reflux and bloating. The good thing is, you can also lose weight and possibly reverse your high blood pressure.


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Hello doctor, A vein is blocked near the heart. The doctor told that he checked up today and there is a pain in the chest when he walks far. He is 45 years old, what should be done?


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Hi. Blocked artery in the heart causes pain especially when one is engaged in activities like walking due to increased heart rate during activity which reduces blood supply to the heart muscles leading to ischemia and pain. This condition is called angina pectoris. It is a problem with the coronary arteries which supplies the heart muscle. The doctor to see is the cardiologist. Do ECG, do clotting time. Take Isorsobide Dinitrate 5 mg three times daily will help to open the heart arteries and relieve the pain. Take care.


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I am looking for my husband doxtor becuase he is a diabetic, asking for you what is the better medicine to lower his blood sugar at the same same time he has UTI .


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Dear User, To decide a medicine for diabetes depends on the current physical and clinical condition. There are several aspects to be taken care of. It would be necessary for a doctor to start medicine after getting detailed medical history. That will include current sugar levels, which type of diabetes he has, basic diet pattern, physical activity status, family history of diabetes, current medicines he is taking for diabetes and uti, his body weight and height, any other physical condition, etc. As long as UTI is concerned, high sugar levels can also cause recurrent UTIs. We can communicate in detail regarding management of diabetes and UTI on this platform. ? uti due to high blood sugar levels. fbs/ppbs/hba1c s. creat urine r/m maintain good genital hygiene in view of uti. practise small frequent meals for diabetes. With detailed medical history.


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Hello doctor, I have had a crippling headache for two days now and nothing seems to help. It starts late morning and gets worse throughout the day. I just want to know what I should do. I am 21, 5'8", female, around 160 pounds.


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Hi. Headache has numerous causes. And according to your presentation, I am going to list some of the causes that could be the reason for what you experience. Please, reflect them to your case. 1. Beginning of acute upper respiratory tract infection, in case you show other signs including runny nose, cough, sore throat or others of cold and flu symptoms. 2. Frontal headache can be due to paranasal sinus inflammation which is part of cold and flu symptoms or part of long-term inflammation. 3. Stress, lack of sleep, anxiety or bad mood. 4. Bad sleeping position (for the neck) or uncomfortable pillow (usually comes in the morning and back of neck and head but can be in the front as well). 5. Anemia (commonly iron deficiency anemia, specially if you are having the monthly period these days). 6. PMS (pre-menstrual syndrome) few days before monthly period. 7. Frontal headache can come with disturbed visual acuity (you might need to visit ophthalmologist for eye test) especially if have concomitant blurring of vision. 8. Head trauma, in case you experienced that before the beginning of that headache. 9. Diabetes mellitus type 2. 10. Hypoglycemia (low blood glucose) in case you are not following appropriate diet or not eating well. 11. Vitamin D deficiency (but usually for long term headache with other symptoms). I will list some of the investigations to do and medicines to take (for a few days). FBS (requires fasting 8 to 10 hours), HbA1c, complete blood count, Fe studies. Naproxen 500 mg tablets one tablet per 12 hours after meals for 3 to 5 days, as needed.


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Hello doctor, I have a nevus on my lacrimal caruncle which has been there for almost 10 years. Recently I have noticed a slight change in it. Could it be melanoma?


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Hello. I understand your concern, but I would not advise you to jump into any hasty conclusions. First of all, birthmarks, moles are very common even with the localization that you mentioned. However, to advise you better, it is preferable to compare this lesion on photos taken during these last few years as a marker, keeping in mind that humans undergo many changes as they age. Second of all, it is more advisable to get digital images of this lesion captured by an optometrist or an ophthalmologist through a slit lamp and under magnification for better evaluation. Thirdly, if an ophthalmologist has confirmed your suspicion, a biopsy can be taken from it and sent to histopathology in the assessment at a cellular level, which will clear all doubts completely.


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Hello doctor, My 16 years old son had a routine CBC performed as part of his physical for summer camp. His white blood count came back low 3.4 thousand/uL (reference 4.5 to 13.0), absolute neutrophils 1445 cells/uL (reference 1800 to 8000), neutrophils 42.5 %. He has always been very healthy and has not had any recent illnesses or infections. The other numbers were within normal range. The doctor wants to retest the blood in three months. Why wait so long? Knowing that some of the causes of a low white count are serious makes me want to retest sooner. What do you advise?


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Hello. The neutrophil in children usually can be due to some temporary infection etiology. Viral infection also can cause neutropenia due to relatively high lymphocytes. I suggest to repeat CBC and peripheral smear examination report again after 10 to 15 days. I am also not in favour of repeating CBC after three months.


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Hello doctor, Almost two years back, I was diagnosed with psychosis. I improved in two months after taking treatment. I took medicine (Olanzapine) for nearly 9 to 10 months then I stopped taking the medication as I recovered from it completely. I did not consult doctors. Still, my condition is good, and I face no such psychological problems. But I had a blackout episode lately when I was heavily drunk. Should I start taking the same medicine Olanzapine? As I do not want to go to for check-up any more.


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Hello. Psychosis should not be taken lightly because psychosis is a term that reflects a variety of explanation like it may be schizophrenia, it may be due to depression, may be secondary to alcohol or any other condition, so diagnosis is very important, that your primary doctor knows better. And every diagnosis has a different course of treatment, as for as you alcohol is a concern that blackout means you should be more concern and should be adequately treated. Do not stop it suddenly, and try not to drink heavily. Go to your doctor and tell your history he would help you to deal with the problem and you need to have health check-up and lab investigation for sure.


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Hello doctor, I suspect I may have tapeworms. How can I be sure and what can I do to get rid of them?


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Hello. Stool tests can identify tapeworm infestation. However, because the worms and eggs are shed intermittently, the test may have to be repeated three to four times if the initial test is negative. Stool tests can also identify other intestinal parasites. Blood tests (serological tests) are also available, including ELISA (enzyme-linked immunosorbent assay) and PCR (polymerase chain reaction). Praziquantel is the drug that is used to treat tapeworm infestations.


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Hello doctor,I did a lot of tests to see if I am bipolar because I have a lot of similar symptoms. They all had the same answer that there is a high possibility that you are bipolar, go to a specialist. I already have a psychiatrist, but I do not know how to talk about it. Could you help me because I am desperate?


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Hello. I can appreciate your dilemma. I will suggest discussing your concerns with your psychiatrist. Write down all the reasons why you think you may have bipolar disorder and discuss it with your psychiatrist during your next review. Screening tests in the search may give approximate guidance, but they not very specific. For example, many teenagers have significant mood swings, which may inadvertently be flagged up as bipolar. A proper diagnosis can be made only by a comprehensive assessment, including detailed background history.


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Q. My blood and urine pregnancy test are positive, but there is no visible sac in the scan. Is this ectopic?


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Hello doctor, My last period was before a month, and it has been nine days I missed my period. I got positive in my blood and urine test. My beta hCG on last month was 675, and yesterday it was 3300. I almost completed 10 days after the missed period. Yesterday I went for scan my doctor told no sac is visible. I have some breast pain heavily and feel like period pain but no other symptoms. My TSH value is 2.9, and my doctor suspected may be ectopic. I do not have any pain or bleeding so far, but it is only like period pain. Please help.


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Hello. By the dates, you are five weeks pregnant. If no gestational sac is visible in your uterus even on transvaginal ultrasound, then it may be an ectopic pregnancy. Ectopic pregnancy presents with symptoms only if it grows or gets ruptured. That is an emergency and can even be life-threatening or at the least cause liters and liters on blood loss inside the abdomen. I advise you to go for a transvaginal scan. Rarely MRI to confirm the ectopic pregnancy. It may be dealt with medicines or go for laparoscopic removal of tube or milking whichever is feasible. Do it before it becomes an emergency.


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Hello doctor,I am a 48-year-old male with 5”8 height and 250 lbs in weight. No health problems. Blood pressure is 118/70. Total cholesterol is 165, LDL is 99, Hdl is 46 and Triglycerides 101. Had sonography of heart and said I had a mild LA dilation of 4.8 cm. Please help.


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Hello. No major concern but it would be important to know why your left atrium is dilated. It may be because of higher blood pressure or problems with the heart valves or due to any heart muscle problem. I recommend you see a specialist as you might need some additional workup, perhaps a heart rhythm monitoring and or a stress test. High blood pressure, and valvular disease. Heart rhythm monitor.


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Hello. By ED do you mean erectile dysfunction or anything else? You are a male, so I pressure you to mean erectile dysfunction. The erectile dysfunction, together with the fact that you have to be on medication for your sugar control that could have been responsible for the depression that is entirely understood. The erectile dysfunction can cause d inability to have a penetrating sex.diabetes cause damages to tiny arteries which supplies the nerves, and when the nerves which carries e erectile sensation are affected, it results to a weak erection. Kindly consult your doctor and take the treatment with consent.


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Hello doctor, I am 35-years-old. My cholesterol level is 222, triglycerides 87, HDL (cholesterol) 60, LDL (cholesterol) 156 and non-HDL (cholesterol) 162. Kindly advice.


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Hello. Do you have diabetes, hypertension, family history of a heart attack in young age? Do you have deranged kidney function? Answers to these questions if not, it is critical to decide medicine. If these are not present, then medication is not required at this stage. Only lifestyle and dietary modification are necessary. Reduce saturated fats and trans fats (ghee, butter) in diet, reduce red meat, consume more dry fruits, and vegetables. Avoid more than one egg yolk per day. Do regular exercise, such as jogging, cycling, brisk walk, etc. Avoid a sedentary lifestyle after three months repeat fasting lipid profile.


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Hello doctor, I have on and off fever since last Friday and been having chest and stomach pain since yesterday (pain somewhere in between the chest and the stomach). I have a loss of appetite and can feel acid coming out of my chest a few times. I also feel like I always need to poop but nothing is coming out when I try to. I already took Biogesic for my fever but did not took any medicine for the chest and stomach pain. Can you please advise me on what medicines to take and food to take or avoid?


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Hi. How high was the fever? Any other symptoms such as cough, colds, body aches, sore throat, and pain during urination? How would you describe abdominal pain, burning, crampy, or stabbing? Does it radiate to the back? If yes, which side? Does it occur after food intake? Do you wake up in the middle of the night because of the pain? Any other symptoms such as yellowish discoloration of the eyes or skin, nausea, or vomiting? I suggest taking Omeprazole 20 mg, 1 capsule 30 minutes prior to breakfast but may take one dose today. Complete blood count. Omeprazole 20 mg one capsule 30 minutes prior to breakfast for seven days, Paracetamol 500 mg one tablet every four hours as needed for fever.


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Hello doctor, My wife is 25 years old. She has been developing lot of moles on her body especially on hands and face. Initially they are very light almost like a small brown spot, but gradually they are becoming darker. They are incrementing periodically. What would be the reason for it? Is there any medication for it to stop and eradicate the issue? Thank you.


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Hi. As you explained the disease that your wife has multiple small moles over face and hands, it certainly indicates solar lentigines. It is a multiple freckles type mole due to sun exposure. Now, let me explain the treatment and precautions. Avoid exposure to sunlight as much as you can. Cover body with clothes and cap while going out. Use sunscreen over face and hand every four hourly till evening. This will prevent further development of disease. Now to treat existing lentigines we can opt for laser. Creams will not be of much helpful in this. Q-switched Nd:YAG laser (neodymium-doped yttrium aluminium garnet) will be very useful. You can consult a doctor around you for this laser. One or two sitting would be enough to remove it completely. There is no side effect. It could be costlier, but results are good.


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Hello. You can surely lose weight with the help of homeopathy. Do you have any medical conditions that may be causing weight gain or taking any medication? In the meantime try taking Natrum Phos 6x two tablets twice a day 30 minutes before taking any meal (empty stomach).Try this for 15 days. In the meantime, please answer the following questions so that I get a complete overview of your problem. Kindly answer these questions.


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Hello doctor, I am a 19-year-old female. I woke up this morning with two medium sized red, itchy and scaly spots on my upper arms, I searched, and it seemed to me that this resembles an early stage of skin cancer (squamous cell carcinoma). What should I do?


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Hello. First I would like to reaasure you that squamous cell carcinoma can not appear all of a sudden (over night). Second, from the pics you attached it looks like fungal infection (attachment removed to protect patient identity), something called tinea corporis, which comes with the same look and other looks as well, in addition to the symptoms that you mentioned (specially itchiness). Please follow the treatment that I will provide you and kindly follow up with photos for the skin lesion in five to seven days. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Lamisil cream (Terbinafine), apply three times a day for 7 to 14 days or Daktacort cream (Miconazole, Hydrocortisone), apply three times a day for 7 to 14 days. Wash your own clothes and bed linens separately as it is infectious.


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Hello doctor, I was initially diagnosed with a urinary tract infection by the presence of white blood cells in my urine. I had symptoms of a typical UTI. I was given a five days course of antibiotics, but the symptoms did not go away, followed by 2*5 days more courses of antibiotics. A urine culture was done after three types of antibiotics failure. A urine culture was conducted, and it was found that I had candida albican (yeast), and I was put on an oral antifungal medication called Fluconazole, but my urine is still dark brown with white substances in it, and I still feel itching after urination. I drink a lot of water, and I am HIV negative, I tested negative for prostate cancer, and I am 27 years old. Please help. I also experience a lot of nausea and heart racing when exposed to cold areas.


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Hello. Went through your post. Generally, urine culture growth showing candida is not anything significant because it is a benign infection and usually does not need treatment unless a person has taken a lot of antibiotics, or is HIV positive. The white substance in urine is phosphate, and it is called Phosphaturia you are taking plenty of water is helpful, so no need to worry about that. I would suggest you complete two weeks of Fluconazole but no other antibiotics.


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Hello doctor,I have been using Minoxidil for about a year now and continue to shed. I now have balding patches where it was not an issue before. Ironically the thinning I had started using it for filled in. Wondering if I need to stop the use or if it is normal to experience shedding still? I use it consistently twice a day.


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Hi doctor, I am a 30-year-old male. I am currently using phimocure silicone rings to loosen up my foreskin. Yesterday afternoon I accidentally used a large ring 26 mm by wearing it for 1 hour 30 minutes. After taking off the ring, I have this persistent pain like burning and pressure on the tip of the foreskin (majority on the left side). I still have this pain and wanted to know if it will go away by itself? I am also using Betamethasone cream.


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Hello. I have gone through your queries. The only solution to phimosis is circumcision. However, you may have minor vascular injury inside the foreskin due to the use of a tight silicon ring. You can wait and watch to buy some time for natural regression of the swelling or else you can straightway go for circumcision after consulting your local urologist. By few days to weeks, the swelling will reduce. But the permanent solution of phimosis is circumcision.


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Hello doctor, Why do our ears feel full or clogged when we are in a closed room? Are these because of air pressure and ambient noise?


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Hello. Rather than a closed or open room, this is related to outside and inside ear pressure. There is an air cavity in our ear called a middle ear, and there is a membrane which separates this cavity from the external environment called a tympanic layer. So, there is air on either side of the tympanic membrane. So, when pressure on either side if high, then the membrane gets fixed and cannot move properly, giving the feeling of a clogged ear. And there is a connection between the middle ear cavity and our throat which equalizes pressure within the ear cavity and outside environment. So, whenever one gets an infection, then this tube blocked and there occurs a mismatch of pressure leading to clogged ear. And also swallowing movements opens this tube temporarily, which helps in equalizing the pressure leading to relief. Similar things occur when one travels in an airplane. So pressure changes are decisive in this. I hope this helps you and get back if you have any doubts.


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Hello doctor, I had a UTI two years ago that went untreated which resulted in the problem. I now have a permanent red dot on the head of my penis. No pain, bump or itching has ever come from the said dot. It has not increased in size in over a year. I have been using Kermatazole on the penis head for over a year now when the redness gets brighter. I take comprehensive STD tests every four months. The readings are always the same and the results negative. Now, I am worried that I have tested as an early case of herpes II simplex (genital herpes). I have performed two HSV2 IGG quant tests this year. Four months ago, I tested with a reading of 0.076. This month, I tested with a reading of 0.232. I had several different sexual partners during this period with unprotected contact, but no unprotected penetration, including two days before the most recent test. Should I be worried I contracted genital herpes?


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Hello. I understand that you are greatly concerned about having early genital herpes. For more information consult a general practitioner online -->


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Hello doctor, I would like to know the diagnosis of this MRI result. Multiplanar and multisequential MRI of the brain without intravenous contrast administration was taken. Single voxel MR spectroscopy through the basal ganglia was also performed. The brain parenchyma demonstrates interval development of diffuse cerebral volume loss, most prominently involving the cortex, with a widening of the sulci and ex-vacuo dilatation of the ventricular system. There is a faint T2-FLAIR hyperintense signal of the bilateral hemispheric white matter. There is sparing of the cerebellum and only mild interval thinning of the corpus callosum. Interval development of a subdural collection along the left cerebral convexity, most prominent at the left frontal convexity causing a mild mass effect on the left frontal parenchyma. It shows mildly increased FLAIR signal, likely related to proteinaceous content. The intraorbital optic nerves have decreased volume, compatible with optic atrophy. There are punctate foci of susceptibility artifact in the right parietal and right occipital region, likely related to minimal hemosiderin staining. No mass lesion or midline shift. There is no acute intracranial hemorrhage or acute territorial infarction. No hydrocephalus. No cerebellar tonsillar herniation. Preserved flow voids of the major intracranial vessels. There are bilateral mastoid and middle ear effusions and mucosal disease of the bilateral paranasal sinuses. Single voxel MRI spectroscopy at the basal ganglia demonstrates increased choline and mildly decreased NAA, nonspecific markers of parenchymal injury. Impression:  Interval development of severe supratentorial brain volume loss with thinning of the intraorbital optic nerves. Interval development of a subdural collection along the left cerebral convexity with mild mass effect on the left frontal lobe.


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Hello. I read carefully and reviewed the patient MRI report (attachment removed to protect patient identity) and would explain that it shows a progressive brain atrophy (brain cell death) and small ischemic strokes, which could cause progressive dementia. These changes are probably related to small vessel disease of the brain (chronic changes in small brain vessels caused by uncontrolled diabetes, dyslipidemia, hypertension, smoking, etc.). There is also a subdural collection, which is causing mild compression on the left frontal lobe. I would recommend consulting with a neurosurgeon about this. I would also recommend to closely monitor his blood pressure values, periodically check his fasting glucose and blood lipid profile. If dementia is present (memory troubles, confusion), I would recommend treatment with Donepezil or Memantine. Hope to have been helpful. For more information consult a neurologist online -->


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Hi doctor, I am a 23 year old male. Currently, I am taking 225 mg Veniz XR for depression. I am taking it for the past 6 years. My problem is ED. For the past one year, I am suffering from erectile dysfunction. Please suggest me some medicine. I am unmarried. Can I use Sildenafil for one night stand? I also have one side affect from Veniz XR. I get excess sweating after sleep at day time. Is this due to medication? How can I overcome this problem? Also please suggest me how to wean off Veniz XR safely without withdrawal symptoms.


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Hello doctor, I am nearly two years into my orthodontic treatment to correct overcrowding and midline correction. Although I am really concerned as my face seems to look really asymmetrical and my teeth are slanting, I feel really self-conscious about it. I feel it is something my orthodontist not correcting. Please advise what I should do and give me your expert opinion.


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Hello doctor, I experienced a sudden and severe pain in my stomach (lower part) and anus, which caused me to shake, become dizzy, and really pale, and I have difficulty breathing. I did not faint, but if I were standing up then, I probably would have. It happened to me once before and I was on my period then. I had consulted a doctor then as well and was told that perhaps my body was just shocked because I had skipped a few months of my period. I am also diagnosed with iron-deficiency anemia, but I am currently not taking my iron tablets. This time around, however, I had my period last month and was not on my period at all. I am not sure what it is but wanted to let you know should you have come across a similar situation with one of your patients. Please reply.


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Hello. Well, most of our patients initially complain to us about very vague symptoms at onset, just like yours. But we explore the possibility based on some more information and yes, of course, investigating them thoroughly. The pain you mention which made you still and shaky, can be arising from the gut as in abdominal colic (a sudden wave of spasm in muscles within the gut). Or can be arising from endometriosis which is anther problem of the female genital tract, whereby there is excessive growth of normal uterus tissues in the lower part of the belly. Thirdly, it can simply be due to perimenstrual syndrome which is pain occurring at the time of menses. For now, I suggest you to do some test and ultrasound abdomen and pelvis, later we can discuss the findings of your result. Functional abdominal colic. Perimenstrual syndrome. Endometriosis. Complete blood count. TSH (thyroid-stimulating hormone), FT3. Liver function tests. Stool detail report. Urine detail report. US (ultrasound) abdomen and pelvis. Follow up after investigation to discuss the results.


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Hello doctor,I have white lines near the teeth on the lower lip which appears and goes by their own. But sometimes it hurts.


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Hello. It could be lichen planus. It does not go off on wiping. If it goes off on wiping, then it is candida. Your case does not support submucous fibrosis as there is no blanching. My provisional diagnosis is lichen planus. History of smoking. Biopsy. Candida, leukoplakia, and submucous fibrosis. Lichen planus. Biopsy (nearest dental hospital) and follow-up with a specialist. Nicotine patch to stop smoking.


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Hi doctor, I am 36 years old, male. I am traveling and had sex two weeks ago without condom. After two days, I felt itching and pain while peeing. Now, two weeks later, I have white painful wound on my penis. I visited a doctor yesterday and received an injection and two pills antibiotics. He said gonorreah. I am scared that he could be wrong. Please help me.


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Hello. You have developed ulcers after two weeks. Usually, in gonorrhea you will have painful white discharge from penis. In syphilis, ulcer will develop after 10 to 14 days, painless single, button like ulcer. Painful genital ulcers in this case are may be herpes simplex, chancroid, and syphilis (from your picture) (attachment removed to protect patient identity).  What medication he gave? Will you please give names of the drugs? Better do  VDRL, TPHA, HIV and HSV2 investigation, smear study from penis discharge to rule out above STD.


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Hi doctor, I found a red dry skin on my scrotum today. What is is? Is it dangerous? How can I treat it? I am still a virgin. I have attached the pictures of the dry skin.


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Hello. I have seen the pictures (attachment removed to protect patient identity). It looks like scrotal dermatitis. Try doing the following. Consult your specialist doctor, discuss with him or her and start taking medicines after their consent. For more information consult a dermatologist online -->


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Hello doctor, My mother's fasting sugar is higher than the post prandial sugar (130 and 115 respectively). She had normal diet only. And also, 2 hours after taking 75 grams of glucose, without any work, the sugar level is 260. Why is this happening?


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Hi doctor, During a recent extraction of 9 teeth, the dentist said that my right upper back molar had attached itself to the bone. When he tried to extract it a piece of my jaw bone cracked off, pierced the sinus cavity and punctured an artery. Blood spurted everywhere and they frantically applied pressure and packing until it stopped. They sutured it and sent me home with Penicillin. The dentist acted very casual like it happens all the time. I cannot find anything about this subject on the internet. It has been eight days and I have been weak and experiencing constant cold sweats. I do not have fever. I am still spitting out fresh clots of blood three or four times a day. They are not very large, but they are definitely fresh. Is this something that happens frequently with lasting and future effects? What is your opinion of these events?


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Dear Doctor, I am a 24 year old female, was prescribed with Celexa 20mg  once daily and Buspar 5mg twice daily for severe anxiety/panic attacks. Both of these medicines are SSRIs though, and I read about it online that everyone/every source says never to take them at the same time due to risk of serotonin syndrome. Today, after taking the Buspar, I felt cold and shivered constantly. I could not get warm and I was very sleepy. Now I am scared to take the night time dose of Buspar and Celexa. I would like to have a second opinion on the safety of taking these medications together. If it is not safe, can I take only one instead? Which one would you recommend, the Buspar or the Celexa? Thank you in advance.


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Hi. You are not on too high a dose of celexa or buspar. However serotonin syndrome is not always dose dependant. I feel just the chills and sedation are too general to be indicative of serotonin syndrome. You should have some level of muscle rigidity, high fever, muscular contractions (myoclonus) to suggest that. In my professional opinion I do not have much faith in Buspar.  Celexa is good enough as an antidepressant (SSRI) to eventually help you have a full remission of depression, anxiety and panic attacks. If I was your treating psychiatrist, I would have supplemented the celexa with clonazepam (Klonopin) on a as needed basis, between 0.5 and 1mg every 8 hours PRN anxiety. If you are feeling cold and shivering constantly you might need to see your PCP (Primary Care Physician) to urgently address if you have an active urinary tract infection and also have him check your thyroid function. In effect, I advise you to stop the Buspar for now. Hope it helps. Get back to a psychiatrist online for further help -->


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Q. I do not feel any sensation in my penis at the time of sex. Does masturbation cause this numbness?


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Hello Doctor I am a 30 year old male, married for 2 years. I do not smoke or drink. There is no medical history. My penis is circumcised from childhood. The problem which I am facing is that I do not feel any sensation in my penis glans at the time of sex or while masturbating.In normal state, my penis is dry. I use lubricants while having sex. But still the penis remains numb. Only a few seconds before ejaculation I feel the sensation in my penis. I started masturbating 10 years back. Is this a reason for this numbness? I do not have any erectile dysfunction. But still I am not able to enjoy sex due to this problem. Is there any medication to enhance sensation? Please help me overcome this problem.


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Hello. I read your query and understand your concerns. Having less or no sensation in penis while having sex is generally due to local factors. The systemic illnesses rarely affect in this way. Masturbation is normal and it does not have any adverse effects either on sensation or erection. So it is time to realize that the sensation problem is not due to chronic masturbation. The possible reason as per available history is dryness of penis which makes the nerve endings non-functional over a course of time. To counter this problem it is essential to use oil based soap (rather than traditional soap) and skin moisturizer which prevent the dryness of skin of glans penis. It can be said that you can use any branded moisturizer for application to penis and local area after taking bath every day. During love making session I advise you to use Durex real feel which is available across the globe for increasing sensation and making the sex more pleasurable. Unfortunately there are no medicines for this purpose and lubricants which I have mentioned above will be helpful to a large extent. Revert back to a sexologist online for further follow up -->


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Hi doctor, My fasting blood sugar is 130 to 135 over last four years. My postprandial sugar is between 90 to 110. Yes, my postprandial is less than my fasting sugar level. Usually, the reading will be taken after 1 hour 45 minutes or 2 hours after eating breakfast. I am unable to bring down the fasting sugar level. My HbA1c reading is 6. I am taking Glycomet 500 mg before dinner daily. Can you tell me why my fasting is higher than my postprandial?


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Hi doctor, I have a painless peanut size bump near the outer side of my anus. I have attached snaps for your reference. It has been there since last 10 years. But, for the past one year I feel it is growing. Sometimes, it bleeds, but no pain at all. It is just like an extended mass and it feels very uncomfortable. I consulted a local doctor. He found a fissure inside the anus and suggested surgery. But, I never felt any pain or bleeding from inside till date. I used to have a hot water seat daily since last few months as per his advice. Do you suggest any medication to restore or reduce the bump? I tried a few antibiotics, but they did not work.


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Hello. Constipation. Digital rectal examination and proctoscopy. Anal fissure and hemorrhoids. Surgery. Medical treatment and diet modification to prevent constipation. For further information consult a surgical gastroenterologist online.--->


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Hello doctor, I have stretch marks on my inner thighs and buttocks area. When I sit for about 30 minutes, the stretch marks hurt (in the scale of 1-10, the pain is around 8). So, I have to stand up once in a while. More and more stretch marks appear when they hurt and they hurt too. It is very uncomfortable, and it already affects my work (programmer) where I have to sit all the time. I have visited 4 dermatologists already, and one of them even said that stretch marks are not painful, maybe it is varicose veins. I already tried laser, derma roller, pain reliever, retin A, collagen cream and cocoa butter (but they did not work) as per doctors advise. This all started when I started gaining weight/muscle a few years ago. I already stopped going to the gym and all my supplements about a month ago, but the pain is still there.


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Hi.I have gone through your history and picture (attachment removed to protect patient identity). I get your worry. I can see that you have already tried a lot of therapies for the same with not much relief. Weight gain is usually a gradual process and not much skin stretch pain is experienced. But few nerve endings become exposed to the exterior in the stretched skin. When weight loss occurs, stretched skin hangs back loose. But it is still not back to normal skin. It is still thin and exposing your sensitive nerves when you stretch, like when you sit or squat. This is why you get that pain sensation during such activity.Now having considered that you have tried most of the options, I would suggest you try a few additional measures that can help.


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Hello doctor, I have a tiny hard spot on the head of my penis. It does not bother me unless I mess with it. It has been there for many many years, but just recently I have noticed a bit of pain when I am just sitting around. It is probably the size of a pinhead and it is dark in color. I have not had a sexual partner in a very long time (years). It does not seem like a boil or a pimple. The very top of the spot is black. Please suggest.


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Hello. I can understand your concern. According to your statement, you have been suffering from a tiny hard spot on the head of the penis. This type of tiny spot can result from various reasons such as mole produced from over secretion of melanin by skin cells. They are harmless and nothing to be worried. Penile papule appears around the penis head which does not itch or produce any fluid. They may disappear as time passes. Angiokeratoma is a tiny red bump that appears when blood vessels near your penile skin become dilated. They are rough in nature and may become thicker over time. Lymphocele has resulted from blockage in the lymph channel near your penile head. It does not need any treatment and dissolves over time. Peyronie's disease is resulted from scar tissue which is found on the top of the penis that tends to harden due to calcium deposition. Treatment is needed when it makes erection of the penis difficult. Again your penile tiny hard spot may be resulted from a pimple, cyst, or STD (sexually transmitted disease). As your penile spot does not create any difficulty in your regular performance so it is nothing to be worried and needs no treatment. I think it will disappear over time. You can undergo FNAC (fine needle aspiration cytology) or biopsy from a tiny hard spot on the top of your penile head.


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Hi doctor, I am pregnant of around 6 weeks now. This is my first pregnancy. I have noticed a few drops of bleeding while urinating twice in a week. I have consulted a doctor and she suggested to do transvaginal ultrasound and got the following report. Uterus is bulky in size. Regular well defined gestational sac is seen. Single fetal node is seen. CRL - 0.64 cm. GA - 6 weeks 3 days. Fetal cardiac activities are normally visualized. Decidual reaction is good. Peridecidual color flow is normal. No peridecidual clot or hemorrhage is seen. Yolk sac is seen. Ovaries - normal in size and echotexture. Impression - single live fetus of 6 weeks + maturity. Now I am in need of a second opinion. Is there anything serious in my case? Can I continue my normal work? Can I take Duphaston 10 mg for next 8 weeks as directed my doctor? What kind of precaution do I need to take?


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Hi. You have a given a complete account of the clinical situation and it is as good as doing a real time face to face consultation. It is not uncommon for women to have spotting early in pregnancy. Most often it is what we call implantation bleeding that is a process of baby getting attached to your uterus. The fact that there is no blood clot in the uterus and the fetal heart beat is present is reassuring. The diagnosis is called threatened miscarriage. In this situation there is a good probability for the pregnancy to go on well that is more than 90%, hence it is unlikely to be serious. You can continue with your normal activities as long as it is not physically demanding. It is also advisable to avoid sexual intercourse for a few weeks. Absolute bed rest is not needed and in fact may be harmful can lead to blood clots in legs. No need to follow diet restriction. Taking Duphaston (Dihydrogesterone) is alright, but again not absolutely necessary. Just be your normal self. Repeat scan in two weeks to ensure things are fine. You will continue to have some form of discharge pink or red or brown or black for a couple of weeks. But, if the bleeding is heavy with clots or with cramping or foul smelling discharge you need to visit the hospital as soon as possible. I would like to stress that more than 90% of times, things will go on well. For further information consult an obstetrician and gynaecologist online -->


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Hi doctor, I am an 18 year old female, and I masturbate very often. I just rub my vagina, but I do not finger myself. I get really tempted to finger it. Whenever I try to do so, I get nervous and just finish it off by rubbing my vagina. Is it safe to finger my vagina? If yes, how do I do it? What are the safest ways to do it and how often should I do it? Is my hymen going to break if I do so? Will I lose my virginity? Also, is it weird that my vagina becomes wet when I am aroused?


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Hi. Get back if you have doubt. Take care. For more information consult an obstetrician and gynaecologist online -->


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Hi doctor, I am suffering with delayed periods. Consulted a gynecologist and started Gestin since 1 week. But still have not got my periods. Home pregnancy tests done and turned out to be negative thrice. Please help.


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Hello. Tablet Gestin (Allylestrenol) contains natural progesterone, which is given for 5 days to bring about withdrawal bleeding. You have not mentioned how long you have taken the drug. Withdrawal bleeding usually occurs 48 hours after stopping the drug to up to 7 days. If you are still in that period, then you should wait for your period to commence. If you are over that, then I suggest you to do certain tests like transvaginal sonography, TSH (thyroid stimulating hormone) and AMH (anti-mullerian hormone testing). Considering your age, you could be in your perimenopause (stage nearing menopause) where menstrual irregularities are common. Revert back after the tests to an obstetrician and gynaecologist online -->


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Hi doctor,I have a small white dot on my gums. It looks like a whitehead. I noticed it a couple of days ago. It is painless. It is just above my left canine. I do not know what it is. It is towards the top of the gum. I have attached the photo. Can you suggest what it could be? I am scared of the dentist, so any option avoiding that would be nice.


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Hi. It looks like a minor aphthous ulcer, which gives no pain and subsides by itself. Please check if there is any pus discharge, pain in the tooth and any other area of the mouth also has this kind of spots. Aphthous ulcer often causes minimal symptoms or problems. Oral ulcers are small round or ovoid ulcers of 2 - 4 mm in diameter. They are round or ovoid in most situations but are often more linear in common site. They have an ulcer floor that is initially yellowish white and surrounded by an erythematous halo or redness. They are found mainly on the mobile mucosa of the lips, cheeks, the floor of the mouth, sulci or below the tongue. Yours is in between the junction of gums and sulcus of the cheek, so it is a soft mucosa looks like to be. They occur in groups of only a few ulcers that is, one to six at a time. In your case, you have one only. They heal in 7 to 10 days, and they may recur at intervals of one to four months. They leave little or no evidence of scarring. If it pains, then you can apply pain relieving gel. If it does not subside in a week or 10 days, then do visit your dentist. Aphthous ulcer. Do not eat spicy food. For further information consult a dentist online.--->


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Hello, I had sex and took i-pill. My periods started around 12 days later and lasted for 4 days. I got my periods next month around the same date, which lasted for just one day. So, I took a urine pregnancy test, which was negative. I got my regular periods on the third month as well and it lasted for 3 days. My next periods lasted for just 2 days. I have read on the internet sources that many women get periods during their pregnancy. What are the chances of me being pregnant? I am doubtful because I always used to have regular periods which last for 5 days.


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Hi. How was your bleeding during the cycles? Was the flow scanty when compared to your previous cycle (I am not talking about the duration of flow here)? Revert with the details to an obstetrician and gynaecologist online -->


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Hello doctor, Is there any chance of hepatitis B spread through eating food contaminated with infected blood?


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Hello. Well, the whole blood and serum (white fluid within blood) contains large amount of virus, and virus can live on blood spots outside the human body for the duration of one week. So actually it depends upon how much blood, and how much time it has been on the stain that can determine the chances of acquiring infection if contaminated with food. So I guess my answer can be partially answering your query. If you tell me the exact event I may be in a better position to tell you the figures. Otherwise, as a general rule, hepatitis B does not spread via food, having said that, it can still spread if blood contaminated food has been ingested. Since virus invades the human body when comes in close to mucosa (lining of our mouth) and then spread to blood within human. This happens in the same way as one infected person can transmit infection via kissing, hugging, sharing of a towel, spoon, plates, and so on. If you are puzzled with all that information, I want you to simply get a blood test for hepatitis B infection. It is a simple blood test that can give us a clue. I hope this helps. Post-exposure risk stratification. Hepatitis B surface antigen. Hepatitis B core total. Follow up after testing.


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Hi doctor,I have a line across my nose going horizontally. This is because I used to push my nose up always. Can u suggest some natural remedy to get rid of it?


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Hello doctor, I consulted two doctors regarding a lump that I could feel above my left collarbone, whenever I strain or turn my neck. Both the doctors said that it was just a prominent tendon, but gave me an ultrasound to ease my mind. The ultrasound said 'there is a 6 by 4 mm hypoechoic nodule in my left supra clavicular area, presumably representing a small lymph node. If clinically indicated, an MRI or a CT can be done for further evaluation. On seeing the reports, one of the doctors said that I need a biopsy right away. The other doctor referred me to an ENT. I followed up with the ENT, but he was not able to feel the lymph node and said that the lump is just a prominent muscle and nothing to worry about. The ENT also said that the ultrasound was normal and that a 6 by 4 mm node is normal and nothing to worry about. I have been reading online, and it is mentioned everywhere that a hypoechoic nodule is cancerous, especially in the left collar bone area. What does a hypoechoic nodule mean? Does this mean it is a small cancerous lymph node? What does it mean by 'if clinically indicated, a CT or MRI can be done for further evaluation.'? I also had a CBC done, and that was normal. I had a neck CT done six months ago for a pulled muscle, and that was normal as well. If it did not detect this small nodule six months back, can it have grown in just six months? Is hypoechoic bad? Why did the ultrasound say presumably a lymph node? I am so worried now. Do I need a biopsy or is there nothing to worry about?


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Hello. There is a lymph node in the left supraclavicular region called as Virchow's node. If enlarged, it may indicate a malignancy of the abdominal region as that is the draining pathway of the lymph from that area. A lymph node from cancer is generally very hard to palpate. A soft node is generally secondary to some inflammatory response, generally an infection. Please ask your doctor to have a look at your abdomen and re-evaluate the node, although I am almost certain, it is nothing but an inflamed node. As it is of a short duration, it is highly unlikely to be anything dangerous. I suggest you get the following tests: For further queries consult an internal medicine physician online -->


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Hi doctor, I have developed symptoms of nerve dysfunction (burning, tingling, etc.) but all the nerve related tests were normal. Over the past 9 to 12 months, my diet was poor, I am about 70 pounds overweight, age 40, and have high LDL. My blood glucose last year was 86, then it went up to 97 by the fall, and then up to 106 this year. I went on a diet and lost 20 lbs so far, but the test this week was at 101 after a 12-hour fast. My question is this: Can a blood glucose around 100 to 105 and high lipids for numerous months cause any nerve related symptoms?


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Hello. I have seen the details given. The glucose levels mentioned are normal. Only 106 mg shows a pre-diabetic fasting level. These levels are unlikely to affect the nerve function. From your information, I get a feeling that you do not have diabetes. Is that right? In that case the nerve related issue is not due to glucose levels at all. It may be related to your obesity. With a BMI of 37.07 kg/sq meter (normal < 25 kg/sq meter) you are already in grade 2 obesity. Your ideal body weight should be 77 kg (169.4 pounds). Which means there is an excess of over 81 pounds. That could be the culprit. Plus it can be the cause for precipitating diabetes in the coming years.


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Hello. Your HVS (high vaginal swab) was negative, so I presume it did not have discharge. Have you done a pelvic scan because if there are infection and collection at the pouch of Douglas, you may not see a visible discharge. Do you have a regular menstrual cycle, like a predictable cycle? The pain you get around be the time of your ovulation could be a sign of an ovarian cyst, pains of the cyst come towards ovulation. Try to do a scan and get back to me through this platform. I may prescribe some antibiotics and analgesics for the pain you can get Ciprofloxacin, Flagyl (Metronidazole) and Doxycycline and take them for seven days, Ibuprofen 400 mg b.d (twice daily) for four days.


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Hello doctor, I am a 31-year-old. I have AVN stage 3 in right hip and stage 2 in the left hip. This is due to the use of steroids. I have done this MRI before two months. Many doctors told me to go for total hip replacement. Today I had an X-ray, and the doctor told me no collapse is done yet and suggest me to go for core decompression and Osteofos 70 mg daily. 1. I want to know, is it possible to treat it without hip replacement? 2. Will core decompression help in my case? 3. Is Pamidronate injection helpful in my case? 4. Any medicine which can stop or delay the progression?


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Hello. The decision to treat conservatively or surgically depends on clinical symptoms. You have not mentioned anything about your symptoms. How much pain do you have? Is it bearable or unbearable? How much distance are you able to walk without pain? Are you ready to perform your activities of daily living comfortably? What do you do?


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Hello doctor, My left foot is swollen with purple color and pain. I am currently on Diamicron 60 mg and Xelevia 100 mg.


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Hello. With history, I feel you have left foot cellulitis. It is the infection on the foot. You might need heavy antibiotics for the infection. Is warmth present on the wound? Any pus discharge from the area? Kindly update these details and also the picture of the purple color. And also I would like to know what is your sugars levels in present condition?


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Hello doctor,I am a medical student, and I came across phimosis. My prepuce can be retracted easily and normally but when I get erect it does not retracts on own and even if I do it forcibly it gets stuck around corona which is painful. Is this a problem? If yes can I do something on my own and if I need a radical therapy, should I wait till my marriage?


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Hello. Welcome to the icliniq.com. In a flaccid state, the foreskin can be retracted back over the shaft of the penis easily even in phimosis case. However, you have a problem in erection state as well, and hence you have mild degree phimosis. For that topical steroid cream can be used after consultation with your dermatologist. If it does not help, then you can selectively undergo one daycare surgery that is circumcision. But it is an elective operation, which means the procedure can be done anytime as per your convenience. I hope I have solved your query.


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Hello doctor,I am 18 years old, and I am worried because I feel that my gums have receded. It is because of my improper brushing routine, they are yellow, not wobbly, and gums are becoming a darker version of red, gums have receded from the front teeth.


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Hello, Welcome to ilciniq.com. Your teeth are stained with yellow plaques, and the condition is called gingivitis.  Try this home remedy, 1) Take one tablespoon of baking soda with two tablespoons of hydrogen peroxide to make a paste. 2) Rinse your mouth thoroughly with water after brushing with this paste. 3) Use an antibacterial mouth wash and rinse. 4) Eat lots of vegetable and fruits. 5) Use a soft-edged toothbrush.


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Q. I have some weird taste of the water as if my mouth is salty associated with excessive thirst. Kindly help.


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Hello doctor,Since yesterday, I had excessive thirst. I am drinking a lot of water and still feel it. The same happened today, I drank over 500 ml and again feel thirsty. When I drink, I think some weird taste of the water as if my mouth is salty. I have anxiety (panic disorder), so this made me slightly worried about what could have happened to me. Can you help?


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Hello. This condition called polydipsia, felling excessive thirsty. Tongue taste is due to dehydration. What about urination, passing more? Usually, this is a symptom of diabetes, are you are in a hot and humid place? For anxiety and panic disorder are you on any medication? Immediately go for investigation such as FBS (fasting blood sugar), PPBS (postprandial blood sugar), HbA1c and urine, sugar ketone RFT (renal function test), LFT (liver function test) and review. If sugar is high go for the treatment.


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Hello doctor,The patient is 65 years old. Doctors have concluded liver fibrosis stage 2. In fibro scan, the lymphocytes are 95 %, amylase is 20 U/L, monocytes and macrophages is 5 %. The fluid is hazy in appearance. Can liver fibrosis be reversed?


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Hello doctor, I am suffering from male pattern hair loss for a long time. I had tried saw palmetto for a short duration and got a decent result (as suggested by a trichologist) but did not continue due to lack of information on long term effects. Please suggest if Finasteride can help in hair sustenance?


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Hello. Can you please upload a few pictures if possible to advise the appropriate treatment. Are you married? If yes, did you complete your family?


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Hi doctor, I am 58 years old and currently working in a meat shop, working always in frozen foods. My problem now is about my hands (fingers). It is numb and painful. I always feel this everyday and wake up with numb and pain. Any medicine or vitamins aside from Vitamin B1, B6, B12?


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Hi. Long time keeping hand in freeze or ice cold things, your blood vessels constrict to avoid heat to escape from the body. Continuously blood vessels constriction will not allow blood to reach to the hand tissues and nerves. So, numbness and pain comes. If you are diabetic or hypertensive, condition will be worse. So, in between your work just rinse your hand and fingers in warm water, not very hot. Use thick rubber gloves to avoid direct cold to your hand.


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Hello doctor, A TB and pneumonia patient for the last two months passed the extensive phase and gained two kg. But recently she lost two kg weight, and she feels ill and weak every afternoon. She takes her medication regularly and on time. Why does this occur?


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Hello. I guess the symptoms of cough and chest pain are resolving. If she compliants with her anti koch regimen she would not be losing much weight. But it is well known that chronic illness like tb and pneumonia can cause extensive weight loss and anorexia which again add to the weight loss. You need to see a dietician for prescribed dieting to help increase your calorie intake. Multivitamin should also be taken to improve appetite. Also do a chest X-ray to see the extend of the lesion in the chest with sputum afb.


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Hello doctor, I am a 44-year-old man with undiagnosed chronic body pain associated with movement. Sed rate and CRP in normal range, uric acid level tested after a bout of kidney stones last year, but that was also in normal range. Is there any tests you could suggest to my attending? Please advise.


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Hello. The normal ESR and CRP essentially rules out inflammatory conditions. Uric acid levels, if high, can lead to joint pains, not body pains. Based on you height and weight, your body mass index is 37.3. This is considered morbid obesity. People with high BMIs can have issues like obstructive sleep apnea, impaired glucose tolerance and high blood pressure. Obstructive sleep apnea can present with manifestations like chronic fatigue and chronic body pains among others. If you are known to snore, have apneic spells (spells during sleep where your breathing stops for several seconds intermittently), feel fatigued and sleepy during the daytime, have frequent headaches and irritability, ask your doctor to screen you for obstructive sleep apnea. If present, that may explain your chronic body pains. Even if you do not have symptoms of OSA, losing weight can improve your overall health and prevent development of metabolic diseases like diabetes. If you want to lose weight, I suggest cutting down on carbohydrates and consuming healthy fats. This is a low carbohydrate, high and healthy fat diet (otherwise called ketogenic diet).


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Hello doctor, I have protected sex with stranger and after that I get inflammation in urinary tract. Should I get worried about it?


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Hello. If you have symptoms of inflammation of urinary tract than you have to rule out urinary tract infection. For that, I suggest you investigate with urine routine microscopic examination report and urine culture for primary work-up. You can revert back with reports once done. Meanwhile, drink lots of water and avoid excess spicy foods intake. Cranberry juice extract tablet also needs to be taken for seven days. You have done protected sex so chance of sexually transmitted diseases is very unlikely.


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Hello doctor,I would like to know your opinion of my complete blood count. I have attached my reports with this which shows absolute lymphocytosis and macrocytic anemia from two years.


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Hello, Welcome to the icliniq.com. In the mentioned history hemoglobin level is low and MCV (mean corpuscular volume) is high, So macrocytic anemia is present (attachment removed to protect patient identity). The cause for which has to be ruled out. Hypothyroidism, vitamin B12 deficiency, liver disease, etc. are some of the causes. B12 deficiency is a common cause, so rule it out by serum B12 estimation. Second reversal of CD4 to CD8 ratio can be from defect in the immune systems like immunodeficiency problems or autoimmune disorders. Chronic illness like HIV also can lead to reversal ration for which fourth generation HIV, ELISA (enzyme-linked immunosorbent assay) testing can be done. Your further workup can be done in the form of peripheral smear examination so that it can guide you further. I hope this will help you. Consult your physician for further examinations and investigations.


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Hello doctor, My upper stomach area is pulsing suddenly from yesterday after eating. What does that mean?


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Hello,  Welcome to icliniq.com. I want to know when did you last have Albuterol. It is is used in asthma for air pipe spasm. It has common side effects such as tachycardia (increased heart rate more than 90 minutes when the person is at rest) where people feel there heartbeat. I also notice your heart rate is 90, which seems to be secondary to Albuterol. Pounding of stomach however, is an unusual phenomenon, but can occur due to certain drugs and sometimes without any cause. The condition is called tachygastria. You can simply decrease the dose of Albuterol to see if it works in your case. I hope this helps. Tachycardia. GI motility disorder. Drug side effects and tachycardia. Reduce the dose of Albuterol.


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Hello doctor,I have PBC stage 4, Gave, COPD, Hashimoto's, etc. I have been around someone who was just diagnosed with mono. I have used her water bottle. Should I be worried and, if so, what symptom could I develop? Do I have to stay away from this person now? I am currently under Urso 300 mg six per day.


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Hello, Welcome to the icliniq.com. I can understand your concern. Do not worry, and I will clear your doubt. Infectious mononucleosis usually caused by EBV (Epstein-Barr), and it can spread through saliva mainly. So sharing of the objects like water bottle or glass object can spread infection. So you are at risk of spending it. But do not be panic. The symptoms are fever and sore throat, mainly with enlarged cervical nodes. Splenomegaly also can occur. If fever, malaise, and sore throat occur than investigate by CBC (complete blood count) and serological test for EBV, which includes ESP (extrasensory perception), Ig M (immunoglobulin M), and Elisa (Enzyme-linked immunosorbent assay). Infectious mononucleosis usually resolves by its own with time. Anyway if you suffer from fever and sore throat that will discuss further and you can consult a nearby physician for examination at that time. It is advisable not to share an object with an infected person. I hope this will help you. Get back with more query if you still have doubt.


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Hello doctor,I am a 24.5 years old female. I am seven weeks pregnant and have a history of ectopic pregnancy and two miscarriages. My doctor has prescribed Folic acid, Duxil, Susten 200 mg, Duphaston, and Ecosprin. All tablets once a day. Should I take both Susten and Duphaston or just Susten is enough? Also till what time am I supposed to have these?


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Hello. As you had previous miscarriages and ectopic pregnancy, your doctor might have prescribed all these tablets for the maintenance of pregnancy and to prevent abortion. As Susten (natural micronized progesterone) and Duphaston (Dydrogesterone) both are progesterone with the same action, you can go for any one drug. Susten is preferable as it is natural micronized progesterone and category B drug in pregnancy. You have to take these tablets until the viability of pregnancy that is around 28 to 30 weeks.


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Hello doctor,I am 29 years old, and I have burning sensation underneath my feet since last year, after treating an STD. It was occurring mostly at nights, but these days it appears to be there from morning till night. Then I had a series of a sore throat last year, for which I was treated with antibiotics. Some months ago, I started having this pain in my left chest, which sometimes crosses over to the center. The pain has subsided, but I still feel slight pain just after and below my left chest and an occasional sharp one on my right breast. Underneath my feet is still burning, my palm feels warm, and my penis has this slight warm sensation. Are they all connected? What can I do?


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Hello. You have given a history of STD treated, What type of STD it is? If it is syphilis, is it cured completely? If it is not healed completely may lead to a complication called tabes dorsalis. When syphilis is untreated, the bacteria damage the spinal cord and peripheral nervous tissue. This leads to the symptoms of tabes dorsalis (neurosyphilis). Tabes dorsalis is now very rare because syphilis is usually treated early in the disease. Do CFS (chronic fatigue syndrome), CT brain, and spine. Repeat VDRL (venereal disease research laboratory test), FBS (fasting blood sugar), and PPBS (post-prandial blood sugar).


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Hello doctor, I have had a dull aching pain just above the back of my left knee (near the hamstring) and in my left buttock on occasions for about five weeks now. I am normally fine sitting but hurts when standing still or walking. Could it be a hamstring strain or sciatica?


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Hello. You lie down on your back, stretch your legs straigh, then lift your left lower limb up without bending knee joint. If you get severe pulling pain from buttock to whole leg, then it is sciatica. This test is called (SLR) straight leg raising test. Hamstring muscle pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over. Do the SLR test to know there is sciatica or not.


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Hello doctor, I went to a massage parlor and got a handjob. I was told by my doctor that STDs are not transmitted this way. Is this true?


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Hello. I understand your concern. This is true. Only direct genital contact or contact through cuts on genitals, blood, semen or saliva can lead to STDs, not hand job. Take care.


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Hello. Is this the first time you are experiencing insomnia or there has been a previous history? Sleep problems can happen if you are stressed, anxious or have a mood problem. Is there anything stressful going on in your life ? Do you do shift work? Try to address the root cause and learn relaxation strategies. I see that you are talking Zolfresh 10 mg (attachment removed to protect patient identity). It is fie to take it for a few days but not recommended to continue for a longer period. Try these self-help interventions: 1. Relax atleast an hour before bedtime. You can listen to music, or take a bath. 2. Go to bed at the same time. 3. Have a comfortable bed, keep the room dark. 4. Avoid drinking tea, coffee in the evenings. 5. Avoid watching TV or looking at bright screens in the evenings. It can affect your natural sleep inducing hormone secretion. 6. Avoid day time naps. 7. Do regular exercises. 8. Avoid eating heavy meals before sleeping. Take care.


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Hi doctor, I am 26 years old, female. I have high blood pressure problem from the last one month (silent BP) and my kidneys are damaging beacuse of this and my platelet count is 12 lakhs. These are continuously increasing from the last eight months, that is 6 lakhs, 8 lakhs, 11 lakhs and now 12 lakhs. My legs and foot pain are increasing day by day. Please reply as soon as possible.


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Hello. The hypertension is multi-systemic disease and can affect many organs in our body including kidney as well. So hypertension need to be controlled with medication. Kindly attach your kidney reports so that I can look how much damages have occured. Your platelet count is very much high. You have to rule out essential thrombocythemia for that. I suggest you consult nearby hematologist for detailed evaluation.


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Hello doctor, I am currently on 37.5 mg of Effexor and 7.5 of Mirtazapine. I started Effexor about 10 days ago, my anxiety has increased since starting, and I am taking Klonopin to help with that. Is increased anxiety a normal side effect when starting Effexor? I am also having nausea, dry mouth, and grinding my teeth at night. I do not want to switch to another medication if this is something that could subside in time. Please help.


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Hello. Some people can experience worsening of anxiety when starting Effexor (Venlafaxine) also nausea, and dry mouth can happen as well. They usually settle by two to three weeks. You are only on a low starting dose so hopefully should settle in due course. Discuss with your prescribing doctor during the next review so that dose titration can be done very slowly as needed. If the side effects do not settle, then, other options need to be considered. You can use Klonopin (Clonazepam) as needed up to four weeks to manage excess anxiety during this period. Do not continue Klonopin beyond four weeks. Keep using CBT(cognitive behavioral therapy) or psychological therapy strategies to manage anxiety and OCD (obsessive-compulsive disorder). Also, try deep breathing techniques and progressive muscle relaxation exercises to manage stress and anxiety.


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Hi doctor, I did a root canal before a couple of days. But I have pain in the exact upper tooth of the root canaled tooth. I have attached the X-ray after the first sitting of the root canal. Please suggest.


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Hi. I can understand your concern regarding dental health. In this condition, it will take time to have healing of the ligament and tissue at the end of the root of the root canaled tooth as it was previously affected by the infection. So do not worry and take antibiotics and analgesics prescribed by your dentist. If the pain persists even after all these, then go for check up with a radiographic investigation of the same tooth.


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Hello doctor, I have had swollen lymph nodes for over 1.5 years. I have gone through scans and viruses blood test, which resulted negative (attachment removed to protect patient identity). I have them everywhere I can feel. Neck, groin, armpits, chest and even on my face. What are the chances it is cancer?


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Hello. Generalized lymphadenopathy cannot always be due to cancer. However, lymphoma blood cancer is one of the cause for that. I suggest you investigate with biopsy of grossly visible enlarged lymph nodes or FNAC scan to identify the cause for enlarged node. If you have lymphoma, then it will be evident by histopathology of biopsy specimen. It is advisable to rule out HIV also by combo ELISA testing.


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Hello doctor, I am 30 years old and married for the last 3.5 years. One and a half years back, I had a surgery to remove ovarian cyst and fibroid tumor from uterus by laparoscopy. But, somehow one incision area got infected and I was under antibiotic for almost 5 months. Meantime, I relocated and the infection become worse for which I had to undergo another surgery to remove the abdominal abscess. In a couple of months, I become quite well but one sudden day pus came out from the same area along with pain. My surgeon said it was fine as the pus was there during the healing period. But this gets worsen and the area again needs to be cleaned out through a minor surgery. I still have that area swollen with pain on the left abdomen and hence recently went through another CT scan and it seems that I am suspected of having nontuberculous mycobacterium infection on my abdomen wall. My doctor wanted another round of surgery to clean up the wound followed by prolonged antibiotic. Could you please guide me by letting me know if surgery is the only option or there are other ways that I can leverage and get cured? I do not want another surgery and looking for alternative but effective solutions. Please let me know if you require additional information.


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Hi. It is unfortunate that you have to undergo repeated surgeries due to the infection. A combined therapeutic approach including surgical drainage, debridement, and prolonged treatment (more than three months) with combined antimicrobial agents, has been used in managing cases of atypical mycobacterium. In some cases based on clinical assessment, successful treatment requires aggressive debridement of all infected subcutaneous tissues and skin. Surgery does play a major role for these kinds of infections and may have to be repeated. I should be able to give you more inputs if I see the scans and reports. Kindly revert back with the same.


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Hi doctor, I am a 62 year old male. I am suffering from multiple neurofibroma of spinal cord and acoustic neurofibroma. I had bypass surgery four years ago and since then I am under medication, which is given below. My present problem is related to stomach. Since the operation, I started having sudden bouts of loose motion. Earlier, the interval between the bouts was about 15 to 20 days which gradually reduced now to about three days. I have consulted numerous doctors including gastro specialist. Sonography reveals all organs to be normal except grade one fatty liver. No blood, pus cells in stool. My hemoglobin is 16.1. I have undergone deworming course by taking Rcifax 400 bd for five days, Noworm 400 and Nortryptomer od for three days, but there has been no effect. The consulted doctors have different opinions, some say that it is due to neurofibroma and some say it is due to reaction of medicines which I am taking. But no remedy has been suggested yet. If the loose motions become uncontrolled, I am forced to take Norflox TZ, which gives temporary relief. These loose motions are sudden, often soil clothes and have imprisoned me in the house. My current medication includes Nikoran 5 bd, Cardivas 3.125 bd, Cardace 2.5 od, Flavedon MR od, Lasix 40 half tablet od, Becosule od, Clopivas 150 od and Rosuvas 10 od. Please help me.


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Hi. Such diarrhea is seen in Irritable bowel syndrome (IBS). IBS is of three types: You seem to be suffering from IBS diarrhea predominant. However, IBS is a diagnosis of exclusion. We investigate suspected cases of IBS with thyroid profile, fasting blood sugar and ultrasound abdomen. If all investigations are normal as you have mentioned blood and stool test (considering these investigations have been performed), then you are probably suffering from irritable bowel syndrome. In case you ever have had blood or mucous in stools, you require a colonoscopy to rule out any evidence of inflammatory bowel disease. I advice the following for treatment of IBS: Idiopathic. Routine. IBS. Stress free life.


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Hi doctor, I took my mother to a dentist. She hit the tooth hard with a hammer and chisel to remove the second molar of upper jaw. She has experience as a dentist for 30 years; still she does not wear gloves. I am wondering, is this practice safe? My mother cried during the procedure, but the dentist told it will not pain. My mother cried because of fear. I am looking forward to hear from you. Thank you.


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Hello. Getting a tooth removed is a terrifying experience for all. It is the dentist's responsibility to address the patient's concerns and make them feel comfortable. Ideally, the procedure should be explained to the patient beforehand. Infection control is very important for the safety of both the dentist and the patient. A dentist must wear gloves and face mask before any treatment. As far as using a hammer and a chisel, these are the instruments usually present in dental clinic. They are a part of the dental instruments used for teeth extractions, especially in difficult cases. Although, a local anesthetic injection is given prior to removing a tooth, anxious patients may need more than one injection. Also, while the local anesthetic is good for numbing the area, patients can still feel the pressure sensation during tooth removal. In the end, it all comes down to proper communication with your patient and constant reassurance during the procedure.


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Hi doctor, I am not sexually active. But my fiance did foreplay and ejaculated on my hand. I washed my hand with soap after that. I do not remember the semen going near my vagina. I am still virgin and he did not penetrate me. However, the next day I got worried and took an emergency pill. I still have not got my period and it has been a week. I also have PCOD. Have I missed my period because of PCOD? Or could I be pregnant? Please let me know.


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Hello. Please do not be worried. There are no chances of pregnancy at all. Firstly, because you had washed your hand with soap which carried the sperms and sperms do not survive on contact with detergent or soap. Secondly, you have taken an i-pill within 72 hours. Hence, your menses are likely to be delayed due to high progesterone pill you have taken. Now, you should get a withdrawal bleed within next 7-10 days from the day of pill intake. So, you should be patient and wait for the withdrawal. However, if you are anxious then as on today you may get a serum beta hCG test done to rule out any pregnancy conclusively. If the hCG levels are less than 5ng/dL then you are surely pregnancy safe and you can then calmly wait for your menses to arrive naturally.


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Hi doctor, Recently, I had an operation in left external auditory canal under general anesthesia. I am having doubt that some GPRS tracking system has been inserted during operation. Is it possible to insert GPRS or something like that inside ear? Please help me.


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Hello. Yes, it is technically possible to implant a small GPRS (general packet radio service) chip in your post aural region. But, that type of device cost a lot. I do not think that anyone can access to that type of device as shown in most of spy movies. So, do not worry. Nobody is going to track you. If still you have any doubt then you can do an x-ray of mastoid region to clarify it.


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Hello doctor, I woke up five days ago with clogging in my ears. Stupidly, I went with one of the first solutions I found online and poured hydrogen peroxide in my ear. It is now stuck in my ear canal and I cannot get it out. I have tried Swim-ear drops, ear candle, wax removal kit and shaking my head violently. It is so annoying. I do not want to get an infection, that could lead to hearing loss in my left ear. I have no insurance and I am a young guy struggling to make it. I am in need of some advise. Please help me.


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Hello. I hope this helps you. Do not worry. It is most likely to be impacted wax. For further queries consult an ENT otolaryngologist online -->


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Hello doctor, My urine is foamy. I am confused whether everyone will get bubble and foamy urine while urinating. Please explain me.


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Hi. I appreciate your vigilance. Mild frothing of urine is usual, but excess of frothing denotes protein leakage in urine. What is your age? Do you notice any swelling of your feet and face? Do you have any other medical problem? To be sure get a urine routine microscopy report and follow up with that. Revert back with answers to the above questions to a nephrologist online -->


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Hi doctor, I am 18 years old and I have started to struggle with palpitations. When I was around 12 I started having high blood pressure and since then it has not stopped. I have gotten many tests done for my heart and all have turned out normal, but I am still concerned. I do have a poor diet and I am not very active. Could this be causing my heart problem or could it be something more worse?


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Hi. You have done many tests with cardiac point of view? First of all, raised blood pressure in very young age, 12 years in your case, should be investigated. It must be secondary to some other disease. One of which is called pheochromocytoma. This condition causes both high BP and high pulse rate, along with sweating, fever. These symptoms are sudden and episodic. Pheochromocytoma is basically a tumor of adrenal glands. Other cause of high pulse rate may be hyperthyroidism in which thyroid gland is overfunctioning. Other symptoms include warm hands, sweaty hands, heat intolerance, weight loss despite good appetite, fine tremors, diarrhea, reduced sleep, thyroid gland may also be enlarged, some changes in eyes, etc. As you said your diet is not good, so it may have caused anemia. Anemia leads to fast heart rate. Another cause may be your sedentary lifestyle. As you said you are not active, it causes fast heart rate on slight activity. These are some non-cardiac causes of fast heart rate. Cardiac causes may be atrial fibrillation, inappropriate sinus tachycardia, atrial tachycardia, etc. Detection and differentiation of these requires ECG. If one of these is diagnosed, then next step is to detect the cause of it. Then treatment is done for the cause. So, possibilities of your condition are many. There is a huge list of differentials both cardiac and non-cardiac. Proper diagnosis requires focused investigations. Please provide your previous tests (ECG, holter, etc.) so that I may devise a plan for diagnosis of your condition which may require some other tests as well. Also send a record of daily BP and pulse rate of one week at least. Remember, if pheochromocytoma is the cause, then high BP and fast pulse may be present only during episodes and normal between episodes. Beta blocker is good to control heart rate. So please follow-up with your medical record and BP, pulse rate record.


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Hello doctor, I am diagnosed with polycythemia (JAK 2 negative). I need more knowledge, my BM and JAK 2 studies are within normal limit.


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Hello. Your present CBC report is not suggestive of polycythemia especially polycythemia vera which is blood cancer condition (attachment removed to protect patient identity). Your JAK 2, EXON 12 study and bone marrow report is normal as per history. So polycythemia vera is very less likely. Your high hemoglobin could be due to secondary polycythemia cause. Secondary polycythemia is pure benign condition. The causes for that include respiratory problem, cardiac problem, smoking, severe dehydration, etc. I suggest you drink lots of water especially three litres per day. Avoid smoking if having habit. It is advisable to repeat CBC again after a few days.


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Hello doctor,I have a patient who is an athlete, has a history of panic attacks. Yesterday, he had palpitations, and some tingling was then sent for an ECG. The findings are sinus rhythm, marked right axis deviation, and ECG without any abnormalities. Would you be able to see it and assess what further steps I need to take?


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Hello. I reviewed carefully your ECG images (attachment removed to protect patient identity) and would explain that besides right axis deviation, I also noticed the presence of prominent P waves in DII lead, which indicates a pattern or left the posterior fascicular block. For this reason, I would recommend performing a cardiac ultrasound to examine the heart and exclude possible structural abnormality. Regarding the tingling, I would also recommend checking the thyroid hormone levels and blood electrolytes for possible imbalance. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need. cardiac structural abnormality. Cardiac ultrasound.


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Q. I am having the symptoms of frequent urination, dizziness, and white thin cervical mucus. Will I be pregnant?


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Hello doctor,I am 32 years and trying to conceive since last six months. My last period was a month before, and intercourse was 10 days after that for four days. I have been facing the following symptoms like frequent urination, dizziness, etc. However, there was clear milky white thin cervical mucus until this month.However, it was less or hardly visible in quantity. I am not sure if it was too slippery for me to have noticed as well. But I did not get thick cervical mucus. And today morning I got traces or a very minute or small thick cervical mucus and negligible in quantity. I am waiting for a missed period, which is due next week. I am anxious because of the absence of cervical mucus. Am I pregnant? Please help.


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Hello. I have gone through your query. You have been sexually active during your fertile period till the end of last month. Now, the presence of thickening of cervical mucus is a possible sign of conception but not conclusive. The earliest now, considering your anxiety, you can be tested conclusively for pregnancy is after eight days post last intercourse is with a serum beta hCG test (blood test). If the hCG levels are more than 5mIU/ml, then you are surely pregnant. So please get the test done and follow-up with the report.


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Hello doctor,I am a 28-year-old man with very less facial hair. Recent blood check-up shows that my DHEAS value is 195.9. Insulin check-up indicates that there is a high chance of becoming a diabetic patient. My doctor suggested me Ashwagandha, and I have been taking it for a month (two capsules per day). Not much gain. So, I would like to take DHEA supplements for beard growth, is it fine?


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Hello. I think it is very normal to have less hair on the face. Even if you have little hairs, it is normal. Do not worry about your DHEAS level. You should not be taking any hormonal treatment unless it is required and so you can consult an endocrinologist for it. If you have normal sexual functioning, you should not worry about it. If it bothers you too much, you can ask a hair transplant surgeon and get a nice beard transplant. Focus on a healthy diet and regular exercise.


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Hello doctor, I am reviewing the patient care of a 4-year-old child diagnosed with the flu. He was having trouble breathing, so we called an ambulance. I was very apprehensive about him receiving any drugs from a doctor. His pulse was 149, 161, and 150. The medic then said his pulse was falling, which I did not see. He then requested an order to give Epinephrine, which does not make sense to me. His pulse rate then fell quickly. What is your opinion?


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Hello. An ECG should have been done immediately to see if the child was having VT, SVT, or anything else that would require you to slow down the heart. Based on the ECG, the next step could have been planned. This is because you have only written to me about the heart rate. The other aspects, like breathing and circulation (blood pressure), also decide the modality of treatment. Does it make sense to give epinephrine to a child having tachycardia? However, if there was no pulse afterward, epinephrine should be given at that particular time.


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Hello doctor, Pain after idiopathic orbital inflammation before 11 years. I have undergone biopt two times due to inflammation with fibrosis and sclerosis. Now the doctors say the disease is gone. But I am still in pain and again using 15 mg Prednisone a day. They told me I have neuropathic pain, and this is more often in other patients with pseudotumor orbitae. My question is, can fibrotic tissue that is still visible on the MRI, cause the pain? Is there inflammation seen on the MRI? Or abnormalities or myositis?


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Hello. I saw the MRI (attachment removed to protect patient identity), the sclerotic tissue from which we have to confirm that the pain you are experiencing is mainly neuropathic and emerging not from the sclerotic tissues as much as from the adjacent structures that are rich with nerves and blood vessels. Due to the anatomic changes that the eye has gone through, all the adjacent structures are still adapting to those newly acquired conditions, and that is what most probably is causing the pain. Whether it is from the compression or the disturbance in blood supply, currently, there is not much to do but to keep reducing the inflammation and prevent future reoccurrence with the prednisolone, but specific preventive measures such as undergoing a comprehensive eye exam as per the ophthalmologist recommendations are necessary. That examination should include tonometry - intraocular pressure, perimetry-visual fields, and optical coherence tomography to exclude any newly acquired changes that might require intervention. As for the diagnosis, although not much changes to the treatment will take place, it should be enforced with a blood test called ANA (antinuclear antibodies) profile to exclude any autoimmune disease that might develop on other organs. I would add a course of Neurobion, which is a complex of vitamins group B and might want to consult a physiotherapist on a method to improve blood circulation in the affected area. I hope I have cleared a few of your questions, and please feel free to follow up with additional inquiries or test results.


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Hello doctor, I got a little tiny pimple on my penis glans it vanishes when I use on ointment Lobate GM, and my glan skin seems to get a wrinkle, and it is not smooth anymore. I do not know what to do? Please help.


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Hello. Lobate gm (Clobetasol, Miconazole, Neomycin) cream contains a steroid, and because of continuous application, your skin gets thinner. I hope there are no pimples at present on your glans. If you have pimples or any rash, then you should consult a dermatologist. Apply two drops of coconut oil after bath and at night time after cleaning your glans with water. Do not use any soap over glans.


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Hello doctor, I am taking Sibelium 10 mg from last some weeks for my migraine and last month I missed my periods. Kindly clarify the reson. Is it delaying due to this medicine?


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Hello. On the aspect of missing your period can be Sibelium (Flunarizine) because it has some effect of blocking the dopamine receptor in the brain. Besides, it is a calcium channel blocking effect. So the possibility is that by blocking the dopamine receptor that will cause a central increase of prolactin. Prolactin will lead to galactorrhea and in turn, alter the menstrual cycle. So it is a possibility that is if you have done a pregnancy test and it is negative. So that dopaminergic antagonistic may cause amenorrhea.


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Hello doctor,I am a lazy one, and all the time's something is running in my mind. I am not accurately able to focus on my studies, and I am getting afraid and tensed by every little issue. So kindly help me.


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Hello, Welcome to ilciniq.com. Continuous something running in mind if it is unwanted is called brooding or rumination. The more you continue it, the more problems it may create. Problems like making you more lethargic. Better start behavioral modifications like exercise, distraction techniques, keeping yourself engaged, etc., with a proper timetable. Watch yourself for anxiety, and depression symptoms if any, then seek help accordingly.


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Hello doctor,I have 100/60 blood pressure, and I feel less active. My TSH level is 0.022, and I am feeling alone and depressed, but I am getting sleep. Please help.


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Hello, Welcome to ilciniq.com. A blood pressure of 100/60 is normal for a woman in your age group. However, if you are feeling lightheaded upon standing, then you need evaluation to see if your blood pressure drops when you stand up. Your blood counts and urinalysis are normal. Your thyroid hormones Total T4 and Total T3 are within normal ranges. A single low TSH (thyroid stimulating hormone) reading may need confirmation with a repeat test. Are you on thyroid hormone supplements? What are your height and weight? You have been prescribed an antibiotic (Mahacef plus). There is no reason for you to take medicines. I suggest stopping it. Also, no indication to take Citro Soda (you do not have a urine infection). Your health is fine, and so you can stop all the medicines. Your symptoms may have other causes like lack of sleep, stress, etc. You will need further evaluation. You can start by getting a repeat TSH test done at a standard laboratory. Stop the medicines you have been prescribed currently. Once you have the repeat TSH level, you can get back to me.


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Hello doctor,I have PCOS, and my recent report says that prolactin level is 42, what does it mean? Otherwise, my period is normal.


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Hello. The serum prolactin levels are high, which indicate hyperprolactinemia. This can cause hypomenorrhoea or shortened menses even though the cycles may be regular. The PCOD (polycystic ovarian syndrome) element further adds to insulin resistance and putting on weight. The aim of the treatment should be the PCOD regimen and Dopamine agonists like Cabergoline tablet to control and treat both PCOD and hyperprolactinemia, respectively. The classical sign of hyperprolactinemia is the discharge of watery substance from breast nipples, also known as galactorrhea. This often leads to breast heaviness and tenderness.


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Hello doctor,My baby boy is 8 months old and has trouble in passing stools. With Laxatives, doctor prescribed he is passing hard stools once in four to five days, and he is crying while passing stools. What can I do to improve his constipation? And what diet changes do I need to make? Currently, I am giving him oatmeal pear puree, pear puree, apple puree, and chikoo puree.


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Hello. Your kid is suffering from an anal fissure that is a cut at anal mucosa. Give syrup Duphalac (Lactulose) one teaspoon full once a day at night time after meals. Apply several ano ointments (Lidocaine, Metronidazole, Sucralfate) locally three times a day for 15 days with the applicator. According to me stop milk from 8 am to 8 pm and give semisolid diet like dal, dalia, khichdi alu kela rice, apple, upama, halwa, rab kadi idle poha satu custard, etc and from 8 pm to 8 am give mother milk is preferable if not give top milk without water and add sugar as per your taste . To start with stop milk for four hours for 15 days and give semisolid diet, next stop milk for eight hours and give semisolid food, lastly, stop milk from 8 am to 8 pm and provide semisolid diet. As 100 ml milk gives 70 calories of energy, 100 ml juices give 55 calories of energy, and 100 gm of semisolid food gives 350 calories of energy. When giving a semisolid diet, provide water as the baby requires. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Continue all the above for at least 2 years of age.


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Hello doctor,I am 24 years old and having extreme hair fall. My center of the scalp has already started showing up. Please help.


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Hello. Use Trichospire hair kit and Qilib men lotion twice daily. I hope it helps. If you have any other question, please do not hesitate to contact us.


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Hi doctor, I am suffering from chronic dry cough originating primarily in bronchial area. I feel fatigue, vertigo, lack of appetite and periodic nausea. Please help.


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Hello. Chronic cough since long time suggests some allergic condition like asthma. For proper diagnosis you should do a chest x-ray and spirometry test. Other symptoms can be suggestive of some infective cause like tuberculosis. So, ultimately after an x-ray and spirometry test we can make a definite diagnosis. Vertigo can be because of chronic cough. But, clinically it is very difficult to say. Some blood test may also be required for making a diagnosis. Usually, the asthmatic patients have some other allergies also. You have not specified any other symptoms in detail. Please do not hesitate to contact me after doing the above mentioned tests. Treatment mainly depends on the reports. Allergy. Chest x-ray and spirometry test. Asthma. Inhaler medicines. Avoid known allergen.


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Hi doctor, My four year old son, weighing 16 kg is taking medicine for benign childhood epilepsy. Medicines he is taking are namely Topamac 100 mg a day in two divided doses and Lobazam 15 mg a day (5-0-10).  His MRI for epilepsy protocol is normal without abnormalities. I would like to know whether he is taking overdosed medication. Does anti-epileptic drug cause lot of side effect? Doctor suggested PET scan. Is PET scan required for epilepsy diagnosis? Please suggest.


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Hello. For benign childhood epilepsy (BCE) your child is on 6.25 mg/kg/day of tablet Topiramate (anticonvulsant) which is a medium dose and is fine. Side effect to look from Topamac is dehydration. For dehydration, he needs to drink at least 700-1000 mL water daily. He can get tingling in finger which usually responds to taking high potassium diet like banana or raisin. Occasional side effects are kidney stones and word finding difficulty. All anti-epileptic medication comes with some side effects and one has to choose between them and benefit one can have with control of seizures. PET scan is performed in epilepsy patients for surgical evaluation in refractory cases. Is your child still having seizures after taking these two medicines? Also, has he been tried on other medicines before?


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Hi doctor, I am a 36 year old male. For mild chest pain, I have got my chest x-ray PA view done as suggested by my rheumatologist. My doctor said that x-ray report shows changes of chronic bronchitis in both lungs more in lower zones and old fibrotic scarring is seen in left apex. I am suffering from arthritis for which I am on medication. I have glaucoma. My medication at present for arthritis is Cobix 200 twice daily, HCQS 200 once daily, Pan D before breakfast, Rosuvas once at night, Tryptomer 10 in night, Espidase DP, Folvite 5 mg and Imutrex 15 mg once in a week. Kindly suggest me medication according to the reports attached. Please do not suggest me any other doctor or any hospital as I want to get treated through your medication.


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Hi. We are here to help you. The treatment would be based on the symptoms that you might be getting. I would advice in such case to first get a HRCT chest (high resolution CT scan) along with sputum for AFB (acid-fast bacilli) done, which would rule out the evidence of tuberculosis. Rest for rheumatoid arthritis, your treatment is going in right direction. Further treatment decision would be based on CT chest. Rheumatoid arthritis. CT chest. Avoid smoking.


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Hello doctor, My friend has white tongue since 20 days, used probiotics from 10 days but problem did not solve. But no sore throat and no discomfort while eating anything. He feels lymph nodes near right side of neck, back side of ear and near arm ankle from last one week. Got some pimples on his face and one or two on chest and stomach. Fourth generation HIV duo tests (p24 and antibody) done on 6th, 20th and 35th day and came as non-reactive. He is in a little worry as symptoms are still there (white tongue and nodes). A kid kissed on his blood wetty pimple of him, did that kid get infected? It was done 24 hours back. Is it good to go for PeP? Please suggest.


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Hi. White patches on the tongue can be oral thrush caused by candida albicans seen in severe imunosupression especially stage 3 or 4. Pain on swallowing can be from involvement of the larynx and oesophagus of the thrush seen in stage four. Persistent lymph node is also common. The kid should be put on PeP very important just to avoid getting infected, because there could be an open wound in the child's mouth through which the virus can gain entry.


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Hello doctor,I am 28 years old. I had my blood test done last month. HBV was negative. When tested again 53 days later, it came out to be positive. Do I have acute or chronic? Are all HBV acute for the first six months? What are the chances that I will completely get rid of it within six months?


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Hello. If your HBsAg was positive on the second occasion, but negative 53 days before that, you have acute Hepatitis B infection. Most of the time, HBsAg is discovered incidentally. It is not common for Hepatitis B to be diagnosed in the acute phase. More than 90 % of patients with acute hepatitis B recover completely and do not progress to chronic hepatitis B. Less than 10 % develop chronic Hepatitis B. I suggest you consult a medical gastroenterologist or hepatologist or an infectious diseases specialist.


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Hello doctor, I am 21 years old, male. I was doing excercise with suppoter. Then I suddenly felt strain in my groin and pain in my left testicles. After two days I went to doctor. He physical examined my testicles and wrote two tests CBC and urine. In CBC, eosinophils was 6. He said it is because of filaria infection, then I got fileria antigen test (ICT) done and test shows not detected. What is it ?


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Hi. It seems the exercise put much stress on your groin, the pain could be from strain or tear of the inguinal ligament around that area, could be from the associated attached muscles to the ligament around that area, the associated left testicular pain may be because the spermatic cord which also carries nerves that supply the testicle which also travel via the groin to the scrotum was strained in the process making the pain to appear in the testicle of same side. Is there any testicular swelling? You can use an analgesic Ibuprofen 400 mg BD for five days, apply Diclofenac gel on your groin and massage it thoroughly three times daily. You can also take antibiotics just in case there is an associated epidydymoorchitis. Tablet Augmentin 625 mg BD for six days. You may feel better.


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Hello doctor, I have had a sharp pain in my tailbone area when I am sitting or standing up. This has been going on for several months and has not improved. I recently saw a doctor. He diagnosed it as a curve in my lumbar and suggested I see a chiropractor here. Is there anything else I could do to fix this problem?


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Hi. Yes, it is worth having a second opinion and clearing your doubts. But I think your doctor is absolutely right about the cause of pain. This is due to a slightly curved spine in the lower back causing the tailbone pain. Chiropractic adjustments and physiotherapy should help solve this problem. You should also try out anti-inflammatory medications to reduce the inflammation around your tailbone causing the pain while sitting. Medicines like Ibuprofen or Naproxen (for about 5 to 7 days). This medicine should only be taken if you are not allergic to it and if you are not suffering from bronchial asthma. If you have a lot of pain while sitting, you should use a doughnut shaped pillow or cushion for a few weeks. But yes, your previous doctor was spot on with the diagnosis. Coccydynia.


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Hello doctor, I have had pain in my right wrist for a week now. But these past three days, my fingers and hand have been numb and it is getting worse and worse. Please help.


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Hello. The pain is in the palmar aspect of your wrist or on the dorsal aspect? Was there any history of fall ,fracture before this and was there a huge swelling? There is a possibility that swelling lead to compression of the nerves that passes through the wrist to supply your fingers leading to severe pain and subsequently numbness. This is most likely a compartment syndrome. Can you still move the fingers? You need to do an X-ray of the hand and then see an orthopedic surgeon let them check you thoroughly.


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Hi doctor, I am 19 years old and I am currently experiencing an issue with the veins in my arms and legs, primarily on the left side of my body. It started about a month ago when I noticed a vein on the top of my left foot that started bulging up out of nowhere. It was concerning but not painful until a few days later, it gave me extreme shooting, throbbing pain. This lasted for a about a week then started to fade to what it is today, a numb pain that gets sharp if I support my weight too much on that foot. This has limited my movement quite a bit, which makes it hard to complete my daily tasks, and I cannot wear closed toe shoes anymore without pain. The problem got even more concerning when other veins in my body started to bulge ang give pain, first in my legs, and now in my hands and arms. My left hand is my primary one and now I cannot lift things or write or hold it downwards without having a pain in my arm, where a big vein pops up just below the wrist. This has all happened in the course of a month. Does this condition sound familiar and if so, what should I do to get treatment for it?


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Hello. Your problem looks like varicose vein. Veins will bulge when you are standing or moving around when unlike down it regressed and blood flows back into the deeper veins and empty back into the heart. Varicosity is due to incompetence or weakness in the valves within veins which prevents the blood from flowing back as the blood has to be returned to the heart for recirculation. Due to weaknesss in the calf muscle which contracts and compress the deeper veins causing blood to be squeezed out of then for upward emptying into the vena cava and into the heart. Blockage of the pathways of flow or deep veins due to venous thrombosis, usually common in women, tends to increase with age, and with use of contraceptive pills and with pregnancy because of increased intraabdominal pressure which in turn comprises the vena cava and affect return of blood back to the heart. Complications can be venous thrombosis due to increased stasis of blood. If there is so much build up of pressure for long time can cause venous ulcers. Management is elevation of the leg when lying down. Use compression stockings to support and collapse the veins, avoid use of high heels. Change your standing or sitting position from time to time. You can do Doppler ultrasound scan.


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Hi doctor, I have been using high quality, highly rated penis extender for two days for 8 hours a day and no for the past three weeks now. Do these things really work? Is it possible to experience penis shortening instead of enlarging? A month ago, I was 7” but now I am almost at 7”.


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Hello. I want to know the reason for which you are using a penile extender. Do you have a very decent size why you want to increase it further? It is like your height is 6 feet but you want it to be 6.3. Everything you do has got side effects. If not done properly can lead to trauma and hence shortening. Are you diabetic or hypertensive? Any other chronic illness?


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Hello doctor,I am a PCOS patient. I have regular periods, but heavy bleeding, overweight, high sugar levels, and the egg size is 15 with using the medicine. But I could not conceive, and extreme hair thinning and hair fall. I am on metformin twice a day from last week. I want you to suggest any supplement for my hair loss. I am very upset. Kindly help.


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Hello. PCOS (polycystic ovary syndrome) clearly has an effect on hair growth on patients. Dietary carbohydrate causes more insulin release in women than men. This stimulates production of testosterone from ovaries in women. First try restrict carbohydrate from diet for few months before starting antiandrogen as a treatment. To avoid food rich in carbohydrates such as rice, milk, yogurt, ice-cream, potatoes, etc.


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Hello doctor, I think I am going through anxiety because I failed in my exams and I am scared to tell parents. I do not know what to do. It is mentally exhausting. Please help.


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Hello. Failure in exam is quite common and always remember that it is only a temporary setback. Almost all successful people would have failed an exam at some point in their life. Do not put too much pressure on yourself by hiding it from your parents. It can be a difficult burden. Your parents may be upset, but eventually, they will get over it. After initial disappointment settles down, they will support you. Learn to develop coping strategies to manage frustrations. You will come out stronger in the long term. Try to distract yourself and relax for some days. Then plan to retake the exam with better preparation. Make sure you eat well, sleep regularly, listen to relaxing music, talk to supportive friends and family. If anxiety is just situational nothing to worry, it will get better when the situation improves. But if it is persistent, you will benefit from some counseling to manage anxiety.


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Hello doctor, I had a cough for six months, and now I have the feeling of something in my throat. I had a sinus X-ray, lungs checked, checked for asthma, swallow test done, and thyroids checked (I have a tiny nodule, in which the doctor said that would not make me cough). Do you have any suggestions on what it could be? I am very tired of coughing.


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Hello. The cough you say is it dry or sputum? Are you losing weight? Is there any drenching night sweat and persistent low-grade fever? Is there any history of contact with someone with a chronic cough in your locality? Do you smoke, is your occupation such that you are exposed to industrial dust, and asbestos? Is there any associated chest pain, any difficulty in breathing, etc. A small thyroid nodule may not make you cough but if the nodule is impinging on your trachea that can irritate which you claim you notice in your throat. The thyroid check you did was it thyroid function test to know the thyroid hormone profile, because a solitary thyroid nodule may be toxic and can be abnormally producing excessive hormones thyroxine which may cause other possible symptoms such as excessive sweating, weight loss, anxiety, intolerance to hot weather, diarrhea, palpitation (as if your heartbeat is audible to you). If non of these is the case, then you have to do screen for TB, do sputum AFB (acid-fast bacilli) and do GeneXpert, that will rule out tuberculosis. If you can help me by uploading some of the tests you did, that would help make a definitive diagnosis in this case.


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Hello doctor, I feel like something is stuck in my throat from two months, and I also have the problem of food coming in the mouth sometimes, and acidity. When I went to the doctor, he recommended Pantoprazole after which I had little relief, but not so much. Please prescribe me something better.


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Hello. Have you been back to your doctor after he recommended Pantoprazole? I think that you need to have an upper endoscopy to look at your esophagus and what is causing this problem. It sounds like you may have a Zenker's diverticulum. This is an outpouching of the lining of the esophagus. There are treatment options for this, but you have to Consult a gastroenterologist who may be able to fix the problem through the endoscopy. I hope this information is helpful.


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Hello doctor,I am a 19-years-old. Recently I checked my thyroid, and the report states that T3 and T4 are normal, but TSH is 8.5. What does that mean? I am skinny and 55 kgs weight. I do not have any past health issues. Please explain this.


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Hello. What was the reason that you had your thyroid checked? Do you have a history of thyroid disease? Have you had your cholesterol checked? The number you provided is consistent with subclinical hypothyroidism. That is a low function of your thyroid that would not account for your low body weight. We usually do not do anything about these findings except to monitor them. I would recommend that you have your thyroid checked again in one to two years. I also recommend that you have your cholesterol checked and followed if necessary. If you develop any symptoms related to hypothyroidism, then you should see your physician immediately. Symptoms include heat intolerance, changes to your skin or hair, weight gain or loss.


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Hello doctor, I am a 26-year-old male. My height is 5'9" and weight is 54 kg. I do not look healthy. I take a regular diet and meals thrice a day. I do not have any health problems like cough, fever, and pain. Actually, I want to put on my weight and develop my muscles because I look very thin. Could you suggest me any medicines or supplements for my better body growth?


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Hi.  Good to know that you are eating well. What about family history? Are your both parents or anyone parent is underweight? If it is familial, it is difficult to gain weight. You can try with any protein powders, Ensure is good for a supplement. Take it as mentioned in the bottle. Try to include some evening snacks. You can eat milk based sweets like rasagollas, milkshake, etc., prepared at home. Exercise every day to increase your metabolic rate. Simplest is brisk walking. Gradually increase your intake of food. Do the above-said things and get back to me after 10 days. Ensure two teaspoons daily with milk. Follow up after 10 days.


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Hello doctor, I am 28 years old. My weight is 55 kg. Whenever I am taking cold foods, I am suffering from nausea, headache, and chest pain. Kindly advice.


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Hello. You feel those symptoms when you take cold foods, and so you may likely be having symptoms of common cold and malaria. The chest pain could be a symptom of an ulcer. There may also be fever, I presume. You can run a test for malaria (blood film) if it is positive then treat it. Tablet Artemether Lumefantrine 80/480 mg b.d (twice a day) for three days, tablet loratadine 10 mg b.d for five days, tablet vitamin C 2 t.d.s (thrice a day) for five days. Add tablet Rabeprazole 20 mg b.d in case of ulcer.


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Hello. Testicular cancer will have painless testicular lump, swelling of scrotum, swollen lymph nodes, or weight loss. Varicocele will have infertility dragging testicular pain, lump or swelling above testis in spermatic cord. Best to differentiate between two is ultrasound scrotum.


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Q. My partner came all over me on top of my vagina without protection. What are the chances of conceiving?


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Hello doctor,My baby is 3 months old. Last night my husband and I did not have intercourse, but he came all over me on top of my vagina without any protection. Any chances that it will make me pregnant? I am very scared. Please advice.


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Hello, Welcome to the icliniq.com. Full penetrative intercourse has a high chance of pregnancy, but nonpenetrative contact of genital with vagina also has some risk of pregnancy because of contact of precum fluid from the penis to vagina. So you have less chance of pregnancy but wait for the next period. If the next period delayed for a week than rule out pregnancy by urine hCG (human chorionic gonadotropin) card test. If you want to exclude early than after three weeks of last menstrual period (LMP) investigate with blood hCG test. Get back with more query if you still have doubt. I hope this will help you.


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Hello doctor,My mother is suffering from breast cancer, and her treatment is going on. We have already done four chemotherapy with a gap of 21 days, but now instead the surgery doctor advised us to take 12 chemotherapy weekly. Please let me know the treatment that is going on is right or wrong?


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Hello. It is called neoadjuvant chemotherapy. So with chemotherapy, the size of the tumor is reduced significantly to make breast tumor operable. She has completed four cycles every 21 days, and now they will start the second phase of weekly chemotherapy (a new drug) for 12 weeks as per international recommendations. After completion of the second phase, chemotherapy she will be restaged before surgery. It would be better if you would have attached CT scan, pathology (biopsy) reports also.


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Hello doctor,Back of my jaw has a bump, and my teeth seem to be shifting. Do I need jaw surgery to fix my open bite? Kindly advice.


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Hello doctor, The bump developed seems to be on your cheeks from the photo you shared (attachment removed to protect patient identity). Also, your lower second molars are erupting now, so the pain can be due to the eruption of that tooth. Even due to new tooth eruption, you may bite your cheek while talking or chewing. Please be cautious not to bite your cheeks and automatically the bump will vanish. From your BMI (body mass index) and weight, I suggest the bump may be your buccal pad of fat gets like bump due to some trauma. Once your tooth erupts, your problem will be fine. Follow rinsing your mouth with salt water twice daily. Your inflammation will subside. Let us wait and watch for 10 days. If the problem continues after 10 days, write to us again or consult your nearest dentist.


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Hello doctor, I am a 54-year-old hypertension patient and in control with medicines Ramipril 10 mg, Natrilix 2.5 suspense release and Rosuvastatin 10 mg. Ramipril was causing dry cough and was nanaging until recently. But now cough becomes very sensitive due to current COVID 19 situation and so visited another clinic for an opinion and the doctor changed to Concor 5mg and Amaasc 5 mg at least for three months until the current situation improves as constant cough due to Ramipril concerns me and others as well.


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Hi. I read and understand that your concern is about the side effects of the newly prescribed drugs. Reduction of sexual drive is one of the side effects of beta-blocker group of drugs. Concor contains Bisoprolol which is a cardioselective beta-blocker. The systemic side effects of cardioselective beta-blockers are less compared to the general beta-blockers. So the effect of Concor on the sexual drive would not be that significant to affect your usual life. And the combination prescribed is safe to take. There are no significant drug-drug interactions between these group of drugs.


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Hello doctor, I was diagnosed with diastolic dysfunction. The report says velocity E is 84.2 cm/s, and the MVA max velocity is 133.5 cm/s. What does this mean?


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Hello. Diastolic dysfunction means there is dysfunction in cardiac relaxation. This is not a worrisome thing and quite common in elders, overweight and patients with hypertension, and other diseases which must have been ruled out on echo and ECG. However, this may cause symptoms like shortness of breath, pedal edema, etc. Needs to have a low salt diet and low dose diuretics like Torsemide for shortness of breath. I Hope this helps you and get back if you have any doubts.


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Hello doctor,My daughter is 17 years old, and she is on Xarelto for four months. Her liver enzymes have gone up. Although it is normal but has increased from the level before drug. Her AST is 43, and the range is up to 31. She is on bcp and has factor V Leiden. This is why her doctor put her on Xarelto.


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Hello, Welcome to the icliniq.com.  At this moment I am giving you further information regarding your daughter condition. She has factor V Leiden mutation, which is a congenital cause of thrombosis. So Xarelto (Rivaroxaban) like good anticoagulant drug prescribed to her should be continued. AST (aspartate aminotransferase ) normal range is usually up to 40 in most of the laboratory. Her AST levels are not alarmingly raised. Sometimes the mild viral temporary infection can lead to high AST. If it is raised much than further workup needed otherwise not. Repeat AST after few days. I hope the provided information will help you. Get back with more query whenever required.


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Hello. Pain in lower abdomen and testes can be due to multiple causes ranging from urinary tract infection, infection of testes, varicocele, or some stone problem in ureter and kidney. You will need a few investigations to see for the cause then only treatment can be advised. You will require sonography of abdomen and testes, microscopic urine test, and renal function test. Depending on the report of this test, we can determine the cause and advice further. If pain is too severe, you can visit a urologist for physical examination. Sonography of abdomen, pelvis and scrotum,with colour Doppler testes, urine microscopic test, and renal function test. Epididymo Orchitis, urinary tract infection, varicocele, and intermittent torsion. Follow-up with reports.


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Hi doctor, I am a 26 year old female. I have had a kidney stone in my right kidney for around eight months and now it is relatively large 22 mm. I have attached my report for your reference. I am suffering from recurrent kidney infections in the past couple years and had a stone in my left kidney when I was 15. I have attached my latest blood, urine and CT reports. I am concerned that I have CKD stage 1 from the GFR I calculated using the parameters in these reports. Could you please advise me on this? In general, does GFR improve after a stone is removed through lithotripsy or PCNL? I am scheduled for a lithotripsy in a week. Any information regarding if you think I have CKD and what prognosis will be very helpful?


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Hi. I saw all your reports and your clinical details (attachment removed to protect patient identity). Your tendency for recurrent stone formation which needs to be evaluated. You need not to worry about eGFR (estimated glomerular filtration rate) currently as creatinine is normal. Removal of stone will mostly increase GFR. Most importantly after your lithotripsy please send the stone fragments which comes in urine for stone analysis. From that we will have a clear idea how to prevent their recurrence. Secondly, some general measures which include drink at least 3-4 liters of water and restrict salt in your diet up to 2 g in total. Do not take any calcium supplements and restrict or possibly avoid animal protein that is non-vegetarian food for some years. Take lots of water particularly in evening so that you at least wake up twice in night to pass urine. These all are general measures which really worked for many of my patients for future stone prevention. Do some blood tests like serum calcium, phosphorus, uric acid, bicarbonate and magnesium from any reliable laboratory and send for review. Revert back with the laboratory reports to a nephrologist online -->


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Hello doctor, I think I was bitten by a bat, so I wanted to know how to know that if I was really bitten by a bat. I did not felt anything at that time but some itching after that. I am not sure that I was bitten by a bat, so I wanted to know how do we feel when bitten by a bat. Also I saw that the thing which landed on my neck was small but had small wings that looked like a bat. I was asking ways to distinguish that I was bitten by a bat or not.


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Hello. If a bat bite there will be bite marks, usually superficial. 1)Early symptoms are fever, headache, and general malaise. 2) If the disease progresses, there will be neurological symptoms such as insomnia, anxiety, confusion, agitation, difficulty in swallowing, hallucinations, excessive salivation, paralysis, hydrophobia (fear of water), or agitated behavior. If you still have doubt better go for vaccination ARV (anti-rabies vaccine).


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Hi doctor,I had one sexual incidence. After 175 and 180 days, I got tested with CMIA technique. Please check my reports and suggest whether these are conclusively negative. How accurate is CMIA test?


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Hello doctor, I am a 30 year old female. I have history of PCOS and hypothyroid from last year. I also have a history of swollen pituitary gland, but it is normal now. I am only taking a 100 mcg pill for thyroid. My problem is that whenever I indulge in sex with my boyfriend, we are able to have intercourse very rarely as I am unable to produce sufficient lubrication in my vagina for intercourse. I get excited when we spend a lot of time on foreplay and I am not scared of intercourse. I actually love to have intercourse with him, but mostly I do not feel myself sufficiently wet to have intercourse and feel pain while having intercourse. What should I do?


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Hi. Although there are multiple reasons for vaginal dryness, the most common among them is deficiency of estrogen, a female hormone. This is possible in your case due to presence of polycystic ovary syndrome (PCOS) which alters the hormonal profile. I will recommend two things which may help you. Firstly, use the topical Estrogen. It is available in the form of gel, ring or cream. As per your convenience you can use either cream or gel and the use of ring requires assistance of doctor. The second thing is stress management. Stress is one of the common reasons for causing decreased vaginal lubrication. Although, there is long list of do's and donot's; principally speaking healthy diet, regular exercise, avoidance of substance abuse, plenty of fluid intake helps most individuals. For further clarifications consult a sexologist online -->


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Hello doctor,I am 40 years old. I have major adult acne breakouts mainly on my cheeks, neck, and under my ear. I am dark complexioned, so when it does clear, it leaves scarring and dark spots. The last dermatologist I consulted suggested birth control. Could please give some suggestions?


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Hello. I saw your pictures (attachment removed to protect patient identity). I can see pus-filled acne along with post acne pigmentation. Start using Azithromycin 500mg of any brand for six consecutive days after breakfast. Apply Epiduo gel once daily bedtime for a short contact period of 30 minutes then rinses off with cool water. Start biluma cream once daily in the morning on the spots. Avoid all sorts of dairy products bedtime and prefer carrots and spinach along with few soaked almonds. Have reviews about salicylic acid peeling and plan for three sessions accordingly. I hope this will help you.


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Hello doctor, My 2.5 years old daughter had a fall around 6 to 7 months back and one of her front teeth was chipped. At that time, it looked fine and till now, she had no pain or any sensitivity issues in eating. But off late, the color of the chipped tooth has turned green. We consulted two dentists, first one was a specialist in child dentistry and recommended an RCT treatment wherein a chemical will be placed to cure the infection. He said that the discoloration will increase with time and this baby tooth might fall off much earlier (in 4 to 5 years) than the expected time (6 to 8 years). The other dentist recommended to observe for six months and see if any rash or boil is developed above the gums and any kind of pain is experienced. He also said that such a tooth might fall off before time. We are confused as to what we should do? If RCT is the way out then we would prefer to get it done before she starts with her formal schooling at 3. But we are mainly concerned if she could endure such a treatment as she is very small. Please provide suggestion. I have attached a photo of the X-ray.


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Hi.  I got your chief complaint and opinions of two dentists. As far age is concerned, your daughter still is in need of these teeth as permanent teeth take time to erupt, by 6 to 7 years they will erupt. Till then, healthy front teeth are important otherwise she will develop irregular teeth later. As tooth has changed color so it is better to act on the suggestions of pedodontist and go for pulpectomy or RCT. It will keep the tooth intact and prevent formation of any cyst later. There is nothing wrong with it and there are modern gadgets to do the procedure, she will not feel any kind of pain during the procedure. If you leave it as such, it will weaken with time and may later contribute to huge financial burden to treat irregular teeth.


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Hello doctor, I am a 28-year-old female. I have been on Nucynta for over a year. I take Nucynta ER 50 mg BID and Nucynta IR 50 mg once a day. For the last two months, my urine tests (immunoassay and lab testing) have come back negative. Two weeks ago a blood test was done and it was also negative. I religiously take these medicines as prescribed by my pain management doctor. Due to these negatives he is now refusing to prescribe any oral medications (including my Flexeril, Gabapentin, and oral Ketamine). I understand his need to be able to prove to Nucynta in my system but he is also refusing to try anything else. I am a walking genetic defect. I also have known pharmacogenetic and pharmacokinetic issues. I also have EDS, CRPS, POTS, MCAS, gastroparesis (severe enough that EGD showed food in my stomach 18 hours after last eating), endometriosis. Could any of this be causing the problem? Could any of the medicines I take be causing the problem? My medicines are Lopressor, Trazadone, Fetzima, Zyrtec, Ketamine, Magnesium Citrate pills, Melatonin, Gabapentin, Flexeril, Nucynta, Junel Fe. What suggestions do you have? Is there any research to help me?


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Hi.  Nucynta is an opioid analgesic, that has high first-pass metabolism when administered orally. It means only 32 % of orally administered dose reaches blood. After it produces its effect, 97 % gets metabolized in gastrointestine and liver and gets excreted out from body through urine.   In your case, you have delayed (slow) intestinal movements, hence the drug may get faster metabolism and faster excretion than a normal individual. Hence, I think it is not detectable in blood or urine.   Another possibility is very less amount of drug reaches your blood (less than 32 %) due to intestinal absorption issues. The half-life of this drug is four hours in healthy individual. It means, after oral administration, 32 % drug reaches the blood within 3 to 4 hours. If I draw the blood after four hours of oral administration, the amount showing in blood is expected to be 16 % (50 % of drug gets excreted by four hours). It is in a normal person. In your case, when to draw blood is the question. So, individualistic reasearch could be done for you with special care.


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Hi doctor, I was lying on my stomach for about 20 minutes. When I moved to a seated position, I get the most intense painful headache of my life. It was in both my temples and lasted about a minute. Should I worry it is a brain aneurysm?


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Hi. This pain seems to be due to vasospasm, unlikely to be aneurysmal bleed pain, if it was aneurysm it should have continued for a long duration. I have another set of questions, please answer them. Is this first ever headache of this kind? Was there nausea, vomiting, and dizziness? Was there any blurring of vision? Are the temples painful on touching? Is there any weakness in limbs or double vision?


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Hi doctor, My wisdom tooth is coming in. I have discomfort in my gums where the tooth is piercing them. I am having pain when I open my jaw and swallow. My throat is a bit red. I have swollen glands under my neck on the side where the tooth is coming in. Do I need medical attention?


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Hi. It is a case of pericoronitis and due to that, you have all those symptoms. Yes, you need medical attention. Right now take these medicines: Amoxycillin Clavulanic acid 625 mg three times daily for five days. Tablet Acelofenac 100 mg with Paracetamol 325 mg and Serratidopeptidase 15 mg or Zerodol SP twice daily for five days but in case you relieve from pain you can stop its use after third day. Capsule Pantoprazole 40 mg once daily for five days. You also try salt gargles thrice in a day and maintain good oral hygiene. In a few days, you will relieve, however in case there is no relief then let me know, you may require radiograph and other surgical procedures.


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Hello doctor, I am a 20-year-old female. My height is 163 cm and weight 63 kg. I have a migraine, and I have consulted many doctors, but I am unable to cure it. Please help.


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Hello. Migraine is a chronic illness and can not be cured completely but changing the lifestyle do help a lot to alleviate the problem to a great extent. You can use pain aborting medication like Ponstan 1 gram (Mefenamic acid) at times of severe pain, and if you have nausea preceding it, you can also take Domperidone 10 mg. You can maintain a pain diary and reduce stress as well as a good sleep pattern and avoid excessive usage of electronic gadgets. Long term prophylaxis depends upon the recurrence of symptoms despite the above measures.


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Hello. Decdan (Dexamethasone) is a steroid and has a lot of negative side effect as such. It may cause you a disproportionate and inappropriate fat deposition in the abdomen, face, on the upper back, and you would not like your shape. And besides the bad shape, you may start having high blood pressure, a heart condition, can predispose you to diabetes later. It can also lead to adrenal gland suppression by which the corticosteroid hormones will impair the natural hormone produced by your body, leading to adrenal failures. If you want to gain weight, you can increase your meal to mostly carbohydrate and fatty meals, increase the frequency of your meal. You can take Cyproheptadine tablet 4 mg in morning and night. It will increase your appetite and cause you to eat more, sleep more, and you gradually gain weight more proportionately.


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Hello doctor,I was scratched by a nail of the dog a week back. Do I need to do anything for that? The dog died today, probably due to some other reason, and the dog was not vaccinated.


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Hello. Are you sure the dog scratched by nail or teeth? Is any open wound or bleeding present at the time? Did the dog die due to rabies or any other cause? So many questions there. Better get ARV vaccination (anti-rabies vaccine). Since dog died, the reason not known take human rabies immune globulin (HRIG) administered only once first, if you are previously unvaccinated. Then take ARV prophylaxis.


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Hello doctor, I had been suffering from this problem from last one week, as I retract my penis outer wall, it is paining and slightly swollen, also the tip of the penis has red small colour dots on it and it is scratchy and painful. So please recommend for necessary action.


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Hi. It is looking like candidal balanitis. Please take the following medications and revert back to me in seven days. Tablet Intawin 200 mg daily for 10 days, Canestan lotion, apply twice daily, tablet Teczin M once daily.


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Hi doctor, I have pimples on my penis, I do not feel any pain when I touch. I just want them to dissappear. I am having this for the past many months, I was feeling shame to consult, but now I do not want to take risk. Please help.


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Hi. I can understand your concern. According to your statement you have been suffering from pimples on your penis for the past few months. Pimples can develop on the penis as they are common elsewhere on the body. Pimples are resulted from blockage of the sebaceous gland of the skin due to excess sebum or debris or dead skin. Sebaceous glands excess secretion of oil (sebum) can develop pimples. For the prevention of pimples, you should avoid excess sweat-producing activities, wear loose clothes for preventing them from frictions, take bath regularly, and do not rub your affected area. You can use topical retiniods, salicylic acid, benzoyl peroxide, etc. Without any medications they are also disappeared with passing of time by keeping personal hygiene strictly.


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Q. I have itching and a pimple-like stuff that is bleeding a little in my scrotum. What could it be?


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Hello doctor,I am a 29-year-old male. I recently realized that my scrotum is itching and there is pimple-like stuff that is bleeding a little. There are reddish black spots on my scrotum, but it is not the area that bleeds. The area that bleeds looks like a ring-cut.


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Hello. I understand your concern. The black, reddish papules may be angiokeratoma which bleeds when you scratch that, but that is not the cause of itching as such. I am prescribing you medications for itching and ring-shaped erosions. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Tablet Fexofenadine 180 mg twice a day. 2. Tablet Ivermectin 12 mg today and after a week. 3. Cream Flutibact (Fluticasone Propionate, Mupirocin) cream twice a day for a week.


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Hi doctor, After suffering with groin pain, I had a double operation 12 weeks ago. During the operation, I had a repair of left side inguinal hernia and right hand hydrocele. I am now in more pain than I was before the operation. My testicle thorns with pain constantly and I have stabbing pain on hernia side. It feels like someone is sticking a bottle in me. I am struggling to walk very far, climb stairs and drive. I am unable to have a sex life. Is it normal to do both operations at the same time? Can you explain any possible cause for pain?


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Hi. Well, ideally if you have bilateral inguinal hernia, or inguinaĺ hernia on one side and hydrocele on the other, the surgery should be done for one first before the other, not simultaneously so that when you are fully recovered of one, then the other can be planned and done. Pain can be due to entrapment of a nerve like ileoinguinal or ileohypogastric nerves which run with the spermatic cords or it could be also present if there is improper repair with subsequent breakdown of the repair and subsequent herniation of the bowel content into the inguinal ring or it can be from infection of the operation site. 12 weeks is quite a long time for surgical pains to have disappeared. You will need to do an abdominal pelvic ultrasound scan to see if there is any reccurence or failure of the surgery or if there is entrapment of visceral content.


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Hi doctor, I have lost my prescription for Lipitor and have been taking it for four days. I will get it tomorrow. I am on 10 mg a day. I am worried, will my cholesterol go up in that time since I am not taking it?


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Hi.  The half life of Lipitor (Atorvastatin) is 14 hours in humans (meaning drug is eliminated in about 14 hours). The main effect of Lipitor is to block the buildup and making of cholesterol in body. It does the job together with the help of other active ingredients and its effect on cholesterol synthesis is maintained in the body for about 20 to 30 hours. In this situation, it does not seem an issue if you just missed a dose or so. Do not worry about it. But start taking medication as soon as you get it back.


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Hello doctor,I am looking to get a prescription for Clotrimazole-Betamethasone. I currently have one, but I am almost out. I have been dealing with anal yeast for around 10 years. Now it goes away with the cream but comes back when I run out. I do not wish to see any more doctors.


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Hello. I presume that this recurrent anal yeast infection is candidiasis, and you have been using a topical mixture of antifungal and corticosteroid cream over it. Have you checked for immune statuses like HIV, and blood sugar level to rule out diabetes? Then if you have been using a steroid medicine for a very long time, that can also depress your immunity. If all these tests have been done and are negative, and you are not on prolonged use of the steroid, then I will prescribe an enteral antifungal together with the topical cream. Get Fluconazole tablet 200 mg daily for two weeks that will kill the candida from inside. You may also continue your Clotrimazole-Betamethasone cream till the yeast disappears. I want you to run a test for HIV and blood sugar.


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Hello doctor,I have been suffering from massive stress for the past 34 months. I have severe pain in neck and shoulder area. My head is tight, and stress levels fluctuate, racing my thoughts and giving me sleepless nights. Please suggest me medication that will help me flush all my stress and pain. I was earlier diagnosed with a generalized anxiety disorder.


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Hello. I can understand your problem. Anxiety might be one of the main contributory factors for the symptoms you have. Racing thoughts, heaviness in the head, pain in neck and shoulder, excessive stress along with sleeplessness, etc., could be because of anxiety. If you have impairment in functioning, then please visit a psychiatrist for evaluation. Drugs like SSRIs (selective serotonin reuptake inhibitor) can help you in coming out of stress. Escitalopram or Sertraline or Paroxetine can be used. These drugs if used, regularly contributes in reducing the symptoms of anxiety, depression, and even the pain. The thoughts will be under control when you start taking the medicines. Kindly visit a psychiatrist for the prescription. Remain relaxed, and you will be alright. The blood test report you have attached shows nothing abnormal (attachment removed to protect patient identity).


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Hello doctor, I am a 59-year-old male. I have dark spots on my cheeks close to eyes on both sides identical. I would like to have medical advice on this problem which I am having for more than three years. I am currently taking Obimet SR 500, Glimisave M1, Pivasta 2 mg, Pinom 40 mg, and Clopilet 75 mg.


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Hello. Please send two to three clear pictures of the affected area for better evaluation and guidance. Do you have any symptoms (itching / burning) over this area?


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Hello doctor, I am a 16-year-old male. I am concerned about my mental health. I have symptoms of ADHD like fidgeting, restlessness, being very talkative, losing focus or attention, but I am very extroverted, and my academic ratings are good. Does someone get ADHD in their teenage years? And am I one of those people?


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Hello. ADHD (attention-deficit hyperactivity disorder) is a developmental condition which is noticeable since early childhood. Symptoms like hyperactivity, impulsivity, inattention will be present before the age of 12 years. Parents and teacher would have commented about it even in nursery and early primary school years. It is unlikely for someone to develop to ADHD in teenage years without having any symptoms before. Other causes like anxiety, too much stress and pressure, family, and social problems need to be ruled out. Also, important criteria for diagnosis is functional impairment like you may not be able to do well in academics and not able to achieve your potential. But you report doing well. So ADHD looks less likely. If you have any other concerns, discuss with your parents and family and consult your doctor.


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Hello doctor,I am 17 years old, and my weight is 98 kg. I am obese, and I need to lose weight. I feel lazy, sluggish, and sleepy all the time. I am on the second day of my period, and the flow is not proper. Kindly advice.


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Hello. Your history prompts me to go through further questions. Do you have a regular menstrual cycle? Any hair growth on the face, arms which is unusual than before? Scanty periods can mean oligomenorrhea (the medical term for decreased blood flow). Weight gain, hair growth, and oligomenorrhea are typical symptoms of a condition called PCOD (polycystic ovarian syndrome) which happens in girls, and multiple cysts are present in ovaries, and this leads to these symptoms. Sugar level also gets high due to this. So I would suggest getting blood glucose level fasting done, and ultrasound abdominal to see ovaries as it is confirmed whether you have it or not as it leads to treatment strategy. Cysts in ovaries, and oily food consumption. Blood glucose, abdominal ultrasound. Metabolic syndrome. Polycystic ovarian syndrome. After getting the reports. Avoid oily food.


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Hello doctor,I think I have a panic attack or panic disorder because I experience hand trembling, chest pain, feeling choking, light-headed, difficult to breathe, numbness, nausea, a sudden fear of death, sometimes fainted, and tightness in my throat but my parents do not believe me. I am sick, and they do not want to bring me to the psychiatrist because they do not believe me.


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Hello. You are right, these are panic symptoms. You can get yourself checked for a thyroid function test and a clinical examination from a doctor nearby to find out if there is some other reason for these episodes, which can happen in thyroid problems. If your doctor finds your tests and examinations are normal, then you can show this as proof to your parents and seek help from a psychiatrist for these anxiety symptoms. It may take some time but let us hope they listen to you. If not, you have a right to get yourself treated for your discomfort.


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Hello doctor, My 5 year old daughter has stomach aches around the navel area that happens from time to time. It lasts a few minutes each time and goes away. Abdominal X-ray and ultrasound were done and has not found any abnormalities or umbilical hernia. Stomach pain starts while eating or drinking and also at random times. Other symptoms including the passing of stools about four to five times a day, including while having a meal. A most recent development within the last week has had several accidents and says she did not feel it coming. This is not normal for her. No other emotional distress could be a reason.


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Hello. I suspect three things, it is just assumption based on history. 1. Stomach ulcer, as she had pain after food and water. 2. Worm infection, need to have a look after food. 3. If non of the above, must be ruled out by investigations. Then it is called functional abdominal pain. I advise you to visit a specialist. She might require one-week antibiotics and if symptoms not settled, then endoscopy also. But the best part is to visit the pediatrician. So he can evaluate her in detail and examine her. Meanwhile, you can give symptomatic treatment. Kindly consult your doctor to discuss the suggestion and take the treatment with consent.


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Hello doctor, I had a constant headache for two days then I visited a close-by pharmacy and I was asked to treat malaria. I was given Metherine Forte tablets (Artemether 80 mg and Lumefantrine 480 mg tablets) and two cards of Paucofenacmol Caplets. Two days after taking the drugs as prescribed by the pharmacist, I started having some stomach bites, serious ones which tended to go down after I eat. It made me eat often. I went back to the pharmacy and was given worm drugs Tindex 500 (Tinidazole Tablets 500 mg) and Wormplan (Albendazole tablets 400 mg). I took those worm drugs in the morning today, yet my stomach pains are still severe.


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Hello. You have a persistent headache in the frontal part of your head. Was there fever, chills, and rigor, were you feeling like vomiting, after taking those drugs prescribed for you? Did your headache subside? The medicines given at the pharmacy are fine for malaria, but it may not have been malaria, but it could be Salmonella typhi infection, which causes typhoid fever. Worm medicine is fine in the case. I will advise you to go to a lab and do blood film for malaria parasite, do Widal test and stool microscopy culture and sensitivity. If there is salmonella infection E coli or any enterobacteria infection, the stool MCS will detect it. If there is worm infestation such as hookworm or tapeworm, it will also pick it in microscopy. You can take tablet Buscopan (hyoscine butylbromide) 10 mg thrice daily. Then get tablet Ciprofloxacin 500 mg bd (twice daily) take them for five days. You can add tablet Rabeprazole 20 mg bd in case if there is any peptic ulcer since the description of the pain and the location in your abdomen was not very precise. Enteric fever. Malaria. Intestinal spasm. PUD(peptic ulcer disease)


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Hello, I had a minor herniated disc L4 or L5 last year. (MRI confirmed nerve pinch, but no broken disc or liquid leaks) With heavy pain, I was hospitalized, but recovered within two weeks. With Ibuprofen and muscle relaxants, I was able to walk and function pretty normally. Sciatica (leg nerve pain) came and go during the time now and when I was in the hospital last year. Right now, I am experiencing almost no back pain, but the sciatica is heavy. Mostly on the back of my left upper leg, down till the end of the knee. I am doing stretching exercises, belly position, upper body up, or on the back, leg stretches towards the torso, plank training, etc. But I still have to sit a lot due to my job. I tried a standing desk, which resulted in feet pain and also more sciatia. Though I am sitting straight, the fascinating thing is that heat and cold are influencing sciatica. As long as I apply heat to the leg (not the lower back), the pain disappears instantly to an almost level of no pain. A bit of cold and the pain becomes very heavy immediately as well. Can there be an underlining other issue causing it?


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Hello. As it is a year old injury now I will suggest doing some physical test like McKenzie maneuver to see if the radiating symptoms stops and the pain gets centralize to the lower back. The McKenzie maneuver is simple, and you can read about it and practice it. Now I think there is still a muscle weakness which is leading to nerve root entrapment like the lateral spinal muscles, paraspinal muscles, hip muscles, etc. I advice to not use cold therapy as it is aggravating the pain symptoms. Do proper exercise which will regain the strength in the muscles and avoid nerve root entrapment. In most cases, the pain is caused due to more of the muscle weakness, and it is common in most cases to have received the symptoms back. Doing proper exercise with proper guidance can resolve the matter.


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Hello doctor, Just for precaution which fruits are safe to have to protect self from Nipah virus? Coconut water and citrus limetta, are safe to take? What to eat to detect Nipah virus? I heard there is a homeopathy medicine already invented to combat that virus? Is that true? Gelsemium 200 is the name? I have no symptoms and fit and fine. Just asking for precaution


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Hello. To prevent Nipah virus, maintain good hygiene procedures like frequent hand washing and cooking food properly before using is the best procedure. It is a brain damaging virus spreading through vertebrate animals to humans and also human to human. Prevention: This virus also shows meningitis symptoms. Homeopathic medicines for prevention:  To detect the virus ELISA and PCR tests are useful. Symptoms of a headache, fever, nausea, fainting. In severe cases drowsiness and disorientation, and coma. In some cases blurred vision, vomiting, choking, fatigue and abdominal pain. According to symptoms, we can give Gelsemium and Eup per also can be given. For more information consult a homeopathy physician online -->


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Hello doctor, I am 28 years old. I had my last period before two weeks. I have PCOS, and the doctor asked me to take Letrozole (3 to 7) 2.5 mg, Clomid (5 to 9) 50 mg, Estradiol 6mg per day (8 to 12) and Metformin 1000 mg daily. I got a positive ovulation test on the 14th day of my cycle, and I went for an ultrasound, and my doctor said I am not ovulating now, so I wanted to know if I am going to ovulate in this cycle or not.


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Hello. It would be helpful if you can share the pictures of the ultrasound you have undergone and also the report which mentions the endometrial thickness on day 14 of your scan.


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Hello. Coenzyme Q10 had a specific benefit. Ashwagandha is a herbal supplement with multiple actions on various biochemical and metabolic pathways. From pharmacology, Naturopathy, and Integrative Medicine perspective, I can suggest taking both the medicine together. But I suggest you have a gap of one hour between these two supplements. While consuming Ashwagandha, please drink a cup of milk or honey and water, which gives more benefit according to Ayurveda.


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Q. I can see white substance globbed together on my stools after having greasy foods. Please advice.


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Hello doctor,After eating greasy food, the following day, I pass stool and floating on the top is a transparent white substance globbed together, my stool is not formed usually and is mostly short segments. I often go about four to five times a day, and sometimes less. I am not on any medication.


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Hello. It does not look like an infection to me. Could be due to some undigested food material. However, you have mentioned that a few tests have been performed. I would like to see the report before I comment further.


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Hello doctor, I have pilonidal sinus. I had two surgeries one with the endoscopic method and the second one six months before by incision and drainage method. After recovering from this, I had a small pimple on the wound. Doctor said it is normal and it is because of surgery. But now I am having redness around that. I am using alcohol swap to clean the opening areas of pilonidal sinus and they are closed. Kindly tell me is this recurrence of pilonidal sinus or boil or what it is? It is causing pain while sitting as well.


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Hello. Do not worry. I will help you with your problem. As you said, you underwent surgery for pilonidal sinus two times and now you have one boil at the same site. As I can see in the image (attachment removed toprotect patient identity) it can be boil or recurrence of pilonidal sinus that may be due to infection of that local area. I will prescribe you some medicine. Please maintain local hygiene shave your hair in that area. Get back to me after five days. I will add some more medicine and local remedies. Sitz bath in luke water with Betadine twice a day, tablet Augmentin (Amoxicillin and Clavulanic acid)625 mg TDS for five days, tablet Chymoral forte TDS for five days, tablet Serradic P BD for three days, Capsule A To Z OD for 10 days.


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Hello doctor,I got a ball hitted on my eye so my eye got swelling, redness and pain and also my vision is lightly blur. So kindly tell what I should do?


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Hello. This is a widespread scenario among children. The pain and swelling around your eyes will disappear. I recommend that you use ice packs to help faster recovery. The vision will likely improve in case you have any watering. This will happen spontaneously. I recommend that you see an ophthalmologist in case of no improvement in symptoms in a day or two. Redness, swelling, and pain can also occur due to a fracture of the orbital and facial bones. These will need repair to heal. Blurred vision can be due to various causes after injury. The most important and dangerous of these is retinal detachment and cataracts. I hope this helps you.


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Hello doctor, I have dryness, redness and red lines in both eyes. No liquid discharge. Right eye hurts sometime. I have 5 to 6 hours work on laptops.


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Hi. People spending longer time on computer, laptop screens have greater chances of developing dry eyes. Because while using computer, blink rate is decreased to 1 to 2 time per minute. Normal blinking is necessary to keep eye surface wet and eyelids function as wipers and spread tear film on corneal surface. If you do not blink, eye surface gets dry and you will feel irritation of grittiness or mild redness. Longer time you spend on screen, more chances of developing dry eyes.  So you need to slightly modify blinking habbits while working on laptop, screen. You should blink every 15 to 20 seconds to keep eyes wet. Secondly, you can use artifical tears, lubricants to minimize dryness. You can use Systane eye drop or Tears Naturale eye drop or any other tears available to you. You can use 3 to 4 times but you can also use more frequently if you feel so. There is no side effect of these drops, these are only artificial tears. I hope your problem will be solved.


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Hello doctor, I have been told that I have a kapha vata imbalance and I have taken vasthi (Panchakarma) procedure. But I still have white coating on tongue and my digestion is weak and. And if I do not eat, I feel weak and nervous. If I eat, I get indigestion. Will Agathiyar Kuzhambu help me?


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Hi. Vasthi reduces vatha imbalance. But, this is not the final treatment. After the purification (detoxifying) therapy, further, follow up with herbal drugs needs to be taken based on your current clinical feature and naadi.  Agasthiyar Kuzambu is given once in four months for a normal individual to detoxify body. For any specific disease conditions, it is given more frequently with suitable Anupanam. It can be given to you after careful examination. Can you consult nearby Siddha doctor? After Agasthiyar Kuzhambu, further herbal medicines need to be continued for 2 to 3 months for better benefit. We need to see directly whether it is a fungal infection.  In your case, I feel, you may take Nannaari Manappaagu (syrup) one spoon mixed with water (morning, afternoon, evening) before each meal. This will remove your tongue coating.


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Hello doctor, I have 3.5 months old baby. I do not have sufficient breastmilk, hence, was giving fomula milk. Baby was not satisfied with the taste of formula milk and was never having it properly, so one day my mother added sugar to formula milk and since that day my baby is having formula milk as per his requirement. Now, if we do not put sugar to formula milk, he will not have it. I am giving him Abbott semilac iq+ stage 1. Please let me know what can I do.


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Hello. You can keep reducing the sugar content of the milk slowly slowly until you reach a stage where there is no sugar in the milk. Also, you can check for your current milk output to see if even little is there. If even a little is there, please give the child breast for sometime and if the child suckles, let him suckle. After removing from the breast you can give the child some top feeds. That way the child will not stay hungry and your milk output will also increase. Slowly slowly a stage will come wherein your milk output will be enough to satisfy the hunger of the child and you will not need top feeds.


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Hello doctor, I started Trintellix yesterday for panic, anxiety attacks and today I felt like a lump in my throat, almost like someone is choking me. I am not sure if this is due to the drug and if this is something to worry about? Should I take my next dose today?


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Hi. Trintellix is a type of selective Serotonin reuptake inhibitor which work by increasing serotonin levels in blood. The serotonin further treats the anxiety and panic attacks but sometimes SSRI may cause activation like rapid increase of serotonin in blood, which may lead to temporary increase in anxiety. To solve the issue, you can start with half tablet, a dose of 2.5 mg for initial five days, then make it 5 mg and continue it further. If it also does not help you, then contact your psychiatrist.


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Hello doctor, I am 17 years old. and have a littl bit of white nipple disharge in both breasts but one has it a little worse and the skin on my nipple appears to be white and has little blisters on it. It does not really itch or anything but it is sore to the touch.


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Hi. I see that you are worried about discharge from both your breasts and you are telling it has blister-like appearance. White discharge with blister-like appearance and sore to touch generally points towards an infection, but an infection occurring simultaneously in both breasts at the same time is very rare. Another possibility, is that milk secretion from both breasts which you might think as white discharge. Do not doubt, there are certain conditions where there can be milk secretion even without pregnancy and birth, which occurs due to hormone disturbances. Need some more information too, Do you have a fever? How are your menstrual cycles? Is it regular? Is the flow high? Do you feel any small lump behind the nipples? Do you take medicines for any other problem? Do not mistake me, but your problem needs a direct clinical examination to visualize the breast, discharge and to see if there are any lumps behind the nipples. You would not be comfortable to post pictures of your discharge and blisters, so I would recommend you to visit a doctor in person and have yourself examined. Meanwhile, do the investigations I have advised and try the medicines given below. Hypothyroidism. Hyperprolactinemia. ? Breast infection. Galactorrhea. Tablet Amoxicillin + Clavulanic acid 625 mg twice daily after food for five days, tablet Aceclofenac + Serratiopeptidase two tablets twice daily after food for three days. Avoid wearing tight vests and too much sweating.


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Hello doctor, My husband is 44 years old and taking no medication but only anti-fungal cream. He has a lot of itching and his foreskin does not go back without pain. Please help.


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Hello. From your history, it seems the skin is inflamed and cannot be retracted, this is called balanitis. There is a possibility of phimosis (tightness making it difficult to retract and painful. I am not sure of his personal hygiene because if he is not cleaning it properly, it can cause some pus like particles smegma which can provide medium for infection in it.  What you can do is use Augmentin 625 mg bd for 10 days, use enteral antifungal Fluconazole 200 mg daily for 10 days, tablet Ibuprofen 400 mg BD for six days. You can get triple action cream (contains combination of Corticosteroid, Antifungal and Antibiotics) that will help too. Permanent treatment for this problem is to see a doctor and get circumsicion that will solve the problem once and for all. Fungal and bacteria infection, poor personal hygiene. Swab for microscopy culture and sensitivity. Paraphimosis. Balanitis.


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Hello doctor, Yesterday onwards I could see one small swelling, seems to be a pimple like one appearing above my penis area. Could you please explain this? I do not have any pain but feeling afraid.


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Hi. The pimple like small swelling you say is not painful and no other similar swelling anywhere else. Was there a history of sexual contact with an unknown woman unprotected prior to the appearance of the lesion, any swellings around your groin, the swelling, is it ulcerated? Is the color same as your normal penis colour or is it darker? Is there any pain on urination?  Based on your presenting symptom, if there was a history of unprotected sex, it may be primary syphilis or penile wart because these do not come with pain. Do laboratory test such as VDRL, then you can get medications IM Procaine Penicillin 1.2 g daily for 10 days, tablet Doxycycline 100 mg BD for five days.


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Hello doctor, I have been taking Ashwagandha, Turmeric, Amal powder and Brahma supplements. I am scheduled for a colonoscopy in three days. It is a preventive screen. I last took them a few days back. Should I reschedule my colonoscopy?


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Hello. I just read your query. You can go for your colonoscopy because these are all herbal supplements and as you have stopped all these, they will be flushed out of the body in a week. After colonoscopy, if you are re-scheduled for other investigations, then do not start these till then. Even if you are not, then you can take after two to three weeks.


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Hello doctor,I have been using an antidepressant for the last two to three years. About two months ago, I received very exciting news that I had been waiting for a long time. After a short while, I had panic attacks one after another. I asked a doctor and learned that the things I was experiencing were depersonalization and derealization.For the past two months, I have been, living in fear and anxiety, hoping it passes, but nothing significant has happened. Now the doctor prescribed me 25 mg of Seroquel an antipsychotic drug. My antidepressant prescribed has also doubled in amount. I have read that Seroquel can have negative consequences when taken unnecessarily, or it can lead to schizophrenia.I am moving abroad within the next three months, and need to have healed by then. Do you think that there will be adverse effects of Seroquel on me, such as worsening my situation, intensifying the feelings of fear or making the time of my derealization last longer? What should I do?


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Hello. Seroquel is Quetiapine and is an antipsychotic drug, but the drug is also used in mood disorders like bipolar disorder or resistant depression. The drug does not make a person schizophrenic. A lot of psychiatrists use this drug as augmentation therapy for depression or insomnia. If they have prescribed this drug, then remain relaxed. This will not cause any harm to your mental health but will help you. The drug is safe to use and has no severe side effects.


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Q. I have irregular periods and waiting for pap smear. Should I worry about uterine or cervical cancer?


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Hello doctor,I am 24 years old. For the past two years, I have been having an irregular period cycle. My doctor recently suggested me to get my exam Pap smear. I have gained 60 pounds in the last three years. When I was younger, I had the HPV shots. I am nervous about the pap smear and having an irregular period cycle. Should I be worried about uterine cervical cancer? I have not lost weight. I do not have pain. I recently had a yeast infection, and I am still healing from that.So when I had intercourse last time I felt a little discomfort in a certain position. I started spoofing today, and I am having normal PMS symptoms sensitive boobs, and I do not bleed in between things. I read that cervical cancer takes 15 years to be invasive, and I am scared.


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Hello. You should not be afraid of pap smear, having pap smear test does not mean cancer it is only a routine check-up. Your irregular cycles may be due to the hormonal problem, and there is no relation with cancer. You should do an ultrasound test of the pelvis and blood tests for sugar PP (postprandial), TSH (thyroid-stimulating), prolactin, and testosterone. Depending on the report, treatment is available.


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Hello doctor, My child is one year old. On routine examination his eye has a power of minus 3.5 and minus 2.5 refractive error. What is the normal refractive error at this age as refraction continues to change? Doctor said to follow up after six months as glasses may be needed if power increases. Please help.


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Hello. First of all, let me tell you that visual development takes until the age of puberty. As your child grows, his vision parameters will change because his eyeball grows with him as he ages. So visual stability will continue to change until the age of 18-20 years old. Normally the child is born with a plus refractive error unlike the case here. Your child has a condition called myopia which is a refractive error with a minus as you said. But that is completely fixable as the child grows whether by glasses, contact lenses, or LASIK surgery if it continues and he needs to take glasses off later. The most important examination in his age is something called a red reflex. You should ask your doctor if he has done it to him. Also, I would ask about the fundus examination too. If both were normal, I would not have any concerns. I want to reassure you that your child's eyes are in good health. He just needs to be examined precisely every follow up every six months as your doctor suggested, just to make sure everything is going right and to treat anything if something happens early. The glasses will not be tolerated by a child as his age is too small, as soon as he can tolerate glasses, put them on. That could happen in two years. If you need further assistance do not hesitate to contact me.


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Hello doctor, I am a 44-year-old female. My height is 161 cm and weight 87 kg. Clarify one doubt about an antidepressant. My new psychiatrist started Uvox CR 10 days back. I was on Stalopam for three to four years before that. For the past some days, I am feeling body pains and disinterested to do any work at all. But I somehow manage to complete the work also but with a lot of effort. Will the medicine take time to set? Why do I have these symptoms?


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Hello.  Antidepressant take around two weeks to show their effect as this much time is required to make changes in chemicals present in the brain. The symptoms you mentioned are typical of depression. Stalopam (Escitalopram) and Uvox CR (Fluvoxamine) both are antidepressant from SSRI (selective serotonin reuptake inhibitor) group but somewhat different profile. In the next few days, you will see some relief as 10 days already passed since starting on Uvox CR. Also, check your thyroid status as you are already on Thyroxine75 mcg and check that this dose is sufficient or not. Meanwhile, do regular exercise and go for a walk for at least 45 minutes, five times a week. Maintain good sleep hygiene and spend time on your hobbies. I hope it clarifies your concern and feel free to ask if anything unanswered.


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Hello doctor, When I try to masturbate or when I am thinking of it, I became very nervous, and a little fainted. I do not know why.


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Hello. Well, in this case, the jerk you had in your first experience is called ejaculation. I am sure you did not take any libido-enhancing drug cause that may also amplify the symptoms. And usually, there is adrenalin surge during ejaculation, which can cause a sudden increase in your heart rate, nervousness and eventually tiredness during ejaculation. After the entire process is over, then eventually you will become calm. I guess your fear may be stemmed from your first experience. Those symptoms you felt are normal for every man who has sex when it is time to ejaculate. It is not a problem. It is a normal physiological respond during ejaculation. So relax, nothing to worry about you are fine. I believe your subsequent experience will make you understand that it is normal. Erotophobia, sexual anxiety.


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Hello doctor, Part of my foot has been numb for several days but I feel fine. No pain or anything. Is this any reason for concern?


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Hi. I see that you need to perform the following tests to see if you have acquired diabetes and/or anemia related to vitamin B12 deficiency. In case the test results are negative and the symptoms resolve in the coming days then there is no need to worry. If the condition continues despite negative result in the tests, then I suggest taking Vitamin B complex supplement, like the one I will mention in the treatment part. FBS (fasting 8 to 10 hours), HbA1c, CBC. Neurobion tablets one tablet a day after food for two months.


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Hello doctor, I am a female aged 50. I have awful pain in the lower abdomen for four days. I have a pain in the right arm and the left side of lower abdomen. My abdomen is bloated and sore. My bowels are moving. I gave up Seroquel a few weeks ago. I have IBS and diverticulitis.


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Hello doctor, I am 50 years old. I have decreased libido, lack of proper erection, and early ejaculation. Please advice.


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Hello. You are 50 years old, and you should get yourself checked by a physician to rule out hypertension and diabetes. These are important causes of erectile dysfunction. Reduced libido could be age-related. But if you have weak erection and early ejaculation, then drugs like Tadalafil can help. The drug will help in making strong erection and will improve the time too. Consult a psychiatrist for the prescription.


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Hello doctor, There is a pain on the left side of stomach and lower back and the skin feels sore. There is also burping a lot these days now. Please help.


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Hello. From your symptoms, it seems you are suffering from diverticulitis. The differential diagnosis is urinary tract infection. This can occur in elderly frequently in people who do not eat enough fibers in their diet. Also with age, our digestive system tends to get slow. You need prescription antibiotics to treat this condition. Also, if you develop other symptoms like rectal bleeding or fever or unexplained weight loss, burning pain during urination, you need to see your healthcare provider immediately to rule out other conditions. Normally, diverticulitis subsides within a few days with medication. For more information consult a family physician online -->


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Hi doctor, I am a 28 year old female. Before 10 months, I got left side abdominal pain with mild fever. I went to the ER. After blood tests and CT scan, they said it as diverticulitis. After using antibiotics, it got cleared. Every couple of months I feel pain when I press my abdomen but no fever. When I take liquid diet for two days, the pain will go away. Even though my bowel movements are regular, sometimes the stool is hard and I can see blood. I am drinking lots of water at least 2 liters a day and stopped junk food. But, still I am suffering with pain. Sometimes, I feel a sharp pain inside the rectum. Recently, I went for an annual checkup. After checking the reports, my GP said that it may or may not be diverticulitis. He said it might be colitis and nothing to worry. My last blood in stool was two months ago. Sometimes, my stool is mushy and fluffy. I am very much worried about this. Please help me out.


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Hi doctor, I am a 22 year old female. I was playing touch rugby two days ago. It just so happens, and I have not exercised in a while now. I am having severe lower back pain, muscular and  joint pains around my thighs. Today is the second day, and I am still feeling the pain. Is this normal? Do I need to seek medical attention?


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Hello doctor, I have a constant fever from the last week, and severe body pains as well. I have undergone some tests for the same.


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Hello. Please send the test results. Revert with more information to a general practitioner online -->


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Hello doctor, My wife is 50 years and I am 54 years old. Last night we had sex with a condom, but I have doubt it may be unsafe. Her period occurs once in one and a half months. Other than this she does not have any gynecological problem. Can she take any contraceptive pill like Unwanted 72?


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Hello,  Welcome to icliniq.com. Though your wife is in the late part of her reproductive age and might be approaching her menopause, yet if she continues to have her menstrual cycles regularly there is a chance that she might be still ovulating and if intercourse happens in her fertile period she might conceive. It is better she takes Unwanted 72 this time. Unwanted 72 is safe for her from a medical point of view but it is not 100 percent effective in avoiding pregnancy and cannot substitute a routine contraceptive. So please do a pregnancy test also if she does not have her periods at the scheduled time. After her next periods follow up for an effective contraceptive with additional benefits for hormone replacement appropriate for her age.


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Hi doctor, I am a 65 year old female, and I fell 10 days back and broke one or two ribs. The only thing that brings any relief is Ibuprofen 800 mg. I need to know how often and for how long can I take Ibuprofen? I tried Oxycodone 10 mg, but it does not work that well. Thank you.


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Hi. I hope it helps you. If you have any further query, please ask me. For further queries consult an internal medicine physician online -->


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Hello doctor, I have cracked nipples that have failed to heal for the past five weeks. I am a nursing mother, and I am not able to feed.


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Hello. Please apply Purelan 100 (Lanolin) to the cracked nipples and express the milk to prevent engorgement and feed the baby that milk (store in hygienic conditions) along with some top feeds if required. Reduce the latching of the baby to enhance healing. Till you have healed completely feed the baby expressed milk and top feeds. I hope this should help.


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Hello doctor, For the last seven years, I have been having about one to three nocturnal seizures (tonic-clonic) a year. There was one year in the previous seven years, where I did not have any nocturnal seizures, but I had two to three a year for the last couple of years. I am not on medication, and I have tried to improve my sleeping habits. What do you recommend?


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Hello. I understand your concern and would first recommend performing an EEG (electroencephalography) and a brain MRI to exclude any possible brain lesions that may lead to seizures. As seizures are persistent, I would recommend starting antiepileptic drugs. In this regard, considering your age, and the fact that you are overweight, I would suggest starting low dose Levetiracetam or Carbamazepine. You should discuss with your doctor on the above tests and treatment options. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need. MRI brain, and EEG.


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Hello doctor, I am suffering from erectile dysfunction. Early morning sex power is also very low. There is a quick immature erection. The genital part does not stand properly. Right now, I am taking 1000 mg L-Arginine once daily. Can you please solve my problem?


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Hello, Welcome to the icliniq.com. For your erectile dysfunction problem, you have to rule out organic cause like thickening of an artery supplying penis due to fat deposition. It is called atherosclerosis thickening of the artery. For that color Doppler ultrasound, penile angiography can be done. USG (ultrasound) testes and serum testosterone estimation also need to be done. I suggest you avoid stress if you are having anxiety or stressful event history (psychological cause like stress is also associated with erectile dysfunction). You have to check your blood pressure and serum cholesterol values as well. Obesity also can be responsible for erectile dysfunction. So lose your weight. Take more fruit juices, especially pomegranates juice once daily at night. Regular exercise, yoga, meditation can be beneficial. If there is no improvement in one to two months, then we will discuss further. I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor, I am suffering from nightfall for past three months. Please give solution to stop nightfall.


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Hello. What is your age? You need not worry for the nightfall or wet dreams. This is normal for young individual who thinks more about sexual things. Practice the following to control the nightfall. 1) Take Fenugreek (methi) with honey daily. 2) Take curd daily as it helps to sleep better without interference. 3) Gourd juice also induces better sleep. 4) Eating onions helps to reduce wet dreams. 5) Bath with oils mixed in the water can be relaxing. 6) You should relax your wandering mind. Enjoy entertainment, listen to soothing music, and read good books. 7) Avoid tea, coffee, and alcohol. 8) Eat healthy foods and drink plenty of water to help the body release toxins from the body. 9) Exercise regularly and practice yoga to keep the mind and body calm and relaxed.


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Hello doctor, My mother's blood pressure is 130/80 in the morning, but by 10 pm before she eats her medicine in the night, her bp becomes 160/80. She is taking calcium channel blockers, which cause swelling in her legs resulting in difficulty in walking. She is currently under,  Moxilong 0.3 mg tablet twice. Tazloc 40 twice. Ecosprin AV 75 in the night. Minipress XL 5 mg twice Prolomet XL 50 twice. Dytor 5 and Benidipine 8.


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Hello. She is taking lots of medicines but still if BP is raised the possibilities may be, 1. Not reducing salt intake, not following a healthy lifestyle guidelines, and not exercising. 2. Medicines may not be taken appropriately, some over-the-counter medicines such as NSAIDs may raise blood pressure. 3. She is overweight, and as such if BP apparatus cuff bladder is less than 2/3rd of arm circumference, then BP may falsely appear high. 4. Some other disease such as hypothyroidism may be present, leading to secondary hypertension. Serum TSH (thyroid-stimulating hormone) test is advised for that. Please consider these issues while measuring BP.


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Hello doctor,My height is 165 cm, and my body weight is 79 kg. I want to start doing exercise, and I want to become healthy. I want to know about what diet I must follow to improve my health. How many proteins, carbohydrates, vitamins, minerals, fats do I need to consume daily, and what diet I must take?


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Hello. An average man needs 2500 calories to maintain, and 2000 to lose one pound of weight per week. At present, you are overweight BMI is 28.7. You have to reduce, but healthily. Choose whole foods instead of processed food, and avoid sugary drinks. Keep healthy food readily available. Fruits, vegetables, lean meats, fish, eggs, and nuts. Eat more fish than meat. Use whole grain flour in baking recipes and eat in smaller plates. Calculate 2000 calories. That means eating the equivalent of six ounces of grains each day, which includes 2.5 cups of veggies, two cups of fruit, three cups of dairy, and 5.5 ounces of protein-rich foods. Divide your food out over five meals like three slightly larger meals (breakfast, lunch and dinner) and two smaller snacks.


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Hello doctor, I feel that my brain becomes hot while studying. I studied the whole day and slept for two hours continuously for three days after that my left eye started paining, and my brain also started getting hot severely. Still, now it is continuing even if I take proper rest during exam time when I study less also.


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Hello. Left eye pain and hot feeling in your head is due to severe mechanical stress to your body because of extreme mental exertion and lack of sleep for three days. As a neurologist, my first advice will be to take some rest and be relaxed and calm. To take rest and enough sleep at least five to six hours in a day is a part of exam preparation. Sleep is a must for better and powerful performance in an exam. It will refuel and restart our brain. Sleep will help to build up and potentiate our memory. So as first advice, please maintain sleep hygiene. And take five to six hours of sound sleep in a calm, cool, and dark room. Take food on time. At present, all your symptoms are due to the same. 1) Take cold water shower. 2) Go to bed and try to sleep. 3) If still, you have problems, you can take medicine to calm down your mind like tablet Etizola (Etizolam) 0.25 mg one tablet immediately. It will give you sleep and calmness. After six hours of sleep with that tablet, you will able to restart your reading, and then you can take if needed.


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Hello doctor, My mother has been diagnosed with 8.5 uric acid and recently underwent a hysterectomy. Which medicine should she take for uric acid?


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Hello. High uric acid will require diet modification followed by medical treatment if not controlled by diet. You can start diet modification like, 1. Have adequate fluid intake. 2. Avoid dry fruits, cold drinks, and chocolate. 3. Avoid broccoli, spinach, beans, and non-vegetarian diet. I would highly recommend testing uric acid once again after one month to reassess the uric acid value. As a single high value should not be the basis for starting medical treatment. Because the treatment usually has to be continued for a long period. So begin the diet modification from today, and repeat uric acid after a month, and review again for further advice. As a patient with high uric acid has an increasing tendency to form renal calculi, I will also advise sonography of abdomen and pelvis, if already not done, before the surgery. Uric acid, RFT (renal function test), sonography of abdomen and pelvis. Review after one month with the above mentioned test.


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Hello doctor,I had my wisdom teeth removed before four days. Even after two days, my swelling has not gone down. I also have mild to moderate pain coming from the site of extraction, that also seems to affect my jaw. My jaw is stiff, and it hurts when I talk too much or move (look down, left, and right). I seem to have bad breath coming from my mouth, but I use salt water rinse every two hours which helps a little, but that odor is still there and seems to be stronger at night when I sleep. Have I formed a dry socket or an infection of some sort? If it helps, I also suffer from a preexisting condition regarding bleeding gums.


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Hello. It is due to traumatic extraction and lack of proper precautions taken during tooth removal. It happens either due to wrong injection technique, lack of appropriate stabilization from the jaws, particularly lower jaw. Moreover, the probability of dry socket cannot be ruled. The bad odor is due to infection of the socket. Can you please send further information like a photograph of the tooth or socket or any radiograph? Do you feel numbness in lip or tongue? Are you able to open your mouth correctly? Your inputs will help to address it properly.


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Hello doctor,Before three days, I had a feeling in my eye that there was something in it, probably my eyelash. I tried to get it out with water, but the sensation did not go. After two days, I met a pharmacist who prescribed me an anti-allergy eye drop (containing Antazoline). I have been using it every three hours. However, the first time I used it, and then I woke up with a swollen red eye. Today is the sixth day of use, the redness has reduced, but the swelling is still there. The vision in the affected eye is now blurry along the side with a burning sensation on exposure to sunlight.


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Hello. Antazoline is not a drug to be used every three hours, and we as ophthalmologists do not use it much. I would advise you to consult an ophthalmologist because the blurriness that you are now experiencing is more worrying than the swelling of the eyelids and redness of the eye. Please take some high-quality photos of your eye and send them. I will try and help you in the best way possible. Also, provide me with your body temperature.


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Hello doctor,I have regular pain in the upper center part of the stomach just below the kidney. Please tell me the reason and medicine. Pain arises, especially in the early morning.


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Hello. The reason can be gastritis, which is inflammation of the stomach. Please do the mentioned test and use the medicine below until you get the test result. H.Pylori in stools. Gastritis H. Pylori infection. Ranitidine 150 mg one capsule two times per day before food. Avoid chilli food, caffeine, mint, soda drinks, chocolates, and heavy fried food. Until I see the lab results. Give two hours gap before sleep and after eating. Follow-up when you get the lab result and mention whether you are getting improvement on the prescribed medication.


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Hello doctor,I was recently diagnosed with polycythemia due to increased red cell count of 5.28x10^12/L, HCT 0.466, and hemoglobin of 161 g/l. I stopped smoking two weeks ago. Six months ago, when I started to smoke, I smoke only four cigarettes per day. Would the high red cell count be a case of secondary polycythemia, or would it be due to smoking? If so, would my red cell count decrease after a month after I have smoked? Also, in this situation, would I need to take a low dose aspirin before a long haul flight (12 hours)?


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Hello, Welcome to the icliniq.com. You have polycythemia. It can be primary or secondary polycythemia. The primary polycythemia is the cancer of bone marrow, which means myeloproliferative neoplasm. However your total WBC count and platelet count within range. So the chance of primary polycythemia less. You have an excess smoking history. Thus smoking can lead to secondary polycythemia, which is a pure benign condition. Smoking can decrease oxygen level in blood and so compensatorily more red blood cells produced. You have to stop smoking to cure your secondary polycythemia. If you stop smoking than gradually your CBC (complete blood count) will be normal. Drink lots of water like two to three liters per day to help in your polycythemia. You may need not to use aspirin as per my opinion. I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor, I need a second opinion on getting a surgery done for breast cancer after chemotherapy.


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Hello, Welcome to ilciniq.com. There is are multifilament lesion (attachment removed to protect patient identity). I suggest total mastectomy, which is complete removal of the breast. The chances of recurrence will be low in this approach.


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Hello doctor, I have a few questions regarding ectopic pregnancy. 1) How long does a fertilized egg stuck and implant itself in a tube? 2) I ovulated on day 15 and felt a sharp pain in the right side (for a moment) on day 24 (8 days post ovulation), is it an ectopic symptom?


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Hello. It depends on your period length and regularity that when and how the system will work. If you have regular periods then 14 days before menses you have ovulation, and if fertilization occurs on the ninth day, then you can have implantation at right or wrong place. If one-sided lower abdominal pain occurs after unprotected sex at the end of third or fourth weeks post period with or without bleeding, then it should be reported that you need urgent beta hCG. If positive, then should repeat beta hCG after 48 hours to check its progression to finalize the diagnosis if the pain is not severe. If after a positive pregnancy test for the pain have a transvaginal scan by expertise hands, immediate intervention. Have complete treatment of any health issue you have. Practice daily walk, yoga, and exercise. Have recreational activities and quit recreational drugs. You need to consult for detailed evaluation. Beta hCG twice and transvaginal ultrasound. Mediate detailed evaluation in case of one-sided lower abdominal pain along with positive pregnancy test.


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Hello doctor,I am a smoker for the past 10 years. Now reduced from last two to three months. During morning cough I can see tar kind of things after brushing. Why is it so?


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Hello. You have been a smoker for 10 years, and I am not sure how many sticks or packs you consume in a day, that may help in quantifying your pack year. Now this cough is productive of dark tar stained mucus. Going by your symptoms and body weight, it seems you have really lost so much weight. I want to know for how long your cough has lasted whether it is more than three weeks or three months. I want to know if you have drenching night sweat, and anorexia that is loss of appetite. Is there any change in your voice like hoarseness, do you have pains in your chest when you cough, any halitosis (smell mouth) difficulty with breathing or any pains with breathing. Do you get breathless on mild or moderate exertion, any dwellings of your feet? Is your fever continuous and not relieved by Paracetamol or Ibuprofen? From all these, based on the history of long years of smoking, and the obvious wasting (weight loss) it is suggestive of a possible COPD (chronic obstructive pulmonary disorder), to rule out malignancy also possible ptb (pulmonary TB). Try and do a sputum microscopy culture and sensitivity, do a chest X-ray, but if you can afford a chest CT scan that will give a better image of your lungs. Do sputum AFB for TB get the results of the test for further review. Chronic bronchitis, pulmonary cancer, TB (tuberculosis), congestive cardiac failure, and bronchiectasis.


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Hello doctor, I am waiting to be booked for what my doctor calls a core-biopsy and it is taking too long. As I wait I would like to research and gain more information. I would like an interpretation of this report please. These are the results of a fine needle aspiration on left breast: The smears are highly cellular. Cohesive branching monolayers of mildly pleomorphic ductal epithelial cells are present in a background containing frequent bare bipolar nuclei, occasional macrophages and some myxoid stroma. Within the epithelial cell aggregates, nuclear streaming and an admixed myoepithelial cell population is revealed. No dissociated malignant cell population or true papillary epithelial cell aggregates with fibrovascular cores are identified.


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Hi. This is a picture suggestive of a fibroadenoma. It is not a malignant bump. But, FNAC identifies only the part that has been included in that needle. So to confirm, we do a trucut biopsy which tests the entire lump and is conclusive. 99 % this is a non-cancerous lump.


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Hello doctor, I am planning to undergo vision correction surgery. I am 37 years old, female, single. My ophthalmologist informed me that I have astigmatism. I am short sighted. My doctor suggested of a super Lasik surgery. Can you please advise if I should go ahead with this surgery? Secondly, what would be the side effects? And the recovering period. The doctor did mention I have a thick cornea and I will recover the same day. But I am not very confident and require your second opinion.


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Hello. It is hard to advise you fully not knowing the full refractive status of your eyes and seeing the keratotopgraphy report that you underwent already and must have a report of it, you could upload it here for better evaluation. However, you have to understand that a human eye starts changing its refraction after the age of 40 and will continue to change every five years after that. So you will enjoy the result of this operation for a maximum of five years and then you will start wearing spectacles for near so keep that in mind. The second issue that you might face a new condition, that is if you are not suffering from it before the operation, and that is dry eye for which you still need to use a lubricant at least four times daily for the rest of your life. In summary, the choice is upto you of course but at such an age, I would not advise. If you would like a more decisive advice, please upload the reports.


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Hello doctor, My period got delayed by 10 days and after checking with a pregnancy kit, I found out that I am pregnant. But, when underwent sonography, there was no pregnancy. I have not got my periods yet and have vomiting and giddiness. Please help.


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Hello.  I would suggest you to repeat pregnancy test immediately and if again positive then repeat ultrasound as well to see what is happening and you can start taking Folic acid meanwhile. In the early pregnancies, sometimes sac is not seen and it becomes visible as pregnancy progresses. So, if pregnancy test is still positive then sac must become visible and if pregnancy test becomes negative that means that the previous one could be a false positive one.


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Hello doctor, I have headache, cramps, nausea, bad morning sickness, back pain, hunger, feel light headed. I am taking Olanzapine and Zyprexa.


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Hi. The symptoms that you mentioned are common side-effects of Olanzapine (Zyprexa). Please, do your best to tolerate the side-effects especially in the beginning of therapy (if you just started taking the medicines) as in some situations the side effects decrease in intensity by time. I strongly advise you not to stop this medicine or skip doses as it is extremely important to stick to its dosage and continue to follow up with your doctor.


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Hello doctor, I have been having increased issues with extreme bloating, abdominal pain, fatigue, vomiting a lot of the time, excessive diarrhea, weird tiny patches of scaly marks on my shins, arms, and face. I literally dread eating anything. I am not starving by any means, I have more than enough meat on my bones but eating is worse than feeling pains of hunger. This has been increasing year by year and has been present for about five years now. My PCP is related to stress but I know there is something much more dire going on. I recently did an at home test for food sensitivities and I had reactions to 93 out of 96 foods tested. Does not seem quite right to me and I understand that IgG does not test for allergies. I am highly reactive to citrus as well as baker's yeast. Previously I thought I was having an allergy to the protein found in wheat and I went on and off of a gluten-free diet. I have gone so far as acupuncture to assist with proper digestion because I frequently find myself vomiting up undigested foods at least 7 to 9 hours after consuming them. I am 35 years old, a mother of five and a business owner of three. I do not consume sweets only because I have never taken a liking to them, I do not drink sodas, teas nor do I consume coffee. I also do not consume red meats and I am not a huge fan of vegetables. I have recently regurgitated a pile of blood and every time I eat anything, I am extremely bloated almost immediately. I am getting worried. Please suggest underlying potential issues that I should have tested with my local GP and specialists.


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Hello doctor, About a month ago, I did a CBC for a regular check up. It came back as elevated WBC and platelets. It was 16.3. Neutrophils absolute 11.8, lymph’s absolute 3.5, platelets 402. Everything else was in normal range. I have had it done twice and it stayed about the same. I recently did an abdominal CT scan and it was normal. My doctor is going to do another CBC and if it is still elevated, she is going to send me to a specialist. I am extremely upset and worried. I have no symptoms. Does this mean I more than likely to have leukemia? I am a single mother and I am terrified. Could I please get a response?


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Hello. Your platelet count is within normal limit. So do not worry about that. Your total count and neutrophils count is high. But your total count is not high enough to be labelled as leukemia. Usually such high count up to 20000 can be due to infection or any inflammation. So in such case, antibiotic course can be prescribed and repeated CBC after 10 days. However, if you can attach your reports then further comment can be given. Do not directly think about leukemia.In leukemia, total count is very high up to 1 lakh.


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Q. I experience on and off acid reflux as well as mild dysphagia. Does it indicate esophageal cancer?


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Hello doctor,I am a 26-year-old male. I have been experiencing on and off acid reflux for a few weeks as well as mild dysphagia (strangely only at breakfast). I am afraid of esophageal cancer. I do not smoke and drink. I exercise regularly, and I am not overweight. I have no family history of any cancer. I do suffer from anxiety issues, though, and I have pollen allergies.


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Hello. First, I would like to reassure you that dysphagia and reflux symptoms are very common and more common than esophageal cancer. I want to reassure you that this is very unlikely to be esophageal cancer. Esophageal cancer is more common in older patients who have a history of smoking and or alcohol abuse. In patients with reflux symptoms, those symptoms are usually longstanding, and progress to Barrett's esophagus before any cancer develops. I think that you have gastroesophageal reflux and I think your symptoms can be easily managed. 1. Start an over-the-counter reflux medication. I recommend Ranitidine 150 mg every 12 hours. It takes about 30 minutes to start working, and you can take this as soon as you get up in the morning. 2. Make sure to not eat for two to three hours before going to bed. 3. Avoid spicy or acidic foods, especially for breakfast when you complain you have the most symptoms. This would include avoiding ketchup, citric fruit juices, coffee, and tea. Try to eat a very bland diet for the next two to four weeks and see if that improves. Eggs and toast, for example, caffeine can cause acid, and so I recommend avoiding coffee and tea. If you must have it (as I can understand), try to wait until later in the morning and make sure that you have any coffee or tea with food (even just a dry piece of toast). If your symptoms have not improved in one month, you may need to see a gastroenterologist to be evaluated for esophagitis or an ulcer.


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Hello, I am a 25 year old person. I have a short penis. It is only 2-2.5 inches long in flaccid state, but the length and diameter is 4 inches in erect state. I want to increase the size of my penis. Apart from this, I also have nightfall problem which lasts for less than 2 minutes. It will occur 4 to 5 times in a month. I had masturbated a lot during my early ages. I am an unmarried person, going to get married soon. So, will the penis size affect my marriage life? If so, I need a permanent solution for this. Kindly suggest me medications with no side effects to solve this problem.


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Hello doctor, I have a premature ejaculation problem. When I am doing foreplay with my girlfriend, it automatically gets ejaculated after four to five minutes. Is it due to my masturbation habit?


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Hello. I can understand your concern. I have worked through your attached query in detail. Masturbation is not responsible for your symptoms. Masturbation has no evil effects on your sex life. Premature ejaculation will gradually subside in due course of time. In case if symptoms persist, few medications like Dapoxetine will help. Practicing sex regularly will help to overcome premature ejaculation. Anxiety. Performance anxiety. Premature ejaculation. Tablet Dapoxetine. Increasing foreplay.


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Hi doctor, My writing skill is very strong but verbally I cannot protest at all against difficult people. My verbal communication skill is proper and organized if and only if I am focused and conscious at that moment. Otherwise, I tend to be unprofessional and non-intelligent in speaking. Even when a friend illogically shouts over me, I cry over phone and still keep talking in gentle manner. My logic remains in my mind, but I just cannot speak out, which in turn disturbs me later. Sometimes, I get angry by thinking I could not stand verbally for myself at the right time. In the past I was taking Trinicalm plus. What is the problem? I have a feeling that either I am too gentle, less courageous, lack confidence or definitely soft natured and lack mental strength. Please help me.


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Hi. Sometimes, it happens because of low self-esteem. Hence, you need to work on it. You need aversion therapy. You do not have to interfere in other's rights but, other side you have to stand for your rights. Do not be very cruel or too innocent, and then people will start teasing you. Remain in between. For some people who are having predicted behavior, you can prepare answer beforehand. So, you will get some self-confidence. Also, do not think too much about others. Forget everybody. Focus on yourself. Remain happy and tension free.


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Hi doctor, I am a 23 year old female. Few weeks earlier, I had tooth pain after eating. Yesterday, I had acute pain in the tooth. I have attached the OPG scan for your reference. I would like to know, from the OPG, what is your opinion about the extent of decay? And also I would like to know about the possible diagnosis. Thank you.


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Hi. Before I answer, I would like to point out a few issues here. You have not mentioned the location of your tooth pain, whether it is on the right or left side. The right and left indicator on the orthopantomograph (OPG) are not visible on the scanned image. So, I am going to describe the findings as I see it. To my right and left, I can see there is decay in two upper molar teeth. Upper third tooth from my right and the upper third tooth from my left.The decay in the upper right first molar appears to be deep. Depending on the symptoms, if you have acute pain that is unchanged, persistent and disturbs your sleep, then the tooth will require root canal treatment (RCT). This is because the nerve of the tooth (pulp) has been involved by the decay. If the RCT is started right away, the tooth can be saved. The decay in the upper left molar tooth is moderately deep and can be filled, if you get it done right away. If delayed, then the decay is likely to progress and involve the nerve of the tooth (pulp), then root canal treatment would be the only option to save the tooth.


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Hi doctor, I have severe ankylosing spondylitis since 19 years. I am a 28 year old male, married and would like to have a baby now. I am taking Indomethacin 75 mg and Omeprazole twice a day. My left hip is completely fused, but I have no pain. There is pain in right hip and lower back. Please let me know, can I have a healthy baby. What should we do to get healthy, fit and fine baby? I do not want baby to be defective. Kindly give me suggestions to improve my health. My wife is completely fine and healthy. I have attached my Hb, CRP and ESR reports. Please guide me.


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Hi. Do not worry about your condition and your future baby. You are fine and your baby will also be fine, as genetic transmission is rare in this case. Again you should change the painkiller if you are not responding to it. You can start tablet Rofecoxib 50 mg daily for five days and let me know the condition of your pain. Apply Dolopar gel (Diclofenac) topically. Go for active physiotherapy exercises. Take a capsule Nutrolin B plus (multivitamin) daily for 15 days.


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Hi doctor, I am a 27 year old man and a student of ecological solution. I do a little bit of sport. I eat a balanced diet. I have fatigue and headache when I do anaerobic exercise, and when I read a book. According to my doctor, my average blood pressure is 12.8 or 12.7. All my family members are in good health. My mother's sister has osteoporosis. Reading a book or something else gives me headache and fatigue, so I need to rest after reading something. When I need to read something I must drink a lot of water to be less tired, because if I do not drink a lot of water before reading I need to rest five times more than the usual. Because of this reason, I have stopped my schooling. I got my standard blood test, TSH and lipid test done, I used to do running of one hour by weekend. I want to do home body building like push-up, but I cannot do it like I used to do before. I do not know why my anaerobic capacity has decreased a lot in the last three years. When I do some push-ups or another anaerobic exercise like 100 m speed running, I have really bad results; I take too much time to do this kind of exercise. I am abnormally getting breathless and my heart beats fast. I was not like that before six years, but my physical appearance has not changed. I must drink 1 liter of water 35 minutes before running, if I do not then I cannot even stand for ten minutes. If I drink a lot of water like 1 liter, 40 minutes before, I can do 70 push-ups at the first series, but If I drink only one or two glasses of water 10 minutes before, I cannot do 45 push-ups and my heart begin to beat hard and I am completely breathless and tired. After a running session of 40 minutes to one hour, immediately when I begin to do my legs muscles stretching even if I am completely relaxed and feel good, without any breathlessness also. When I do my stretching my heart begins to beat very fast and hard and I begin to be breathless. Then I must wait and drink water and do my stretching very slowly. I have never felt this before, and I used to work at school with pleasure, read some books and do sport more easily. My wear has a strange smell after sport. It smells something like a rotten wood plank. It is a smooth bad odor not too much aggressive but really unusual. The few doctors I have seen do not know what the source of the problem is, but we found that I do not have a good thermoregulation because I am cold and need a lot of clothes. It seems like I feel better when I am in vasodilation period like under the sun or in a hot place. So, I tried a supplement called Citrulline six months ago, to have more arginine in the body to have a better vasodilation. Indeed, I feel really less tired since I take the Citrulline. I feel like my muscle cells and other tissue are more supplied in something that I need in these cells. Citrulline helped a bit, but it did not resolve the problem. Hope you could help me. Thank you.


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Hi. All your clinical problems appear to be related to anaerobic respiration. Based on your query, my opinion is as follows: For respiration, oxygen is most important - Anaerobic respiration mainly occurs because of reduced oxygen. You might require a lung function tests to evaluate for adequate oxygenation. If you are a smoker or exposed to pollution, dust or industrial exposure, it can get affected. Anemia requires evaluation. Hope your hemoglobin level is within normal limits. Get a hemogram done. Anaerobic respiration leads on to lactic acid production. This lactic acid accumulation causes muscle pain and tiredness. Do get your lactic acid accumulation level in blood evaluated before and after the exercise. Lactic acid level requires correlation with possible muscle storage disorders or dystrophies compared to exercise; there may be increased lactic acid production. Hydration would be washing of this lactic acid, which is possibly making you feel better. Meet a biochemist to get yourself tested for lactic acid increase and possible causes. Sweat glands can produce abnormal smell depending on diet. Look into your diet closely. Citrulline produces nitric oxide leading on to vasodilatation. It could be removing some amount of lactic acid or increasing oxygenation, but overall the main cause from lungs to blood and blood to muscle requires identification. Get the tests for hemoglobin level, lung function tests along with oxygen saturation and serum lactic acid. If all are normal, then muscle glycogen storage disorders or muscle biopsy for any pathology maybe necessary.


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Hello. Please wash the area with lukewarm water regularly. Use a mild soap. Do not use the same towel in pubic area that which you use elsewhere on the body. Observe clearly if there is any change in color, foul smell, lesions over the penis. Maintain good hygiene down there. Remove pubic hair and keep the area dry. If you are the type who sweats a lot, then use mild antiperspirant talc over the groin area. If the climate where you live is very sultry, and you may need to bath many times daily. Use a different set of clothes every day. Do not use the same clothes again.


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Hello doctor, I frequently get bleeding from the nose, but it does not create pain. But some times it flows from my nose automatically. What could it be?


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Hello. Do you have any medical problems that we should know about? How old are you? Are you exposed to any environmental stimulants (irritating chemicals, etc.)? Most often, a bloody nose is not concerning, but it should be evaluated if it is happening regularly. How much blood is coming out? A teaspoon? Is it always one nostril? You can certainly start using a saline nasal spray three to four times a day in each nostril. You can also put some Vaseline in each nose before you go to sleep at night. However, if there are any other medical problems or anything concerning in your history, as I mentioned above, then you should be evaluated in person. You may need to see an ear, nose, and throat (E.N.T) doctor who can take a look in your nose and see if any blood vessels are prominent and can be treated with cautery. Or you may need to see your general medical doctor and have some blood work done, including a full blood count and platelet levels. Please let me know your answers to my questions, and hopefully, I can direct you further.


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Hello doctor, I am constantly worrying about little things and I am emotional most of the time. I feel tired all day. Please advice.


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Hello. Generalized anxiety, social anxiety, and related low mood symptoms are quite common in adolescents. It is positive that you are insightful about your symptoms and seeking help. Have an open talk with your parents and trusted family members about your worries and difficulties. It is important not to isolate yourself as it will worsen things. You can practice some self-help interventions to manage your anxiety like, 1) Try progressive muscle relaxation exercises. 2) Deep breathing techniques. 3) Exercise regularly for at least 15-20 minutes daily. 4) Eat healthily and sleep regularly for at least eight hours. 5) Develop some relaxing hobbies like listening to music and watching exciting programs on TV can help to provide a useful distraction. If anxiety is persistent, you can consult a doctor locally and have some counseling or talking therapy to manage your anxious thoughts and develop positive coping strategies.


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Hello doctor, According to the lab report which was taken a week before TSH level is normal but T3 and T4 level is mildly increased. Please suggest will I be cured with medicine or without medicine. Currently, I am under medication for a chocolate cyst (Dienogest 2 mg).


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Hello. I have just read your query, and from what you have mentioned, it appears that you have a normal thyroid function test results. The slightly high T3 and T4 are not a thing to worry because they can be caused by other hormonal medicine that you are taking for your chocolate cyst.You can keep checking your thyroid function test every three months. I hope you find my advice beneficial.


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Hello doctor, I am 27 weeks pregnant and have had Braxton Hicks steady for two days with my back cramping and pressure in my bum and vagina. Could I be in preterm?


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Hello. You have not mentioned your gynecological, obstetrics, menstrual and drug history. Have you previously had a normal delivery? If no, then the body prepares itself for normal vaginal delivery in the third trimester. In the first time mother, this process is long as it is happening for the first time. So, it takes more time than mothers who already had labor and normal delivery. Everyone's threshold for pain and body's reaction to late perineal changes in the third trimester and labor are different. Only mild cramps without severe contractions episodic going towards lower pelvis from the back are Braxton Hicks and it does not show labor changes in the cervix. Pressure symptoms, bladder heaviness, and recurrent urine are usual symptoms in the third trimester as the baby is mostly in cephalic presentation and growing size creates pressure in neighboring organs naturally. But precautions are necessary. It is better to differentiate between just Braxton Hicks and labor pains with cervical changes. Preterm delivery having lots of factors like infection, fetal, and maternal anomalies and diseases, rupture membranes, etc. Pain threshold relation to cervical changes is different for everyone. I cannot rule out that back cramping, the pressure in bum and vagina cannot lead to preterm delivery but there are factors behind that also that need to sort out. Otherwise, backache, pressure symptoms, mild labor like pains are normal symptoms in most of the women in late pregnancy. I hope you get my point. If there is a pain in the third trimester, we need to check with baby monitoring and mother's cervical changes with the strength of contractions. I hope u get my point. In case of labor-like frequent contractions, rupture of membranes and reduced fetal movements, you need to report to the hospital for monitoring and examination. For more information consult an obstetrician and gynaecologist online -->


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Hi doctor, I am an 18 year old female. I have noticed that my vaginal opening feels lumpy and possibly a bit swollen, and I am panicking. It does not hurt, and it is not raw or itchy either. Please help me put my mind at ease.


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Hi. How are you doing? At this young age of 18 years, I do not see any reason for you to get tensed. Hope I have clarified your query, do write back. All the best. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am a 58-year-old cyclist. I recently started having a strange problem with my vision that started almost a month ago. It was also around the same time I was getting new glasses, but my optometrist said that he does not think the two are related. He referred me to see a neuro-ophthalmologist, and it looks like I have a 4th nerve palsy issue. After reading about it, it is familiar to my recent experiences. No accidents, history of diabetes or other issues. It seems to be my right eye. Looking straight, left and up is fine. The problem comes when looking down (bifocals) or looking right. I also read that blood flow could be an issue. I have been using my inversion table lately more often. I do feel obvious pressure in my eyes using this. Is that an issue? It scares me now, so I put it in the garage. I read this can be idiopathic and can even go away in a few months. Is it true?


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Hello. The symptoms you are experiencing can all be in 4th nerve or superior oblique muscle palsy. This muscle acts to stabilize the eye when looking down and is the primary muscle acting while looking down and outwards. Since you mentioned that you do not have diabetes or other systemic illnesses, the cause could be idiopathic. Such idiopathic nerve palsies do have a good chance of improving on their own. The best sign to look for improvement is to see the double images moving closer to each other, and eventually disappear, on the complete resolution. In case you have any further questions or want any additional information, please let me know.


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Hello doctor, My baby is 2 years old. For the past four months, she gets constipated. She has to move her bowels daily because if she does not have it more than 24 hours, she will get constipated. We tried changing her milk, but it only made her stools harder. She is currently on similac go and grow. We add water on her milk because she hates drinking water and she is a very picky eater. I use pedia lax to help move her bowels. What should I do?


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Hello. Instead of using 30 ml water with each scoop, please add 45 ml water to each scoop for making the formula. Also, reduce the consumption of milk and simultaneously increase the consumption of fruits, vegetables, chicken, etc., whatever the child likes. As of now, you can use laxatives as and when required. However, as soon as a week or two after the above diet changes are made, the need for a laxative should be much lesser than what it is now.


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Hello doctor,I am 28 years and 6'1" tall with weight 85 kg. I had frenuloplasty a few days back and feeling normal about it. Sometimes I get erections, and it hurts a lot as the stitches may be the reason. I want to admit that I had a premature ejaculation issue as well before the surgery. Was it because of this short frenulum, and will it be better now? Also, I was unable to penetrate the vagina easily. Will it be rectified? If no what else should I do?Please suggest.


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Hello. I can understand your concern about your symptoms. Yes, for a few weeks you will be having pain. The premature ejaculation could be because of the short frenulum, now after the procedure we will know it for sure. If your premature ejaculation persists, we can think of the other causes. Yes, you will be better after surgery with proper foreplay and appropriate lubrication you can easily penetrate since you just had the procedure. We need to wait for the recovery to to think about other cause of your issue and work on it. I hope I have answered your query. If you have further doubts, I would be happy to help you.


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Hello doctor, I am having bad stomach cramps that I can feel through my throat and diarrhea for the past one week. Kindly advice.


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Hello, Welcome to ilciniq.com. Please follow the following prescription. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. IBS (irritable bowel syndrome), abdominal flatulence, and diarrhea. Buscopan (Hyoscine ButylBromide) one tablet three times a day. Eucarbon (Charcoal) two tablets three times a day after meals.


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Hello doctor,I am 26 years old. I am not being lustful lately and not getting lubricated easily. So I want to ask that is it fine to have Estrogen tablets. Are there any adverse side effects of it?


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Hello. I can understand your concern about your symptoms. No, you should not use estrogen tablets without an endocrinologist or a gynecologist review. Decreased lust or libido can be due to, 1.	Infections. 2.	Diabetes and hypertension. 3.	Hormonal disturbances like low testosterone, low levels of thyroid, and high levels of prolactin. 4.	Obesity, high cholesterol 5.	Chronic disease. 6.	Drugs and anxiety. You have to do vaginal examination by a gynecologist to rule out local infection. USG (ultrasound) pelvis to rule out pelvis infection and ovaries and uterus abnormalities. Thyroid check-up Free T3, T4, TSH (thyroid stimulating hormone), and lipid profile to know the cholesterol level. Also check blood pressure, and RBS (random blood sugar). Kindly share more details regarding above reason so that we can work on cause and treatment.


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Hello doctor, I may have a liver problem and would like to get advice. I had done some medical tests recently and the liver turned out to be a bit problematic for me. Hence, thought of consulting a specialist. I am currently blood pressure, blood thinner, cholesterol-reducing drugs, and medicine for thyroid.


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Hello. I have gone through your query. Your BP and cholesterol levels seem to be fairly well under control of treatment. Kindly share all your available reports, liver function tests, and details of the symptoms and problem that you are facing at present. Kindly get back with the above details and any other questions if you have further discussion and management.


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Hello doctor,I have dandruff, hair fall, and lately, I saw tiny white balls on my scalp after which my scalp became very itchy. Please tell me how to treat this condition.


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Hello. You have seborrheic dermatitis probably. Use the following medications. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Zydip-C lotion (Clotrimazole, Beclomethasone) apply once at night on the scalp. 2. Protar K shampoo (Ketoconazole, Coal tar) three days per week. 3 Tablet Desloratadine 5 mg once at night. Do this for 20 days and avoid hair oil.


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Hello doctor,In the left side of my face right in front of the ear and around the lower back of my ear is swollen. I had a sore throat a few days before, and I have been coughing hard with lots of mucus. I had also swollen a teary, red, and slightly painful left eye, which started, a week before. What is this? Shall I go to the ER or doctor for my swollen face? I already consulted a doctor two days before the swelling and under antibiotics.


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Hello. There are multiple reasons for what you suffer from, and your case could be one of them. First, that could be part of the illness, which is acute upper respiratory tract Infection (viral or bacterial, usually viral comes with such symptoms). The swelling could be as part of the disease as well which is swollen lymph nodes located around the ear and nothing to worry about as it is part of the infection that can be confirmed by neck ultrasound scan in all circumstances. I suggest you move to the emergency room for further evaluation and clinical examination. Acute URTI (urinary tract infection), reactionary lymphadenitis. Consult the emergency room for further evaluation.


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Hi doctor, I am getting facial warts again and again at the same place. I go for swimming every day. Is it because of that? I have undergone laser treatment twice and it went away with it. Now, again I have the same problem. What should I do? Is there anything that I can apply as I do not want to get laser treatment again and again? I have enclosed my picture. Please help me.


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Hi. Facial warts occur due to HPV (human papilloma virus) and some people are more susceptible to it due to some complex immunological parameters. They are too notorious to recur and avoid shaving for some time. Also, the probable treatment is electrocautery. Going to the swimming pool will not affect their behavior as you are already infected. But, you should use separate towels to prevent other susceptible person getting infected. For further information consult a dermatologist online -->


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Hello doctor,I am 21 years old with weight 58 kg, and height 5'7". My penis size is 6 cm in normal, in erect it is 12 cm. Is this normal? What are the normal sex and ejaculation time? I feel very uncomfortable when I meet my girlfriend or talk with her in the phone about some hot topic because my penis becomes erect when she touch or hug me, and there is a seminal fluid is a discharge. What can I do for these problems?


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Hello. I can understand your concern about your symptoms. Many research says the average length of a flaccid penis is 3.61 inches, while the average length of an erect penis is 5.16 inches. Few studies recommended flaccid penis length of less than 1.6 inches or an erect penis of less than three inches should be considered for treatment. Pre-ejaculatory fluid when you are with your partner is normal. Considering your age, you will be fine in a few days. Normal sex time can be from 3 to 20 minutes, depending on the experience and stamina.


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Hi doctor, I have low blood pressure and am suffering with low pain in the heart for the past two days.


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Hi. We define low blood pressure if the reading is lower than 90 mm Hg systolic or 60 mm Hg diastolic or if the patient has symptoms which are lightheadedness, dizziness, fainting, blurred vision or lack of concentration. These symptoms are most prominent when individuals go from the lying or sitting position to the standing position. The causes of low blood pressure could be endocrine problems, dehydration, blood loss, severe infection (septicemia), severe allergic reaction (anaphylaxis), or lack of nutrients in your diet. My advice to you is to eat a diet higher in salt, drink a lot of fluid especially in hot weather and while sick with a viral illness. And for your case, try to measure your blood pressure before and after taking normal saline. If there is no change, you can talk to an endocrine specialist. For more information consult an endocrinologist online -->


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Q. I have itchy rashes at the bottom of the ears with negative HIV tests. Do I need another HIV test?


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Hello doctor, I had protected sex with a woman. After a few days, I had an itch at the bottom of one of my ears. After 12 days, I done an HIV RNA PCR test and it was negative. After a few days, I had a wart-like bump in the shaft of my penis and body itching. Then after 60 days, I have done HIV duo combo test and it was negative. In these days, I had intense itching with rash similiar at the bottom of both of my ears. After 90 days, I have done the ELISA test, test for hepatitis A and B, herpes, syphilis, chlamydia, and they were negatives. After a few days, I had small itchy red bumps in the body. After 225 days, I done HIV tridot test and it was negative. But the itching in the body with bumps continues. Now I am 314th day after sex. What should I do? Should I go for another HIV test or other STD tests?


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Hi,  Welcome to icliniq.com. I have gone through the case. In my opinion, if you have no contact history for almost a year then there is no need to repeat all the tests. But first, you need detailed physical examination because there are different types of itchy red bumps and some of these are linked to sex and some are not. So do not go for all tests at once.


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Hello doctor, I am a 27-year-old man. Sometimes, I feel very weak. My BP goes down and I am unable to stand properly. Also, there is a pain in my foot. Please tell me the treatment to cover this type of problem.


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Hello. You have two main concerns. The weakness is not due to low blood pressure. The low blood pressure can lead to dizziness and inability to stand as described by you. For that try to maintain hydration with lots of water and whenever you feel dizziness take salted food and fruit juices. You can check your blood sugar level as well. For tiredness, I suggest you investigate with serum potassium, serum sodium estimation, serum TSH (thyroid stimulating hormone) estimation, CBC (complete blood count), liver profile, and kidney profile. You can revert back with reports. For pain in the foot, avoid prolonged standing or walking. It is advisable to investigate with X-ray foot for further work up. You should get checked your serum calcium and vitamin D level as well.


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Hi. Low blood pressure may be due to genetic factors. Do you have a family history of low blood pressure? Hydration and correction of electrolytes might help you. Mix one teaspoon of Electral powder (essential electrolytes) in a glass of water and drink thrice a day for a month. Low blood sugar and blackouts can occur if you do not eat your meals on time. Make sure you eat more frequent smaller meals, once in two hours. Alternatively, you can carry Hypotab tablets that contain a fixed dose of glucose. Pop it in when you feel a blackout coming. Palpitation can occur if your hemoglobin level is low. Include green leafy vegetables in your diet. If your blood counts are not good, you might need a supplement. Get a complete blood count done and get back with the results to a general medicine physician online -->


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Hello doctor, I am a 75-year-old male. I had IHD 40 years back. 23 years back, my doctor asked me to add Ismo 10 mg twice a day. Since then, I am taking it twice a day uninterruptedly. Then I was 54 years old. My BP has always been normal in all these years. Maybe 150/80 or 140/90 till a few years back. Now it is in normal level say 120/80, 120/73, 115/70, etc. Since a year, I am experiencing low blood pressure at times, giving me vertigo-like dizziness for 1 hour or 2 only in the early mornings and when I take Vertin, it subsides after 1 or 2 hours. Recently, I went to a well-known cardiologist in my area. He checked me and said that I have systemic hypertension and I need not take Ismo any longer as I do not need it. The BP at that time was 130/70. Before my going to the above cardiologist also I have experienced these levels like 120/70, 110/69, 125/75 likewise. He further said after stoppage of Ismo, the BP levels come to normal levels and I will not experience dizziness anymore. But, I am afraid of stopping the Ismo abruptly for fear of getting an anginal attack, which I have never experienced. I am afraid whether to ask my doctor about this. So, I have stopped taking one dose of Ismo 10 mg during the night. Slowly I shall stop the other doses also in due course. Kindly give me your valuable advice about Ismo, about stopping Ismo and dizziness. Is there any harm if I stop one dose? Does long usage of Ismo trigger low blood pressure and vertigo? Please enlighten me on this subject.


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Hello. Firstly, Ismo (Isosorbide Mononitrate) is given for angina or chest pain. If one is not having it without Ismo then it may be stopped. So it is not an absolutely necessary medicine in absence of angina. Next thing, it can cause low BP, and low bp can cause dizziness. But, you mentioned, the lowest BP recorded was 110 systolic, and it is not too low to cause dizziness usually. Have you checked your BP while you being dizzy? So this BP can cause dizziness but not usually. Next thing, you said the response to Vertin (Betahistine), which is not likely in Ismo or hypotension induced dizziness. Vertin is for vertigo induced from the internal ear which is a very common problem. Also, importantly. dizziness induced by hypotension or Ismo will occur on standing or walking, but not while lying down or resting. So if it occurs on lying down as well or on neck movements then it is likely from the internal ear. Next, you should get one echo done to rule out the decrease in heart function as BP is remaining on the lower side. So overall, just go through the above description, and try to decide whether it is Ismo induced or from the internal ear, and you may stop Ismo as advised by the local cardiologist. Also, echo is necessary.


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Hello. No, low blood pressure is not to be worried much but you should take little high protein diet and sodium diet. Keep an active lifestyle and eat lots of fruits and vegetables to maintain good blood pressure and keep away the weakness. Keep getting your blood parameters checked as it is beneficial for one to stay updated with your vital parameters.


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Hello doctor, My mother found a lump in her breast, which is movable and mildly painful. Then she was suggested for a mammogram, and it resulted as a mass lesion with an irregular margin of 8*10 cm birads v category. We are waiting for the biopsy result. She does not have any symptoms other than a lump, and she is very worried about the issue. Please help.


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Hello. Mass of 8*10 cm will most likely be cancerous. If I were your treating doctor, I would first evaluate in detail the extent of the disease, with the help of examination, chest X-ray, ultrasound of the abdomen. Once confirmed that the condition is limited to the breast, her treatment options will involve surgery, chemotherapy, and radiation. These days with advanced techniques, we have high cure rates for breast cancer with minimum side effects.


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Hello doctor, My eye has become red and is watering, I think a foreign object has entered but I am not able to find it. What should I do? It happened yesterday and icing did not help. Currently, I am under medication for high blood pressure.


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Hi. First this to rule out is a foreign body in the eye. For that ask someone to examine your eye with a torchlight and also check the upper lid by everting it because that is the common site for foreign body. Sometimes a very small foreign body cannot be seen with the naked eye and need an eye exam by a doctor. Wash your eye with clean water. If there is no foreign body seen then it is most probably conjunctivitis (that presents with the same symptoms) usually viral conjunctivitis. It usually takes 7-10 days to complete recovery but during this period protect your other eye and other family members because it spreads from one person to another through contact. For symptomatic relief, keep washing your eyes with cold water and do icepacks. That helps to relieve discomfort. Start antibiotic (Moxifloxacin 0.5%) eye drops four times a day to avoid secondary infection. If pain and discomfort are severe consult your nearby eye doctor for a complete eye exam.


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Hello doctor, I have red spots on my hands that started about 10 days ago. I also have a couple of spots on my foot. They are mildly tender and itchy. They have gotten worse but not more that 8 to 10. I have no medical history and do not take any medications daily. I had a cut on my finger from opening a metal box a few days before onset.


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Hi. I saw your pictures (attachment removed to protect patient identity). There are multiple erythematous (red) plaques and papules (bumps) on palms, sole, and wrist. Few lesions do look like target lesions. With these features, I can list a few possibilities as follows: May I know your age? Is there any similar rash inside the mouth? Did you have a fever before this rash or in the past one month? Have you used any topical cream? Is it the first episode? Did you take any painkillers, Ibuprofen, Diclofenac in the recent past? Do you have any history of eczema? For more information consult a dermatologist online -->


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Hello doctor, My son is 5 years old and has developed rashes on face and few on his hands. He has no fever and is fresh playing around. He went out to farm with family and zoo last week, and since yesterday he started developing few rashes. He was having very low fever a couple days back but recovered without medication. My concern is these rashes could be due to any viral or the possibility of allergy? Please suggest any test or treatment.


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Hi. Probably may be a viral infection like hand foot and mouth disease. Do not worry. Please give syrup Crocin (250 mg/5 ml), 3 ml SOS, if the temperature is above 100 F. As for the rash, please apply Calamine lotion. It should be better in a few days time.


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Hello doctor, I had palpitations and episodes of passing out on and off for a few years. I had blood, ultrasound, and ECG (electrocardiogram) tests done, and so far, I have no answers as what is causing it. Is there anything they can do to help the symptoms at this point or do I have to put up with it and hope they find a cause and treat.


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Hello. The probable cause in you is a cardiac arrhythmia. Firstly, were these episodes witnessed by others? And I guess there are tonic clonic movements as seen in seizures. Also, any precipitating events like stress, urination or passing stool, etc., this is to rule out the possibility of vasovagal syncopes. So, considering the likely possibility of cardiac arrhythmia and recurrent syncopes, there is an option of electrophysiological studies which can answer the cause. Otherwise, we will have to wait and watch until the episode of arrhythmia recurs and captured on ILR (implantable loop recorder). But, if you are having symptoms at present and there is nothing on ILR, then it cannot be a cardiac arrhythmia. So, if you are symptoms at present, then ILR should be interrogated, and if asymptomatic, then electrophysiological studies is an option. Otherwise, wait and watch. I hope this helps you and get back if you have any doubts.


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Hello doctor, I have small red bumps on both sides of the bottom corners of my mouth. They look like small pimples, but they are not very bumpy. It seems like it is more just redness in little pimple areas rather than actual bumps like pimples would be. I was given Metronidazole and I used it twice a day for 30 days and it seemed to get a little better at the start, but the problem still persists. I have had this problem for six months and I have scheduled a visit with a dermatologist, but it will not be for a few months. I am not sure if this is relevant, but I work with pig guts, so, maybe I got something from them, but I am not sure since I have been working for almost five months before I got these symptoms. One thing I have noticed is that in the morning it looks like it has improved, but then by the end of the day it looks like it is back to normal. I am not sure what the problem is and am not sure if it can be treated without a prescription, but I am willing to try various things.


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Hello. I understand your concern. It seems superficial folliculitis (attachment removed to protect patient identity). In this condition you get small red lesions with yellowish pustules. Use the following medications: Cream T-Bact (Mupirocin). Apply twice a day on the affected areas as well as the nasal vestibules which harbor the bacteria responsible for the recurrence. Do this for 10 days. Take care.


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Hi doctor, I am sexually active. But always use protection and double check after to see if the condom broke or not in case we need to take a pill. My period is fairly regular and lasts for 7 days. This time I did experience mild PMS symptoms and stomach cramps prior to onset. My period was five days earlier. And this time, period lasted for only two days but the flow was proper as always. Is there something I need to worry about?


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Hello. Firstly, a single episode of early menstruation with normal flow does not qualify for being labeled as a case of polymenorrhea. Secondly, as you have been protected during intercourse, an implantation lasting for two complete days is also unlikely. So, you are pregnancy safe. Thirdly, the early withdrawal is likely to be stress induced hormonal imbalance especially progesterone level during this cycle which caused PMS (premenstrual syndrome) and menstrual cramps in this cycle. So, there is no actual need to be worried. Just maintain a menstrual calendar for next three months to understand the pattern of bleed. If the pattern continues then a hormonal profile and an ultrasound pelvis shall be required. But as of now, no intervention or investigation advised. Just increase your water intake and if not then try yoga and meditation which are great stress busters.


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Hi doctor, I noticed that for the past three months, I have had vaginal infection. But, all the tests were negative including vaginal swab and urine, which was done last month. I would like to know whether the vagina closes due to psychological reason. For example, when one do not want to have sex with someone. Please explain.


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Hello. It is called as vaginismus. It is muscle spasm causing contraction of vagina. It happens due to various psychological issues. It could be due to guilt of sexual activity and some unconscious unresolved issues. It could also be due to dislike of partner. It needs counseling and medicines.


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Hi doctor, I have lower back pain and right buttock pain. I have consulted a doctor for this, but I am not satisfied with the explanations. I have undergone MRI as per advice and here is the result. Posterior disc bulge with annular tear, moderate to severe stenosis of both neural foramina and mild stenosis of both lateral recesses at L3-L4. Disc desiccation and posterior disc bulge with moderate to severe stenosis of both neural foramina at L4-L5. Posterior disc bulge with mild to moderate stenosis of the left neural foramen, moderate stenosis of the right neural foramen and mild stenosis of the right lateral recess at L5-S1. Straightening of the lumbar lordosis most likely due to muscle spasm. Apparent posterior convexities are noted at C3-C4, C4-C5, C5-C6 and C6-C7. Disc desiccation is seen at C4-C5, C5-C6, and C6-C7. Please guide.


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Hello. You have mentioned that you have pain in lower back region with radiation of pain to right buttock region. Along with this, you have also mentioned about your MRI reports (attachments removed to protect patient identity) which show degenerative disc disease at multiple levels. Actually, I need your clinical details after which it can be correlated with MRI images and then I can advise you accordingly. Please tell me in detail the intensity of your back pain on a scale of 1-10. I would like to see your detailed neurological examination if possible that includes assessment of motor power, sensory examination and evaluation of deep tendon reflexes. This can be done either by a qualified physical therapist or an orthopedic or spine surgeon. That will give me an insight on whether there is any compression of nerves, etc. I also want to see your MRI scan and dynamic x-ray anteroposterior and lateral - flexion and extension views of the involved region of spine. This can tell us, whether there is any dynamic instability at the involved region or not. Kindly also enclose any recent blood tests if you have done, your past significant medical history, etc. Once I have this information, I can clinically correlate and let you know the treatment plan. 1. Clinical examination findings. 2. MRI image. 3. Dynamic x-ray.


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Hi doctor, I have been in menopause for 6 years now. Over three months I have been having bouts of weakness in shoulders, arms and sides of stomach. I feel very weak and strange. I do not feel dizzy. Sometimes it starts with a hot flash. Or else I will stay awake with this terrible feeling and will have hot flash at the end of it. I had CBC. As my symptoms become worse I went to an urgent care and the doctor took 6 vials of blood. He checked many things including EKG, which is normal. My fasting finger prick was 74 and HbA1c 5.6. I have attached the rest of the blood reports.


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Hi. I have gone through the details provided by you. All investigations are normal (attachment removed to protect patient identity) such as hemoglobin levels, non-diabetic, with normal resting EKG. So, these are not issue in your case. However, the following are the possibilities. Post menopausal hormone imbalances - You might have increased spurts of estrogen production which are causing the hot flashes. This is common in such menopausal age and requires only mild treatment if there is evidence of the increase. For this, get the following tests done - FSH (follicle stimulating hormone), LH (luteinizing hormone), estradiol and progesterone levels in blood. Hypertension - Get your BP monitored on daily basis at different times of the day and see if there is increase in levels at any point of time. This is again a reason for hot flashes, anger and weakness. It can be cured with mild medicine if found to be present. Check for your thyroid levels. Since you are overweight, there might be a possibility that you are suffering from hypothyroidism. Vitamin D3 levels - this is another reason for general weakness. Now if we go to further serious reasons, then one probability can be TIA (transient ischemic attack), there can be slight loss of blood supply to the brain which might be causing weakness in limbs. I am not sure if this would fit into you as coming to a conclusion requires medical examination which we cannot do online. I would suggest that you send us all reports as mentioned above and also go to a doctor to get full examination done. Only then we can comment on what is the right treatment in your case.


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Hello doctor, 2 years and 6 months old with abnormal CBC test results (two tests seven weeks apart). First tested because of enlarged lymph node (only one side) in neck. Node has reduced in size to what appears normal. Low MCHC (just barely outside range of 32.0 to 36.0) 31.3. Low NE % of 26.1 Auto diff with range 43.0 to 65.0, high LY % 62.7 with range 20.5 to 45.5, high EO % 3.9 with range .9 to 2.9. Highly # 6.2 with range of 1.0 to 5.5. What does this indicate? I have read all the horrible possibilities. Is it possible these are indicative of something not serious?


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Hello. Your CBC report is suggestive of lymphocytosis (attachment removed to protect patient identity). The common cause for lymphocytosis is viral infection. The enlarged lymph node could be due to that. Now, your enlarged node return to normal size as per history, so suggestive of infective etiology. You might be feared about leukemia like condition. But in blood cancer, total count is very much high like more than 50000. So, it is not suggestive of blood cancer. However, if you have persistent lymphocytosis, then it is advisable to investigate with peripheral smear examination report for further work up. It will be able to help in identifying any abnormal cells, if present like atypical lymphocytes, blast, etc. You can consult your pediatrician for detailed physical examination.


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Hello doctor, My bicep muscle has been twitching and my leg and arms muscles twitch occasionally. I am super anxious about ALS. I am 36 and postpartum six weeks but I cannot stop obsessing about ALS. Please help.


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Hello. I understand your concern and would explain that there are a lot of other benign causes that may lead to fasciculations like anxiety and insomnia, benign fasciculation syndrome, vitamin D and vitamin B12 deficiency, an electrolyte imbalance or thyroid gland dysfunction. For this reason, I would recommend performing some tests: Complete blood count, blood electrolytes, thyroid hormone levels, vitamin D and vitamin B12 plasma levels. Nerve conduction studies would help to definitely exclude ALS and put your mind to peace. You should discuss with your doctor on the above tests.


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Hello doctor, Taking CTD-L 6.25/25 for hypertension and Amaryl MV-1 for diabetes for more than five years. My fasting sugar level is always above 200 on average. Besides this, I have vertigo syndrome, RBBB, severe constipation, and for the last three years itching in lower legs (right leg in winter and left leg in summer). Most of the time I am sitting for my job. My height is 181 cm and weight 110 kg (no change for the last five years).


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Hello. After going through short the medical history I want to address some points for you. First important aspect of management of diabetes is diet. That will remain the primary objective for the management of type 2 diabetes across the globe. Please elaborate a little about your basic diet pattern. Second important aspect of management of diabetes is exercise. As you have mentioned your are an accountant and that will make you a less active person during a major time of the day. While on the job and presently in lockdown at home, take small 5-10 minutes of time and walk across the corridor. Start with little things. Then on the third part comes the medicines. You have not mentioned how many times a day you are taking Amaryl MV 1. Please do mention that. Your weight is also more compared to your height, Amaryl can cause a little weight gain also. You should opt for tablets that will not gain weight. There are certain medicines available now which controls blood sugars and also help in weight loss. Apart from this, I would like to know about your family history of diabetes and the stress levels you are facing on the scale of 1-10. Are you getting enough sleep? How many times you have to go for urine at night? Any pain, or burning sensation in legs? Obesity. Uncontrolled sugar levels. FBS (fasting blood sugar). PPBS (post prandial blood sugar). HbA1c (glycated hemoglobin). Lipid profile. Serum creatinine. Type 2 DM. Continue the same medicines until we work on detailed diabetic history. Take six to seven small frequent meals a day. More leafy vegetables, fruits, pulses. Take less grains, maida, and processed food. Once detailed history available and reports done.


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Hello doctor, I am having upper stomach pain, nausea, loose stools, fatigue, gas. I had one episode of vomiting (regurgitation) about five days ago, and the symptoms all went downhill from there. I am taking Aspirin, Zoloft, Prednisolone, Cellcept, Hydroxychloroquine, Amlodipine and Clonidine. I have lupus (SLE), anxiety, and GERD. I am also 18 years old and 200+ lbs.


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Hi. The symptoms that you mentioned are consistent with acute gastroenteritis. Please follow the following diet, take the following medicines and do the following investigation. Diet: BRAT diet which is short for banana, white rice, apple sauce and white toast (bread). Stop eating all vegetables and fruits except bananas and potatoes. Drink ample fluid. Avoid dairy products, caffeine drinks, spicy food, food from outside, fried food, sweets. You can eat poultry or meat but cooked blandly. When you start to get better, introduce normal diet bit by bit. Feco-oral. Stool analysis, stool C and S. Acute gastroenteritis. 1. ORS one sachet in 1/2 cup water every four hours for four days. 2. Metoclopramide (Primperan) tablets one tablet two times a day for three days. 3. Eucarbon (Carbon) tablet two tablets three times a day after food for five days.


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Q. My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. What does it indicate?


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Hello doctor, My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. Presence of diverticulum and ulcer near the pyloric ring. I have constant nausea, bloating, and throat tightness.


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Hello. Gastritis is an inflammation of stomach mucosa. It happens due to Helicobacter pylori a bacterial infection, smoking, alcohol and also certain medicines like Aspirin. Presence of diverticulum also causes gastritis. You are taking good medicines to your concern, continue them. You can add Panchsakar Churna 3 gm twice a day with warm water after meals and Arogyavardhini Vati 1tab twice a day after meals. Avoid spicy and fried junk foods, quit smoking and drinking if you have these habits. There may be need of surgical removal of diverticulum.


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Hello doctor,I want to get some information regarding bipolar disorder because I think I have it. I had horrible mood swings, one moment I am overly happy, and the next moment I feel depressed. My sleeping schedule is also different than usual.


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Hello. Let me answer your questions via some bullets some points to make things easier to understand. 1. You are only 14 years old, and it is very unusual for a significant mood disorder like bipolar mood disorder to manifest at such a young age. However, this does not mean it is impossible but just far less likely. 2. As a young woman at 14 years of age, it can be considered completely to have mood swings and sleep disruption due to premenstrual hormonal changes. Puberty, overall, is a time of huge biological and psychological change and is not uncommon for a person to experience broad mood changes within one day. 3. I feel your mood swings and general well being should have a keen eye kept on them. If you have a severe mental health disorder, it will become clear fairly soon. 4. From your point of view, as long as you are still able to function normally at school and keep up with your academics as well as maintain relatively good social interactions you are very likely not suffering from a severe mental illness like bipolar. Also, consider the extent of your inner sense of personal distress. Sometimes things can seem like the end of the world in puberty but are much less severe when viewed from a different perspective. 5. I think it would be wise if your parents could allow you to see a psychotherapist or counselor regularly going forward for you to unload your feelings in a safe and confidential environment. Also, such a person could keep an experienced eye on you, and if any severe psychiatric symptoms appear, they can be recognized and acted on it correctly. 6. So my final suggestion is to ask your parents if they are willing to help you find a suitably qualified psychologist and counselor that you can see regularly and feel you can trust them with your feelings. Remember if you are unsure about how you feel and if it is reasonable and not something to worry about, it is always better to speak up about how you think, just as you have done here. Should see a clinical psychologist or counsellor regularly.


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Hello doctor, I went to the chiropractor and got my neck adjusted. I had sore on my neck more in the back left corner then the pain passed down to my left arm. After checking, they said it was a flare-up and to ice it. The next day I had it adjusted again, and he pointed out that I had a swollen lymph node on the left side. I still had sore in the same spot and was worried about my artery and my lymph node. Could my lymph node be painful because they adjusted my neck or because my muscle was sore and irritated?


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Hello. I do not think that because of chiropractor there will be any trouble to the lymph node. If the pain is radiating in nature, then it can be related to intervertebral disc injury which can be a past injury and due to which you had a sore neck. As the intervertebral discs are located in between the two vertebral bodies and the muscles are the supporting structures any trouble to the disc can first make the muscle sore and change the normal curvature of the cervical spine. The radiating symptoms can arise due to nerve root entrapment by the muscle as well as the intervertebral disc. Having an MRI scan of the cervical spine will be useful to avoid further injuries. Also, doing hot water fermentation will help to reduce the muscle spasm of the cervical spine region and the trapezius muscle by which the normal alignment of the cervical spine is achieved. Using cervical soft collar will help to reduce the mobility of the cervical spine leading to stabilization of the joints and less nerve root entrapment. Exercises like static neck exercises, shoulder stabilization exercises, interscapular muscle strengthening exercises will help to regain the muscle strength and correct the cervical spine alignment. If you have any more questions, you can ask me anytime.


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Hello doctor,I am concerned about a possible raccoon roundworm exposure. I have read that I can take a prophylactic 10-day course of Albenza to keep any eggs from entering my CNS. I might have type 2 diabetes for a while and have put off bloodwork to find out. I am a glaucoma suspect based on the last eye exam. How hard is Albenza on the body? Is it generally well tolerated for many days? Do immediate side effects get better after a few days?


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Hello. Albendazole 400 mg single star dose is enough for prophylactic deworming. 10 days course is not required. Usually, it is very safe and is well tolerated. A rare side effect is a seizure, that can happen if the worm is already lying dormant in your CNS. I generally prefer a three-day course of Mebendazole 100 mg twice daily as it does not enter CNS and so there are no changes of seizures. I hope it helps. If you have any further queries, please ask me.


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Hello doctor, I am 51 years old. I am having sweaty palms and feet every morning. I also feel nausea and headaches. What is the cause of this?


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Hello. As per your presenting complaint, the diagnosis is migraine. Migraine headaches are a common cause of combined headache and nausea. Migraines can cause a variety of symptoms, including nausea, dizziness, sensitivity to light, and severe headache. You can make small changes to your lifestyle so that you prevent future migraine attacks. Here are a few steps to take to relieve migraine pain. You should drink a lot of water throughout the day so that you stay hydrated at all times. You should avoid eating less and should eat enough so you are getting all the nutrition that your body needs. Eating proper and healthy food is key to ensure your body is healthy. You should try and eat at the same time daily. Sleeping deficiency can trigger migraines, which is why adequate sleep (eight hours) is important. You should maintain a steady sleep cycle by sleeping at the same time every night and wake up at the same time. I hope this helps.


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Hello doctor, Recently I came to know that my ward has a germ cell tumor. He is undergoing surgery for the removal of right testes today. It is unknown whether he is affected with cancer if so, what is the type and whether it is curable or not? How long will this take and what are the steps should be considered for the treatment? Please help me because I am depressed.


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Hello. This is a high-grade testicular germ cell tumor (attachment removed to protect patient identity). The molecular markers such as hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase) are high. Also its spread to the liver and adjacent lymph nodes. Ideally, the primary tumor in testis has to be removed and then treated with a chemotherapy called BEP (bleomycin, etoposide, and cisplatin) regimen for the rest of the metastatic disease. If after surgery, his markers fall, and if he responds very well to chemotherapy, we can expect a cure where we could do a stem cell transplant in the future. But for now, his plan would be a surgery followed by chemotherapy. Also, consider semen preservation before surgery and chemotherapy.


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Hello doctor, I have a habit of eating fennel seeds a lot. Could this be the reason for not getting pregnant even after trying for two years?


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Hi.  Fennel seeds can normalize your gastrointestinal tract and nervous system. It balances excess pitham. It helps in balancing heat within the uterus, that is very much essential for getting pregnant. So, daily consumption of fennel seed life long will never affect the pregnancy. You may continue consuming it. Please check gynecologist or Siddha or Ayurveda doctor to evaluate why there is a delay in conception. Please check for your husband too. The reason may be identified for specific treatment.


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Hi doctor, I am thinking about getting a kitten, my father and brother are allergic to it. So, it will be kept in the upper room. I want to know if I have the same allergies. During my college days, I have spent six years with cats, never touched them but you could see them walking around, some even came close and hid under my tables.


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Hi.  Allergy can run in families, you have a chance of being allergic as your father and brother are allergic to cats but not a must. Being close to cats in the past for many years is a good indicator that you might not be allergic to cats but still allergy can develop at any age. You can do a skin allergy test by a dermatologist (skin doctor) to know if you are allergic to cats or not. Skin allergy test. ?Allergy. Avoid contact with cats, if proved to be allergic.


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Hi doctor, My kid is 4 years old (baby girl) and weighs around 14 kg. She has fever of 101 from last evening followed by vomitings and motions. She is vomiting green color fluid and passing stool of same color, we have given her Calpol 250 mg 4 ml doses twice from yestday for every six hours. Should we give her Vomita medicine? Or continue with Calpol?


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Hello. Based on your history, I can suggest please go to pediatrician urgently. May be need to do abdominal sonogram because green color vomiting is unsual in 4 years old children, sometimes there may be lying some intestine problem like obstruction. I am not making you scared but informing you regarding possible urgency. You can give Calpol every six hourly. For vomiting, you can give syrup Ondansetron 5 ml three times a day for three days. Give ORS to prevent dehydration. I am not giving you full prescription because I want you to visit pediatrician and get herself checked first. Ultrasound abdominal.


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Hi doctor, My lab tests are as follows: Seven months ago: blood glucose of 105 mg/dl, GTT one hour 160 mg/dl, two hours 118 mg/dl, morning insulin 6.2 μU/ml, HbA1c 5.2 %, A1 6.1 %. This month: BG 110 mg/dl, GTT one hour 184 mg/dl, two hours 115 mg/dl, morning insulin 5.3 μU/ml. Every other blood test within normal ranges. I am male 32 years old 1.86 cm 93 kg 13 to 14 % body fat athletic with healthy nutrition habits. No history of diabetes in the family. Could I be having cancer in pancreas judging from the insulin values you are seeing? I have had many years to do a blood test and with this random one seven months ago. I was told by my doctor that I had to keep monitoring my blood glucose since I could develop diabetes later on, and since I have never had a problem with blood sugar as a kid and no family history of diabetes, I was wondering what might be going on cause insulin levels dropped from my last test and since my diet was pretty much same with healthy choices why is this happening. My doctor for the last seven months kept telling me to calm down and that I do not have anything cause stressing is bad for my blood glucose too. Should I be telling him to get a pancreas MRI done?


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Hello. I just read your query and from what you have mentioned I would like to say that the reason that your insulin levels are dropping is because of your beta cells of the pancreas are getting exhausted and are not gradually decreasing the production of insulin. Pancreatic cancer does not have these manifestations at all. So testing for cancer without any strong family history or clinical manifestations is just not recommended. Continue with your healthy lifestyle and try to workout more as they reduce insulin resistance and thereby decrease fatigue of your pancreatic cells. For more information consult a diabetologist online -->


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i have pain while passing stool and also blood with it sum time spots and some time much more, and i have physical exam to a doctor, who said it is not piles, it is anal fissure then i ask whtat is this he said in simple words its a cut. he suggest me gtn 0.2% and brixin tab if there is no relief in 10 days there will be need of operate please suggest me


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hello I will definitely help u regarding your problem anal fissure is a cut in the anal pessage due to hard stools it may present with pain and bleeding in 99 percent cases surgery not required but proper medicines and prevention is necessary here I will advise you complete treatment only one gel and tablet will not help follow my treatment, you will get better in 5 days follow me after 5 days so I will modify your treatment anal fissure Sitz bath with betadine 2 times for 15 minutes Syp Duphalac 4 tsp HS ointment Diltigesic locally 3 times Ointment Smuth locally 3 times Tab Enzoflam 2 times daily Tab Pantop DSR OD plenty of water avoid spicy and fatty foods high fibre diet 5 days


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Hi doctor, I was diagnosed last week with a dysfunctional pancreas but further tests are needed. Yesterday, I had a couple of beers and I woke up today with pain in my pancreas (I am quite sure). In the pain scale, it is about where I should take a Paracetamol, but I am afraid to put something down in my stomach. It is not severe. What should I do? Eat lean food and drink water till it goes away or is another treatment needed? I have been on Nexium, Ranitidine for four years and my pancreas gets worse when I take that medication. I stopped Ranitidine one week ago. I had endoscopy last week and esophagus and stomach looked fine. Could it be gallstones blocking pancreas? Hope you can help me here.


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Hi. I have reviewed your query and can well understand your worries. I would recommend combatting this situation without medications as these medications will also affect your stomach. Try not to take pain medications as much as possible. In severe and unbearable pain you can take though. You already had fundoplication and taking pain medications can cause gastroesophageal reflux disease (GERD) or gastric ulcers along with hyperacidity in the stomach. Without having a look at gallbladder it is difficult to say anything about the origin of issue that may have caused pancreatic insufficiency. For diagnosing gallbladder issues (sludge accumulation inside or gallstones) we need to go for an empty stomach ultrasound study of the abdomen. It can show most of the gallbladder issues along with any correlation between the gallbladder and pancreatic issues like gallstones and pancreatic insufficiency. Alcohol is not good for the pancreas. It is the single most dangerous threat to the pancreatic normal functions. It may also lead to pancreatic cancer along with smoking, age, and infection of the pancreas. It is not severe. Yes, you should deal it like this conservatively, as aforementioned in detail. Hope it helps. Please go ahead for further pancreatic studies as advised by your physician and avoid smoking and alcohol as these are like a poison to the pancreas in this scenario.


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Hello doctor, I had an ear infection but my ear infection has gone now but very low pitched ringing in my right ear is not stopping.


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Hello. The symptom you are experiencing is called tinnitus. Tinnitus is not always due to a sinister cause. Simple conditions of the ear like wax or ear infections both of external ear canal and middle ear can cause it. First and foremost you must know that tinnitus may be aggravated by apprehension and anxiety. You have to make a conscious effort to ignore it. Most of the times, it does not need any treatment. So be assured most likely to be a benign condition. I would like to know the duration of symptoms and whether it is unilateral or bilateral. Are there any symptoms of hearing loss and giddiness? Did you have any earache and prior history of upper respiratory tract infection? you may do a hearing test which will give us further insights. For now, you may just wait and ignore it. It might resolve in a few days.


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Hello doctor, I am continuously hearing a metallic scratching sound for the past one month. Best described as like the sound of cricket insects as heard in the dead of night. I am taking medication, namely, Syndopa plus, Rasalect, Pramipex ER3, Rozucor, and Amantrel for Parkinson for last seven years.


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Hello. I understand that you have tinnitus. Has it been there only for a month? Is it associated with any decreased hearing? Is it there in both ears? Is the tinnitus accompanied by vertigo or vomiting sensation or fullness in ears? Have you done any testing for the same? When a patient comes to us with symptoms like yours we ask for all these details in history to rule out any neuroma in the nerve or age-related hearing loss or Meniere's disease. A basic investigation that we ask is pure tone audiogram. Additionally, I would suggest you get a SISI (short increment sensitivity index) test done. These two should give us a fair idea and help us rule out the above conditions and check for the cause of tinnitus. If the tinnitus does not have any cause we can help you tolerate it using tinnitus matching and masking. Some centers also provide tinnitus retraining therapy. These are useful. Certain medications like Caroverine and Nicotinic acid also are helpful in improving the condition. For more information consult an ENT otolaryngologist online -->


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Hello doctor,I am a 44 year old female, mother of 2, 165 cm tall and 75 kg weight. Two months ago, I fell ill with a bad flu (may have been also an acute viral infection) with high temp (39 degrees), probable inflammation in the sinuses, nose, and throat and sinuses pain. The first antibiotic (Klacid) did not help much and low temp of 37.3 to 37.5 persisted for weeks. Then a throat swab analysis showed the presence of streptococcal pneumonia. However, X-rays of sinuses and lungs did not show any problems.In the meantime, a month ago, the nose cleared, and the pain in sinuses subsided. However, the right ear got clogged for a week, and as it unclogged, the left one got clogged. In the meantime, local doctors gave the diagnosis of post-viral infection-caused inflammation of the eustachian tubes. A second antibiotic was prescribed and taken two weeks ago - Augmentin. After the second antibiotic, temperature normalized. However, the left ear clogging persisted.Additionally, three weeks ago, shortly after the clogging of the left ear, a high-pitched noise in the left ear appeared (tinnitus ?), which is particularly audible at night and has caused me sleeplessness, stress, and depression. Audio tests performed by local doctors have proved that the hearing and hearing nerves are intact for both ears.I have taken for two weeks now Flixonase spray (corticosteroid like Nasonex), spraying once per nostril every morning. However, as a result, I developed an extreme dryness in my mouth and throat, and after three days, I stopped that. Now, my left ear feels better but is still clogged and ringing. What would you advise us to do?


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Hello. The clogging of ears and ringing sensation (tinnitus) are probably due to accumulation of fluid in your middle ear post eustachian tube blockage, as a result of the upper respiratory tract infection you had had previously, a condition known as serous otitis media. I suggest doing tympanometry (if not already done) to confirm the diagnosis. If tympanometry confirms the diagnosis, then I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an ENT otolaryngologist online -->


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Hello doctor, I have developed tinnitus after using a nasal spray Sudafed, please assist. Not on any medication, hearing is fine. I was suffering slightly with dizziness prior to the tinnitus four months back which had cleared by then.


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Hi. I just went through the complaints that you been having. This sounds like peripheral vertigo and this is how people usually present with. The treatment management part, take a tablet called Betahistine 16 milligrams twice daily for three days followed by once a day for three days and stop. Drink plenty of water just to prevent dehydration as dehydration sometimes worsen this tinnitus and giddiness. If you still continue to have the symptoms or the symptoms persist, I want you to consult with an ENT specialist and if you still have any queries please feel free to contact me.


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Hi doctor, I am 21 and suffering from tinnitus from last four months. The sound in the ears is not constant. It is changing. Sometimes, it is loud enough that I can hear it even in a crowded place and sometimes so low I cannot detect in a normal environment and the most important of all with a loud noise like train horn it is taking a peak and when the sound goes off it comes back to normal. My doctor told me this is due to cold and prescribed some antibiotics. But it did not work. So he told me to visit an ENT specialist. After visiting an ENT specialist, he told me my ears are fine but I should do an audiogram. And also given me some antibiotics. There was no hearing loss in the audiogram. And the medicines also did not work. Then I again visited the doctor. This time he told me there is nothing to worry about and sent me back home. What I want to ask is, if there are any other tests that could detect why this is happening and how this could be treated?


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Hello. You are suffering from fluctuating tinnitus for four months as you have said. Tinnitus (ringing sensation in the ear) may be due to problems of the ear or problems not related to the ear. Ear problems causing tinnitus are generally associated with hearing loss. But that is ruled out in your case as your audiogram is normal. Some investigations need to be carried out: I would suggest you go for the investigations as suggested. If no cause is found, you should go for tinnitus retraining therapy. An audiologist may help. Avoid loud sounds, have a diet comprising of green vegetables and fruits containing beta-carotene (mango, papaya, etc.). For more information consult an ENT otolaryngologist online -->


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Hello doctor, I have constant tinnitus and sensorineural hearing loss for about five months. I am sending you reports of my PTA and otoscopy. Now I have ear fullness, tinnitus, and hearing loss in my left ear. My right ear is normal. Tinnitus is continuous for past four months. I do not have any vertigo or dizziness episodes. Please tell me is my symptoms of Meniere's disease. Please tell me the cure for ear fullness.


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Hi. I have seen the reports (attachment removed to protect patient identity). There is minimal loss in the left ear. The symptoms do not seem to be due to Meniere's disease. The tinnitus is due to the hearing loss. Take tablet Cinnarizine 75 mg once daily for 15 days and tablet Vitamin B12 1500 micrograms once daily for 15 days. You will definitely be benefited. Consult with your doctor before taking them. Avoid any excess mobile usage or earphones use. Take care. For more information consult an ENT otolaryngologist online -->


