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key: Patient
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Hi doctor, My son is 15 years and medium built. He recently has some concentration problem. What homeopathy medicine can I give him? Please suggest the recommended dose. Thanks.


key: chroma:document
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Hi. It is essential to understand the cause of a concentration problem. Based on the limited information provided here I can think of a few remedies. If your son has taken too much stress of his studies and due to which he is not able to perform well or unable to concentrate, then you can give him Kali Phos 6x two tablets twice a day for 15 days. If Kali Phos 6x is not available, then get Phos 30c three pills once a day in the evening for seven days. You can give him Five Phos 6x if he is generally not able to concentrate and the cause is not known. Five Phos 6x two tablets can be given twice a day for 15 days. I would suggest you seek help from professional homeopath either face to face or online consultation on icliniq.com. It is very important to understand the details of his problem to prescribe any homeopathic remedy correctly. I hope he will feel better with this remedy. Let me know if you have any questions or else report back in 15 days.


key: Patient
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Hi doctor,Five days ago, when I woke up, I felt dizzy, and my vision was off. I was sluggish all day and had a headache upon waking. I figured I was coming down with something and laid around all day on the couch. When I woke up the next, I had no headache and was no longer lethargic, but my vision was still off. I noticed that I was having double vision when I looked at objects both close and far away. I closed one eye, then the other, and my vision was perfect (binocular double vision). I also noticed that if I looked at something with my head and eyes straight, it was there and got worse if I looked down. But, when I look up with my eyes, it went away. Keeping my head pointed slightly down and looking up at something made it go away. I also noticed that it seems to be my right eye because if I gently pull the corner of my eye outward towards my ear, my vision goes back to normal.I went to the eye doctor, and she said it is because I am 44 and I need readers. I bought a pair from the local pharmacy, and it does help with my reading on the phone, computer, etc. Even though it is blurry looking at a distance, there is no double vision. Granted, maybe I do need them at my age, but that does not explain the double vision or how I can get it to go away by looking up or pulling the corner of my eye. My vision was tested along with all of the other standard tests, and it was all fine. I have 20/20 vision still after having Lasik to correct nearsightedness 13 years ago. I am not nauseous and no longer have a headache, but the problem persists. And, it is 15 days since starting the Keto diet, and I thought that maybe that could be causing this. So today I carb-loaded to replenish my glycogen stores, yet the problem persists. I flew back from a trip and read that maybe something could have happened with the pressure. I am not diabetic and do not have high blood pressure. I have no idea of what is going on and if it is severe or not. I do have an appointment with an Ophthalmologist coming week, but I am getting worried. Do you have any idea on what could it be? What should I do?


key: chroma:document
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Hello. The fact that your vision becomes better upon changing the position of the head or pulling your eyelid towards your ear proves that this is only related to your newly acquired age-related refraction. By reducing the area of the eye slit (changing the position of the head leads to the being covered more by the upper eyelid and reducing it manually by pulling your eyelid to the side), you reduce the refractive changes in your eye. The fact that the specs provide you with better vision while reading and relieves you of your main symptom is enough to make you feel calm towards this newly acquired physiological (it always starts after 40) change in vision. However, please refrain from using that correction to see distant objects because it is not designated for that distance, taking into consideration that you do not need it for distant objects, and might lead to headaches if you do. Otherwise, you should be good to go and start adapting to this newly acquired condition because from now on, every five years it is going to change and you will need more correction to correct that age-related deficit. Some additional recommendations would be to increase the size of the fonts on your devices to evade the necessity of using the specs every time you need to visualize your devices at a near distance. Also, lubrication of the eyes with artificial tears can also help maintain an absolute clarity during visual activities.


key: chroma:document
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Hello, I welcome you to icliniq. I can understand you must be very upset about your problem. It seems that you have a defecation disorder. which is difficulty in passing stools. It can occur to any body, but common among individuals who have difficult learning the art of passing stools. For this you have to relax , remove your anxiety and start learning the art of pooping. Here are some tips for that. If all above fail then there is computerized therapy called biofeedback therapy. I want you to follow above tips first, and let me know if improvement; if required, I will suggest when to go for biofeedback therapy. The pain is a secondary phenomenon, once your stools became normal the pain will go away. Do not use painkillers, because they may slow your bowel and can cause more constipation. Defecatory disorder Slow transit constipation Defecatory disorder As above Follow up in 1week and update me about your problem


key: Patient
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Hi doctor,I was wondering why my tailbone seems to pop in multiple places like my back. It only happens when I stretch in the morning and tense the muscles around the area. Also, I would like to know why my back keeps hurting right where the spine meets the pelvis, i.e., at the bottom of my back but above my butt. I am 18. Will it make any difference?


key: chroma:document
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Hi. Thank you for providing a brief history. It sounds to me as the SI (sacroiliac) joint dysfunction. Due to which, there will be a kind of biomechanical changes in the bone and the joint compression leading to pressure on the joint receptors. Also, there might be a weakness of the muscles of the hip and lower back which may be leading to this discomfort. I would recommend you to take up an x-ray because it will reveal if there is any structural or anatomical alignment change. Also, having a hot water fomentation and exercises will help strengthen the muscles of the core, lower back, and hip and help reduce the symptoms. Please let me know if you had any history of fall on the hip, any other thing like sitting for long hours for study, etc.


key: Patient
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Hi doctor, I had a root canal done some years ago. Now, the tooth has broken off. I can still feel some screw in the gum. I am now getting some constant puffiness and bleeding.


key: chroma:document
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Hi. I have read your complaint. Firstly I would like to say that you do not have any screws unless you have done an implant. It is the broken tooth root which you might feel sharp. That is again the reason for bleeding as it irritates the gums around. The root canal treated tooth when not protected with a cap or crown always break eventually and that is what has happened in your case. Now the treatment would be to pull out the remaining tooth remnants. Meanwhile, some painkillers like Panadol (Paracetamol) would help you. I reckon you to visit a dentist and get it treated as soon as possible. Kind regards.


key: Patient
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Hello doctor, Kindly give a report of my CT scan. I had CT scan for swollen lymph node in the left neck, posterior cervical.


key: chroma:document
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Hello. Please find the CT scan report as below (attachment removed to protect patient identity). Contrast enhanced CT neck, •	Bilateral neck spaces appear normal. •	Visualized neck vessels appear normal in course and caliber. •	Thyroid, submandibular and parotid glands appear normal. •	Few enlarged reactive lymph nodes with intact fatty hilum (hilum is a the portion of a lymph node where the efferent vessels exit) are seen in left sub-mental and jugular region. •	Visualized bones appear normal. •	Visualized lung fields appear normal. Incidental note is made of a simple renal cyst in the upper pole of left kidney. If any further doubts please feel free to discuss.


key: Patient
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Hello doctor, My boyfriend is 24 years old. Being a fitness trainer, he does not take any drugs. He has been getting chest pain for the past four months and sometimes lightheadedness. He went to the doctor and had done a blood test which came back normal. His blood pressure is low, and he had a 24-hour Holter monitoring and ECG. The results came back as second-degree heart block four times in 24 hours. Our appointment with cardiologist is after a month. I am worried because he feels weaker when he exercises and the pains are more frequent. Not sure what we can do in the meantime or what is causing it.


key: chroma:document
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Hello. I understand your concern. I want to explain that when we are in front of a cardiac conductance abnormality in an young adult first, it is necessary to exclude an infectious and inflammatory disease, like Lyme disease, sarcoidosis, and other cardiac issues, like myocarditis, and anomalous coronary artery, etc. It is necessary to undergo a full blood test panel and a cardiac ultrasound test. For a more detailed cardiac tissue characterization, it is necessary to undergo a cardiac magnetic resonance imaging test (CMR). Meanwhile, I recommend that your friend refrains from competitive sports and any excessive physical exertion. I hope it is helpful for you.


key: Patient
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Hello doctor, I am 24 years old. My crown area is almost bald, and I want to regain my hair. I had PRP treatment for hair, but there is no result. Hairfall still persists. Why? I am currently on vitamin C tablet.


key: chroma:document
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Hello. As your hair loss is quite severe, I suggest you go for 5 % Minoxidil with Aminexil solution (brand name - HAIR 4U solution). Aminexil helps regrowth in fibrosed hair follicles. Apply it daily twice over the area and see that it is undisturbed for at least four hours which means you should not apply oil or any other cream over it, and you should not sweat much in that time because those things will dilute the medicine. Also, take a hair strengthening tablet like Follihair twice daily. Take a lot of Vitamin A, iron and protein in your diet. Tell me after thirty days on the response. We will decide on how to proceed after that.


key: Patient
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Hello doctor, I had circumcision two months ago and still have swelling around my penis. I did a CBC and urine test last week, and all came back normal. The doctor last month said all the incision have healed. Will swelling last this long? How long will it take for the swelling to disappear? Should I be concerned? Will night erections affect healing?


key: chroma:document
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Hello. The healing looks fine (attachment removed to protect patient identity). The swelling is mostly an extra skin that is bunching up in a non-erect position. When you have an erection, it might be less prominent. If all excess skin were removed, sometimes there would be pain during erection due to the stretching of the skin. I think things will be fine in about another month. Night erections will not affect healing.


key: Patient
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Hello doctor, I had unprotected sex with my partner today. She is on the 22nd day of her cycle. Will she get pregnant? We do not want to have a baby now. What should we do now?


key: chroma:document
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Hello. If she has a regular cycle of 28 to 30 days, then there are no chances of pregnancy, and these are safe days. So nothing to worry. I hope it has helped you. If you have any further queries, please do not hesitate to contact me.


key: Patient
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Hello doctor, Suspicious cancer in my breast scanning report. What are the symptoms of breast cancer? The report mentioned there is a relatively well defined hypoechoic mass with small calcifications at periphery. There is no necrosis. Suspicious cancer. No enlarged axillary node. BI-RADS 5.


key: chroma:document
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Hello. Looking at this report, the suspicious finding needs to be evaluated further (attachment removed to protect patient identity). You need to do the following things. 1. Consult a breast surgeon or an oncologist, who takes complete history such as since when these symptoms started, any family history, etc. He or she examines this and gives his or her point of view. 2. If needed this mass should be biopsied or Fnac (fine-needle aspiration cytology) preferably under USG (ultrasound) guidance. Depending on the report we can take things further. Regarding symptoms of breast cancer, there are many such as a lump in the breast which is increasing in size, location of the lump, nipple discharge, and skin changes over the breast, etc. Occasionally there are none. Kindly revert if you have any queries.


key: Patient
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Hello doctor, I changed my four weeks old baby’s formula milk, and it caused him to vomit after feeds and he had diarrhea. Should I change it to thick formula milk because he has reflux? Is this a normal side effect?


key: chroma:document
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Hello. From the reflux point of view, the first thing that is to be done is to keep the baby at an angle of 35 degrees to the ground level after feeding. This will reduce the chances of reflux more than any medication. The next thing to be done before feed thickening is to start the child on Perinorm (Metoclopramide) and Rantac (Ranitidine). If all these do not work, food thickening is to be done. Also, I would recommend you to get a reflux study of the child done for a better knowledge of what grade of reflux the child is suffering from.


key: Patient
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Hi doctor, I have bumps on my nose and chin. I believe that as pimples but I am not sure. They do not contain any pus or pores because nothing squeezes out.


key: chroma:document
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Hi. The history that you have given and the picture (attachment removed to protect patient identity) that you supplied makes me inclined to believe that these are what we call closed comedones. Pimples are often referred to as open comedones. Closed comedones occur when cells, oil, and other substances get trapped under the skin without a way to come out, they appear as bumps on the skin that are often painless. Closed comedones can be extracted by a qualified individual, and I would advise you to approach a dermatologist. Dermatology consult.


key: Patient
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Hi doctor,I am a 17 year old female struggling hard with bulimia and binge eating. My mom is anorexic, and so is my grandmother. I suffered from low weight until I started binging which has been going on for almost a year. I purge sometimes, and I am terrified of how much weight I continue to put on, yet I still regularly binge. I try everything to stop. I try new methods all the time and constantly research, but I keep hearing the same things. I lie to my parents a lot, and we both feel helpless. I guess I do not know what I am expecting because I am already on CBT treatment (which I do not think to help me), Prozac and Wellbutrin, but I need reassurance and some help with these extreme and constant binges.


key: chroma:document
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Hi. According to your height, your weight is average. In bulimia, CBT (cognitive behavioral therapy) is helpful. If Prozac (Fluoxetine) is not working, then you have to increase the dose of Prozac or shift to another medicine. It is a learning process so that you have to change this to a better one. Continuous thought of purge will come to mind, but you have to stop the though by not reacting to that. Have patience because learning is a prolonged process and as age grows it is challenging to change the previous learning method. You can respond in another way rather than purging. I hope you understand.


key: Patient
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Hello doctor, I am on Effexor 187 mg and Trazodone 50 mg at night for depression and anxiety. My depression and anxiety have been worse, and I did not want to keep going up on with more medicines. So I tried Ashwagandha 600 mg in the morning and have seen a great deal of help in my mood and anxiety. I have not even considered if it is safe with my medication. Kindly advice.


key: chroma:document
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Hello. Effexor (Venlafaxine) and Trazodone are good drugs for depression and anxiety but will have some side effects. You may take Ashwagandha 600 mg (morning and night), Centella Asiatica (morning and night) as a supportive therapy. There must be one hour gap between modern drugs and herbal supplements, to prevent their interactions. Consuming Ashwagandha and Centella Asiatica is safe. On a long term basis, it will reduce the side effects of modern tablets and also stabilize the nervous system functions.


key: Patient
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Hello doctor, What can be the muscular thing right out of my anus? I had a normal delivery a month ago, and it is almost healed. When I pass stools, I feel pain in that place with bleeding. While passing stools, the muscular thing gets torn, and blood comes out. This started a day before yesterday and now happening every day. What is the treatment for it?


key: chroma:document
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Hello. It is anal hemorrhoids (attachment removed to protect patient identity), and it is very painful. You may be suffering from constipation, or you must have been eating very spicy food. The treatment is sitz bath, and it means you have to sit in a tub full of warm water. It gets relieved, and you have to do this for two to three times a day. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. You may apply ointment Pilex over the area. Stop eating spicy food and take syrup Duphalac (Lactulose) two spoons daily at bedtime to avoid constipation. If it is not relieved, then you have to consult a general surgeon.


key: Patient
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Hello doctor, I am 29 years old and a mother of 2.5 year old girl. I have PCOD and I am obese. I am continually taking oral contraceptives to get my periods. I have Kalarchi Kai powder but I do not know how to use it?


key: chroma:document
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Hello. Kalarchi Kai powder is a well known Siddha medicine to manage PCOD (polycystic ovary syndrome). It is very effective in such kind of issues but It will take some time. USG lower abdomen, and thyroid profile. Take Kalarchi Kaai powder 3 gm twice a day with warm normal water after meals regularly for three months. Avoid spicy, fried, and junk foods. Drink plenty of water. Do regular Kapalbhati and Pranayama like Anuloma Vilom Nadi Sodhan and Bhramari. If you are a breastfeeding mother, then you should not take this powder.


key: Patient
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Hello doctor, I am a 34-year-old female ophthalmologist. I have a single gallstone which is 10 mm in size that was noticed incidentally in ultrasound. Is it necessary to undergo cholecystectomy before planning my second pregnancy? I had nonspecific episodes of abdominal pain in the last two years which were not typical of gallbladder pain because the pain was more located in the center and lower abdomen. But the intensity of the pain was severe and was associated with nausea, and vomiting which relieved only after taking intramuscular painkillers.


key: chroma:document
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Hello. I have gone through your case and reports (attachment removed to protect patient identity). This looks like a symptomatic uncomplicated gallbladder stones. Even though you say that the symptoms have not been typical of biliary colic but the repeated episodes of pain, need for parenteral analgesics, and no other attributable cause leads to consider gallbladder stones as the cause for your pain. Without surgery, there is 50 % chance of recurrent pain episodes per year, 2 % chance of biliary complications per year, and 30 % will have no further pain if there was only one episode of biliary pain previously. The best option in this situation is laparoscopic cholecystectomy especially if you are planning a pregnancy. Since during pregnancy, the risk of recurrent pain and complications are higher. The other issue is that risk of surgery in the first and third trimester is significantly higher with the preferable period for surgery in pregnancy being the second trimester. You can consider medical dissolution therapy of gallstones but the efficacy is 30 to 49 %. And this is mainly based on the unimpaired motor activity of gallbladder, which has to be assessed before therapy (only with good motor activity of gallbladder the efficacy of 30 to 49 % can be predicted). The best option in your case is laparoscopic cholecystectomy.


key: Patient
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Lower back pain unable to put pressure on legs to walk. 3 weeks ago I was lifting my dog into the car. I got a sharp pain in my lower back..went away in about two days. Today I was lifting my two year old into an inflatable tube, While setting her down I had the same pain but on the mid right side of my back. This pain continued all day. Then while bending down to get a dish out of the dishwasher I got a horrible pain in my lower back. The pain knocked me to the ground. My husband had to help me off the ground to the bed . Since then I have not been able to put pressure on my legs to walk without horrible pain.


key: chroma:document
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Hello, You need to be examined to determine if this is a back strain or a sciatica from a pinched nerve. Is there any numbness in the leg, does the leg feel weak apart from the pain you feel while trying to walk, can you control your bladder well ,does the pain worsen upon straining ? If the answer to the questions is yes then you have a disc prolapse and you will need to see a doctor and perhaps a MRI too. In three mentioned to need to take anti-inflammatory tablets and muscle relaxant top help with the muscle spasm and apply Ice to the sore area on the back, rest in bed but not absolute such that you walk as much as to feel comfortable


key: Patient
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Hello Doctor, I recently consulted a counsellor suggested by my probation officer and discovered that I have extreme post-traumatic stress disorder, anxiety, and depression, etc. I wonder if any of this could be related to the trouble I have got myself into. When I get very overwhelmed with emotion or stress, I tend to black out completely but still functioning, and I come back to normal after a few minutes, but I have no memory of what I have done during those minutes. In my whole life, I had a lot of bad things that have happened to me and my family, but I have never dealt with them. This past year a lot of bad personal situations have happened, and now I am starting to notice the blackouts. What can I do?


key: chroma:document
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Hello. You should get yourself investigated for the blackouts and memory problems you face. First, you should consult a neurologist for that. Once every other neurological issue are cleared, then only we can diagnose whether it as related to your anxiety, depression or PTSD (post-traumatic stress disorder) if so then it is psychogenic. In most cases, a psychogenic blackout is an involuntary reaction of the brain to pressure or distress. Psychogenic blackouts sometimes develop after people have experienced ill-treatment or trauma and such conditions are treatable and curable. But we need to identify the severity of anxiety and PTSD and then the treatment slowly starts with medicines, psychotherapy and relaxation therapy. You can be cured completely, but it takes some time. Consult a psychologist or psychiatrist. Take care.


key: Patient
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Hello doctor, A few months ago I had a right side upper molar issue. I went to a clinic and was given an antibiotic, but it did not help. I went to the clinic after some days, and I asked for Clindamycin and still there was no result. The dentist tapped on the tooth, and there was no pain. He surmised it as chronic sinusitis. I purchased a lavage apparatus and all kinds of nasal sprays. The pain was really bad because I thought it might be a viral infection. I used Tylenol after reading how to deal with the pain. Though I know that Tylenol is not the correct drug for my pain, it worked for some time. Now I get unbearable pain (burning sensation) above the molar on both sides. I started using Tylenol many times a day. I am not addicted to it but thought of getting relieved from pain for at least six hours. Kindly advice.


key: chroma:document
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Hello. You need to get a professional evaluation because your symptoms may lead to septal perforation, nasal bleeding and permanent loss of sense of smell. I would advise going for nasal endoscopy if you were to do that then follow it up if needed with a CT scan of nose and sinuses. If there is any sign of infection go for a sample culture sensitivity and take the most appropriate antibiotic after the culture sensitivity report comes from the microbiology lab which usually takes three days. If there are no signs of infection, you can have some nasal saline douching with steroid nasal sprays and nasal anti-inflammatory steroidal sprays.


key: Patient
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Hello doctor, My mother is 59-years-old and has mitral stenosis. CMV was done 35 years back. Now recently she had a heartbeat of 150 and atrial flutter, and she was on Acitrom previously. She has undergone DC cardioversion shock. Now latest ECG shows atrial ectopic and her heart rate is 70 to 80. Can she undergo operation soon? If yes, which valve would be best for her biological or mechanical? Which is the best and latest generation biological valve in the world market?


key: chroma:document
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Hello. Yes, she is now a candidate for mitral valve replacement. However, you should make a note that valve replacement is not a complete solution. Firstly, at this age, a mechanical valve is better considering the durability of the valve. Bileaflet valve is the preferred one. Next, she has to be on regular blood thinners. Otherwise, there is a risk of valve dysfunction which may lead to a repeat surgery if blood is not adequately thinned.  Also, this heartbeat problem may not go even after valve replacement and has to be controlled on medicines. Even now she should be on beta blockers like Metoprolol, then Diltiazem to keep heart rate controlled, which are quite effective. I hope this helps you and get back if you have any doubts.


key: Patient
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Hi doctor, I am having problem of acute flaky dandruff and also itching in my hair. I have tried Topisal, Nizral and various other shampoos as well. However, there is no respite from dandruff. Please suggest me some good mediation as well as shampoo and oil. Currently I am under sugar and BP medication. My height is 5'6' and my weight is 80 kg.


key: chroma:document
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Hi. I have gone through your complaints. You should start with shampoo containing Salicylic acid and Ketoconazole. Use it every alternate day in the beginning. Once you notice improvement gradually taper it to twice weekly and then once weekly. Along with this apply, Clotrimazole and Betamethasone combination lotion on the affected areas of the scalp twice daily. I also recommend you to take tablet Ketoconazole 200 mg once daily in the morning and tablet Levocetirizine 5 mg at bedtime. Continue this treatment for two weeks and revert back. 1. Immune factors 2. Hormonal factors 3. Fungal infection Seborrheic dermatitis. Avoid oiling of scalp as it will increase your dandruff.


key: Patient
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Hello doctor, My query is about my sister. She is a 31 year old female who is unmarried. Her height is 5 feet and she weighs 55 kg. She is suffering from huge uterine fibroid measuring 140 x 83 mm arising from the right fundus of the uterus. I would like to know what are the best treatment options available? Can natural treatments be tried upon? We have tried ayurveda, which helped only in shrinking bulky uterus but not fibroid. How serious is this condition? She is pale and underweight. Will surgery cause difficulties? Please guide.


key: chroma:document
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Hello. As this is a subserosal fibroid, she is unmarried, the remaining uterus is bulky but endometrial lining is normal and there are no other intramural fibroid detected, the best form of removal for this large fibroid would be through a laparoscopic approach. A laparoscopic myomectomy can be performed through 3 hole technique and the fibroid can be removed with the help of a morcellator by slicing it into pieces before removal through the port entry puncture hole.


key: Patient
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Hi doctor, I had high hs-CRP of 3.86 around 8 months back. I have got it rechecked and it has gone even higher to 5.36. I have attached the reports of blood test done a couple of days back. This blood test report includes other tests too apart from hs-CRP. I have previously been advised that high lipoprotein and hs-CRP can cause cardio related issues. How do I get the hs-CRP back into range? And do I need to go for further checkup to find the actual cause of inflammation? I have no other medical condition except lower back pain. Please suggest.


key: chroma:document
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Hello. I understand your concern regarding the raised hs-CRP (high-sensitivity C-reactive protein) and lipoprotein levels (attachment removed to protect patient identity). These biomarkers are predictors of future events. They tell you that there is an inflammatory state that is going on and that will contribute to your blood vessels to the heart and brain possibly getting blocked. So, you need to take steps to prevent a heart attack in the future. They have done a study called JUPITER (Justification for the Use of Statins in Prevention : an Intervention Trial Evaluating Rosuvastatin) where they used an anti-cholesterol medicine called Rosuvastatin 20 mg for patients like you with a raised CRP and normal cholesterol levels. They have found it causes a 50% reduction in future heart attacks. You may benefit by taking tablet Rosuvas (Rosuvastatin) or Rozat 10 mg once daily for at least 2 years. This will prevent heart attacks, stroke and bring down your hs-CRP levels. But you need to also know that there is a very small risk of new onset diabetes for patients taking this drug. Second you need to change your lifestyle. You need to lose weight. Just going on medications is not the answer to these diseases. You need to get yourself a personal trainer in a gym and work with him to lose weight. You may also consult a dietitian to reduce your calories. Is there any family history of heart disease? If you smoke, you need to quit smoking at the earliest.


key: Patient
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Hello doctor, I was diagnosed with ADHD. I was on Ritalin from 9 years to 14. I am 30 years old now and feel like I need some help. I have started retaking Concerta last year as it improves my concentration but also makes me even more hypersexual. I have a major problem with being over sexual to the extent that I would harm myself for gratification. I want to be humiliated and struggle with what is called small penis humiliation. I have never harmed others, but I am afraid that I will make myself into risk by doing self-harming and repeating it for the needs. I want to stop it, so I tried lowering my testosterone, but it just comes back occasionally. And it masks the problem that there must be something wrong in my brain.


key: chroma:document
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Hello. If you think that your sexual need is increased by Concerta (Methylphenidate), I have a few advice for you, which you should discuss with your psychiatrist. 1. Can he slightly decrease the dose? Till your symptoms of ADHD (attention-deficit hyperactivity disorder) does not flare-up. 2. Add some second-generation antipsychotic like Risperidone which ultimately increases your prolactin level and decrease sexual urge. 3. Avoid porn and do not watch such type of videos. 4. Relaxation technique like yoga, meditation, and mild exercise may also help you. Avoid junk foods and take healthy foods. Have proper sleep.


key: Patient
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Hello doctor, I have a white scab on the inside of my right nostril. It has been there for over a week now. It is very irritating and it hurts when I touch it. I am coughing up alot of green mucus. I was given Amoxicillin for pharyngitis a week ago and thought that would have killed any bacteria that I had.


key: chroma:document
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Hello. As per what you say, you have a white scab in your nose. It can be due to viral or allergic rhinitis. You have taken Amoxicillin for pharyngitis. So no need to take any antibiotics now. Just clean your nose with salt water 2 to 3 times a day, the scab will get loosened and will drop off. Do not try to remove it with force. Otherwise, it will bleed. Even after using a saline wash, it is not getting removed, take help of ENT doctor. He will also prescribe you medicines for rhinitis also. Though it not a serious problem you should consult ENT doctor. Allergy, viral infection. Rhinitis. Saline nose wash.


key: Patient
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Hello doctor, I am 18-years-old. I am 52 kg in weight. My problem is I am not defecating in the morning, but I am urged to defecate after some time. The stomach does not become clean. And I also have metal allergies. The other problem is nausea and vomiting while traveling.


key: chroma:document
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Hello. Please take warm milk with excess sugar daily at bedtime and along with it two spoons of Duphalac (Lactulose) syrup every day for a week. Eat a lot of fresh vegetables during the day and drink a lot of water. You may also eat papaya every day that is very good at clearing the stomach. Regarding your second query, you have a tendency of nausea when you travel. Many people also have this problem. You can chew a candy or a mouth freshener when you travel. Do deep breathing when you feel like vomiting. Eat light, and your tummy should not be full while traveling. You may also take an antiacid before traveling.


key: Patient
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Hello doctor, I am a 55-year-old male. Ever since I can remember I have been able to retract my foreskin fully, all the way to the base of my penis. I have always had a problem with the phimotic ring once it passes the head of my penis it is very, tight around the shaft of the penis which can be somewhat painful when the penis is fully erect. Is there any way to treat the phimotic ring to make it less rigid and more elastic? So, when it is around the girth of the shaft, it is not too tight.


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Hello. By your description, it is clear that you have phimosis along with tight frenulum, which causes the pain during erection and difficulty in retracting the foreskin. It can be easily treated by circumcision, which is a day care procedure. However, you need to undergo an evaluation to rule out diabetes, as phimosis is associated with diabetes and it needs to be treated by medication before surgery. At present, there is no medication to increase the elasticity of the foreskin. Phimosis with the tight frenulum. RBS (random blood sugar). Circumcision.


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Hello doctor, I have been having spotting during my past two cycles on an off for days on end. I am not sure if I should be concerned. I have stopped birth control for over one year, and I am trying to conceive from the past two months. I have had a couple of urinary tract infections during these cycles. I am worried that my hormones are out of balance.


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Hello. The presence of pinkish-brown spotting in the proliferative phase of your cycle does indicate that you are having inadequate endometrialization possibly due to decreased serum estradiol levels during the phase. Also if the spotting turns darkish brown in the second phase of the cycle, then the level of progesterone is also inadequate which can cause early spotting premises as well. It is suggested that you should get your hormonal profile for day-2 of cycle done and also take to sequential ultrasonographic follicular and endometrial thickness monitoring which would indicate the state of endometrialization due to estrogens and also the correct time of ovulation. This can be corrected by starting estradiol pills in the first half of the cycle followed by progesterone-only pills post ovulation, which shall prevent these bleeding episodes.


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Hello doctor, I had mucus from the throat, and it had minor blood in it. I went to the ER, and the blood pressure was 190/110. The doctors told the bleeding had to do with the blood pressure as the bleeding stopped as soon as blood pressure reducing pills were given orally. I had blood tests done today, and everything came out normal. Can high blood pressure be the reason for this bloody mucus from the throat? I am feeling very anxious about this. PTT tests were done, and they were normal as well. ECG and echo were done, and both were normal. I have attached the images of the reports.


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Hello. I have gone through all your reports you sent (attachment removed to protect patient identity) and they are normal. Regards. For more information consult an internal medicine physician online -->


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Hello doctor, I have chronic fungal ringworm infection in the groin region. Please suggest some Ayurveda medicine.


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Hi. Ringworm is a skin disease fungal infection. Mostly occurs in wetty areas. Its common symptoms are red skin rash that forms a ring-like structure. That is the area with itching and dryness. Infection of tinea group of fungus. Generally not recommended. Scabies. 1. Gandhaka Rasayana one tablet thrice a day after meals. 2. Sinduradi lep- Apply externally three times a day. Keep the affected area clean and dry. Wear cotton undergarments.


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Hello doctor, I tried Venlor XR 75 mg during the night and got very poor result for put me to sleep. I tried to take it only in the morning and that too resulted in me being very sleepy. Can I try Fluoxetine? Or any other alternative medicines like ayurveda? Can I take St.John's wort or 5-HTP? I would also like to know can Tofisopam be tried? If so, in what dosage do I need to take them? Can any combination among these provide good sleep only during nights and keep one fresh and active in the morning? Please guide.


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Hello. Rather opting for ayurveda measures or opting for St John's wart or 5HTP; you can add the following supportive measures. For further information consult a sleep medicine physician online -->


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Hi doctor, For about a month or so, I have been dealing with what I thought was hemorrhoids. I have used preparation H suppositories and some cream and they seem to help some. The pain starts after or during a bowel movement and there is blood on the toilet paper almost every time I wipe. Today, I decided to take a picture of it because it has not gotten any better and I am really scared it is something worse than hemorrhoids. Also, the irritated skin around my anus has some white spots.


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Hi doctor, I am a 24 year old lady and married. I have thyroid and irregular period sometimes. For thyroid, I am taking Eltroxin 75 mcg and I am in control. It has been two months since, I last got my period. We used condom while having sex. For three days, I had light cramps on and off in lower abdomen. Since two days, I am having nauseous feeling. Took a home pregnancy test and got negative result. Kindly suggest.


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Hello. Irregular periods are not only be associated with thyroid but few other conditions too. Check this time for your periods. Suppose, you are still not getting, but having nauseous feeling and vomiting sensation, then I would suggest you to get a beta-hCG test done to rule out pregnancy. Beta-hCG test is a blood test carried out that gives more confirmatory and accurate results even after home pregnancy test is found to be negative. No matter whether the results of beta-hCG is found to be positive or negative, I would recommend you to get an ultrasound of pelvis done. If the ultrasound scan shows negative result, we can rule out the possibility of polycystic ovary syndrome (PCOS). If the ultrasound scan turns out to be positive, we can know the pregnancy details. Medicine to get periods can be prescribed if pregnancy is ruled out. 1. Beta-hCG and 2. Ultrasound of pelvis. Follow up with reports to an obstetrician and gynaecologist physician online.--->


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Hello doctor, I had pain in my left ear and I went to an ENT specialist. He said that my ears are fine and there is no infection. He said that I have soreness in my TMJ joint as I have a tendency to sleep on my left side with my left arm tucked under the pillow. That puts pressure on my TMJ joint and the pain is radiating to my ear. He gave me a cream (Voveran) and a muscle relaxant (Etoshine MR). The pain has subsided, but I get a clicking or crackling sound in my ear sometimes when I am relaxed and doing nothing or sometimes when I swallow. Is the crackling because of the TMJ soreness? Will it go away on its own? There is no wax in my ear. My ears are cleaned.


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Hi doctor, I took thermogenic Phendimetrazine for two days. I am now experiencing shortness of breath and excessive yawning. I am also burping all the time. I stopped taking the medicine six days ago and, yet I am still gasping for breath and experiencing these side effects. My doctor did an EKG and it came back normal. I also want to know, will this go away? How long will it last? Could taking these medications for only two days cause permanent damage? Is this a normal side effect?


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Hi doctor, I am a 34 year old female. I have been itching all over for months and constantly covered with bruises, petechiae and livedo reticularis. I was diagnosed with erythromyalgia. I also have severe bone pain. My blood work came back with elevated RBC, Hb, Hct, low alkaline phosphate, low BUN and creatinine. My vitamin B12 levels are in 1000s and not under 200. The neurologist says that I have fibromyalgia and changed my seizure medicines for juvenile myoclonic epilepsy. Do I think that I should visit a hematologist and figure out why my bones hurt so badly in my legs and why I am so itchy? My current medication includes Oxycodone and Lamotrigine for epilepsy.


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Hi. Based on your query, my opinion is as follows: The elevated hemoglobin, red blood cell count and hematocrit signify polycythemia. Elevated Vitamin B12 level is one of the markers of myeloproliferative disorder. I would strongly think of polycythemia vera. Other values are within normal range (attachment removed to protect patient identity) suggest no renal or liver disorders. Increased hematocrit will slow down blood flow due to increased viscosity and this can cause few RBC to move out and lead to these symptoms. Even migraine, bone pain and increased itching can be attributed to sluggish blood flow. Polycythemia vera is a cancerous condition and requires evaluation. I would strongly urge you to meet hematologist. Hope there are no other causes of polycythemia like lung disorders or staying in hilly regions, etc. With high vitamin B12 and polycythemia, polycythemia vera needs to be seriously evaluated. For further information consult a hematologist online -->


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Hello doctor, I have fungal infection in groins and underarms. My doctor suggested me to use Hh Zole and Clocip. After using Hh Zole cream alone I got better result. But, my doctor suggested me to continue with Clocip cream. Why should not I continue with Hh Zole? Please explain.


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Hello doctor, I am 12 weeks pregnant. My doctor has prescribed me tablet Moxclav 625 antibiotic for cough and infection. I also take progesterone tablet. Are these tablets safe for my baby? Please advice.


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Hello. Ideally, till 14 weeks of pregnancy, no antibiotics are prescribed. Symptomatic and natural methods of management of cough and sore throat (if present) are advised. This is because these are the organ forming weeks for the fetus and hence all antibiotics are usually avoided as a safety precaution. But if the infection has increased and the situation is such that fever is continuous with a bad sore throat, yellow sputum and cough, then pregnancy-safe antibiotics like Amoxicillin alone without Clavulanic acid combination is considered safe before 14 weeks. Another antibiotic being Azithromycin 500 mg single dose daily can be taken for 5 days safely. Progesterone, on the other hand, is an absolutely safe medication and given during the first trimester to support the pregnancy in the form of adequate placentation into the uterus and sufficient trophoblastic invasion into the endometrium for better uteroplacental flow. So, progesterone at this stage is absolutely safe.  However, it is advised that before using antibiotics you may try warm saline gargles thrice a day and steam inhalation twice a day accompanied with adequate hydration as symptomatic management. If this fails, you can then resort to antibiotics.


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Hello doctor, I am 30 years old. I observed something on the penis. It is like it burns and is red in color. I do not have any pain and itching. I started applying Clobesym-OZ cream. Now it seems some transparent shiny skin developing on it and also other parts of skin around it started becoming shiny and scaly. I have uploaded the image. I do not have any pain and itching. My blood sugar is normal. Please tell what it is, seriousness, remedy and how long will it take to improve?


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Hi. I have seen the image (attachment removed to protect patient identity). Clobesym (Miconazole) is a potent steroid based cream and whatever you are noticing now are the side effects of steroid usage. For more information consult a dermatologist online -->


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Hello doctor, I am a 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just slight urethra burning. I went to a urologist. He told me nothing was wrong, maybe an overactive bladder. I go to the toilet every two hours or three. I never knew what was wrong, but I started to obsess over it and it got worse to a place that my mind is in urination 24/7. I almost gave up until I went on a vacation and during that vacation, I forgot about it totally. The frequency was gone and even the burning urethra. Also, I had to remove my wisdom teeth and when I did, I was so occupied thinking about it that I forgot about urination and I noticed that I do not use the bathroom like I used to. But, I got back obsessing about it again and it got to a point that I urinate a lot of high volumes every hour. It comes suddenly and goes on its own. I use to get those episodes every few months when I had stress but since I got the fear it might never go away I get it almost daily now. I do not know what to do. Can anxiety cause polyuria like this clear urine when I am stressed?


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Hello. I read your query and understand your concerns. First of all, I like to state that the stress and anxiety can affect almost every organ of the body and polyuria is not an exception. In other words, yes the stress can cause almost all the symptoms narrated in your query. Secondly, I would like to assure you that this is only stress and nothing more. The statement is based on the following facts: I hope this answers you. For more information consult an andrologist online -->


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Hi doctor, My 5 months old baby has pretty bad eczema. Just recently, he had a bad flare-up in which he was weeping from both legs, arms, hands and cheeks. For 80% of the day he is suffering with rash and seems to have no relief at all. He scratches and cries continuously throughout the day and wakes up in his sleep. None of the remedies we tried have produced relief such as wet wraps, bleach baths, ointments, eczema creams, cortisone, etc. Is there a product that is good and available OTC? Would he need something prescription based? Could it possibly be something in the environment that is causing the flare-up like dust? His mother has altered her diet to accommodate him accordingly. Is weeping a sign of infection?


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Hi. This is atopic dermatitis. It has many causes. Most common is due to allergy to various dietary protein or external stimuli. We need to elicit the history properly and need to do investigations to delineate the cause. First we will do basic investigation then we will proceed according to the reports. My advice is as follows: We may need systemic steroid to control this intractable eczema. But, first we need to do basic investigations. Please get the following investigations. Complete blood count, liver function test (AST (aspartate transaminase), ALT (alanine transaminase), bile and protein), ESR (erythrocyte sedimentation rate), platelet size and IgE level (immunoglobulin E). Revert back with the investigation reports to a pediatric allergy asthma specialist online -->


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Hi doctor, I had a blood work on my liver. The results came back saying that my ALT and AST are very high and out of range. So, I would like to know what that exactly means. When I received my laboratory test report they said that I should seek medical advice. My AST is 75 and ALT is 35. My MCV 116 and MCH 39.2. Also, I am a heavy drinker. Please explain the report.


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Hi. Based on your query, my opinion is as follows: Alcohol induced liver damage has caused increased enzyme levels. Possibly early stages, as no jaundice is seen. MCV high (mean corpuscular volume) is due to associated vitamin B12 and folic acid deficiency. Malnutrition due to alcohol abuse has caused this. Need to abstain from alcohol on an immediate basis as liver would take another six months to possibly recover. Repeat the test after three months. Also start Vitamin B12 and Folic acid supplements. Nothing major for now. If it progresses then may require liver transplant in next few years. For further information consult a hematologist online -->


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Hi doctor, I am 24 years old. I had pearly papules on my glans penis a long time ago. I got them removed three months ago by a dermatologist with CO2 laser. Now, bottom of the glans penis is very dark purple in color. I have tried to put some gels on it, but had no success with that. I will attach the picture of my glans. Is this normal? Please tell me your professional opinion.


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Hi. I have gone through the attached picture and provided details (attachment removed to protect patient identity). For further information consult a urologist online -->


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Hello doctor, I am a 44-year-old female. After my three miscarriages, I am 13 weeks pregnant now with IVF treatment. I have got my NT scan with double marker blood test. The results are as follows: Biochemical Trisomy 22 risk: 1:249, combined Trisomy 21 risk. Using NT & Other parameters: 1:946. Trisomy 18 risk using NT: 1:10000. PAPP-A: 4.97 mIU/mL and Fb- HCG: 30.9 ng/mL. Crown Rump length: 70.3 mm, Nuchal Translucency MoM : 0.99, Nasal Bone: Present, Nuchal Translucency: 1.74 mm Is my report fine? I am really worried.


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Hello. The NT (nuchal translucency) scan levels of nuchal translucency are normal with NT < 2.5 mm. However biochemical trisomy 21 risk is high but the combined NT+ biochemical risk is low at 1:946. You may upload the picture of the cutoff graph for a convincing opinion regarding whether you would need amniocentesis for karyotyping confirmation or not. For more information consult an obstetrician and gynaecologist online -->


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Hi doctor, My husband's eye got hurt with my finger accidentally. Now his eye hurts and can barely open. There is a red spot on the white area of his eye. What do we do? Please help.


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Hi. Your finger might have hit the eyeball blood vessels. These vessels can bleed due to trauma and can cause a subconjunctival hemorrhage (bleeding behind the conjunctiva thereby causing a red eye). This does not cause any major problems and resolves on its own in a week. Other possibilities for not opening the eye can be an injury to the cornea, which can have an epithelial defect. This causes a lot of pain and watering, and he may not be able to open his eyes due to pain. For this, he has to use antibiotic eye drops, and artificial tear drops to prevent infection and pain. There can be a possibility of orbital edema which can also cause difficulty in opening eyes. This will resolve in a week; just give cold compress. Please attach pictures of the affected eye for a detailed evaluation and diagnosis.


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Hi doctor, I have steroid induced rosacea. In my childhood I was prescribed Elocon and ever since I have been using the same for my entire skin problem. Hence, if I did not use then my skin starts reacting with itchiness, redness and flushing. I am having this problem for than 10 years. Also, I am allergic to dust. I want to get rid of Elocon without any oral medicine. Please help.


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Hello doctor, I am suffering from NAFLD for the last six months. Now, I am having RUQ heaviness, back pain and flatulence for the last three months. I had several tests and I have given the details below with the findings. USG of whole abdomen - hepatomegaly with fatty liver, fibroscan - 3.2 kPa median value, upper GI endoscopy - GERD grade A and small hiatus hernia, hepatitis B non-reactive, hepatitis C non-reactive, FBS - 94 mg per 100 mL, lipid profile completely normal, liver function test - indirect bilirubin elevated 1.3 mg per 100 mL and others are normal.My doctor advised me to avoid oily and spicy food. Also, prescribed two medicines named Sompraz D 40 and Liv 52 DS. I have lost 9 kg weight in the last four months. Now, my weight is 75 kg and Height is 175 cm. My age is 30 years. Actually, I am having a constant RUQ discomfort and right-sided back pain for the last four weeks. I had the same fine before some time and it recurred again. Also, sometimes I felt tiredness and dizziness. All the reports, which I had shared, are all the recent ones that are taken before seven days. How to recover faster from this situation? Is it dangerous? Also, Please let me know about a perfect diet for me to recover faster.


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


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Hello doctor,I am a 26 year old female. At the beginning of this year, I had a bad cold, and two weeks later, I had a tingling in the wrists, feet, and legs, which the doctor said was reactive arthritis which lasted a few weeks. Then, the first time my left hand felt weak was five months back. It felt weak, more so at rest but, when I had to grip things, I was able to. I went to a physio and had a neck massage as my back was also tense and the next day, the weakness was gone. So, the massage helped it. Now, more recently, I had foot weakness on the left side and a weakness and very mild tingling in hand. Again, my back is very tense and tight from gym and work position. As soon as I get this, I get very anxious, and I feel the tingling gets worse. The only difference in daily activities is lifting weights at the gym, weighted squats, and heavier arm exercises. I used the foam roller on my foot last night, and today the foot weakness was gone. The foot weakness lasted 12 hours on and off. There are no problems walking or anything like that. It just felt weaker but, it was not. The weakness always comes randomly but, I do seem to always have a tight back when the weakness occurs as well. Could this be MS? Does it sound like it? I am extremely worried now. I have never been diagnosed with it. I have just read about it online. What could this be from? I went to the opticians last week, and my eyes were fine. There were no eye symptoms. It was just a standard check-up. My eyes were said to be perfect. I do not have any bladder or bowel symptoms and no other weakness anywhere else.


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Hi doctor, I am an 18 year old boy. Last year, I made a very best friend. He was like my second half. He used to share each and everything with me. A few months back, I saw him with his ex-girlfriend, and they were in a relationship now. He never told me that. She lives near my home, and my friend always drops her to her home, but whenever I asked him to come to my place he used to tell that it is too far away. Then we had a major fight without any violence, and we both stopped talking. Then I started realizing that I like him so much. I miss him as he used to hold my hand in public places always. I started remaining sad the whole day. I was depressed, and I tried to commit suicide. After that, it is like at sometimes during the night I express all my warm feelings with anyone on chat, and after a few minutes, I regret it. I feel like there are two persons inside me. First I thought that it is split personality, but I do not have memory loss. Please help me. What should I do? I hate his girlfriend. But, I am not sure whether I love my friend or not. Sometimes, I feel like I love him and after a few minutes, it is like just friendship. Am I gay? But, but I have a crush on girls also. I think I am attracted to both boys and girls. I am totally confused. Please help me.


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Hi. I can understand your problem. This is completely normal at the age of 18 years. You like your friend as a friend and not as a partner. He was very close to you, but it does not mean you are gay. This is a very common feeling at your age. At this age, we can get attracted towards both the sexes, but this feeling is temporary. As your friend is in a relationship with a girl, it is evident that he will less interact with you. So do not get hurt. You should respect your friendship and his decision. Presently you are irritable because of depression, and you miss your relationship. You have suicidal ideation. To avoid this situation get involved yourself in some outdoor games and other hobbies. Make new friends, interact socially and stop negative thinking. If this thought sustains, then you can visit a local psychiatrist for treatment with medicines. But, do not worry. You will be fine. For further information consult a psychiatrist online -->


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Hi doctor, A 44 year old woman, suddenly felt uneasiness and weakness. Her BP was measured and the reading was 141/96. She weighs 55 kg, non-diabetic, no previous history of dyslipidemia and she is quite active. What investigations should be done immediately? And how to proceed?


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Hello. Well, a single episode with the symptoms of uneasiness and weakness is most of the times nonspecific or due to a mild anxiety attack. If such is the case you should not be worried about it. But, if such episodes are frequent and comes repeatedly, then definitely it should be thoroughly investigated. Though her BP (blood pressure) is slightly on the higher side, it is not as high as to cause sudden onset and prolonged uneasiness. To be on the safer side, I would like to suggest her very mild antihypertensive and anxiolytic for a short duration. But before that, I would like you to get few investigations done on empty stomach and let me know the reports. Another important factor to consider for her is that it may also be related to menopause, which can lead to hormonal disturbances, anxiety, uneasiness, hot flushes, mood disturbances and intolerance to mild/moderate heat and cold. So, kindly let me know about any recent changes in her menstrual cycles, so that I can evaluate that aspect too. Revert back with the investigation reports to a general medicine physician online -->


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Hello doctor, I am suffering from loose motions since last three days. I have visited a doctor. He advised me Oflox 200, Entroquinol and Deulac forte for three days. I have taken the medicines as prescribed until today but even then they have not reduced. I am traveling, so it is difficult for me. Kindly suggest the course of action.


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Hello. Since there is no response, you need to change the medicines. You should have Oflox OZ (Ofloxacin and Ornidazole) 200 mg or 500 mg twice a day for five days along with tablet Pantoprazole 40 mg before breakfast for five days. Also, for symptomatic relief, you should have tablet Racecadotril (Redotil) 100 mg up to three times till stools stop. This will reduce stool frequency and output but need to continue above mentioned antibiotics for five days. More importantly, you need to have plenty of water and ORS (oral rehydration solution) 100 to 200 ml with each stool output. For more information consult a general medicine physician online -->


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Hello doctor, I will be facing major surgery for stage three lung cancer contained in the left lobe. I am extremely allergic to Fentanyl, Propofol, and Versed. Are there any alternatives to these anesthetics? I am currently on Synthroid.


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Hello. If you are allergic to these agents, I suggest you undergo a detailed allergy test with various agents so that you will be able to know which agents are safer for you. There are so many agents and techniques available nowadays in the field of anesthesia. If you are allergic to Propofol, Thiopentone (Sodium Thiopental) or Etomidate is a safer option. For analgesia, the multimodal technique will be a safer option including regional anesthesia, various blocks, NSAIDS, etc. Versed (Midazolam) can be avoided at all during surgery. So my suggestion to you is to inform your anesthetist about this and leave your worries on him.


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Hello doctor, I am a 39-year-old male with a history of hypertension. My BP medication was changed for the past six months and doctor put me on Metosartan 50, and Amlodipine 5 mg. For four to five weeks, my ankle joints are swollen. I went to an orthopedic, and he asked for a venous Doppler lower limb. Other results CRP, vitamin B12, ANA, uric acid, are normal. ESR is 20. There are remarks in venous Doppler, and he suggested for a physician opinion. I am attaching the Doppler report. Please give your opinion.


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Hello. I have gone through your Doppler report (attachment removed to protect patient identity). Before making the diagnosis, I want a few things pertaining to your problem, like your complaining of swelling of both ankles joints like on and off. 1. Do you have a fever with regards to swelling? 2. Do you have any history of injury? 3. Whether the swelling is continuous or is there any joint pains? 4. It is better if you can attach your picture of ankle joint. And do you a history of varicose veins? From the above Doppler, I can make an inconclusive diagnosis. Bilateral inguinal lymph node signifies infection that can be treated with proper antibiotics. And another one with prominent perforators of GSV (great saphenous vein) as it means initial stages of developing varicose veins might eventually lead to swelling of the leg.


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Hello doctor, I am a 20-year-old female. I had my last periods, last month for four days. I had unprotected intercourse on the next day after my periods. But he did not cum inside (not sure about precum). Next month I found some white sticky thing outside my vagina, and there was white discharge (only drops) for two days. My periods were four days late. From the past four days, I am having lower back ache, lower abdominal pain (sometimes cramps), and leg pain. I had done a home pregnancy test yesterday (which is two days after a missed period), and the test was negative. Is there anything to worry about?


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Hello. No, there is nothing to worry about. That was a usual vaginal discharge which usually increases during mid-cycle due to estrogen surge in the body. It is a normal phenomenon. I would advise you to get a regular birth control method for your peace of mind.


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Hello doctor, Yesterday while preparing food, a spoon full of hot oil splashed on my hand. Small blisters started popping up, and it started getting more significant. By today morning, the skin around the blisters has become black. I applied ice and cold water and also one over-the-counter cream. Please find attached the picture of the burn. Should I keep applying ice or should I do anything more to expedite the healing? Is it healing as it is supposed to be?


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Hello. I have seen your query and examined your given picture (attachment removed to protect patient identity). It seems you have developed superficial burn.Take injection Tetanus and use Silverex ointment (Silver Nitrate) local application twice daily for one week after consulting your general physician or nearby dermatologist.


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Hello doctor, My father is 48 years old. He is suffering from pleural effusion and TB for the last two months. DOTS treatment is going on. I want to know what foods should he take and what should he avoid?


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Hello. Good your father is under treatment, continue without any break, that is the most important thing. Diet also plays a vital role in TB treatment. Consume fruits, and vegetables like orange, mango, sweet pumpkin, carrots, guava, amla, tomato, nuts, and seeds are an excellent source of Vitamin A, C and E. Protein-rich foods, and foods rich in B complex Vitamins should be taken. Ask him to have a boiled egg daily. He needs more protein because they aspirate effusion fluid from the chest, that is rich in protein. So there will be protein loss. To compensate add more protein-rich food.


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Hello doctor,My wife is pregnant. Her hb level is 8.7 and delivery due date is 4th may. The doctor suggested blood transfusion. Is it necessary?


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Hello. Yes, it is extremely necessary to transfuse her blood otherwise you may pur her life on risk during delivery. Kindly do not delay in making this decision as delivery may occur any time now because she has already completed her term. Low Hb may cause heavy bleeding during childbirth which if become uncontrolled may even lead to death.


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Hello doctor, We have started seeing thyroid in my wife after her delivery before three months. We can see a mild swelling in her throat. After thyroid test we came to know that values were not in range, all have exceeded too much. We are afraid and do not know what will happen. Please find attached test reports and please suggest how much she has impacted and how this can be treated. This is the second baby. Before five years after first baby birth, we saw the same in her throat, and it went away after the observation by a physician and some medicine, in around three months last time. Now we see again but with high range. Currently taking Calcium and Iron tables as suggested by doctor after baby birth.


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Hello. I saw her reports, and it appears that she has postpartum thyroiditis. She can start tablet Carbimazole (Neo-Mercazole) 5 mg twice daily for four weeks and then repeat her thyroid function test to adjust her dose further. I hope you find my advice beneficial.


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Hello doctor, I have OCD for past seven years. My OCD is triggered only during my exams. Last year, I took Prodep 20 mg one month before exams and then stopped. I have my exams coming up next month. I have OCD attack, not able to concentrate on studies. Is it alright to use Prodep 20 mg for one month? I read online that it causes many side effects like loss of libido and erectile dysfunction.


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Hello. Prodep (Fluoxetine) can be used in OCD and yes it has some side effects as you mentioned but not all the persons taking it suffer from these side effects. And, these are not permanent side effects and remits when you stop the drug. Secondly, it is advisable that you take these drugs only after consulting your psychiatrist, as these are prescription only drugs. Also, this drug is not used for as and when required basis. This may need to be taken for a long period. Hope this helps you. Thanks and regards. For more information consult a psychiatrist online -->


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Hello doctor, My 2-year-old daughter had been eaten up by mosquitoes, and those areas are red, bumpy, and some have red rings around them. These bumps are itchy to her, and they look infected. Does that mean she is allergic and what can I do to help her?


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Hello. This is the normal reaction to mosquito bites. Please wash with soap and water and apply Cortisone cream (Hydrocortisone) two times a day for three to five days. You can also give about 2 ml of Benadryl (Diphenhydramine HCl) once a day as needed for itching. Please use full sleeve shirt and pants when moving outside. You can also use insect repellant lotion to prevent mosquito bites next time. If the rash does not get better in five days or gets worse, please see a primary doctor for evaluation. Mosquito bite.


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Hello doctor, My daughter has small boils at the back of her neck for the past eight days, and it seems to be getting worst. Her major allergies are milk, peanut, and egg. Semi allergies are wheat, soy, and beef. When we first noticed, we started to apply Hydrocortisone, but it seems to be getting worst. We took her to the child doctor and he said switch to antibiotic cream, but today we notice fine boil around the bigger spot and the toddler complaining of burning feeling and crying.


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Hello. I have gone through your case in detail (attachment removed to protect patient identity). In my opinion, your daughter got some insect bite reaction as in pictures all pinpoint boils are in curved fashion as most commonly seen when any bug or insect crawl bite on skin. It has some peculiar foot prints. Hydrocortisone is considered a good cream in such type of reactions as it controls itching. But sometimes it exacerbates infection while it controls burning. I would recommend you to mix Hydrocortisone cream with Fucidin cream (Fusidic acid) in an equal amount and apply twice daily for seven days. Do not use any cream alone. Give antiallergy syrup like Cetirizine half teaspoon once at night. No specific test is usually required in such cases.


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Hello doctor, Over the last three days, the tip of my penis has become very tight and looks swollen. It is difficult to retract the foreskin and also there was blood after masturbation. This issue started when I used antibiotics for chest infection. Currently I am taking Prednisone for chronic hives and antibiotics for the chest infection.


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Hello. It seems like posthitis or inflammation of foreskin leading to phimosis. This may require a circumcision sooner or later. Consult your family doctor for this, and he may refer you to a concerned specialist. It is a short day care procedure. Take care.


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Hello doctor, I need a multivitamin supplement and digestive enzymes to regain bone, ligaments, and tendons weakened by digestive issues. Malabsorption of essential nutrients due to digestive conditions like chronic atopic gastritis resulted in bone loss, osteoporosis, low stomach acid, and joint weakness like ligaments of knee, etc. I need supplements that do not depend on stomach acid.


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Hello. After going through your query and detailed report I suggest to calm your gut first which in turn helps to increase absorption of vitamin and calcium and start with L- glutamine supplement 5g capsule daily preferably before going to bed or at least an hour before meals. Later you can opt for multivitamin supplements with good food intake. Along with that follow these tips. 1. Increase high protein diet, including almonds, vegetables, fish, chicken, and eggs. 2. Do muscle strength exercises if allowed by ortho. 3. Increase fluid intake. 4. Do rest for 8-9 hours of sleep. 5. Manage stress with meditation. 6. Do breathing exercises. 7. Manage to follow small frequent meals. 8. Do take 2500 kcal diet. If required you need to add supplement (whey protein) L-Glutamine.


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Hello doctor, I am married it has been one and a half year of my marriage. It was an arranged marriage, so we took the time to understand each other before making love we took five months, and we did not do it. But after five months period, he tried for one year and could not make it. He can only ejaculate for some seconds. Is this because after marriage we took five months and so he is not able to make it now?


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Hello. It is not because of the five-month gap. He might be suffering from premature ejaculation disorder. Why did you wait for five months? Does your husband have any bad previous sexual experience? If he had a failed sexual intercourse, he will try to avoid it, because he thinks it is going to be a failure again. And he woulod be afraid of getting humiliated infront of you. So he thinks it is better not to have sex. On management part, first try to relax him, and make him understand that you love him even without sex. Now start working on a treatment. 1. SSRI (selective serotonin reuptake inhibitor) antidepressants and Clomipramine. 2. Anesthetic spray on glans penis before sex (only a few studies support it). 3. Weak pelvic floor muscles sometimes contribute to it. Kegel exercises may help strengthen them. Wear a condom as it may desensitize him. Some men find that masturbating a few hours before sex helps them stay in control during intercourse.


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Hello doctor, I am 22 years old. My height is 165 cm and weight 67 kg. I have receding hairline and hair fall, for a year. I am not under any medication. Kindly advice.


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Hello. I read your query and saw the attached files (attachment removed to protect patient identity). There can be many causes behind this kind of hair fall like genetic cause, nutritional deficiency or improper lifestyle, etc. If it is due to a genetic cause, then it will be hard to control with medicine. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Follow-up after two weeks. 1. Mahabhringraj oil for local application. Apply it on every alternate day and wash your hairs with mild herbal shampoo. 2. Take tablet Asthiposhak two tablets two times a day with water after food for two weeks. Take healthy and fresh food. I hope you understand my point. For more queries, you can consult me.


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Hello doctor, I have a 6-year-old child. She has flatulence, digestion problem, and stomachache after eating. Today, her stool was like mucus. Please suggest some medicines. Currently she is on Neopeptine.


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Hello. I understand your concern. Please do not give milk products for the time being. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Syrup Rantac 5 ml (Ranitidine) twice a day for five days. 2. Econorm sachets (Saccharomyces Boulardii) 1 sachet twice a day for three days. 3. ORS (oral rehydration solution) as much as she wants. If she develops fever, foul-smelling stool or blood in stool or tummy pain, then please consult a pediatrician as soon as possible. She may require to start antibiotics. Food. Stool routine SOS (if above-mentioned symptoms occur) Early dysentery. Give homemade food and plenty of liquid to prevent dehydration.


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Hello doctor, I feel a tight band like pressure around my head while wearing specs. I try not to flinch my head muscles while feeling the head pressure fearing it will escalate the pressure feeling. I started wearing specs from the age of 16, and now I am 19. I do not want to wear contact lenses and cannot go for LASIK because of keratoconus in my right eye. When can I get rid of this feeling or get a proper way of coping with it?


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Hello. You probably have a tension-type headache. This can be managed with medicine and relaxation exercises and by reducing the stress as well. Even with specs, you can manage these headache symptoms. For more clarity on your symptoms and further evaluation, you can visit nearby psychiatrist or neurologist. So as of now, limit your time in watching tv or mobile. Do regular relaxation exercises, manage your stress effectively and have adequate sleep. Painkiller drugs like Paracetamol or Ibuprofen can be used whenever required. A drug like Fluoxetine or SSRI (selective serotonin reuptake inhibitor) can be used to manage symptoms associated with stress. I hope this clarifies your concern.


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Hello doctor, How to brush after removing a tooth? Two days ago I got it done. How to know if I have a dry socket and what are the ways to prevent it?


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Hello. Keep usual brushing habit after the removal of your teeth. No need to worry about brushing habit. Use mouthwash twice a day after brushing your teeth. Take care of the wound, like after taking any food make sure that you gargle your mouth with lukewarm water. Do not do vigorous gargling. This will prevent you from dry socket. To prevent from dry socket. Do not put your finger or tongue over the wound area. There will be a slight amount of postoperative pain or discomfort after the removal of the tooth which you will feel for almost a week. Just maintain your oral health care. No need to worry.


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Hello doctor, I have acne and oily skin with very bad acne scars and dark spots all over the face. Please help.


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Hi. If possible provide me photographs of the affected areas which will help me for better understanding of your skin problem and proper treatment plan. Photographs are required for diagnosis purpose because the treatment given without proper diagnosis can be less helpful or can also harmful for you.


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Hello doctor, I have been experiencing bleeding, pain, and discomfort during sex. It started about three weeks ago when my fiance and I had multiple sexes in a day for almost a week. At first, the bleeding was very little, only during intercourse, and stopped immediately after the intercourse. We had sex before three days, and the bleeding was minimal. But now the bleeding continues. I can tell that it is coming from my vagina wall (near the entrance) instead of the uterus. Neither of us has STI or STD. I am on combination pill Rigevidon for almost a year. The pain goes away immediately after intercourse, and it is not that intense. What could be the problem? I also do not have a yeast infection.


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Hello. The most common cause of post-coital bleeding is either vaginal mucous frictional lesions, and the other is cervical erosions or cervicitis (lesions over the cervix which bleed due to frictional injury during intercourse). It is essential that you should get speculum examination, and pap smear done to check for cervicitis, and any vaginal mucous lesions if any. Please avoid intercourse. If diagnosed then this may require a course of antibiotics for the next 10 days as would be advised by a gynecologist after evaluation. Please consult your gynecologist.


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Hello doctor, I had a pink eye. An allergy specialist advised me medications, and my eyes improved a lot. But I used Visine for a year every day, and that made my eyes addicted to that, and every time they became more red now. My allergy is controlled, but my eyes are not white, again they are like a little yellow and red stained. Also, they advised me Vigadexa drops because I had bacterial infection. But my eyes are still weird color even when I do not have itchiness.


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Hello. I understand your concerns and have gone through your photo attachments (attachment removed to protect patient identity). The brown patches are suggestive of benign melanosis, and the red lines are blood vessels. The blood vessels can reduce in size and number when Visine (Tetrahydrozoline HCI) drops are used, but due to the mechanism of action, the drops will lose their potency over prolonged periods of use. Other than that your eyes look fine. The benign melanosis, as the name suggests is a harmless patch of pigmentation and the blood vessels although a bit prominent are not suggestive of any disease. There are no signs of serious infections. I hope this helps you. In case you have any further questions, please let me know.


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Hello doctor, I am a 35-year-old female. I am 11 weeks pregnant. On the sixth week, I had a threatened miscarriage and started taking Cyclogest 400 mg suppository, twice a day. Now I am facing severe shortness of breath. Is it because of the high dose of Progesterone I am taking? Does this affect the baby in any way? Kindly advice.


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Hello. You can switch to oral administration of Progesterones and half the dosage with tablet Susten 300 mg SR (sustained release) once at night daily orally. This shall reduce your possible breathlessness, and uneasiness. You should repeat your ultrasound now, and see if the placentation has improved, and the fetus is viable with no evidence of subchorionic hemorrhage. Please follow-up with the ultrasound report and discuss with your obstetrician to decrease the progesterone dosage, and take an informed decision.


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Hello doctor, I am 31 years old. I have pain in my knees especially in the left one. I have not been able to walk for quite long, and sometimes it feels that some fluid is traveling towards the feet and some cold sensations as well. My job profile needs lots of walking. Can the pain be due to the wearing of improper shoes?


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Hello. Kindly give me the following information. 1. Since how long you had the pain? 2. Have you had any injury in the knee joint? 3. What aggravated the pain? 4. Is pain more in the knee or foot? 5. Do you have any back pain radiating down to the left leg? 6. Do you have any other medical problems for which you take medications?


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Hello doctor, Our 12-year aged daughter has a problem with the skin around the lips, below the nose, and on her chin. It started before seven months, and the skin in those places is red with little white spots and often very itchy. We visited many general physicians a few times, but they cannot determine what it was. They suspected it to be some bacterial infection, acne or something else. She has tried different creams and ointments such as Hydrocortisone, Hydrocortisonum Oceanic, Bactroban 2 %, Freederm, Duac, Virupos, Fusidic Acid, Oilatum, and even Elocom. And Elocom seemed to work but just for a few days. Without any cream, it gets worse very fast, and changes are visible in hours. She had eczema and some skin allergies, but it was not so severe and long-lasting. The condition at this moment is, so severe and she needs a quick help.


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Hello. This condition is known as perioral dermatitis, which usually results from the use of topical steroids. One feels better when they use topical steroids like Elocon (Mometasone), but it gets worse as soon as it is stopped. You need to stop using steroids and start taking following medications A. Pimecrolimus, 1 % Cream, apply once at night. B. Metronidazole gel 0.75 % apply once in the morning. C. Use sunscreen every three hours during day time. D. Capsule Doxycycline 40 mg once a day. E. Tablet Fexofenadine 120 mg once a day. Do this for 20 days and then follow-up. Please stop using topical steroids for this.


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Hello doctor, My fiance had her periods (period started) five days before, we had oral sex on the fourth day, and I had precum. When I tried to enter her vagina, she said it is paining, and we stopped. I have not ejaculated. Is there any chance of pregnancy? She had her period regularly after 28 days. If chances are there for pregnancy, please suggest pills to avoid it. When to take and can she take pills in the evening?


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Hello. If her cycles are regular, then you had sexual activity in a safe period, and there is no risk of pregnancy. No need to get worried. Also, the sexual activity you had does not result in pregnancy. So you can stay relaxed and there is no need to take any pills to avoid pregnancy. Use condoms during sex to remain safe, and emergency pills are alternative but should be used in accidental or emergencies only.


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Hello doctor, He was diagnosed with Budd-Chiari syndrome before five months, and he is feeling very uncomfortable due to ascites. Currently on Acitrom 3 mg, and Udiliv Dytor 10 mg. Kindly advice.


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Hello. Budd-Chiari Syndrome is a rare condition caused by narrowing and obstruction of the hepatic veins. Obstruction of the veins prevents the flow of blood from the liver to the heart. Obstruction is due to the formation of a fibrous web in the blood vessel or blood clots. It can be due to a blood disorder, infections, chronic inflammatory disorders, cancer, liver enlargement, and fluid collection in the abdomen, etc. Do LFT (liver function test), RFT (renal function test), CBC (complete blood count), CT (clotting time), BT (bleeding time), and US abdomen (ultrasound). Treatment depends upon the cause. But generally, treatment is medical or surgical. Mainly ascites fluid is taped to relieve tension and portal hypertension management is done. Some times liver transplantation may be needed.


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Hello doctor, A 6-year-old gets itchy rashes on her face and stomach after taking Paracetamol syrup, may be a probable allergy to Paracetamol. We have been giving her Calpol for the past three years. And it is showing these symptoms now. 1. How to make sure that this is Paracetamol allergy or not? Is there any test? 2. Why were there no adverse symptoms earlier when I gave her Calpol for the past three years? 3. Do children outgrow these allergies after a few years or months? Can she be able to take Paracetamol later in her life? 4. Is it true that any future exposure to Paracetamol will delay the ability to outgrow the allergy? I mean if she is exposed to Paracetamol will she take more time to become normal? 5. I tried Ibugesic instead, and it was tolerated well. Should we give her Ibuprofen instead of Paracetamol during fever?


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Hello. For allergy, you can give Cetirizine syrup. Paracetamol is one of the safest drugs. It is very rare that Paracetamol causes allergy. And you are also giving Paracetamol for the last three years, and there was no allergy. Generally, allergies increase by repeated exposures. So I think it may be due to some food allergy or infection. At present do not give Paracetamol if you feel that it is causing allergy, continue with Ibuprofen. If she is developing so much rash, itching or breathing problem then go to a pediatrician as soon as possible. Food allergy. Syrup Cetirizine 5 ml BD (twice a day) for five days.


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Hello doctor, I have been bleeding heavily for the past two days. I had large blood clots, and I soak through a sanitary pad every one to two hours. My last normal period was before five months. After that, I did not get a period for the next two months. I got a period on the third month but it only lasted for one day, and it was light. In the fourth month, my period was strange. It was a mixture of spotting, light bleeding, and moderate to heavy bleeding which lasted for 11 days. It stopped because I took a Plan B emergency contraceptive pill not because I had unprotected sex but because I read that it will stop the period. My period ended after that for three days. I had spotting before seven days which continued as a normal period after two days. From the next day of my normal period and till now, I have been bleeding very heavily and passing large clots. I had a surgical abortion last year at 13 weeks. My period came back on the very next month of my abortion. After three months, my gynecologist did a transvaginal ultrasound to check me for PCOS. The ultrasound showed that I had polycystic ovaries, but blood work showed normal hormones, so PCOS diagnosis was not confirmed. The ultrasound was otherwise normal. Before three months, my endocrinologist wanted to do a scan because she still believed I had PCOS. The scan was normal, and It just showed polycystic ovaries. She did another round of hormone testing, and my hormones were normal after which PCOS diagnosis was not confirmed. I am 5’9 in height and 270 lbs in weight. I gained over 50 lbs since last year due to depression from abortion. Now I have been reading a lot about uterine (womb or endometrial cancer), and I am worried that I might have cancer. Can uterine cancer develop that quickly?


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Hello. I doubt that you have PCOS which is the most common cause of irregular cycle in young age like you. Secondly, it is not necessary that hormonal levels become abnormal always to make a diagnosis of PCOS. It could be a clinical diagnosis as well as based on the presence of irregular cycles and ultrasound evidence of polycystic ovaries. The main cause of heavy bleeding is that when one does not get periods regularly the lining of the womb becomes thicker and when it sheds it causes heavier and prolonged bleeding. And the thick endometrial lining is one of the risk factors for the development of endometrial cancer in later life. But it does not develop at early ages commonly. It is usually a problem of menopausal women, but PCOS is one of the risk factors for development. So it has been recommended to regularise your cycle with the help of pills to avoid heavier bleeding and regular shedding of the lining of the womb. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


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Q. I am a HIV negative man married to a HIV positive woman. We would like to have a child. Please advice.


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Hi, I am a 26 year old HIV negative man married to a HIV positive woman. We would like to have a child. I want to know if there is any medication that can prevent the child from being infected. Is there any risk of me also getting infected?


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Hi. Hope I have answered your query. If you have further questions, revert back to a HIV AIDS specialist online -->


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Hi doctor, The imaging of the neck region was done and some lesions were detected. The operation of lower jaw and neck region was done followed by chemotherapy and radiotherapy and it was stated that things will settle to normal. During routine checkup, some swelling in neck region was detected and FNAC was done, which shows metastatic poorly differentiated squamous cell carcinoma, and after that full-body scan was performed. The reports are attached. Kindly look into it as the second opinion is required.


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Hello. I am sorry to know the recurrence of cancer. (attachment removed to protect patient identity).  You got diagnosed with squamous cell carcinoma in buccal mucosa of the left oral cavity in December 2019 which was operated. Then you received chemotherapy and radiation therapy and now on routine evaluation, there are some new lesions coming up in the thyroid and neck. So basically there are two sites of new lesions now, in parotid and around it one more lymph node. So please undergo a biopsy of this lesion from parotid to see if it is same cancer as before or a new second primary cancer. If it is confirmed as same cancer as before, it will be operated and taken out and also few more lymph nodes on the same side of the neck followed by chemotherapy. If a second primary cancer, then treatment can be different depending upon what type of cancer it is (on biopsy). So your first step is biopsy.


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Hello doctor,I am preparing for my entrance exam. I am not able to concentrate on my studies since four months. I got shifted to a different hostel with my friend before four months. In the beginning, all was good and he is very much talkative and creepy. He always used to sit in my room and talk about movies and games. Regularly, we together will go for movies and to a restaurant for food. I started skipping my homework in his company. A couple of months ago, I came to realize that I am wasting my time. So, I started ignoring him. I did not let him enter my room. But, I do not know what type of person he is. After all this, he always comes to me and whenever I see him I get disturbed. His room is just next to me and whenever I come out of my room he also comes and starts talking and making mischiefs. I am ignoring him and I think he has also released that. But, he is not leaving me alone. He came to my room checks my homework copy, my cupboard and used to take my book unnecessarily to his room so that I could go to his room. I do not know what to do. I have a choice to shift to another floor of the hostel. But, if I do so, then he will feel bad as he is my only friend in the hostel. But, because of him, I am not able to concentrate on my work. I need some privacy. Please give me some solution.


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Hi doctor, I am currently pregnant and still used to have sex with my husband. After sex, there is a burning sensation in my vagina that last for minutes to hours. The thing is, it only happens after he ejaculates inside me. Please help.


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Hello. Thanks for choosing this platform. For further information consult an obstetrician and gynaecologist online -->


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Hello doctor, My partner and I had sex and a day after, the skin on his penis was peeling. I have no clue what it means. It is still peeling and we had sex a week ago. I went to get it checked out I have not heard anything yet. He said he got checked two weeks ago and I got checked a day after. Please note, I had chlamydia two years ago.


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Hello. The peeling of skin after sexual intercourse occurs in 3 to 5 % of men. The most common cause is allergic (contact dermatitis), followed by fungal infection and STD like chlamydia or gonococcal infection. However, STD is associated with pain and dysuria. The other two are possible causes in your case. For more information consult a general medicine physician online -->


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Hello doctor, I have a bacterial infection in my gums because of my wisdom teeth coming in. I have taken Clindamycin and Motrin but it does not work.


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Hello. Gum infection can be due to a number of reasons like tooth infection or cavity, abscess, etc. If Clindamycin is not working, I suggest taking Amoxicillin 500 mg twice daily for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Along with this, start with some warm saline gargles at least five to six times a day for a week. Hope this helps you. For more information consult a dentist online -->


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Hello doctor, I am a 31-year-old female. I have lost my sexual drives, and it is affecting my marriage life. Kindly advice.


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Hello. If you have a low sex drive, then this should be evaluated properly. Medical causes like diabetes and hypertension should be ruled out. This might be due to hormonal issues. Your serum prolactin and progesterone levels should be checked. Normal levels will rule out the hormonal cause. Do you have pain during sex? Because pain could be one reason for low sex drive. Using a good lubricant during sex will reduce pain and will also help to increase pleasure which in turn will improve the drive with time. You should spend more time in foreplay. This will increase the chances of good orgasm which will make sex more pleasurable. This will also increase sex drive with time. As such there are no specific drugs for female sex drive. Drugs containing L-Arginine have some roles in improving drive. L-Arginine in a dose of 500 mg per day help to increase engorgement of the clitoris which will increase sexual pleasure and drive with time. I hope this helps. If you have more doubts, please let me know.


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Q. HIV tridot antibody test negative till 10 weeks. Are there chances of turning into positive at 12 weeks?


key: Patient
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Hi doctor, HIV tridot antibody test done at 6 weeks, 8 weeks and 10.5 weeks. All negative. Are there chances it will turn positive at 12 weeks now? Test done with blood taken from vein.


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Hi. Following is my opinion for your asked question. HIV tri dot antibody test is having good sensitivity and specificity in ruling out HIV as like that of fourth generation ELISA. Usually tri dot HIV test is able to rule out HIV after six weeks of exposure. However, HIV test can be considered conclusive in ruling out HIV after three month of exposure. So, I suggest you investigate with HIV rapid test after 12 week again. You can revert back with HIV report after 12 week of exposure to check it.


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Hello doctor, Red itchy patches on groin area all the way spread around anus and thigh. Tried treating with camphor mixed with coconut oil first. Then used Cosvate GM, Ketoclean and Keto Soap. It has worsened.


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Hello. You have tinea corporis/cruris which is also known as ringworm/fungal infection. Kindly stop using the earlier medicines. You should take capsule Itraconazole 100 mg twice a day for 3 weeks. Also, take tablet Cetirizine 10 mg at night for the itching. Also apply Luliconazole/Sertaconazole/Eberconazole cream twice a day. Kindly take bath twice a day. This will help in cleaning the sweat on the body which helps fungus to grow. Also, as you are a diabetic, you have to maintain your sugar levels. In uncontrolled diabetes, fungal infection is very common. Take care and stay healthy. Tinea corporis/cruris As explained above Avoid wearing wet undergarments


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Hello doctor,A few days ago one of my female friends had pain around the belly button. She went to a physician and was told that it could be because of a decrease in iron in the blood. Does iron deficiency relate to pain near the stomach? What can be the other causes?


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Hello. Yes, it can be related. One of the causes of a low hemoglobin count is low iron in the body, which may occur either due to inadequate diet or excessive loss from the stools or menstruation. There are multiple causes, and we need to confirm it by hemoglobin level, serum iron studies, and stool for occult blood testing. If bleeding occurs due to acidity and gastritis, especially if associated with nausea, bloating, burping, pain on eating, sour water feeling in the throat or chest burning, then she should: If she is bleeding due to a worm infestation, then she should have tablet Bandy plus once at bedtime, to be repeated after two weeks. To confirm this she will need stool routine examination. Hope this helps. Get back if you have any doubts. For more information consult an internal medicine physician online -->


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Hello doctor, I have been sick with side effects from Doxycycline for two weeks. I had a UTI which has cleared. I have been to the doctor twice, they checked my urine, and there is no infection. I feel tired, have chills, I feel cold, have a back and joint pain. I do not have a fever. I have read that, sometimes it can last up to three weeks. Is it possible to last this long? My blood tests are also normal.


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Hello doctor, I am having dry patches around both eyes. Although I have dark circles for a long time, this has never happened. I am using mild face cream to keep the area moist, but it is not sufficient. It is also slightly painful. Please advise.


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Hello. It seems like an allergy reaction. I advise you to use a mixture of one portion of baby shampoo diluted in five portions of warm water, clean your face and the affected area. Rinse with warm water, then with cold water immediately. At the end apply Tobramycin cream or Fucidin cream (Fusidic acid) locally. Avoid eye contact. Try this twice daily. During day time you can apply vitamin E and zinc oxide cream. You can also apply fresh Aloe vera locally during the day. Let me know if you have any other question.


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Hi doctor, I feel my legs are restless and lack energy. I am feeling tired with frequent yawning and sleepiness in daytime. Sometimes, I feel nervous and vertigo while walking. Please suggest a medicine. I had Escitalopram 10 mg bd, but it did not work well. My other medication list is attached for your reference.


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Hi. The symptoms described by you are symptoms of depression which are due to low dopamine levels. Escitalopram increases serotonin levels and there is a dopamine deficit remaining in most patients. My advice would be to add Bupropion (Bupron XL) 150 mg to existing drugs. You can make it 300 mg after a week if necessary. Do not stop Escitalopram. This should make you feel fresh and energetic. If your leg restlessness remains, ask your physician if you can take a beta blocker along with current medicine. Take care. Specify probable causes if any. Major depression, dopamine deficit. Tablet Bupron XL 150 mg in the morning along with previous medicine.


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Hello doctor, I am feeling very restless, sleepy and crying the whole day. I have a feel that I am suffering from depression. Please advise.


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Hi doctor, My niece, who is 1 year and 8 months old, got choked today when she drank her milk. She got cough because of the choke, but the cough keeps coming back the whole day. I thought it was just a simple choke as it is just milk. Why does it last for the whole day?


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Hi doctor, I am having a polyp in my sinus and have been suffering from frequent cold for a long time. Now, I am facing a fluttering sound in my ear. What should be done?


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Hi. Generally, polyp in sinus needs to be removed. If ethmoidal polyp, then it can be treated with steroid spray. Ear problem can or cannot be due to a polyp. You need to tell your complaint in detail. Sometimes, polyp can block the eustachian tube and ears and it can cause ringing or fluttering in the ear. Kindly tell me in detail so that I can guide the treatment. If you have got a CT scan done, then you can send me or else you must get a CT scan PNS (paranasal sinus) done. Revert back with detailed history to an ENT otolaryngologist online -->


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Hello doctor, I have had a sinus infection for over eight weeks now. After trying to get rid of it using Neti pot and Flonase, I started taking antibiotics. I had my sinuses scraped about four years ago due to a recurrent sinus infection. I went to a dentist because of a broken tooth, that was causing me pain. The dentist put me on two more antibiotics to treat the pain. So, currently I am under Alprazolam 0.5 mg (four times a day), Truvada (once daily), Quetiapine and Buspirone at bedtime. I have horrible diarrhea and nausea every morning and wake up with a terrible sinus headache still. I am at my wit's end, and cannot see my regular doctor for a month. I am getting the tooth extracted in two days, hope it will help. Any guidance would be so much appreciated.


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Hello. So you have two issues, one is your sinusitis, and the other is diarrhea. Gastritis is probably antibiotic associated, so you need to discuss with your doctor and change the antibiotics that are causing your diarrhea. I would suggest the following for your gastric problems. For sinusitis along with antibiotics I would suggest you try the following. For a headache, you can have Paracetamol or Ibuprofen whenever needed. If it is not helping, then you need to discuss with your local doctor for a short course of oral steroids. Consult your specialist doctor, discuss with him or her and start the medication after their consent. Get back if you have any doubts. For further information consult an internal medicine physician online -->


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Hi doctor, Whenever I sit or lie under a fan or walk outside when it is windy, I suffer from running nose and nasal congestion. So, a few days back I did a CT scan PNS, and the report says there is predominant ethmoidal sinusitis and DNS deviated towards left. Kindly tell me how serious is my condition as per the above description of CT scan PNS. I am not willing to do surgery. Let me know whether it can be taken care of without doing surgery or not, and also kindly advise me with medicines and other measures to take care of my illness.


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Hi. It is not a severe condition, and the surgery is not always required if there is a response to treatment. You appear to have two issues, one is allergic sinusitis, and another one is DNS (deviated nasal septum). Your predominant symptoms are likely due to allergic sinusitis. So treatment depends upon the frequency of the symptoms. If the symptoms are occurring on a daily basis or most of the days of a week, then you may need a long course of treatment. If you are having symptoms on and off, then you may require a short-term treatment. It is advisable to get yourself examined by a local doctor once. We usually prescribe Duonase nasal spray (Fluticasone propionate with Azelastine) which is given two times a day for four to five days if the symptoms are occasional. It is not advisable in persons having infections like fever and body ache. Also, we also ask to have tablet Solvin cold (Paracetamol with Phenylephrine) at bedtime whenever required. Steam inhalation done during a significant period for three times will help. Usually, patients respond well to medicines and surgery is not always needed. For more information consult an internal medicine physician online -->


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Hello doctor, I am a 20 year old female. I am not on any medication. I take probiotic, multivitamin, vitamin D, Cal-mag and omega supplements daily. I seem to have recurrent infections. In the last three years, I have had two strands of mononucleosis, pneumonia twice, ongoing sinus infections, recurring strep throat, and tonsillitis which resulted in getting the tonsils removed. I also had a stomach infection. I cannot take antibiotics anymore because the infections come back when I stop the medications. I was referred to an allergist and have tested negative to all the allergies. I do not know where to go from here. Hodgkin's lymphoma, leukemia, as well as colon, prostate, and breast cancer has been in my family. Is there a chance I could have any of those? Doctors have said that it could be just a phase of being sick. But, I am tired and worn out. I want to get my life back. Any guidance would help.


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Hello. Firstly, do not worry, your condition is not suggestive of those cancers. Hope this helps. Get back if you have any doubts. For more information consult an internal medicine physician online -->


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Hello doctor, My son is 1 month old. His weight is 2.7 kg, and he has been suffering from allergy in his face especially on his cheeks and chin since last five to six days. Now it looks like a sunburn and an allergic reaction. But I could not understand the cause. He has trouble in breathing, and nausea and no medicines were used till now. Kindly suggest any anti-allergic syrup with dose.


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Hello. The allergy that you may be talking about is probably milk dripping from the sides of the lips onto the cheeks and chin. This milk may be causing those allergic rashes on the cheeks and chin. Please observe, and if it is so, please wipe off the milk that is dripping. Another thing that you mentioned is that he has trouble breathing and nausea. Generally, children below the age of six months make certain sounds from the nose and mouth that makes us feel they are breathless. However, these children can take feeds well. If such is the case, then your child is normal with respect to your sense of breathlessness. Do not worry. Please note that even after taking the above steps if there is no improvement or worsening over the next few days, it is best to get the child evaluated physically by a pediatrician.


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Hello doctor, I have questions concerning about the skin on my face. The skin next to both sides of my nose gets red and flaky with dry skin. It is itchy and appears often. I do not scratch it, and I have used shea butter and aloe vera. It helps a little bit, but so far still the same condition exists. I have been smoking occasionally for a few years and never had a problem. I stopped about three weeks ago due to this problem to see if the irritation is due to my smoking, but it is not getting better. I will be visiting a doctor in about a month. Kindly give your opinion.


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Hello. It can be seborrheic dermatitis, an inflammatory response because of seborrhea, caused by a superficial fungal infection. Do you have dandruff?Seborrheic dermatitis is usually associated with dandruff. Kindly send me the picture of your face from a distance (not in a close up view).


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Hello doctor, My daughter who is 2.8 years old cried hard before two weeks and developed a hoarse voice the next day. It subsided in about three days. Before a week, I remember her throwing tantrums and crying hard for every small thing and again developed a hoarse voice. I gave warm water and honey, and it has subsided a lot. Sometimes her voice sounds normal, and when she screams or cries, I can still feel her voice is a little hoarse. Is this hoarseness due to crying or could be any other infection? I read that hoarseness could occur due to cancer. I am a paranoid mother who gets scared after reading the stuff. She does not have any cold, cough and eats normally. In spite of her hoarse voice, she is taking ice creams and cold stuff. If the hoarseness is due to any serious medical condition, would she have any accompanying symptoms? My main concern is cancer. What would be the symptoms of laryngeal cancer other than hoarseness? She is a very adamant kid and still screams if things do not go her way. Suggest remedies to get rid of hoarseness. Please remove my anxiety towards cancer.


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Hello. Relax do not worry. She does not have laryngeal cancer (vocal cord cancer), it is a vocal cord abuse. It is due to screaming she is having hoarseness of voice, so it is temporary. Give her warm water and if she can gargle then let her do it with salt water gargle. Based on your history I can understand that she has a minor behavior issue, typical of a toddler. When she starts screaming then try to divert her attention, so you can stop her screaming. A positive note is that the child forgets quickly and so you can do it. If you still have some queries, then please visit ENT doctor and get her vocal cord checked.


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Hello doctor, I feel like I have water in my chest,and neck which goes down to the stomach, underarms. The precise explanation is like a sweat inside my body that travels in those areas (chest, stomach, underarms, and abdominal wall). What can this be?


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Hello. Firstly, this does not appear to be a life-threatening or severe issue. Most probable diagnosis goes with your explanation is of dyspepsia (indigestion) or gaseous issues. Does your upper abdominal pain, nausea, bloating, and burping increase while taking food? Do you have sour water feeling in the throat or chest burning? If yes, it further supports the diagnosis. You should avoid fatty, oily, and a high-calorie diet. Go for a walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Eat lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tablet Pan DSR 40 mg (Domperidone, Pantoprazole) before breakfast once a day for a week. Do you feel any palpitations or chest pain along with it? If yes then we should rule out the cardiac issue. Anyway, you should get yourself examined and auscultated to rule out any other issues. So, overall, does not appear to be a worrisome matter, and your symptoms do not indicate any severe disease. I hope this helps you and get back if you have any doubts.


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Hello doctor, My baby is 2 months old. He is on pumped milk and once a day formula milk (Enfamil). He is gassy and cries mostly from evening till midnight. Spits up even after burping for 30 minutes. I give exercise, and tummy time, but there is no change. He gets reflux which makes him uncomfortable. His spits are watery. My pediatrician suggested Colicaid and Yamoo which I am using four times a day. Still, he gets gas and spits up. And now he did not poop for the past two days and trying very hard and cries in between feeds by trying to poop. Is this an effect of enzymes? Please help.


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Hello. Please note the following, 1. The clinical picture that you are giving is most suggestive of reflux. It is advisable first to get a reflux study done to find the grade of reflux. 2. The initial medications to be given in reflux are Zantac (Ranitidine) and Perinorm (Metoclopramide). In most cases, this works. The next step beyond this is Gaviscon (antacid) and feed thickening. 3. Also very important is to keep the child in a slightly upright position (30 degrees to ground) after feeding (and most of the time) to reduce the amount of discomfort the child may be facing due to reflux. This one method goes a long way in helping children. As the child grows bigger, the need for this reduces eventually. 4. As regards to the crying episodes during stools, if the stools are hard or if there is gas the child may cry. Both are less likely due to the enzymes. They are mostly physiological considering the clinical scenario of the child.


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Hello doctor, My mother is currently taking treatment from a psychiatrist for depression. Her major symptoms are heaviness in the head, lower back pain, mood swings, feeling sad, and negative thoughts. Recently MRI and CT scan were done. CT scan was fine. MRI indicates multiple small T2/FLAIR hyperintense foci without restricted diffusion are seen in bilateral centrum semiovale, the subcortical and deep white matter of bilateral frontal and left parietal lobe. No demonstrable signal alteration was seen in the corpus callosum at present. No evidence of restricted diffusion or blooming seen. Features suggest the possibility of demyelinating etiology or pronounced microangiopathic changes. Please suggest what should be done? Either psychiatry treatment, or neurology treatment? Her main issue is the heaviness of head. She wakes up with negative thoughts, feeling like crying and suicidal behavior. She is currently on Ventab Xl, Mirnite, Clonotril, Olimelt, Lupirtin SR, and Sertee.


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Hello. I understand your concern and would explain that your mother's symptoms seem to be related to depression with psychotic signs. The lesions in MRI are suggestive of small vessel disease. I would recommend taking daily baby Aspirin 80 mg to help the progression of these changes. In my opinion, her current therapy is quite complicated, and many interactions between drugs can worsen her situation. I would recommend stopping Mirnite (Mirtazapine) and Sertee (Sertraline) because they both interact with Ventab XL (Venlafaxine). Increasing the dose of Ventab XL may be necessary. Treatment of depression will help reduce the headache. You should discuss with her psychiatrist on the above treatment option.


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Hi doctor, My son is 5 years old. His doctor told that he has a cylindrical power of 1 and 1.25. He also said that his muscle power is weak. Is it a must to wear eyeglasses?


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Hello. I can understand your concern regarding your child. Revert back with the prescription to an eye care ophthalmologist online -->


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Hello doctor, During root canal treatment does air spray over CaOH filled canal cause emphysema on soft tissues of the face? How can one distinguish emphysema from flare-up?


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Hello. I appreciate your question. Emphysema of the face is directly linked with air trap under your skin. It gives a crackling sensation because of the air pressure underneath and looks like a smooth swelling of the face. Root canal flare-up might result in swelling but with severe pain. Visible periradicular changes start two to three days after endodontic treatment. To my knowledge, air trap in a medicated canal would not directly cause complications but the major reasons are improper canal irrigation, preparation, and over instrumentation. It is most commonly seen in upper canines and centrals. Antibiotics are advised for treatment.


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Hello doctor,I went to a parlor for upper lip and chin waxing. I am scared if the wax was contaminated by a person before me and if he or she bled and had an infection like HIV. The person double dipped, and I do not know that on how many people the wax was used? And what issues they might have had?


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Hello. You are right. You have every reason to think and fear about the procedure. But the fact is, HIV cannot survive in the outside environment and cannot transmitted in this way. But what you have to fear for is HBV (hepatitis B virus) because HBV can live and infect for one month in the outside world. HIV can only survive for two minutes maximum, and after eight seconds, it loses their infective capacity. So, regarding HIV infection, you are safe.


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Hello doctor, I am 79 years old. I am having spinal surgery on L4 and L3 next month. I have been on 90 mg of Nardil,an MAOI, for the last 32 years. Is there any general anesthesia that can be used so that I do not have to come off this medication, or do I have to be off it two weeks before surgery?


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Hello. The anesthetic drugs and their dose are carefully chosen after considering patients age, general health, condition of vital organs, previous history of diseases, concomitant medications, and duration of surgical procedure, etc. Hence, before any elective surgery, the anesthesia specialist will do a thorough examination and necessary investigations to fix the anesthetic drugs. Rarely in some case, it becomes very difficult to fix safe anesthetic drugs. Only in such cases, the anesthetist may deny the surgery. In your case, many good safe anesthetic drugs will not interact with your MAOI (monoamine oxidase inhibitor) drugs so that you can continue the current medication. If your anesthetist feels that those safe anesthetic drugs are not suitable for you (based on your body condition and duration of surgery), then he may use anesthetic drugs that may interact with MAOI. In such a case, alternative to MAOI will be started with the help of a psychiatrist. The anesthesiologist will coordinate all these. Hence, you do not worry about this part. With the current details given by you and without doing a personal examination, I am not in a position to discuss further drug details. But, I can assure you that your concern will be solved when an anesthetist examines you.


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Hello doctor, I am a 40-year-old male. Recently I was diagnosed with LVH in ECG (possible LVH). My cholesterol level was 175, and pressure was 90/150. Now pressure came down to 80/135. I am taking Diovan 80 and I have little chest pain. Is this disease curable with this medicine? The sugar level is borderline.


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Hello. Left ventricular hypertrophy (LVH) is reversible and is caused by high blood pressure for a long time. When the heart has to exert more against raised BP, it hypertrophies just like an athlete when exercises, his muscles undergo hypertrophy, same is with heart. So when an athlete stops his exercises, weight lifting, training, etc., his muscles come back to normal over time. Just control blood pressure and sugar. Consume a low salt diet. Regarding chest pain, I would advise you to undergo ECG, treadmill test and exercise tolerance test (ETT). After that, send me reports so that I may guide you better and for future planning regarding preventing other issues.


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Hello doctor, I am a 38-year-old female. I have extreme fear, suicidal thoughts, and fear of failure. I am not able to concentrate on my daily activities. How to overcome all these situations? I had an aortic valve replaced through open heart surgery. I was under Nexito and Rivotril for two years after my open heart surgery.


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Hello. Decrease in concentration, suicidal thought, fear of failure, and sleeplessness are features of a depressive episode. Why did you stop the medicines? Did you take the medications in the proper dose, and is there any episode similar to the illness has occurred previously? I think you should again start Nextio Fort (Escitalopram and Clonazepam) for the adequate duration, and if not improved, some second-generation antipsychotic can be added, or try cognitive behavior therapy. For sleep you can take help of sleep hygiene to wake up on fix time irrespective of sleeping hours. Avoid coffee or other stimulating agents, have a brisk walk, avoid food before three hours of sleep, and you can take a shower with lukewarm water.


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Hi doctor, I am losing my hair day by day. Can I use Finasteride? I have hydrocele. Is it related to my testosterone?


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Hi. Please do not go to Finasteride straight away. First, the cause and the pattern of your hair loss have to be assessed. It could vary from seborrheic dermatitis to androgenic alopecia to any other skin disorders too. Then, treatment can be planned. Have a consultation with a dermatologist for physical evaluation and get your problem assessed. Hydrocele is not related to testosterone. It is just a fluid collection in the sac. So, please do not get confused. For further information consult a dermatologist online -->


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Hello doctor, My period was due on 22nd this month. Last period was on 22nd of last month. Usually I have a 28 to 30 days cycle. I was on antibiotics for cold and cough infection. I had unprotected sex on 24th of this month and took an Ipill within four hours. I am yet to get my period. Do you think there is anything to worry? Please advice.


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Hello. No, there is probably no chance of pregnancy as you were near to your due date and you have taken Ipill as well so nothing to worry about. Ipill usually makes periods delayed.


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Hello doctor, My husband and I are currently trying to conceive, and hope to be pregnant in the next few months. My in-laws are planning a trip after three months, and I am trying to verify if there is still a risk for pregnant women in regards to the Zika virus. The CDC states to consult with our physician, which I, unfortunately, do not have one currently, especially a gynecologist. I am hoping to get even just pointed in the right direction if it is safe for a newly pregnant woman to travel for a week as I have read that pregnant women are at the highest risk during the first trimester. Kindly advice.


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Hello. Yes, Zika virus is affecting pregnancies and does have adverse effects on your baby if the mother gets exposed to it in her first trimester or either later in pregnancy. Unfortunately, no precautionary measures are available other than avoiding the exposure to it. I would suggest you to better avoid it in the first place rather than having remorse afterward. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


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Hello doctor, I am having loss of libido, premature ejaculation, erectile dysfunction, and extreme fatigue. I am currently on Lipicard 200, and Esomeprazole. Kindly help.


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Hello. I can understand your problem. Your weight in proportion to height is almost near the normal range. But in lipid profile, the cholesterol levels are high, and HDL levels are low (attachment removed to protect patient identity). Deranged lipid profile is one of the common reasons for reduced libido and sexual dysfunction. You should try to improve your physical activities and try to bring weight and lipids in a normal range. Exercise will help in improving the libido too. For weak erection and reduced libido drugs like PDE-5 (Phosphodiesterase) inhibitors like Tadalafil can be used. Low dose Tadalafil in 5 mg per day after dinner daily will help to make a strong erection. To improve erection at the time of sexual intercourse, you can take an extra 10 mg tablet on SOS basis about half to one hour before sex. Kindly consult your doctor for suggestions and take the treatment with consent. This will improve libido and will make erection hard. Avoid smoking, and alcohol use to stay healthy. Supplements containing L-arginine and Yohimbine have great roles in improving libido. Take Nano-Leo which consists of L-arginine that helps to reduce the fatigue.


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Hello doctor, Can you please help me understand my test results? My platelet count is at 1314, and my doctors are unable to give me a specific reason for it.


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Hello. I have gone through your reports (attachment removed to protect patient identity). Take care. Consult your physician for an examination keeping these points in mind. Hope your concern solved. For more information consult a hematologist online -->


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Hello doctor, My wife is having high platelets count, diagnosed with mild anisopoikilocytosis, predominantly normocytic with ovalocytes (RBC), WBC mild leukocytosis is present, platelets: appear increased in the smear.


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Hello. The increased platelet count in your wife case seems to be due to reactive thrombocytosis. The iron deficiency anemia can lead to reactive thrombocytosis and so platelet count can be high. You need to treat her anemia with Ferrous Ascorbate tablet like medication for a month. The high total count along with high neutrophil and lymphocytes need to be treated by empirical antibiotic course. Her diabetes is also not controlled well and with a medication, it needs to be controlled. After a week, repeat CBC to check total count.


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Hi doctor, Four days ago, when I was away from home for some work, I felt sick and my hands and feet were numb for several hours. Then, I had fever for three nights with soaking sweats followed by continuous diarrhea for the last four days. I am going nearly 8 to 12 times a day. I read the symptoms on Campylobacter and it seems pretty similar. Do I need antibiotics? Does it go away by itself? I assume that I should not take medicine to stop the diarrhea. I did have chicken before all of this started. Not sure if that is connected. Thank you


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Hi doctor, I went to the doctor for a general physical examination and did the normal blood work. Everything came back normal, except my blood protein was 8.5 g/dL. She sent me for another blood test today, monoclonal protein test. I am worried sick until I get the test results. Should I be concerned if my other results like blood counts and platelets are within the normal range? I read that it can also mean that I was dehydrated. As I had a doctor's appointment, I did not drink and eat much before the tests. I only had half a cup of water since the previous evening before having the blood test. The doctor sent me for a monoclonal protein study today. Please help.


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Hi doctor, 8 months back, I was detected with kidney tumor and immediately had an operation. In that operation, one kidney was removed. My health has slowly improved and now doctors say that I am fine. I want to know, this year after 8 months, can I keep my roza during the month of ramzan? Is it advisable to fast for a month? Every day I will not be drinking water or eating anything from sunrise to sunset. Please advice. Thank you.


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Hello. I would strongly advice you against fasting for ramzan. For further information consult a urologist online -->


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Hello doctor, I am 26 years old and I have missed my period this month. Last period was on 19th of last month. Few days ago, I vomited two times, so I have checked urine test a few days back. There was a faint line. Again I checked it in the evening on the same day, the result was faint line. But when ultrasound and T.V.S. test were done then result was negative. The doctor has suggested me to keep in touch and again check up after a week. Please suggest me what to do.


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Hi. I can understand your concern. Urine pregnancy test may give faint line during early pregnancy. And also in ultrasound it may take around six weeks for visualization of gestational sac. So, you better go for blood test for pregnancy which will give accurate result compared to the urine pregnancy test. Beta hCG levels above 25 indicates positive result for pregnancy. Take care.


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Hello doctor, I took GABA supplement and I am unable to sleep. If I fall asleep, I am only sleeping for a few hours, and then I am wacking up. I did not start experiencing this issue until I took the GABA supplement.


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Hello. GABA (Gamma-aminobutyric acid) supplements can both, make one go to sleep and keep awake. As for now, I suggest you wait for a few hours until the effect of the medicine wears off. I suggest you do not take the GABA supplements by yourself.


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Hi doctor, I have a 5-month-old baby who is having loose motion, so got his test done for reducing substances. It has a pH level of 6 and a positive report. What does this report signify? Otherwise, he is very gassy and burps and passes gas a lot. Please help.


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Hello. The reports (attachment removed to protect patient identity) state that he is lactose intolerant. You have to avoid milk and milk products for a minimum of 15 days. Give him normal food, rice, dal, and vegetables, etc. After his stool has returned to normal color and consistency for four days, then you can start with small quantity such as 100 ml once a day and check if the symptoms return. For more information consult a paediatrician online -->


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Hi doctor,I am on new birth control (NuvaRing) and getting some discomfort. When I looked up the side effects of the birth control, it said that all my symptoms could be toxic shock syndrome. I am currently on Doxycycline and Wellbutrin. How can I be sure about the syndrome?


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Hello doctor, I have been diagnosed with schizophrenia and have been prescribed anti-psychotic medication Olanzapine. I have been taking it for 2 to 3 years. I was wondering if there is an alternate route to treatment? Or if there is another solution for a possible cure? I do not want to deal with the negative effects. I do not experience any of the positive effects for 2 to 3 years as long as I have taken Olanzapine. Can I come off the medication?


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Hi. Olanzapine is an antipsychotic medicine. Yes, Olanzapine is available in injectable form. If Olanzapine is causing some effects then it can be changed to other antipsychotic like Aripiprazole, Risperidone or Ziprasidone. You need to take medicines or injectables to keep symptoms in check. I want to understand what negative things you are experiencing.


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Hi doctor, I am six weeks and six days pregnant. My urine test is positive and beta hCG is also increasing but I am very upset about my ultrasound report. There is gestational sac in my uterus but from last week there is no yolk sac and fetal pole. I have a dark brownish discharge from six days with no cramps. Do not know what is going on with my pregnancy. This is my first pregnancy after 10 months of marriage. The doctor suggested me to wait for two more weeks. The wait is going to be long. Can someone please tell me what would be its result? Your answer will be truly appreciated.


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Hi. You are receiving enough supportive treatment. In case of discrepancy between dates and scan, yolk sac and fetal pole could appear but there is continuous brown discharge which is risk actually. Have a complete avoidance of restricted activities that can trigger a miscarriage, like stairs, stress, sex, abnormal blood pressure, sugar levels, thyroid levels, hormonal imbalance, etc. Have a strict check on symptoms like the passage of clots, bleeding with or without pain, etc. In case of miscarriage request to send expelled product for histopathology. Complete treatment for any health issue you have, recreational activities and quit recreational drugs, balanced diet, weight, and BMI. Scan after 10 weeks. Threatened miscarriage. Scan after 10 days. Report symptoms immediately to gynecology emergency. Restrict activities. Continue medications as before. Complete treatment for any health issue you have. Recreational activities and quit recreational drugs.


key: Patient
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Hello doctor, My sperm count is 64 M/mL, motility 60 %, rapid linear progressive 15 %, sluggish linear progressive 15 %, forward progressive 30 %, morphology normal 35 % and abnormal 65 %. Are these values normal?


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Hello. Are there any pus cells or WBC's (white blood cells) in the sample report? Also, is the fructose test positive? Please share the complete report as an attachment.


key: Patient
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Hello doctor, I have a cluster of bumps nearly identical on either side of the penis (frenulum), about five each side. They are yellow in color. Are these fordyce spots or genital warts? I previously had a couple of warts on the shaft, but they looked different from what I am having now. Kindly help.


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Hello. I understand your concern. Yes, these are fordyce spots, (attachment removed to protect patient identity) that is ectopic sebaceous glands, when present at this site they are known as Tyson's glands. They are completely harmless, and no treatment is required unless you want to get them removed for cosmetic purpose. In that case, they can be removed by cautery.


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Hi doctor, I am having irregular periods. My cycle is usually on the 10th of every month, but I had heavy spotting on the 19th of last month. Then, I had my normal periods on the 10th of this month. But, I had my periods today, which is 10 days earlier than the normal cycle. During mid of last month, I had some Iron tablets for around three to four days. Please help me with this irregular period issue. Thank you


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Hi I have gone through your query and can understand your health concern. For further information consult an internal medicine physician online -->


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Hello doctor, I am suffering from OCD and doctor prescribed Depakote XR 500 mg and Paroxetine CR 25 mg, which I am taking for last eight years. I read that these medicines can cause drug-induced Parkinson's. Please advise how to stop taking these medicines without withdrawal symptoms.


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Hello. I do not think that those medications can induce Parkinson's. Antipsychotic drugs are more common to induce extrapyramidal symptoms like Parkinson's. Still, if you want to stop it, then you need to taper off over months gradually. It may lead to worsening your OCD.


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Q. I am under treatment for stable angina. Do I need a cardiac MRI to gain the status of my disease?


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Hello doctor, I am a 70-year-old male. I am under treatment for stable angina for the past three years. 80 % small artery blockage, and 50 % large in certain areas. I am taking Clopidogrel, Nitrates, Amlodipine, etc., with tiny sublingual Nitro, averaged 25 Nitro pills over three months. Occasional episodes of twinges occur, but then they remit. I feel there is a need for cardiac MRI to gain a current picture or status of my disease. I feel occasional chest tightness and dull pain but I also have acid reflux disease. What could it be?


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Hello. You have stable ischemic heart disease for the last three years. You are taking medicines and want to know about the heart in detail for which you want cardiac MRI. You have 50 % blockage in the major coronary artery. As far as your heart condition is concerned, it only needs detailed echocardiography to know the function of left and right side of heart, structures of valves and other structures. MRI is only done in case when comprehensive echocardiography is unable to provide information which cardiologist wants to know. Stable ischemic heart disease is treated with lifestyle modifications and medicines. If signs or symptoms remain stable, these are continued without intervention such as angioplasty or bypass. When symptoms are out of control despite maximum medicines and lifestyle modifications, then revascularization is done. I hope your cardiologist got complete information about your heart from angiography and echocardiography. So there is no need of cardiac MRI. MRI is required when there is congenital heart disease, any infiltrative disease whose complete details are not evident on echocardiography. I am sorry I could not promote your views about having cardiac MRI, yet you may ask your cardiologist to tell you the benefits of cardiac MRI over echocardiography, and then you may ask about undergoing MRI in your case. Remember, in most patients, MRI does not provide any additional information that may aid in planning medicines and treatment plan beyond echocardiography and angiography. I would advise you to adhere to a healthy lifestyle, medications, and follow the advice of your cardiologist. Moreover, you may send your reports to me, so that I may guide you more accordingly.


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Hello doctor, I had a silent missed abortion last year in the third month of my pregnancy. After that, I got some tests done, which resulted in CMV IgG positive. Then I got vaccinated for rubella to prevent any casualties in the next pregnancy. Now I want to try and conceive, but just now I got my torch panel done again. And now the HSV IGM is positive with 1.15 range along with CMV and rubella IgG positive. Should I wait or can I try to conceive right now? My husband's torch panel also done, nothing abnormal. I am currently under Folic acid and Multivitamin, for now, to conceive faster. And also a homeopathic medicine for migraine.


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Hello. Yes, you can try for your pregnancy as IgG (immunoglobulin G) means that you do not have any current infection. It is only due to prior exposure. And for HSV, the only thing you have to watch is the presence of active lesions. Otherwise, there is no other reason not to try for pregnancy. You must try for it whenever you and your partner feel ready to do so. Secondly, abortion is a very common thing in reproductive age and only after one abortion there is no need to undergo all these extensive investigations. I hope it has helped you.


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Hello doctor, I had my first appointment with a new pulmonologist today. I presented with a productive (clear) cough which I have had for two weeks. I am very frightened by them and I am terrified that I have COPD, as it seems to appear from the numbers. The doctor was very non-committal about it, gave me a Breo inhaler and said to come back in a month. FEV1 is only 71%. And can you explain a percentage predicted the result for the FEV1/FVC value? It seems to me that the report is stating that my percentage is only 58 %. Is this low value dangerous? I am terrified right now. Please see the enclosed report and give your impression.


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Hello. Percentage predicted means how much is your observed value to the expected value. The computer predicts based on your height, age and gender and on equations how much your FEV1 (forced expiratory volume) and FVC (forced vital capacity) values should be if you are normal. Then in the test we calculate how much are your actual values. To say as normal in FEV1 and FVC we want your calculated value to be not less than 80 percent of your expected. That is 80 % predicted. Here your FEV1 is 71 % percentage predicted. As per values it suggests COPD (chronic obstructive pulmonary disease). But few observations, 1. This test is not very reliable as your graph picture shown on right hand side is not an acceptable one. So I personally would like to repeat it. 2. I do not see a bronchodilator reversibility test here, which is a must to see if it is asthma. 3. If you were a smoker and have symptoms I would suggest a repeat test with bronchodilator reversibility to get a definitive diagnosis.


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Hello doctor, My wife was previously diagnosed with bipolar II and was taking 100 mg Lamotrigine daily for depression maintenance. She was on that dosage for nine years. She recently suffered a more chronic depressive episode and went out of town for ketamine infusion therapy. The infusions were very successful, and the psychiatrist who was assessing her for the infusions suggested that she did not need the Lamotrigine, that it was ineffective for treating depression in bipolar II. She tapered off the Lamotrigine, which was very difficult. It has been three to four weeks since her last dose of Lamotrigine, and nine weeks since her infusions. She is feeling very moody and depressed, irritability, fatigue, loss of focus. The question is, do you think she needs to go back on the Lamotrigine? Or does she need to get a booster shot of Ketamine? Both are difficult solutions. Getting off the Lamotrigine was awful, and getting Ketamine requires out of town travel, etc. Kindly advice.


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Hello. I can understand your problem. Ketamine infusion therapy has great roles in depression but regular maintenance treatment is needed and which results in a significant burden on patients. Lamotrigine is the right drug for resistant depression. Even in maintenance treatment, the drug has good roles. So, in my opinion, the drug should be started again from a low dose, and gradually the doses are build-up. Lamotrigine is safe and is free of severe side effects.


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Hello doctor, I am a 46-year-old female. I have burning discomfort in my legs, buttocks, arms, hands, and lower back for six days. There is no weakness, no tingling, no numbness, no confusion, and no stroke symptoms. My friend told me that I might have multiple sclerosis. What could it be?


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Hello. I would like to know some more details about your symptoms, 1. Did you have burning sensations over the whole body below the neck at one time? Or had uneven patchy distribution? Or the location of burning sensation was varying with time like, sometimes at legs, sometimes at arm and sometimes back? 2. Do you have any neck pain or lower back pain? 3. Did this burning sensation start suddenly? Or it gradually progressed and is it persistent? 4. Is there any particular position of body or activity in which this burning increases, during walking, neck flexion, and forward bending? Or any specific situation like stress or anxious state? 5. Have you any urinary symptoms like urgency, frequent urination or urine incontinence? 6. Do you have a history of a burning sensation or other neurological problem? 7. If burning is episodic, how long does it last? And is it also associated with palpitations and breathlessness? 8. How is your sleep? And how is your mood these days? 9. Have you any other medical problem too, like diabetes mellitus or a heart problem?


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Hello doctor,I was diagnosed with gallstones (multiple with largest 14.4 mm in gallbladder lumen). The allopathic doctor says surgery is the only option. Currently, I do not have any symptoms apart from dull ache during daily exercise. Can homeopathy help to dissolve gallstones? Kindly help.


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Hello. Yes, homeopathy can be helpful to you, and you have to take medicines for a long time. At present, if there are no symptoms then do not go for surgery. It will be useful if you can give details regarding, flatulence (gas), acidity, pain site, and constipation. At which time does the pain get increased? Do you have any other health issues?


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Hello doctor, I am a 29-year-old male. I am having severe pain in abdomen and I was diagnosed with stones in the right kidney and ureter. The USG report shows right nephrolithiasis, right lower ureteric calculus with mild to moderate with hydroureteronephrosis. I am currently under Tamsukem Plus for 15 days and Alkaston B6 200 ml syrup. Can you help me?


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Hello. As it has been prescribed in the USG, the kidney stone that has moved within the urinary pathways have caused the pain you experienced. Alkaston B6 (Magnesium Citrate, Potassium Citrate, Pyridoxine) will help dissolve the stones. Increase water intake. Take uva-ursi, cranberry, and fern tea or supplement to help dissolve the stones. Take Mefenamic acid or Ibuprofen for the pain. Keep following up with a urologist.


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Hello doctor, I am a 20-year-old female. I have many hard skin patches majorly in exposed areas like hands and feet. They started around when I was 10 years old. I have consulted many doctors in the past, and all of them have different opinions like some would say it is an allergic reaction or it is a mosquito bite allergy and also deficiency of vitamin E. After any mosquito bites, it really urges to scratch, and I tend to scratch a lot and due to some reason I do also pluck my skin. Also, I have sensitive skin. I can also send you a photo of these patches. I am looking forward to your reply. Currently, I apply Mometasone furoate cream on the affected area.


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Hello. It indeed looks like an insect bite hypersensitivity reaction, also known as papular urticaria (attachment removed to protect patient identity). The best way to manage this is protection from insect and mosquito bite. Use repellents, or liquid mosquito vaporizers, or full sleeve clothes and mosquito nets, etc. As this is not always possible, you need to take medications also. Continue using Mometasone furoate cream and take these tablets. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Tablet Dapsone 100 mg once a day. 2. Tablet Teczine M 10 mg (Levocetirizine, Montelukast) once at night. Get G6PD test (glucose-6-phosphate dehydrogenase) done before starting Dapsone once.


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Hello doctor, Three months ago I had chest pain with nausea and shortness of breath. Since the BP got controlled, the sob decresed. Though they increased the Nitropatch to 0.6 and started the beta blockers, I am having a fewer episodes. I had an angiogram last week. It showed no major arteries blocked. The cardiologist mentioned thickened heart muscles are due to high blood pressure. I would like to know how to get tested for the micro angina and is there a need to go to emergency when I have severe chest pain? Why am I getting chest pain with no major blockages? I have diabetes, copd, severe arthritis in my spine, and diabetic neuropathy in my feet that could also partially be nerve pain from my spine. I have had two knee replacements and at present have carpal tunnel in both hands but have not delt with that yet. Also with the thickened heart muscle, will that be the cause for acute chest pain?


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Hello. Microvascular angina can be diagnosed on nuclear stress test with perfusion defects if any and also on angiography which shows slow flow in the absence of blockages in major arteries. So, if these tests are showing any abnormalities, then we have to consider the possibility of microvascular angina. Another modality is a treadmill test which can also show changes, but another test is not necessary as two tests are normal and you were not able to complete it. And microvascular angina usually causes pain on exertion rather than severe chest pain at rest. So we have to find other causes for it. If you had been evaluated or examined and had ECG etc., at the time of chest pain, then it also rules out other causes like vasospastic angina or accelerated hypertension as a cause of chest pain, which are relatively rarer causes. So, overall appears to be noncardiac pain. I hope this helps you and get back if you have any doubts.


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Hello doctor, I am a 21-year-old female. For the past four months, my menstrual cycle was not right. It lasted a whole month and was heavy by the end, and it stopped after I took some vitamin C. Then, after one month, it started again and lasted for two weeks (stopped after I got some vitamin C again, and I was not taking any before). After that, it disappeared for two months, and started again, except this time it appears for a day, the next day it is gone, shows up every couple of days, and there was a very little of blood. None of this ever happened before, although my cycle was never exactly every 30 days, everything was fine. I am not sure what could be causing it, it might be stress related, but I do not have an opportunity to see a doctor for the next three months. Currently I am on Omep 40 g, for duodenal inflammation and Cinnabsin N for sinusitis.


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Hello. At the age of 21 years, possibilities for such irregular cycles are, 1. You have severe physical or mental stress in any form, which would interfere with regular normal ovulation and periods will be haphazard. Try to reduce stress with meditation, breaks, etc. 2. If you have suddenly put on weight. This excess cholesterol will get converted into hormones and interfere with ovulation. So have a healthy lifestyle and diet. You can have cyclical birth control pills for five to six cycles. You have to take pills from day one of the periods for three weeks, then no pills for one week. After eight days start a new pack. Do not wait for next period. 3. You have not mentioned about your sexual activity. If sexually active, then infection could be a cause. If so, you and your partner need to meet a doctor and have a course of antibiotics. 4. If none of these a reason, have a pelvic scan to look for any local problem like polyp or fibroids inside the uterus. 5. Do have a serum thyroid hormone profile and serum prolactin levels to rule out, a hormonal angle. I hope I have clarified your query and do write back if any other questions, and for feedback.


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Hello doctor, I have undergone angioplasty (2 stents) before four months. The doctor prescribed Clopitab 75 in the morning and Metoprolol 25 mg in night. I am having a fast heartbeat of 84 to 100. Can I take Hawthorn or Motherwort or Valerian? What should be the dosage and where will this be available in?


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Hello. You have ischemic heart disease so your heart rate should be kept low as much as possible to prevent from further deterioration. For this purpose, you are taking Metoprolol 25 mg one time daily still your heart rate is high. Moreover, you are asking about some herbs or herbal products for heart disease. Regarding these herbs, there are no consistent results in clinical trials for heart conditions. Moreover, these products have not been studied widely as for as there beneficial effects on ischemic heart disease are concerned. Also, their side effects have not been assessed in the long term. So, in such case, these herbs cannot be recommended provided there are many evidence-based medicines available for reducing morbidity and mortality one of which is Metoprolol you are taking. There many trials of Metoprolol in ischemic heart disease and heart failure which shows beneficial effects. Regarding your heart rate, I recommend to increase the dose of Metoprolol. There are two forms of Metoprolol available in the market, short-acting Metoprolol Tartrate and long-acting Metoprolol Succinate. Hope you are taking long-acting Metoprolol Succinate because short-acting Tartrate form is to be taken two to three times per 24 hours to reduce heart rate and reap benefits. I advise you to take long-acting Succinate form 50 mg per 24 hours to reduce heart rate. Apart from these, adopt a healthy lifestyle, take a heart-healthy diet low in salt, low in trans fats, low in saturated fats, high in fiber, fruits, vegetables, poultry, low-fat dairy products, dry fruits, legumes, lentils, etc. Please send me your angioplasty and echo report and all medicines you are taking so that I may advise you proper medicine dosages and guide you further regarding your heart.


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Hello doctor, My mother’s blood test report shows low hemoglobin 10.9 and high platelet count 623000. The sugar test report shows 107 glucose fasting and 144 postprandial. We also had her ultrasound done as she had pain on the left side of the groin area. I am attaching all the reports. Kindly advice.


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Hello. Increased platelet is called thrombocytosis (attachment removed to protect patient identity). This can be present in anemia due to iron deficiency. Since your mother has anemia platelet count may be increased. Pain in her left side groin may be due to hernia. Lastly very rarely we have to rule out that is there any cancer lesions also. Kindly send your mother's ultrasound report.


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Hello doctor, I am a-25-year-old female. I am a PCOS patient and had sex two days ago (that was after five days since my periods ended). My periods are usually irregular but it occurs sooner or later and I usually have a long cycle more than 30 days. So while sex, my condom broke and I took an I-pill immediately and also in the next day morning. I want to know if the I-pill will work irrespective of having PCOS and what are the chances of getting pregnant?


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Hello. Since you have a longer than usual cycle as expected of PCOS, less likely that you are fertile on the day you had sex. It would be an even added protection that you took the I-pill. The I-pill will work whether you have PCOS or not. Comparing to a non-PCOS patient, you have lower chance of getting pregnant after taking the I-pill. If you took the first pill within 24 hours after sex, it is said to be 95 % effective.


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Hello doctor, There is no withdrawal bleeding after Unwanted 72. Period date: 4th of this month, sex date: 16th and tablet intake: 17th of this month. When will I get my period or withdrawal bleeding and when to have home pregnancy test?


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Hello. It is not always necessary to have withdrawl bleeding after taking Unwanted pill. Some women do not experience that. You should wait for your regular cycle date which might also get a little bit delayed due to intake of pill and if you missed your periods only then you have to do a pregnancy test. Otherwise, if periods start there is no need to go for it. You just relax and calm down. These pills are quite effective in preventing against pregnancy and your periods might start around 3rd or 4th of next month hopefully.


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Hello doctor, My teeth are getting deposited with something which gets removed after scaling but, soon develops after 20 days. This situation has taken place twice. I do not have soft drinks, coffee, and chocolates. I am very upset about this situation. Please help.


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Hello. Scaling is a temporary solution. You should maintain your oral health. As I have seen in pictures, there is stain deposition in your back teeth (attachment removed to protect patient identity). There are several reasons for stains, most common is smoking, fail to brush at night, not changing the brush for every two months, ignoring the brushing of back side teeth. Brush twice daily (especially night brushing), flossing, avoid smoking and gutkha paan. Make your teeth free from any deposition. Change brush every two months. If you follow these instructions, you do not need any scaling for several years. The most important thing is proper brushing technique. All surface of teeth should be involved, and prolonged brushing is not required.


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Hello doctor, In my penis, veins are visible and it is painful. Last month I consulted urologist, and he gave me Evion 400 tablet for 20 days. I masturbate daily. What I have to do now? Shall I keep Heparin cream on penis vein? Please help me.


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Hello. There are always large veins on the upper aspect of the penis, and they transport blood back towards the heart. Since the penis is an erectile organ, the veins have to be large and zigzag (tortuous), so they can elongate when the penis becomes erect. Sometimes the pain may occur due to rough masturbation. Please do not use Heparin cream as it is not needed. Avoid rough masturbation for a few days. Take care.


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Hello doctor, I am 21 years old, girl and I think I have genital herpes. I am full of white blisters that are very sore and burn. My lymph nodes in my groin are swollen and tender too. I generally have been feeling very poorly for the last few days. I am extremely uncomfortable. I am taking contraceptive pill.


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Hello. It is better to confirm that it is herpes by having one local examination by infectious control specialist and to have high vaginal swab or biopsy from lesion to check in laboratory. If it confirms, you can have tablet Acyclovir 800 mg five times a day for 10 days but only after confirmation. Have complete treatment of any health issues you have. Have recreational activities and quit recreational drugs. Have balanced diet, weight and BMI. Have a strict hygeine.


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Hello doctor, Before a week I went to the hospital and I found out that I was pregnant with a hCG level of 23. The next day, I started getting cramps on my lower right side stomach. Four days later, I got two transvaginal ultrasounds and nothing was found in the uterus, or anywhere else. So I was sent to the hospital again concerning an ectopic pregnancy or possible miscarriage. I got blood tests done, and they told me that my hCG levels went down. So, they ruled it out as a miscarriage or I was in the process of losing it. So on the next day, I went to my doctor, and she told me that she does not understand why they said to me that my levels went down as they went up from 23 to 100’s, so she said it could be an ectopic pregnancy. I got more blood test done, and I came to know that my hCG levels are going up but very slowly. I do not know what is going on. First, they said it was a miscarriage and now something else. I need answer. This is my first pregnancy.


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Hello. Let me give you a few basic facts about beta hCG (human chorionic gonadotropin). This hormone is produced from fetal tissue. Once it reaches a level of 25 mIU/mL, it is detectable in the urine test. A normal rate of rising of beta hCG is double in 48 hours. This doubling would mean a healthy pregnancy inside uterus. Rise less than double would mean either an abnormal or ectopic pregnancy. But your level has risen satisfactorily. Many times even a rise just below double also is normal. Only when the level reaches 1500 mIU/mL, then the fetus will be seen on the scan. So do not decide about the health of the baby until the scan sees the sac or fetal heartbeat. The blood test is not always right. Just wait for 10 to 14 days and have a scan. Hope for the best and pray well. I hope I have clarified your query, do write back if any more questions, for feedback.


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Hello doctor, My friend got boiling water thrown on him. Will Taro-Mupirocin help the burns go away or help him in healing the burns?


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Hello. I do not think Taro-Mupirocin will be much effective. Instead of this, you may use Silver Sulfadiazine ointment which helps to relieve the burns and give a cooling effect also to much extent. Also, apply a lot of ice over the burnt area. Ice application helps to heal much faster. Take some anti-inflammatory consisting of Ibugesic (Ibuprofen) and Serratiopeptidase combination to relieve the pain and inflammation.


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Hi doctor, I have been having ice pick headaches. Hence, I went for an MRI scan and regular blood tests. Now, I am wondering whether my report is normal. Can you please guide me? Thank you.


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Hi. The attached MRI images (attachment removed to protect patient identity) showed normal findings. Revert back with the complete pictures to a radiologist online -->


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Hi doctor,Every morning while I brush, I notice bleeding from my gums. I do not have any pain. What is the possible cause and solution?


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Hello. I understand your concern. The most common cause of bleeding from gums is inflammation of the gums, otherwise called as gingivitis which leads to periodontitis if left untreated. The reason to develop gingivitis is mostly associated with oral hygiene and oral hygiene habits. You may consult your local dental doctor and get a dental cleaning done and follow up after a week to check if your symptoms have subsided. It is most likely to resolve if associated with oral hygiene. Other factors affecting gum health may be menopause, diabetes, etc. Visiting a dentist every six months for a regular check-up is recommended. For more information consult a dentist online -->


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Hi doctor, In the home test, I observed a faint pink line on five days overdue of periods, kept checking and a faint line got a little bit darker in 2 to 3 weeks. But not exact darker as it was during my first baby time, who is a healthy boy of 10 months. I am now at six weeks four days pregnant. I took 3 to 4 hCG blood tests and the results were 400 (previously 150 and 350). I was precribed to take Duphaston due to some spots, now I am asked to stop due to hCG not rising properly. On TVS, I was told to have a thick endometrium of 20 mm. My doctor asked me to wait till next ultrasound. Also, I have been a PCOS patient and treated and delivered a healthy baby. I cannot feel any symptoms of pregnancy as I felt last time. What do you feel about my condition and advise, please? I am taking only Folic acid and asked to wait if period comes or not. Stopped Duphaston two days ago.


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Hi. I have read a detailed description of your query. Beta hCG should increase around 66 % after every 48 hours in a normal healthy pregnancy. Have a strict check on your symptoms. Beta hCG if shows increase but less then 60 %, then ectopic should be excluded by having transvaginal scan and symptoms. In case of a suboptimal increase in beta hCG, actually happens in pregnancy outside the uterus. In your case, beta hCG is very less, not even above 500 and should be followed strictly. Symptoms could be abdominal pain, bleeding, etc. It is better to repeat beta hCG after 48 hours and have a detailed scan with expertise hands. Follow beta hCG scan, check in detail and report symptoms that you have to an emergency gynecologist. Ectopic. Beta hCG, a detailed transvaginal scan. Ectopic, early pregnancy. Have beta hCG and detailed expertise scan with a local examination. Strict check on symptoms and report.


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Hello doctor, I eat three fruits together in the morning that is kiwi, guava, and papaya for breakfast. I read that this combination is fine. I do not eat many vegetables, but I would love to have a vegetable juice for complete nutrition. Can you please suggest a juice which I can have as a daily routine.


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Hello. In this age group, it is better to take fruits and vegetables in your daily diet. You can take the following vegetable juice in your daily routine. 1. Carrot juice, contains beta carotene and natural source of Vitamin A. It helps to improve your eye health naturally. It contains fiber which helps to evacuate bowel easily. 2. Spinach juice, is a good source of multivitamins like Vitamins A, B2, B6, C, and E, etc., and micronutrients like zinc, copper, magnesium, manganese, calcium, and iron, etc. It helps to improve your overall health, hair, and skin. 3. Cabbage juice has a high capacity to heal the peptic ulcer. It also helps to fight against cancer. It is a good detoxifier. 4. Sweet potato juice, is a good source of Vitamin C and B12. It helps to resolve arthritis and inflammatory issues. 5. Beetroot juice, is a rich source of multivitamins and minerals. It helps to improve Hb (hemoglobin) count, and subside skin disorders. Here I have mentioned some vegetable juice and their benefits. You can also select tomatoes juice, bottle gourd juice, to fight against abnormal cholesterol and hypertension. You can mention it in your daily routine as per your issues or for natural health.


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Hi doctor, I eat healthy food on time. When I feel hungry I used to eat good quantity of food, but I am not putting weight. What could be the reason?


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Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. Every person has his/her own metabolic rate of body. Some have high metabolic rate causes high combustion of nutrients into heat, that dissipates in vain.  Some diseases also cause such issue. I am ordering some laboratory work for you. When you get the reports, upload them for review and I will guide you why is this issue with you. 1. Thyroid profile. 2. HbA1c levels (glycated hemoglobin). 3. Fasting blood sugar levels. Immunity booster foods good for you are:- Citrus, red bell peppers, broccoli, garlic, ginger, spinach, almonds, yogurt, cashew, turmeric, green tea, berries, citrus fruits, kiwi, apples, red grapes, kale, onions, sweet potatoes, carrots, old fashioned chicken soups and shiitake mushroom.  These foods have got miraculous effects on patients of this category and I have a wide variety of experience on observing improvements in my patients. Most of my patients name them as the magic foods. Also tell me your age, height, weight and waist circumference to help you in a more personalized medical way.


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Hi doctor, I have mild vertigo for the past one month. There is no sweating or vomiting. I do not have any pain in the head and there is no problem of hearing and vision. I am only experiencing some balancing problem. My ENG test is absolutely normal. What will be the possible way to reduce this?


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Hello. I understand your concern. I would like to tell you the causes of unsteadiness or dizziness. They are aural (disease of ear) and extra aural. Under extra aural there comes a long list of diseases. As your electronystagmogram (ENG) is normal, there is likely less chance of aural cause. Please consult your doctor for thorough examination and relevant investigation to reach correct diagnosis that may be managed accordingly.


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Hello doctor, I had been on Femilon last month and did not continue with it this month after my periods. When I was on Femilon, I had discharge after the intercourse and I assume that the semen flows. Now, while I am not on Femilon anymore, I am still getting discharge after intercourse. Does this discharge mean that the semen is not getting inside and comes out entirely? If no, what could cause this discharge? If yes, would I be able to still conceive if the semen flows out of my body after the intercourse? Please help.


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Hello. The discharge after the intercourse is more likely to be cervical physiological discharge which is following sexual excitation and can come out as mucoid homogeneous non-smelly vaginal discharge. If the semen is coming out after ejaculation then it is advised that you should practice sex in missionary position and keep two pillows under your back during the act and after ejaculation cross your legs and lie down for 10 minutes. This shall avoid extrusion of sperm and shall increase your chances of conception.


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Hi doctor, My mother underwent gallbladder surgery 10 months ago. From past 3 months she started having chronic cough. She tried many home remedies. She did not recover completely. I took my mother recently for a health checkup. As I suspected the chest report was not absolutely fine. But, the doctor was not at all concerned about her cough and said everything is normal. Why is it so? I want to know what is the meaning of this x- ray report and what should be our next step? Presently she is under medication for thyroid as well as diabetes. I have attached her reports. Kindly have a look at them and suggest how to go about the treatment. Thank you.


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Hello. Thanks for choosing this platform. As you said your mother is having chronic cough 4 months after surgery. It can be just coincidental finding as her x-ray (attachment removed to protect patient identity) is showing prominent basal vascular markings and cough can be aggravated by surgery. The x-ray findings are suggestive of interstitial lung disease called lung fibrosis which can be confirmed only after HRCT (high-resolution computed tomography) scan of chest. So at the earliest, I advise you to do HRCT scan of chest to rule out IPF (idiopathic pulmonary fibrosis). Once the diagnosis is made, treatment can be started accordingly. IPF or lung fibrosis is a chronic and progressive condition. So, diagnosis should be made as early as possible.Talk to your pulmonologist regarding further investigations and treatment. He will guide you better as frequent follow-up visits are required for monitoring the disease. Autoimmunity. HRCT chest to rule out IPF. Interstitial pneumonia. IPF (idiopathic pulmonary fibrosis). 1. Steroids 2. Immunosuppressants. Strict control of BP and blood sugar is a must.


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Hello. May I know your age, and since how many months are you experiencing thinning of hair? Please send the pictures of the scalp.


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Hello. I have seen all your FDG-PET reports, which is very sensitive to detect any tumor activity in unidentified mass as the scan shows solitary pulmonary nodules in the left lateral lower lobe. This scan is beneficial to identify and detect tumor by detecting the oxygen utilization level as tumors have growing tissue, which takes more oxygen, so it shows increased activity of that area. Now I will tell you what is happening in your case. Generally, a solitary nodule is very common in the population as it has asymptomatic, multiple etiologies like infection, tuberculosis, simple benign tumor-like hemangiomas, inflammatory disease like sarcoidosis, malignancy, and pulmonary embolism, this all causes pulmonary nodules, out of which 90 % are asymptomatic or benign type. But in your case in the scan 1. Some metabolic activity is seen but not that significant as normal-malignant tissue shows,  2. The nodule has a well-defined shape, but with pleural extension. 3. There is no hilar lymphadenopathy, which is very common in lung malignancy. So it can be a healing granulation tissue, secondary to infection or immune reaction, but it is more unlikely to be a tumor. The last thing I wanted to ask you is, do you have any symptoms of breathlessness, weight loss, anorexia (eating disorder), or heavy smoking history, or hemoptysis (coughing up blood)? Kindly tell the history for better detection.


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Q. My daughter has acne in chin and jawline with intake of Cabergoline for high prolactin. Please help.


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Hello doctor, My daughter has acne on her face for the past one month. I think that is hormonal acne because it is in her chin and jawline as per my knowledge. She is taking Cabergoline .25 mg per week for an increased level of prolactin as prescribed by an endocrinologist for the past three years. There is no acne on her face for the last three years but now suddenly it appears on the face. Sometimes it is white and small and it often occurs on a daily basis. Kindly suggest.


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Hello. I have gone through the history and prescription you have attached (attachment removed to protect patient identity). Honestly speaking, I cannot understand what is written in the prescription. Can you send me a picture of individual medication so that I can get an idea of what is she taking? It will be of great help to guide you further with new medicines and creams.


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Hello doctor, I am a 30-year-old married male. Me and my wife are trying for a baby but not able to concieve. I did semen test, sperm count was 84 million, morphology 60 percent, and 40 percent viable but motility was very low five percent rapid progressive, and 10 percent slow progressive. So the doctor gave Fertyl M and Hey Forte Plus tablet (twice per day) to take every day. I am consuming for the past two and a half months and trying for a baby. How long I need to continue these tablets, and when will it be effective?


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Hello. Usually, these medications take one sperm cycle (around two months to act). As you have already taken for two and a half months, repeat the semen analysis test to see the improvement. Further course can then be decided accordingly.


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Hello doctor, I took an STD panel test and got a positive result for HSV-1 IgG Ab test. My result was 49.20, but the reference range was 0.91 for negative and anything over 1.09 as positive. Does my 49.20 mean the infection is a very recent one because it is so high? I am confused about why it is so very high. Should it go down over time? I have also heard that a high IgG could be related to HIV, as I was tested negative for it at day 105 after potential exposure (the last sexual encounter I had was three and a half months ago). Does an HSV IgG antibody test measure for antibodies that are only relevant to HSV, or should I be worried about HIV?


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Hello. HSV (herpes simplex virus) IgG (immunoglobulin G) antibodies indicate previous exposure and HSV IgM (immunoglobulin M) indicates current disease. The positive IgG can become significant only if you have active lesions. The type one usually causes oral lesions which look like small blisters. The HIV testing recommended post exposure is the PCR (polymerase chain reaction) or the fourth generation. Which testing did you get? If the antibodies are negative for three months out it is a good sign. But I would be satisfied if HIV by PCR is obtained. I hope I have answered your questions.


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Hello doctor, I have read that cracked skin is a symptom of genital herpes. But I searched to find a picture or an example of what this cracked skin would look like and have found nothing. Could you explain what this would look like? And would these cracks become permanent or how long they would take to heal? I have had sore legs that occurs and disappears in the groin area.


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Hello doctor, My age is 22, and I have lots of pimple, acne scars, and dark circles. I am trying to get rid of them since last year. And I have white hair which are increasing. My nails are very week, and my foot nails become dead after some time. Kindly help.


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Hello doctor, I am a 41-year-old female. I am suffering from sensorineural hearing loss. Is there any Ayurvedic treatment for this? Because I do not want to use hearing aids. Please help.


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Hello. Sensorineural hearing loss cannot be reversed or cured. Scientific evidence about preventing it from causing further damage due to age also is not very sound. However, what is the cause of neural loss? Is it present in both ears or only one? Can you upload your audiometry to check? Was an MRI scan done to rule out neuroma of the eighth nerve? Ayurvedic medicines rely on improving the nerves so that their functioning stays sound. It will not help in overcoming the loss. It may, however, prevent further deterioration of hearing in that ear due to aging with time.


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Hello doctor, I am a 42-year-old male. Because my half brother had a heart attack at 21 and died. I paid for an angiogram and exercise stress test. I had a good exercise outcome, but the angiogram showed triple vessel heart disease. The cardiologist said it was very mild and probably due to smoking. Cholesterols were in the normal range. I was placed on Statins and low dose Aspirin and discharged. The doctor told me that I need not worry and many people would have mild atheroma at my age. My concern is triple vessel sounds very serious and also I have a print out from the angiogram that I cannot understand. I need a second opinion. I am so anxious about it every day, and I am worried.


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Hello. Thanks for providing a detail note (attachment removed to protect patient identity). I understand your concerns, but no need to be worried you will be fine. The study only shows minimal evidence of coronary heart disease, which is reversible as of this moment. In cases like this, I usually advise my patients to modify their lifestyle. Do the regular exercise of at least 30 minutes three times a week, stop smoking and adopt a healthy eating habit. Continue the medications as prescribed and hopefully you will be fine.


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Hello doctor, I have a skin ulcer that appeared about a week ago in the pubic area. The initial lesion is now surrounded by four liquid filled bumps that look like they also will become ulcers. A small itchy bump developed into an ulcer in 10 days. Three days between photos at a different stage of the ulcer. Now itches and oozes.I have never had a skin issue like this. My girlfriend thinks it was because my swimsuit was not cleaned for days. We live in a hot, and humid climate overseas. Please recommend medicine.


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Hello. 1. Looking at the images (attachment removed to protect patient identity), I could think of two differentials for it and they are pyoderma, a superficial bacterial infection, or herpes genitalis, a disease spread via sexual contact and presents with grouped blisters with pain. 2. Right now treatment for pyoderma is all that you require as even if it is herpes anti-herpetic medications are not needed after 72 hours. So clean the area with normal soap and water and apply following cream twice a day and take these medications for five days. Kindly consult your doctor and take the treatment with consent. 1. Tablet Cefadroxil 500 mg twice a day. 2. Tablet Fexofenadine 180 mg once a day. 3. Cream Mometasone plus Fusidic acid twice a day. Get following investigations done if possible, HSV 1 and 2, IgG, and IgM serology.


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Hello doctor, I am a 34-year-old female. I am on my second pregnancy. My last menstrual period was a month ago. Last month my beta hCG was 2708 mIU/mL, and transvaginal ultrasound showed GA (LMP) 5 weeks. Gestational sac 0.66 cm (no yolk sac or fetal embryo seen). A single intrauterine pregnancy with left corpus luteal cyst. I was suggested to take Ecosprin 75 mg, Folic Acid, and Progesterone injection weekly. Kindly advice.


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Hello.  Your details show that there is no yolk sac seen on the scan until now (attachment removed to protect patient identity), but you have not mentioned any query. I suppose you are worrying for absent yolk sac. I would suggest to repeat a scan after a week or so and also repeat beta hCG after 48 hours of the previous test date and check if it is almost doubling or not. If it is nearly doubling that would mean that your pregnancy is viable. And soon yolk sac will appear, but if the level is falling, then it would mean that abortion might be there. I hope it has helped you. If you have any further queries, please do not hesitate to contact me.


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Hello doctor, I have had a lot of hair loss in the past year. Mostly on top of my head. Lost half my hair. My regular doctor did not find anything wrong with my blood test and said hair loss affects a lot of women and accept it. My new Naturopath thought my numbers seemed low and suggested iron and thyroid supplements. I need another opinion. I have tested positive for Hashimoto’s, and I have ankylosing spondylitis. The dermatologist did scalp bio negative for inflammation. My TSH is 3.71, T4 is 99, T3 is 110, and FSH is 8.1. The values of zinc is 82, ferritin 36, Iron 93 and TIBC 315. Please help me know what I should do?


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Hello. Hair loss in females can be due to many causes, most common being 1. Telogen effluvium stress-induced, due to illness, a diet with low protein intake, surgery, post-pregnancy, and mental stress. 2. Female pattern alopecia is genetic and hormone-mediated, runs in the family. 3. Diffuse alopecia areata is autoimmune condition usually associated with other autoimmune disorders like diabetes, thyroid disorders, and ulcerative colitis. 4. Drugs such as Isotretinoin, and Chemotherapy drugs induce hair fall. 5. Lupus, scarring alopecia. With your description, it seems like diffuse hair loss, but I cannot confirm unless I see the pictures. In your situation, I feel it is autoimmune condition most probably diffuse alopecia areata, because you have been diagnosed with Hashimoto's and ankylosing spondylitis. I do not know if you have taken an injection of corticosteroids (Triamcinolone) for the scalp. This is very helpful in an autoimmune condition. I am considering the most probable cause, and it could even be female pattern alopecia. Do you have a family history of baldness, history of surgery, illness, stressful events before you noticed hair loss? Please send the pictures of the scalp.


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Hello doctor, I am a 27-year-old male. My weight is 255 lb, and I am a smoker. I suffer from panic attack, anxiety, and fear of cancer for six years. Right now I have been spending all my day reading about brain tumor because I think I have it since I have all the symptoms. Two weeks ago I had a panic attack where I felt I could not breathe, and feeling fainting. After that day, my ears started hurting a little bit, and I started feeling lightheaded, which is very hard to explain. My head feels like I am drunk but it is not spinning. I have not slept for days. I had this problem before when I had anxiety issues, and I went in urgent care, where they checked my ear and I did not have ear infection. The doctor said your neck muscle feels irritated and sore. He said it could be due to it or allergies. And he prescribed me nasal spray to use, but when I used that, I experience terrible headache with neck pain. After two days, I had the feeling that I am about to pass out again, so I decided to go in the ER. I told the doctor I need MRI and may have a brain tumor, and she said I could not do MRI on you without doing a blood test, ECG, and some tests where she makes me walk in a straight line and, etc. My blood test and ECG came back 100 % good. My doctor said there is no need for an MRI. I doubt that how she knows I do not have brain cancer? She gave me some pills for allergies, but I am not taking it because I think I have a brain tumor. I am a painter, and I paint houses, and I work 14 hours a day. I do not feel any tiredness just this feeling in my head is killing me. Do I have a brain tumor and am I going to die within a year? I do not have a loss of appetite or anything, and I am just really thinking that I have a brain tumor. What do you think my problem is?


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Hello. Possibly you are very anxious with thoughts of having a brain tumor. It may be part and parcel of your previous anxiety problem, which might have increased recently. I suggest you consultant a psychiatrist for anxiety issues. For relieving your current thoughts and anxiety, you can get an MRI brain. Otherwise, your thoughts will keep on making you restless. The doctor might have said of not having a tumor because you do not have a different kind of symptom. Still, you can get MRI done, to relieve these thoughts. But for further management, you should meet a psychiatrist. T3, T4, TSH, serum vitamin B12. Anxiety disorder. Daily exercises in form of jogging and yoga.


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Hello doctor, Over the last two days, I have had a bad sore throat. It also accompanies with a slight cough, trouble in sleeping, occasional uncommon sweating, body soreness or fatigue, slight vomiting and voice loss. It is not really getting better. It originally appeared to be just a bad cold, but today there is blood in my sputum. It started about 15 minutes ago and it is only when I spit it out every few minutes. Should I be concerned? My mom thinks that it may be due to a laryngoscope I got at the ENT yesterday. But, no bleeding occurred until now. Thank you.


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Hello doctor, I am having red rashes on the bare skin of the penis. I used Candid Total and it disappeared completely. Again after seven days it appeared on right and left side of the penis. I continued using it and then got an advise from one of my friend for using Surfaz sn along with DOXT-SL 100 which I am using it since last seven days. The patches are getting orange type color. Sometimes the foreskin of the penis burns while urinating. No pain, no difficulty in urinating, sometimes itching is there on the forehead of the skin. Please advise.


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Hello doctor, I had retina detachment in my left eye before three months. I have silicone oil in the eye. Vision is not bad, but I have a problem with depth perception. Everything is smaller in the bad eye. I see people with small heads and big bodies. Is this normal?


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Hello. I understand your concerns. The main problems you mentioned are depth perception problems, and distorted images also called metamorphopsia. Depth perception occurs when both the eyes see well, it is hampered when one eye has blurred vision or squint. Metamorphopsia happens when the central area of the retina (macula) is affected or the retina becomes edematous due to the effects of surgery. These problems can be troublesome but do not indicate any specific information regarding the progression or recurrence of retinal detachment. I suggest reviewing with your ophthalmologist to clear your doubts. I hope this helps you.


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Hello doctor, I am having left-sided headache, mostly frontal and behind my eye for a week. I have ear pressure and pressure in my nose while moving and chewing. I have seen my PCP, and I was given Imitrex that does not help. I have tried Aleve, Motrin, and Excedrin.


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Hello. Your symptoms could be related to a sinus infection, especially considering the pressure in the ear, eye, and nose. For this reason, I would recommend performing a sinus X-ray study to investigate the possible cause. Antibiotics and nose decongestants may be necessary in case of sinus infection. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need. Sinus infection. Sinus X-ray. Migraine. Sinus infection.


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Hello Doctor, I have very thin and short eyelashes and eyebrows. I want thicker and longer eyebrows and eyelashes. Please help me.


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Hi Thickness and size of eyelashes and eyebrows depend on your genetic inheritance. If your genetic makeup indicates your eyelashes to be thin then they will not grow bigger than your genes allow. In case your genetic material indicates your eyelashes to be thick and beautiful and because of some disease they do not grow well, the following steps will help: Consult an ayurveda specialist online for further queries -->


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Hi doctor,I had a question about birth control for acne. I was initially on Tri-sprintec. However, that did not help my acne. My doctor initially prescribed my YAZ. I was wondering if I should just stop birth control altogether or give Lo-Lo a try. What is the difference between birth controls and how that would help or hurt me? The last thing I want is more breakouts.


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Hi. Birth control contraceptive pills are hormonal pills that help to prevent conception by interfering with the normal menstrual cycle and inhibits ovulation, conception, fertilization, and implantation. These pills are hormonal contraceptive pills that have generalized as well as a specific short and long term effects on the body but it differently affects different individuals. Combined oral contraceptives are composed of two hormones mostly and can give unscheduled bleeding, acne, mood variation, breast engorgement, endometrial hyperplasia, headache, stroke, high BP, stroke, endometrial hyperplasia, breast, and endometrial cancer as long-term. All side-effects cannot be for all patients so side effects differ from person to person. For removal of hairs or reduce their growth or for better skin better to have local treatment mostly natural and herbal remedies along with a reduction in weight, balanced diet (more fruits, vegetables, and water). Have waxing with honey and ginger paste. Have threading for face hairs, plucking for arms and forearms or electrical removal. You can have a mud mask to reduce oil production of face that is the main cause of acne. After some time, acne is supposed to be resolved after teenage actually. Have a balanced diet and try to avoid oil, spice, salt, and sugar. Have daily walk, exercise, yoga and try to have normal BMI. Try to change contraception frequently to reduce their side effects. For now, you can have injection Medroxyprogesterone for three months. Contraceptive with acne. Injection Medroxyprogesterone for 3+3 months, then change contraception mode. A balanced diet, weight, BMI. Waxing, threading, plucking of unwanted hair. Mud mask for face oil.


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Hi doctor, I am 24 years old. I am not on any sort of birth control pills. I had a normal menstruation in the starting of this month and normal bleeding. After six to seven days, I started bleeding again. The bleeding was not very heavy, but lasted on and off for about six days. Now, after a gap of four days, I have got heavy bleeding again. It is not brown blood as I normally see during my period. It is dark red, much thinner and flows readily like a liquid. I feel pain in the lower abdomen whenever I get this bleeding. I also feel weak. There is no pain on urination or sex. I do not have a history of any infections. Also, I am not on any other regular medication. I am pretty sure that I am not pregnant. I have got a GP appointment in a week, but it is really worrying and painful sometimes. What could this be?


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Hello doctor,I have spotting but it is only when I wipe. It seems like it is stuck or something is there. My lower back hurts. Something is seriously wrong. Pease help. Currently, I took birth control pills.


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Hi. I do not know how long you have been on contraceptive pills and which one these are? Either combined oral contraceptive pills or mini-pills have Progesterone only. Combined pills have lots of side effects especially for females with high BMI (body mass index) while Progesterone only pills show irregular bleeding. It depends on every individual females body (that how long and how much you get bleeding). Have some healthy lifestyle. Try to avoid long-term use of same contraceptives to avoid its side effects. Have some investigations and have proper treatment. Try to reduce BMI by having daily exercise and walk as this will help you to prevent side effects of many things. Try to change contraceptives. Have full treatment of any disease, if you have any. A healthy nutritious diet with recreational activities and avoidance of recreational drug if you are using occasionally. Have local examination by gynecologist doctor even hysteroscopy to exclude any local pathology. Get a transvaginal scan, colonoscopy clinic visit to exclude cervical pathology, complete blood count, thyroid function test, and high vaginal swab. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am 19 years old. I had sex four months before and ovulated on the second day after having sex. I got periods on the next month for four days, and after five days of my periods I got a Nexplanon birth control, and the doctor gave me a negative pregnancy test. I then had a period of 14 days in the next month and I am still spotting. I am just wondering if there is any way for me to be pregnant? I have not had sex since then. But I am paranoid that I am pregnant I cannot afford an abortion. Also, I cannot even afford to go to the doctor or have a way to buy a pregnancy test. For the past couple of days, I have felt movement, but it could be gas. I have also been having sharp pains in my lower abdomen for a while especially when sneezing or coughing hard. I always had very painful and heavy periods associated with sharp pains while pooping on period. The birth control has helped by stopping my period, but I still get the sharp pains randomly. Kindly advice.


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Hello.  No, you are not pregnant as your pregnancy test was negative at the time you got Nexplanon implant, and you did not have had sex afterward. So calm down now and give relief to yourself. Your periods have reduced due to the effect of Nexplanon as it is a contraceptive as well as it also reduces blood loss during periods and some women get reduced bleeding or absent bleeding in the very start of the implantation. Your periods will slowly return to normal. So do not have to worry about pregnancy now. And secondly all of the symptoms you told are pointing towards anxiety, and you need some stress reliever. The problem with passing stools may be due to the lack of fiber in your diet. You must drink plenty of water and increase the intake of fiber by eating more vegetables, and less junk food will help improve your bowels, and hopefully, this issue will be resolved soon. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


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Hello doctor, I am a 37-year-old male. I had brief nausea before five months. I visited a general physician who suspected GERD and put me on Motilium for GIT and later Pan 40 then Ranitidine for three months. I vomited only once but had been having a burning sensation in my chest. The burning chest has long stopped. I even had an OGD done which was normal. The pain, however, moved to my throat, and I had a feeling of something in my throat ever since though I have no swallowing problems. I have this persistent pricking pain in my throat that does not go away, and also the back of my tongue on the right side feels kind of inflamed (not sure about this. But the tongue feels sore-ish). Throat pain and tongue discomfort are always present. My general physician later recommended to do a neck MRI which I did and was told looked fine. So I am stuck on what exactly could be wrong with me. I do exercise (treadmill and gym) regularly, I am an active person though I must admit I worry too much about my health and it stresses me.


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Hello. I viewed your MRI images of the neck and chest area (attachment removed to protect patient identity). Neck findings, there are few small mucosal cysts in the right maxillary sinus. There is a small lobulated cyst like area anteriorly in the floor of the mouth to the left of the midline and is a benign lesion. The findings are incidental and not of any serious cause. The oropharynx, hypopharynx, and cervical esophagus are normal. There is no luminal obstruction. Chest MRI findings, there is no significant abnormal findings in the chest. It is sometimes possible for anxiety to cause soreness of the tongue. You can have a follow-up visit with your doctor after a month if the soreness is still there. I agree that finding a serious cause can make you stress-free. However, you are lucky to have no serious findings in the images and can continue to be in good health. Please avoid alcohol or any food that can irritate the oral cavity for a few days.


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Hello doctor, I have doubts regarding indigestion, severe hair fall, acne with irregular and short menstrual cycles, which is lasting from a few days. Are these interrelated? I am suffering from PCOS, as the latest lower abdomen test shows a cyst in the lower ovary. Also, my menstrual cycles are getting reduced to one to two days with severe pain and indigestion during periods. For the past one month, I have started taking Shatavari gulam. Sometimes I also observe the cracking of bones in my legs. Please suggest me the treatment plan.


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Hello. I came to know from your complaints that you have PCOS with hair fall, indigestion, and reduced menstrual flow. Yes, your doubt is right, it is all related. As per Ayurveda PCOS is caused by eating excessive sweet, fatty foods which increase kapha (mucus) in the body. When kapha increases, it reduces the digestive power and patient complaints of indigestion. That is your main problem that I understand. Due to improper diet and physical activities, vata (pacifying foods) also get aggravated in PCOS. Hence the digestion is not proper, and the rasa dhatu is not formed properly affects the menstrual blood (rakta dhatu) and that cause more kapha and medas, and this is why some PCOS patients will gain more weight. The undigested food is called ama. This ama will produce hormonal imbalance that causes changes in menstrual flow. Some patients will complaint heavy flow once in three months, or some complaints less flow that lasts for one or two days. The energy responsible for transformation is called as pitta. In PCOS, pitta is also getting vitiated and patient complaints of hair loss, pimples, painful menstruation sometimes with clots. The movement of follicles from ovum to fallopian tubules is controlled by vata. When vata is impaired producing scanty menstruation with pain, the cracking of bones in legs happens due to aggravated vata. Hence treatment will include all steps to reduce vitiated vata, pitta, and kapha. Treatment plan. Kindly consult your doctor, discuss the suggestion and take the treatment with consent. 1. The first step is to improve digestion through Ashta choornam or Vaishwanara choornam or Hinguvacadi choornam or Amruthotharam kashayam. 2. Next step is to pacify the increased vata through intake of Narayana thailam one teaspoon in kashayam which I am going to explain in the third step or simply oil in hot water. 3. Pacify pitta and kapha through Varanadi kashayam, Kulathadi kashayam, and Kumaryasavam. 4. Raja pravartini vati is also effective. 5. Regular intake of sesame seeds (black) with jaggery is also a natural remedy for menstrual problems. 6. Garlic roasted in ghee is very effective for painful menstruation. Garlic should be taken three weeks before to menstruation. 7. Avoid junk, spicy, oily and fast food. Try to reduce the intake of pickles which produce water retention and cause pain during menstruation. 8. Proper sleep and stress reduction are also important. I saw in your report that you have a cyst in the left ovary (26*26 mm) which is not dangerous and it is a simple cyst that can be managed with medication (attachment removed to protect patient identity). I think my reply will help you. If you have any doubts or complaints, please contact me. For better results, please follow the medications for one month and contact me later.


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Hello doctor, My son is 11 months and 25 days old. He has some gas problem for last one week. And he is not eating properly, breastfeeding is done during night and one to two times in the afternoon. He does one potty a day, sometimes four potty, and watery potties also. He releases gas very often. Potty smells very bad sometimes. Can I give Enterogermina respules twice a day for two to three days? Our pediatric doctor prescribed it before two months and also before four months. He mostly has this type of gas problem. Is any medicine available for daily medication purpose to get rid of it?He is not gaining weight for about the last three months. He is always between 7.4 to 7.6 for the last four months. Pediatric suggest Hemsi-D drops twice a day. We are giving it for the last two months but not getting results. Kindly advice.


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Hello. I got your concern. No need to give Entrogermina (Bacillus Clausii) and Hemsi-D is tonic, is not for weight gain. At this age, he is more active than before so weight gain will be slower. Monitor his weight regularly give home food and breastfeeding. Give Albendazole, and do one stool report. Indigestion. Stool routine report. Syrup Albendazole (200/5) 5 ml stat at night. Follow-up after a week.


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Hi doctor, I struggle to focus and I cannot concentrate on my studies. I just think about other things, not always bad things, but sometimes I think about throwing myself out the window. When I am asked a question or if there are some people around, I used to get panic and struggle to answer. My voice will be too low and can hear my heart racing. I have been self-harming myself for over a year now. I have got cuts and scars on my arm. I do not get along with my family and I barely do anything anymore, either I sleep or think simply lying in bed. I sometimes hear voices of people who are not present. I feel like tight chest and my breathing is difficult. I want to do well at college, but I am not happy. My mood changes within a few seconds. I am too shy to visit a doctor. Please help.


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Hi. Personality issues. Psychotherapy (DBT - dialectical behavior therapy). For further information consult a psychiatrist online.--->


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Hello doctor, I get headaches very often. It is very sharp and painful. I feel tired if I workout a little bit. During workout I get headaches. I started losing my memory like I forget things too soon. Why is this happening? What might it be?


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Hello. While workout you are getting a headache. What kind of workout you are doing? Is the headache one side or mention the area whether front, back or sides? And you said after headache you are getting tiredness and memory loss. Some times in migraine headache you will have like this but usually one side. So I will suggest a few investigations. 1.CBC (complete blood count) and Hb (hemoglobin). 2.ENT (ear, nose, and throat checkup) and ophthalmologic check-up. 3.MRI brain. 4.Blood sugar levels. For the time being, take this medication with the consent of your treating doctor. 1.Tablet PAN-D (Domperidone and Pantoprazole) 1 bd (twice a day) before food. 2.Tablet Stemetil (Prochlorperazine) 5 mg thrice a day. 3.Tablet Paracetamol 650 thrice a day for five days.


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Hello doctor, I am a 47-year-old male. I have chronic fatigue being on healthy diet. I am not on any medication. There is also low libido. In the blood test report, the levels of UIBC, DHEA, estradiol, vitamin D, progesterone, phosphorus, and platelets were low from the normal level and high B12 level. In the past, my blood test has shown low RBC. Can you tell me what is going on?


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Hello. Your chronic fatigue can be explained by low levels of vitamin D, low phosphorus, and low DHEA (dehydroepiandrosterone). I will explain why do you have these low levels. There are many causes of vitamin D deficiency, but most common is inadequate exposure to sunlight which I think is the cause in you. Other causes of vitamin D deficiency are malabsorption of vitamin D, kidney disease (not in your case). Vitamin D is essential in the absorption of phosphorus in the intestines. So, a low vitamin D will eventually lead to low phosphorus. And both low vitamin D and low phosphorus can cause chronic fatigue. Remedies are, increase your exposure to sunlight. There is no need for vitamin supplementation at present. Your LDL cholesterol and total cholesterol is on the higher side. I advise you to take tablet Rosuvastatin 5 mg at night after dinner for one year and repeat lipid profile after one year. Also, go on a low-fat diet. Now coming to your low DHEA and low estradiol levels, DHEA levels usually decreases with increasing age so that it could be an age-related issue in your case. It can also be reduced in conditions like adrenal insufficiency, diabetes, kidney disease, but there is nothing in your reports to suggest these diseases. Low DHEA can explain for low libido and chronic fatigue, but low libido can also be due to depression and even abnormalities in prolactin levels (which has been not tested in you). Also, get one serum prolactin level tested. My advice is to increase your physical activity and decrease your calorie intake, this will help in increasing DHEA levels. There is no need for taking DHEA supplements. Low estradiol is also due to low DHEA, but that is not significant. Increased vitamin B12 levels are usually seen in liver diseases or myeloproliferative disease (diseases of the bone marrow ), but one more common cause is if you were on multivitamin tablets it might have caused increased levels. But if you were not on multivitamins, then I advise you get one bone marrow biopsy done for the evaluation or detection of myeloproliferative diseases because even low platelets are seen in these diseases. Kindly revert for any further queries or clarification.


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Hello doctor, I am a 31-year-old woman. My menstrual cycle usually lasts between 27 to 30 days. I usually ovulate on day 12 of my cycle. I usually track ovulation so I know I do ovulate. I recently took a blood test that shows my MCV is 77 and my MCH is 25 both below normal range. My HbA1c was 5.90 and my ALP levels were mildly elevated as well, at 134 (report said it had to be between 42 to 128). My TSH was fine and well within range. My problem is that my follicular phase seems fine but my luteal phase keeps changing. It lasts anywhere between 14 to 18 days. I wonder, is that normal? Do I need to test myself for PCOS? I never had acne problems. I have gained weight, but that is been over five years. I have never missed a period yet.


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Hello. It is really good to know that you are very knowledgeable about your cycle routine. Let me add a few things further into it. The first thing is that the luteal phase is always fixed (14 days) while the follicular phase varies in women's cycle due to hormonal changes in the first half of the cycle. If you want to calculate your ovulation day, then we usually deduct 14 days from the total cycle length. So in your case, your ovulation day is around 14 to 16 depending on if your length is varying between 28 to 30 days in my view. Ovulation on the 12th day is possible in those women who have a cycle length of 26 days. I hope it might have cleared how to calculate ovulation day. Secondly, all your tests are normal, and you have nothing to worry for PCOS as you do not have that because the cycle length of 26 to 35 days is being considered normal for any woman and you are falling in this criteria. I hope this information has helped you. If you require any further queries, please do not hesitate to contact me.


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Hello doctor, My son is 17 years old. He is doing odd things, such as calling the police for ear pain. He is under a lot of stress from national exams and high expectations. He does not sleep much, but his appetite is well. After calling the police and talking to them, he was back to his room studying. Late evening he told me that he is doing well and not to worry about him. Overall, he is distracted, and his grades are dropping. I am desperate as I am in the health field and I know that can mean severe pathology or simply a reaction to stress.


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Hello. It seems he is not in touch with reality, like calling the police for ear pain. Can you tell since when he has ear pain and how it started? Since how long has has such odd behavior and sleep problem? Does he express any other odd behavior? Is there any history of substance abuse or truancy? He might be suffering from adult ADHD (attention-deficit hyperactive disorder), depression, anxiety and ATPD (acute and transient psychotic disorder). The management depends upon the disorder he is suffering from.


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Hello doctor, I had sex with my fiance a month ago, and I did not use the condom. After 15 days the testicle pain started with abdominal pain, and then the small bubbles at penis glands. Now with the tiredness of the head, the headache is accompanied, and the sweat is high. I used to get testicle pain in only summer, three or four times per three months. The urine albumin present 1+ in the urine test, the urine epithelial cells 15 to 18 and the urine RBCs 10 to 12. What it could be?


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Hello. I have gone through your query. I would like to know a few more details to answer your question better. Have you have had any fever, rashes or joint pains in the last two weeks? Based on your symptoms, it is most likely that you either have a urine infection or some infection of the genitalia. The urine test reports also suggest the same. It would be necessary to have a complete physical examination to find out what is the exact infection and treat it with medication which should be able to get you back to normal. You may require a urine culture test or urethral swab test to pinpoint what the infection is. I would suggest you to visit your local urologist at the earliest to get the tests. I hope this helps, feel free to revert with any other questions or concerns.


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Hello. Please mention your last menstrual period date. Ideally, menses can be delayed safely and effectively by starting progesterone only pills from day 21 of your cycle daily till as long as you wish to delay your menses but advisably not more than 15 days. Once the pills are stopped, one usually get her withdrawal bleed in the next three to five days. If started later, on just a few days before the expected date of menses, then there are high chances that complete cessation of bleeding may not occur and you may experience irregular spotting in between the course of medications. Hence it is important to learn about your last menstrual date. You can use tablet Medroxyprogesterone acetate 10 mg one tablet twice a day from day 21 daily for the next 10 to 15 days to delay your menses. The most common side effect faced are progesterone side effects like headache, constipation and often bloating sensation, but it can be controlled by increasing daily water intake up to three to four liters a day.


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Hello doctor, I had an unprotected sex and noticed two issues on the shaft of my penis. The first thing I noticed was a dry, flaky area about the size of a dime. I have applied mosturizer to it thinking it was just dry skin, but it has not gone away over the past two weeks and that spot is still noticably lighter than the rest of the skin. I have also noticed a single, small white bump near the head of my penis. It is raised but only slightly. The white bump does not itch and is painless. Both I have noticed after unprotected sex about a month ago and did not change much. What should I do?


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Hello. If it is not sexually transmitted disease then it can be acne, Fordyce spots which develop when skin's pores are clogged with natural oil, called sebum, sweat, and dead skin, it can also cause infection. Pearly penile papules (PPP) is small, fleshy bumps that usually develop in gland penis in rows around the head of the penis. A skin tag is normal, and it happens as age advances. If it is lichen planus, it can lead to infection and needs medical management. If you have PPP, then it is normal, and there is no need for treatment. Regarding the white growth, if it is not painful, it can be syphilis. Swelling in the shaft, if not painful then think of syphilis. Please share more details regarding the issue, and we will work on treatment.


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Hello doctor, A while ago, I started noticing milky discharge from my breast, the discharge continued for about three months. After two months I started to develop red burning rashes on my breast. The rash first appeared as a single ringworm like red rashes on my breast and no improvement for two days now and rashes have increased at the sides of my two breasts. What could cause this? And are these two occurrences related? I applied a triple effect cream (Bmn plus cream) on it, that is when it started to produce blisters. Please help.


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Hello. I can understand your concern. Milk secretion in nonpregnant women is galactorrhea that can occur due to causes like increased prolactin levels in the body, prolactinomas, continuous usage of antacid like drugs, etc. Rubbing of clothes to the nipple can also lead to discharge. Tight innerwear, allergy to fabric material lead to skin rashes, etc. can aso be the cause for the discharge. So, you, please consult your gynecologist once, get examined and go for serum prolactin levels and if needed sonomammography. With this work up the possible cause of your problem can be identified and treated. I hope I have answered your query. Take care.


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Hello doctor, I believe I have dissociative amnesia. I am unable to recall memories until the age of 13. Every now and then I remember a spotty memory but it is never concrete and when I do remember something, in my mind it seems like a dream instead of a clear memory. What could I do with this?


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Hello. Memory is the most surprising thing. You remember some events so vividly while others wash out as if they never happened. The retention of things depends on our concentration and attention at that particular time, and the wish to remember it. We all forget most of our childhood memories only a few remain fresh in our conscious. Again individual variations present, but one thing I can tell you this forgetfulness is unlikely to be dissociative amnesia. Dissociative amnesia is usually followed by a stressful, traumatic event in which our mind subconsciously want to avoid. In the absence of stressor, it often does not occur. So if you have some really bad childhood memories, you may have dissociative amnesia. A detailed assessment of yours would be required for dealing with it and appropriate treatment requires some therapy sessions.


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Hello doctor, I have a question about hearing. Firstly, I am aware that hearing loss takes place when the tiny hair cells within the inner ear are damaged. My question is, once a particular hair has been damaged, will the same sound level that previously damaged it, hurt it again? For example, if you listened to a sound at 90 dB for nine hours and your hearing was damaged, would doing the same thing another day further damage your hearing? Or would it not change anything, as your ears would not be registering the same level of sound as the previous time?


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Hello. There is something called a temporary threshold shift and permanent hearing loss. Temporary loss is the loss which if a sudden burst of sound and you get hearing loss as hair cells are fatigued however hearing regains soon in some time. If it is a permanent loss that too at a severe level for all frequencies chances are the person will not notice the same loudness of the sound afterward however there are some pathologies where the sound amplifies itself, and it is called recruitment. So in that condition, the person may not even respond to a loud sound of 80 dB however they might complain abnormal loudness at 90 and feel the same discomfort as a person with normal hearing has. It all depends on the pathology and condition of the hearing loss.


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Hi doctor, I am having a tough time with my skin infection. It is being around two months since I got affected by that. I am having the hives of dark reddish in color in specific areas like on the penis point and on the buttock. It is so itchy and the whole body is getting so itchy like on hands and legs too. There developed some red spots. Can you provide me the best cure? Till now, some dermatologist suggested HH Mite ointment and I forgot the name of the other tablet. He said to apply that ointment for the whole body from neck to legs. I did, but no improvement. Please help.


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Hello doctor, I am 32 years old PCOD patient with primary infertility. My LMP was 10 days before. I took tablet Letrozole 2.5 mg once a day for five days from the next day of my periods. Today is my eighth day. I had a USG today. Findings are, ET 3.6 mm, right ovary follicle is 11 mm, left ovary follicle is 1.8X1.2X1.8 cm. What am I supposed to do now? Shall I take tablet Progynova to build up endometrium. Is that follicle on left ovary a cyst? Please guide me in the further course of action. You can prescribe me medicines, I can take it, as I am a gynecologist and I need guidance from an infertility specialist.


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Hello. As you are on day 8, ET (endometrial thickness) is low for the day of the cycle. You should be starting on Progynova (Estradiol) 2 mg one tablet twice a day for the next seven days. Your follicular scan days should be on day 11, 15 and 17. The follicles are appropriate for the age in the right ovary and are developing. The left ovary may be a simple cyst or late recruited follicle from the previous cycle but needs to follow-up with scan. At a follicular size of 20 mm, you should be opting for injection hCG 10000 IU intramuscularly for initiating ovulation. If this is a timed intercourse cycle and not an IUI cycle, then intercourse should be started daily from the day of hCG injection, else IUI to be done after 36 hours of injection hCG administration after a TVS scan (transvaginal ultrasound) to confirm rupture of follicle and also endometrial thickness (target 8 to 9 mm). Also progesterone-like tablet Susten (Natural Micronised Progesterone) 2000 mg one tablet twice a day can be started from day 16 for the next 10 days, to support pregnancy if fertilization occurs. On day 14 post ovulation, you may get a serum beta hCG test done to check for conclusive results with regards to pregnancy.


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Hello doctor, I am 55 years old and had my left ovaries removed when I was 40. I have low estrogen and suffer from brain fog, hair loss, pain, and weight loss. Currently, I am taking Vitamin supplements. What should I take and how often should I take it?


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Hello. In this age group these symptoms are very common due to hormonal changes. These are menopausal symptoms. You can take the following medicines regularly. Kindly consult your doctor, discuss the suggestions and take the treatment with concern. You should take Ashwagandha and Shatavari powder 3 gm each and Prawal Bhasma 500 mg twice a day with warm milk after meals. Also take Ashwagandharishtam 15 ml twice a day with equal amount of water after meals. Take these medicines regularly for one month. You should take Ashwagandha and Shatavari powder 3 gm each and Prawal Bhasma 500 mg twice a day with warm milk after meals. Also take Ashwagandharistam 15 ml twice a day with equal amount of water after meals. Take these medicines regularly for one month. Avoid spicy and fried junk foods, Drink plenty of water, do regular kapalbhati and pranayama like anuloma vilom nadi sodhan and bhramari.


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Hello doctor, I am a 53-year-old male with 6'2" height and weight 220 lbs. My HbA1c is 8.5, high triglycerides, vertigo, and some gait issues. I had a massive pulmonary embolism two years ago, not on any blood thinners, and sometimes I have high blood pressure. Contrast MRI shows a small focus of T2 prolongation present within the medial right cerebellum just posterolateral to the fourth ventricle measuring 5 mm which is also T1 hypointense and nonenhancing. This could represent sequela of an old lacunar type infarction with surrounding gliotic changes. Should I get the GGT blood test done? What is the cause of this problem?


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Hello. MRI findings are compatible with an ischemic stroke in the brain. The stroke could be related to atherosclerosis and diabetes. HbA1c is high, indicative of diabetes. For this reason, I recommend physiotherapy and take daily baby Aspirin to help prevent a future stroke. It is also necessary performing a Doppler ultrasound of the carotid arteries or a carotid and vertebral artery angio CT scan. It is also essential to check your blood lipid profile. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need.


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Hello doctor, I have brain fog like symptoms, chronic worry and stress issues for more than one year. What can be done?


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Hello. Fog like symptoms as you have mild cognitive impairments, cloudy thinking, and judgment impairment, these all are due to generalized anxiety disorder. Kindly consult your doctor, discuss the suggestion and take the treatment with concern.  1) Tablet Fluotexine 20 mg once daily. 2) Tablet Tryptomer (Amitriptyline) 25 mg once a day in the evening for two months. 3) Need behavior therapy with a local psychiatrist. If you have more queries, contact me.


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Hello doctor, I am a 26-year-old female. I have been experiencing unusual vision problems. I have lost sharp clarity, and I had an OCT which showed thinning of ganglion cells in my maculas. Other clinical results looked normal. But I am scared that I have damaged my eyes because it seems things are starting to blur. I do not know what to do. Do I have macular degeneration? Currently, I am on Sertraline 100 mg and Diazepam. Kindly give me your opinion.


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Hello. I am sorry to hear that you are experiencing these symptoms, but hopefully, we can get them resolved or attended to. Unfortunately, I cannot assess the OCT because you only attached the doctor's conclusion (attachment removed to protect patient identity) and not the scan itself, please upload it as soon as possible. What you are experiencing might be the common side effects of Zoloft (Sertraline) it can cause widened pupils and blurriness of vision. I would advise you to approach the doctor that prescribed it for an alternative. I would also recommend you start using lubricating eye drops to compensate for the acquired dryness of the eyes. Use any over the counter (OTC) artificial tears four times daily in both eyes during the day and not before going to sleep. Hopefully, that will reduce the blurriness. As for macular degeneration and the changes in the ganglion layers, you need not worry at the meantime because of many reasons like you are young, no significant changes on the OCT (optical coherence tomography) were detected. There are other reasons for the blurriness that need to be excluded. However, and to eliminate your suspicion, a yearly OCT is recommended to compare the changes and see if the process is stable.


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Hi doctor, For controlling my hypertension, I was prescribed Benicar 40/12.5 mg once in the morning, Amlodipine 5 mg twice a day and Clonidine once in the evening. These were prescribed after ECG and blood work. Even, after taking the medication, my BP is usually 160/85 mmHg. What to do further. Please advise.


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Hello. I want to highlight a few important points here: Amlodipine should be used once daily. Instead of taking 5 mg twice daily you should take 10 mg once daily, which is the maximum dose. Clonidine on the other side can actually cause rebound hypertension, which can explain your high blood pressure. It should be the last resort of the treatment of hypertension. It would be nice to know the dose that you are taking these days. I would like to know when did you take your blood pressure and if you follow a low salt diet. Benicar - Olmesartan is a good medication. Please consult your specialist doctor and discuss my opinion. I would like to know if you have any other medical conditions like diabetes, stroke, high cholesterol or a heart attack to determine your blood pressure goal according to the latest guidelines. Revert back with the answers to the above questions to an internal medicine physician online -->


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Hi doctor, My last period was on 11th of last month. Now, the pregnancy report is positive and blood test for hCG was done in which report showed 1176. 14 hCG level and 48 hours later showed 1342. 41. Is it normal pregnancy? My age is 36 years.


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Hi. I can understand your concern. According to your description, the possibilities are:  You are pregnant which is indicated by urine and blood tests. Now, we have to confirm whether the pregnancy is in uterus or not. Usually blood levels of beta hCG should double in 48 hours. But that did not happen in your case. Now, we have to rule out the possibilities like abortion or ectopic pregnancy. For this, please undergo ultrasound once which will help in ruling out ectopic pregnancy. Take Progesterone supplements to prevent abortion. And repeat beta hCG levels again after 48 hours, this will help in confirming the site and nature of pregnancy. Take care. Ultrasound, repeat beta hCG levels after 48 hours. Ectopic or abortion. Progesterone supplements.


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Q. The foreskin covering the penis is very intact and not retracting during erection. What could it be?


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Hello doctor, I am a 24-year-old male. I am afraid that I might be suffering from phimosis. My foreskin is too intact that it covers the whole penis, without retracting even during the time of erection. There is no problem while erection, masturbation or urinating. It is just that my foreskin is too intact that it covers my whole penis and I get to see no glans penis, as it is totally covered by my foreskin. My foreskin starts to retract from the middle of my penis. I am so afraid that this might affect my sex life. Please help.


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Hello. You can try to retract foreskin daily during bathing, a little more every day. If this does not work or is painful, better get a circumcision done. This will ensure there is no problem during intercourse. It is a small surgery done by urologist or surgeon.


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Q. What are the chances of re-tearing of acromioclavicular joint after surgery using cadaver tendon?


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Hello doctor, How likely is it to re-tear (or re-separate) the acromioclavicular joint after surgery was performed on it with a cadaver tendon? It has been a year and a half post surgery. He was lifting 50 lbs overhead, wind pushed equipment back, causing loud popping in left shoulder (previously had surgery). Shoulder is now presenting with swelling, no mobility and pain.I want to know the likelihood of acromioclavicular joint getting separated again.


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Hi. There is a high likely chance since you are symptomatic (pain and swelling). Subjecting to vigorous exercise and history of previous surgery adds to the suspicion. It is better you get evaluated and treated earlier. Though cadaver tendons are stronger and it is been 1.5 years. It can never equate your original strength. First get your pain and swelling down with analgesics and get an X-ray. If no bony injury and pain persisting, get an MRI done. X-ray followed by MRI shoulder if needed. Acromino-clavicular joint dislocation. Analgesics and anti-inflammatory followed by evaluation.


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Hello doctor, I am concerned about this lesion on my son's foot. It has been there for a couple months and it is not going away. Can this be some type of melanoma (acral)?


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Hello doctor, My daughter is 2 years old. Now, she is speaking only 3 to 4 words. She is not talking like other children. Please tell me if she has any kind of disorder. I have been to the doctor once and he told nothing to worry. After 2 years only they can speak. But my elder daughter spoke when she was 1.5 years old. I am so worried about her. Please tell me what to do. Her birth weight is 3.2 and now she is around 9 I think.


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Hello. I got your concern. Based on the above history, my comments are: 1. I think she can listen and understand but there is a problem with expression. 2. Her weight is low according to age, so give her more energy rich food to gain weight. 3. Let her play with same age children, day care center or neighborhood children. 4. Do not confuse her with multiple language if you are speaking multiple language at home. 5. Sometimes, some children learn to speak late. So do not worry. Just be vigilant. Watch her behavior. Follow up after one month. Isolated speech delay.


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Hi doctor, I am a 27 year old male. Doctor prescribed me Azithral and Fepanil for fever. But, the fever is on and off for the past seven days. My blood test showed normal no malaria or dengue or typhoid. First, I took Azithral and Fepanil and then the next day doctor added Cefuroxime axetil along with it. As the fever continues, I have got Amikacin intravenous. And now I have stopped all the medicines and still have a fever. What fever is it? I had four Fepanil capsules per day for every six hours for the past seven days. My blood report is normal and there is no pathogen for malaria, dengue or typhoid. But, the value of WBC is high with ESR of 50mm showing microcytic anemia with neutrophilia.


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Hello. The possibilities for fever in your case are as follows: For further information consult a general medicine physician online -->


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Hello doctor, I am a 33-year-old male with no significant medical history aside from essential tremors treated with Inderal 120 mg, and anxiety treated with Venlafaxine 75 mg. Three months before, I consulted an ENT doctor because of an unilateral (right) tonsil enlargement. I am attaching a photo of what it looked like at that moment. Upon clinical examination, my doctor was not worried and suggested to monitor the volume of the tonsil in the upcoming year. I had underwent adenoidectomy during childhood. In the last few months, I have noticed that the same tonsil has gained in volume and now appears round, red and more swollen than before. It is not painful when I swallow, but I have the sensation that something is stuck in my throat (most probably a collateral effect of edema). I am attaching another photo of what it looks like today. I do not feel any lumps in my neck. I have an appointment to see my ENT again, but it is only in one month from now. Being a big fan of catching things early I am a bit worried about waiting another month. Could you please give me your opinion?


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Hello. The two tonsils are unevenly enlarged. Whereas it is usually not any abnormal growth, we can say conclusively only after biopsy. I suggest you discuss with the doctor about the option of tonsillectomy and histopathological examination of the sample. Meanwhile you should get some Benzydamine gargles and check if the symptoms resolve.


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Hello doctor, I had sex with my partner before two days and that was my ovulation day. I started taking Krimson 35 from the next day. Am I safe?


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Hello. Actually Krimson 35 is not an emergency contraceptive pill. Hence, there a chances of pregnancy. I would suggest to do serum beta hCG (human chroionic gonadotropin) after 10 days of sex.


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Hello doctor, I am 17 years old. In my right eye my pupil is barely visible in the centered, but it never dilates or constricts, most of the pupil seems to be covered by my iris. My left pupil is perfectly fine and dilates and constricts according to the amount of light. I can see out of the affected eye but it is not as clear as my other eye. I have this condition since birth, and it is not anisocoria. Kindly help.


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Hello. I understand your concerns and have seen your photo attachment (attachment removed to protect patient identity). From the image you have attached, I can say that this may be a persistent pupillary membrane. It is a disorder of eye development that occurs during embryonic growth and development. A condition such as this is usually asymptomatic except for the appearance, but if thick can obstruct vision. There are various treatment options, including laser iridotomy which can be done as an outpatient procedure, which will change the appearance. In case you need further information, please let me know.


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Hello doctor, My son is 8.11 years old. He had an eye injury one week before, which caused left eye corneal epithelial defect (3 mm, no infiltrate). He was adviced for constant use of single vision white glass. His reports are, Right eye (SPH=+0.00), (CYL=+0.75), (AXIS=95), (VISION=6/6). Left eye (SPH=+0.00), (CYL=+0.25), (AXIS=90), (VISION=6/6). Does he need to wear glasses? Or eating a carrot, beetroot will help him to be normal?


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Hello. I understand your concerns and have gone through your son's eye records. I can confirm that the power given cannot be reversed by eating carrots and vitamins. This type of power is called a cylindrical power, and if he does not wear the glasses, he can develop weakness of his optic nerve in the long run, along with short term effects like blurred vision and headache. A drug called Low-dose Atropine in a way can be used to control eye power in children and halt progression but it is only tested in minus powers and not in plus powers. My suggestion is to advise him to wear glasses regularly and follow-up with the ophthalmologist every six months. I hope this helps you.


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Hello doctor, My lower front tooth broked in an accident. I visited the dentist here in my place and he suggested RCT. My first session of RCT has been done 11 days before, and the last session was two days back. I want your advice on steps after RCT. Is laser filling possible for such tooth break or crowning is the only option? Which type of crowning is most suitable for it? Please help me. I am waiting for your valuable advice.


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Hello. Crowns are best after RCT. Best crowns are zirconia. They are metal free, and they have good strength than other crowns. Other than that is CADCAM crowns. They are 3D porcelain metal crowns and have good strength. They come with a warranty. Both look very good and have exact teeth color. Filling of teeth will be done on the last day of RCT. Ask for post and core if possible. But the crown is important in everything. I wish you good health and happiness. Keep me updated with the improvements.


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Hello doctor, I am a 21-year-old male. I have OCD for past five years. I went to several doctors and used too many drugs such as Sertraline and Fluoxetine and Anafranil. The only drug that helped was Anafranil. I asked from my doctor to prescribe Anafranil but he denied and in every visit he prescribes SSRI, but it does not help me like Anafranil. What is the highest dose of Anafranil for OCD? Can I use only Anafranil 75 mg once a day? Please help me.


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Hello. Anafranil (Clomipramine) is a type of older antidepressants, and it has some undesirable side effects like constipation dryness of mouth, at times effect on the heart. Because of the side effect for file usually, doctors refrain from going for higher doses. But if you are not facing any adverse impact, then we can increase the dose of drug top to 150 to 200 mg. The toxicity of this drug occurs easily as compared to SSRI (selective serotonin reuptake inhibitor) which is again a limiting factor for prescribing commonly. But always follow your treating doctors advice in increasing and decreasing the doses of drugs.


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Hello doctor, I have a very blurred vision due to high eye grade and astigmatism. My left eye is 225, and the right eye is 675. I am planning to get a pair of contact lenses, but the special lenses are a bit pricey. Will it damage my eyesight if I am going to choose regular contact lenses?


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Hello. In general, contact lenses are only meant for occasional use and cannot be used every day. In case you meant the special lenses have higher oxygen permeability and help your cornea stay healthy, please go ahead with those. The best option to remain permanently free from glasses is refractive surgery. If your power has been stable for around a year, I will recommend that you see your ophthalmologist for SMILE (small incision lenticule extraction) or PRK (photorefractive keratectomy) than using contact lenses for a long term. In case you need further information, please let me know.


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Hello. On daily basis, it is suggested that one should try tooth brushing with paste recommended by the American dental association (ADA) and Indian dental association (IDA). While buying a paste, you should look for whether it is ADA or IDA approved. Second is choose the paste containing ingredients like fluoride, sorbitol, glycerol, sodium lauryl sulfate, calcium carbonate, and saccharin. You can use them daily particularly before sleeping. However, if you have sensitivity in teeth and issue with cold things like ice cream, then you can try pastes containing high fluoride which strengthens teeth and prevents sensitivity and also prevents further progress of cavities. You should try usual toothpaste but after three months try this fluoride-rich paste for one month so that you will not develop future caries. Mouthwashes contains mostly Chlorohexidine, but it is not recommended for daily use. It is used in the case when there are gum inflammation and bad breath. Moreover, it is not recommended for more than 15 days as these cause staining of teeth sometimes. If you have gum infection or bad breathe, you can try it.


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Hello doctor, I am 20 years old and I have myopia (-3,50 ). I always avoided smoking, lived a healthy lifestyle and ate a balanced diet but my vision just got worse. I just became worried about my vision. What else can I do to stop this progress?


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Hello. I understand your concerns. I want to assure you that such myopic progression is quite common at a young age such as in your case. This is mainly because of the exponential growth and development of all the parts of your body at this stage of life. I can confirm that this has nothing to do with the diet you eat. Over a period of time, this growth will cease, and your eye power will stabilize. One suggestion to reduce progression is to avoid excessive near work like reading books, using smartphones, fine near work like jewelry or watchmaking, etc. I hope this helps you.


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Hello doctor, I had a bump on my arm. I thought it was a burn so I broke it and it became more prominent. It was there for almost two months. So I went to a skin doctor, and they said it is a wart from a germ. They gave me three options. Either apply a cream, liquid nitrogen, and laser (C02fl). I chose the third option because they said it is more effective. After I did it, there was a scab remained which looked like a burn. It has been four days now. I have been asked to apply Bactrocin twice a day for two weeks and Derma V10 rescue oil after that. From the third day, I am seeing like something spreading from the corners of the scab which looks like blood inside and it is red. Is this normal? Please advice.


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Hello. I have gone through your case (attachment removed to protect patient identity). In my opinion, it is posted inflammatory scab or crust. You need not to worry about this lesion. Whenever wart is treated either with lotion or with cautery or with CO2 laser, in the end, it similarly forms scab or crust as you are having right now. This shows the germ or virus which was the causative factor has been killed or dead by now. The red area which is lying beneath it is a raw area of skin which will heal once this scab will fall off. Bacitracin ointment is fine. Apply this or apply Polyfax (Polymyxin B sulphate, Bacitracin zinc) ointment twice daily for days. Apply petroleum jelly on it at night. Your lesion is fine. Do not get worried about it. Human papillomavirus. Apply Petroleum Jelly or Polyfax ointment.


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Hello doctor,I am a 28 year old male. For the past five years, I have few swellings on both underarms. Recently, my mother was diagnosed with breast cancer. While browsing on the internet, for her condition, I found out that my swelling may be of lymph nodes and may be cancerous. This urged me to get consulted. My swellings are a bit painful while touching. It at times gets sore and brings out smelly pus, which is yellow in color. I am anxious and would like to know what the best way to proceed here. Many thanks.


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Hello doctor, I am a-32-years old male. Two days ago my wife and I had diabetes tests, and as of now, we do not have diabetes. Three to four months ago when we tested my result was 120, and my wife result was 140. But two days ago when we had tested, I have 122 before breakfast and 240 after two hours of breakfast. My wife had 142 at fasting and 242 after two hours of breakfast. We were shocked and worried. My mom and dad do not have diabetes and wife side her mom had diabetes, but her father does not have. My weight is 81 kg, and I am 5'5" height. My wife is about 87 kg weight and 5'5" height. Again we did a test at another place using glucometer after four hours after lunch, and surprisingly I got 102, and my wife had 170. The lady who did our test in front of us and confirmed that we do not have diabetes. Please help us. We do not know how to proceed. Awaiting for your response.


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Hello. A glucometer is not the standard gold method it has a variability of 30 Plus or minus for conforming. Do HbA1c (glycated hemoglobin), FBS (fasting blood sugar), PPBS (postprandial blood sugar level) and urine complete. If these all reports turn to be normal, then there is nothing to worry. Maybe from tomorrow do regular exercise and take the test after seven days.


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Hello doctor, I had a sudden weight gain. Are there any foods that should be avoided either at certain times of the day or all together while taking Levothyroxine to treat an underactive thyroid?


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Hello. Avoid raw cabbage, cauliflower, brocolli, soy and soy products like soy sauce, soy milk, tofu, strawberry, walnut, spinach, and brussel sprouts. Do not take any meals or drink except plain water for atleast 45 minutes after taking medication. Avoid taking acidity-causing foods, calcium and iron supplements with the medicine.


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Hello doctor, I am a 34-year-old male with height 5'10" and weight 170 lb. Last week, when I turned my head to the right, I started to blackout. I have been doing neck stretches, pinched nerve exercises, etc. Ever since with no improvement to the condition, this may be due to golf, or light weight lifting related, but I am not sure as I did not do anything abnormal and there was no pop or any pain afterward. One key piece of information may be that if someone else turns my neck to the right for me, there are no symptoms. It only occurs when I do it. I was hoping this piece of information narrows it down. It has been one week and a half with this issue. I try to avoid turning my head to the right. I can go 45 degrees without symptoms, but when I approach 90 degrees, the symptoms start. There is no pain and numbness.


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Hello. Do you mean blackout as the sudden loss of consciousness? May I know what is the extent of the episode? If you feel blackout when looking up or turning your head, this may be due to pinching of the arteries that are present alongside the spine, called vertebral arteries. This can sometimes happen as a result of changes in the vertebrae. Pinching of these vertebral arteries can occasionally cause blackouts as the blood flow is temporarily reduced. One condition called cervical rib, here extra rib in the neck area may compress the artery. Some time any lesion in brain clot or ischemia may cause transient ischemic attack (TIA). Better go through investigations such as CT brain, x-ray cervical spine AP or lateral view, FBS (fasting blood sugar), PPBS (postprandial blood sugar test), lipid profile and CBC (complete blood count).


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Hello doctor, I have some rashes on and behind my ear. I have tried everything but it is still there for over one and a half month. I have been ignoring it because I get better quickly but does not entirely disappear, and right now is worst than ever. It is quite itchy and at night it is even worst. Sometimes I feel the itchiness inside my ear. I went to an Otolaryngologist, and he told me to use Clotrimazole, but it did not work and turned worst. Other doctor told me it looked like herpes because sometimes when it is horrible, you can see little red bumps in the ear. I took Acyclovir and at the beginning looked like getting better, but it has not got better. I have not consulted a skin specialist yet.


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Hello. I understand your concern. This is not herpes (attachment removed to protect patient identity), and this is a superficial fungal infection known as tinea corporis. If it involves the face exclusively, then it is called tinea faciei. Kindly consult your doctor, discuss the suggestion and take the treatment with consent. A. Capsule Itraconazole 100 mg twice a day after meals. B. Tablet Levocetirizine 5 mg twice a day. C. Cream Terbinafine apply twice a day. Do this for 10 days, and you will feel better. Follow up after that.


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Hello doctor, I have some questions regarding allergy. When I was a kid, I had eczema on my mid-arms. Then it went away. Some years ago, when I was around 22, it came back aggressively on my face, neck, and shoulders. Then I was referred to blood food allergy tests (IgE). A lot of allergens was detected (wheat, melons, peach, cucumber, potato, parsley, carrot, etc). I did avoid those foods. After seven years, I wanted to test it again, and unfortunately, the test showed the same results, more allergies (coconut, plum, chestnut, buckwheat - things I eat regularly.) I also did the FABER test and had a lot of red lines. The doctor told me that none of those tests are 100 % sure and I should test all foods. But I am very afraid of the anaphylaxis reaction. I am now afraid to eat coconut, chestnut, etc., which I did regularly eat before not to have the severe reaction (not had one earlier though). I wanted to ask if the most severe reaction can develop for any food? Even for meals that I do regularly eat and have no problems with. Please help me.


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Hello. 1. Yes, some food can cause urticaria and rarely angioedema like peanut and seafood allergies. 2. But, there is no significance of the test you have mentioned, as that is a very nonspecific kind of test and most of the people who get themselves tested found themselves allergic to hundreds of things like that. Hence, it is not significant. 3. And you have been eating them all regularly before, so I do not see any reason to stop them now.


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Hi doctor, I had unprotected sex with my girlfriend. She took Unwanted 72 and vomited within one hour. She was late in her period by six days now. So, we had a pregnancy test and it showed negative. It has been eight days and she still did not get her period. What may be the reason?


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Hi We are here to help you. For further information consult an internal medicine physician online -->


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Hello doctor, I am taking my second-day pill of my Krimson 35 for PCOS. I had unprotected sex with my husband, and we are not planning for a baby now. Should I take I-pill also along with Krimson 35 to avoid pregnancy?


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Hello. Krimson 35 (Cyproterone, Ethinyl Estradiol) is used as an oral contraceptive pill as well. It should be started from day one of the periods. So if you are having periods and started Krimson as well from day one and had unprotected sex, then there are fewer chances of pregnancy or conception. There are fertile periods in each cycle and first five days of periods in which there is menstrual bleed are included in the infertile period of sequence, so fewer chances of pregnancy if you have started Krimson in periods. You can further clarify if Krimson not taken on the second day, then kindly mention which day you have started Krimson. Please have complete treatment of any health issues if you have, follow some recreational activities and quit recreational drugs. Have a balanced diet, weight, and BMI. Send scan and detailed sex hormonal markers reports as well. As above. With detailed history and reports.


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Hello doctor, About three weeks ago, my wife noticed a blood stain on my underwear while she was doing the laundry. I was surprised because I did not feel pain or any burning sensation. A week later I noticed this but I thought it was the old underwear my wife found. Recently I noticed blood in my underwear, and on the tip of my penis, while changing dress after morning exercise. It probably happens during my daily 60 minutes walk on the treadmill. And I do not know if this has anything to do with it. Sometimes I noticed I have slight pain on my penis, and this morning during my drive I noticed a mild burning sensation. Kindly give your opinion about this.


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Hello. I would like you to get urine routine test, urine cultures creat, RBS (random blood sugar), CBC (complete blood count), USG (ultrasound), KUB (kidney, ureter, and bladder) plus prostate done. Possibilities are, 1. Blood in the semen. 2. Blood in urine due to infection or stone disease etc. 3. Exercise-induced hematuria. Blood in semen may occur due to swelling or stones in semen tube, and this can be treated with a course of antibiotics and anti-inflammatory. Urine infection needs a course of antibiotics. Exercise-induced bleeding is usually benign and may not need any treatment. You can get the above tests done and get back with reports. Till then start, 1. Tablet Oflox 600 mg (Ofloxacin) once daily. 2. Tablet Enzoflam (Diclofenac, Paracetamol) twice daily after food. 3. Tablet Pantocid (Pantoprazole) 40 mg once daily before breakfast. All medicines for five days until the culture report comes. Take care.


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Hello doctor, I have been really thin since my childhood. Though somewhere it is genetic now I do not feel comfortable. I am not able to gain weight no matter what I eat. My pelvic bones have started to show slightly. My weight is just 41 at 17. I have tried eating different foods but no positive result. When I choose exercise as an option, I lose additional weight rather than getting an increased appetite.


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Hello. 1. Calorie dense food should be incorporated in your diet like dried fruits, potato, sweets, nuts, jam, jelly, banana or mango shake, porridge, badam kheer, etc. 2. Leafy vegetables should be restricted in your diet as they reduce appetite. 3. You should take three major meals a day and snacks in between. Also, butter and margarine should be considered. 4. An adequate amount of egg, meat, fish, milk should be taken as it helps you for tissue building in your body. 5. Try to eat one boiled egg every morning. 6. You should eat more food at each meal. 7. Before taking a meal, you can walk for some time as it help to you feel hunger. 8. You should take more water.


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Hello doctor, I have a problem with unity. And for me, it is a big problem that threatens my future. When talking to my face, my mouth tends to cry like a child when I am afraid of something, and this causes me a significant inconvenience. Please help me to overcome this problem before I lose my job as a manager. I have met a doctor, and he prescribed me Cipralex 20 mg for two years, and the result was almost 60 % excellent, and I stopped because the problem still exists. Kindly help.


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Hello. I understand you took Cipralex or Seroplex (Escitalopram) 20 mg for two years which is a good medication for managing anxiety disorder, depression, and other emotional disorders. Did your doctor prescribe it for anxiety? Did he also diagnosed any other problem? You report that result was 60 % and the problem still exists. Did you stop the medication on your own? Sometimes it is advisable to continue for a more extended period especially if the problem is persistent. Has there been any relapse in your symptoms since the medication was stopped? How long has anxiety been a problem? Is it something present since your early age or start only in recent years? Can you please clarify what you mean by problem of unity? You have described some symptoms suggestive of excessive anxiety in some situations. You need to develop strategies and techniques to manage anxiety. Did you receive any psychological therapy like CBT (cognitive behavior therapy) to manage your symptoms? Kindly explore the availability of CBT at your place. Along with medication, CBT is very helpful in managing excessive anxiety. Please also try these self-help measures at home to help manage stress and lower your anxiety. 1) Practice deep breathing techniques. 2) Do progressive muscle relaxation exercises daily. 3) Avoid too much coffee, tea, and fizzy drinks. Also, avoid alcoholic beverages. 4) Regular walking or exercise will help to improve your mood and lower your anxiety. Go for at least 20 minutes of brisk walking daily. 5) If possible, you can start some martial arts training (like karate, etc.) as it will help to improve your confidence and self-belief. 6) Do not isolate yourself and do not bottle up difficult emotions. Talk to trusted family member or friend regularly. You are welcome to contact again for any further advice.


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Hello doctor, I had this acne situation for the past three months. I am not sure of the cause. It started from the side jawline till the cheeks, and it got worse. I tried Benzoyl peroxide and it only helps to control but does not get well, and the skin got dried. Is it a hormonal change? What can I do? I am depressed for a year. Kindly advice.


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Hello. Acne along the jawline and lower face can indeed be an indicator of hormonal imbalance. Do you have any menstrual irregularities, or facial hair growth or recent weight gain? I would appreciate if you send me the photograph to assess the severity and nature of your acne. Use the following medications after consulting your treating doctor. 1. Tablet Azithromycin 500 mg three days per week, for three consecutive days. 2. Use Adapalene plus Clindamycin gel. Apply once at night on acne in little amount without rubbing it and wash after one hour. 3. Use Benzoyl peroxide face wash. Do this for three weeks.


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Hi doctor, I have recently noticed a lot of wrinkling of my skin on both my thenar muscles of the thumb. I just noticed it a month ago. I also have a dent or atrophy on the back of my right hand between the little and middle finger. I am not sure whether this is new as it seems to appear in a video of myself taken before three months. I am a 35 year old male. My grip strength seems good. I recently did a personal best hang test of 1 minute 20 seconds. Two years ago, my neurologist told me that I had cramp fasciculation syndrome as I had a lot of calf and feet twitchings. I am concerned now that I may have MND. Please help.


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Hello doctor, I have some pain in my lower left leg. It is more focused behind and around the knee, in my upper calf, and in the arch of my foot. It is not discolored or swollen or warm or colder than the other side. It is just uncomfortable. I have been pretty stationery due to an infection, but I do get up quite often to use the bathroom, and I often stretch. This pain started before four days. It has not gotten worse but at the same time has not reached better. Does it sound like a pinched nerve maybe or DVT? Should I go to the ER or make an appointment to see my primary care doctor? I am currently under Macrobid. I have done blood tests, hormone levels, CBC, and electrolytes test many times and all seems to be normal.


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Hello. Leg pain behind the knees which is localized, non radiating in nature with no swelling, no history of prolonged bed rest and no fracture of a limb. Hence, this is not deep vein thromboembolism. DVT occurs when there is a prolonged history of immobilization with sudden onset of swelling. This also does not look like cellulitis where is a superficial subcutaneous infection, which is most common cause of swelling and pain. If this is more on walking, then we have to rule out claudication first and second is knee joint pathology. Kindly tell me if there is any history of trauma or fall, or any associated disease.


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Hello doctor, I have never achieved orgasm without a vibrator. For years, I have experimented with different pressures, methods, stuffs and followed the advice of hundreds of articles, but nothing worked. I always make sure that I have enough time and relaxation. I have tried so many methods involving fingers, my partner and more, but still, nothing worked unless I use a vibrator. I even went months without using it to see if I would desensitize, but nothing changed. Just wondering if anyone else has the same problem. What I can do about it?


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Hello. Female masturbation is a complicated one. Yes, I have few patients who were not satisfied with many methods. Male masturbation works only more physical, and few mental work but female masturbation works with more psychological and few physical tasks. Method, if anything needs to be changed. 1. Fingers are used gently and rhythmically over the clitoris, apply study pressure with one finger and can increase two to three finger according to demands. Do not double the pressure of your finger unless you need. Rhythm in moments of the finger should be maintained. Do not be eager to give climax early, female will take them as they like or enjoy. 50 % of the female will reach orgasm or peak within three minutes and, few may take four to five minutes, it also depends on how the vagina and other parts of the female body are manipulated. 2. Vaginal massage as massaging the clitoris with one finger, other finger or fingers moved between the labia. Sometimes labia strokes alone will give results as it is attached to the clitoris. Speed of the stroking depends on personal likes. Initially, it starts with mild strokes and increase the speed according to the needs. 3. Females do not reach climax by inserting fingers or vibrators inside the vagina, since walls of the vagina are practically without nerves, although few sensory nerves close to the entrance of the vagina. Inserting big objects inside the vagina will have no use, since no erotic nerve supply inside the vagina. Deep vaginal penetration in men is fantasy, and it is not a sexual need for women. Only occasional vaginal insertion that to just for a few females will cause an erotic feeling. Keep exploring as much as you can. 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 saw red spots, and skin crack on my penis head. Sometimes, it become painful. Urine open area is also painful and open like a lip.


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Hello. You may be suffering from balanitis or pearly penile papules or sexually transmitted disease. If you have any sexual contact with an unknown person, then we can think of HPV warts (human papilloma virus) which comes under sexually transmitted diseases where you need investigation and start you on antiviral and surgical removal of the wart. If you had sex with a known person, maybe you would have caught simple infection and that can be treated. If it is due to condom allergy, balanitis inflammation due to painful sex, simple antibiotics and anti-inflammatory will help you. Another condition is pearly penile papules where there is no need to worry about infection. Sometimes it will heal on its own, or you need to meet a dermatologist to confirm the diagnosis for its removal. 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 have these eruptions randomly on my skin since the past few weeks. They are present mostly on thighs, forearms and lower back. They feel tight and are painful to touch. What are these? Do I need to get them treated or will they go away over time?


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Hello. These are furuncles, a bacterial infection of the hair follicles. Use the following medications for five days. Kindly visit your physician, discuss the suggestion and take treatment with consent. A. Tablet Cefadroxil 500 mg twice a day. B. Tablet Flexon 500 mg (Paracetamol, Ibuprofen) twice a day. C. Ointment T-Bact (Mupirocin) twice a day. You will get better with these medications. If you have these again and again, then you might need some other drugs but for now, use these for five days.


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Hello doctor, What to do when we find blood in our semen? There was a blood clot in my semen when I ejaculated during unprotected sex, but I have had unprotected sex regularly. The next day I masturbated to see if I still have it and this time blood was mixed in the semen. Although, it does not hurt and when I urinate it does not burn. I sometimes forget to drink water, but I still drink enough. Should I take a hepatitis shot or urinalysis? Do I have STD? Should I be concerned or will it go away? This happened to me before two years ago but it subsided.


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Hello. Blood in semen with no other symptoms is very likely idiopathic or no pathology. After a period of abstinence sometimes aggressive frequent sexual activity leads to hematospermia. Majority of times it is self-limiting. Unprotected sexual intercourse will not give rise to this (rather it causes urethritis). Seminal vesicle can occasionally be infected from the blood. Just once examination by surgeon or urologist to feel seminal vesicle per rectum is preferred. For the present episode, wait for some time that it will resolve on its own.


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Hello doctor, I have depression, anxiety, lack of confidence, lack of energy, palpitation, and excess sweating for the past 18 years. I have consulted so many psychiatrists. My current doctor prescribes me Nexito Forte, Prothiaden 25 mg, and Toficalm 100 in morning and evening. But I feel some sleep issue and sweating. I have also consulted one of a top psychiatrist, and he prescribed me Nexito 10 and Clonazepam 0.5 mg in morning and evening and Mirtazapine 15 mg in night. But it causes me some stomach problem as I have IBS, diarrhea too. Unable to understand that which combination of medicine is better for long term use. Please suggest.


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Hello. You should go with Escitalopram (Escitalopram Oxalate), Clonazepam and Mirtaz (Mirtazapine). These combinations have a minimal side effect. You take antacid with it. Please do not take the above medications in an empty stomach. You must lose your weight. Do the daily exercise for 30 to 45 minutes and practice meditation for 10 to 20 minutes daily. Avoid junk foods, eat healthy home-cooked meal. Stop alcohol, smoking tobacco or stay away from any type of substance abuse. Spend quality time with friends and family. Spend time for your creative hobbies like read good books, write journals, do paintings, learn new skills or music, etc. Take enough seven to eight hours of sleep. Take a cold shower. Drink three liters of water daily. Live your life, do not just spend. Go for a vacation, spend time with nature. Stay away from social media as much as you can. Prothiaden (Dosulepin) will cause constipation. And low energy can be due to depression or anemia or thyroid abnormalities. It is less likely due to medication. Toficalm (Tofisopam) and Prothiaden will cause you oversedation or make you drowsy the next day.


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Hello doctor, I am a 23-year-old-female. I have been losing a lot of hair since last year. I do not see any bald patches but I do see my hair thinning over time. I do not understand why this is happening since I have always had a mane full of thick hair. Is there any way I could stop the shedding of my hair?


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Hello. There can be a lot of causes of sudden increased hair fall which can include sudden weight loss, stress, illness, dietary changes like crash dieting, drugs, childbirth, thyroid problems, anemia, etc. If you think you have any of these kindly mention it. Get the following investigations done. 1. T3, T4, TSH (thyroid stimulating hormone). 2. CBC (complete blood count). Take the following medicines after meals for 3 days meanwhile with the consent of your doctor. 1. Tablet Hairfollic woman one tablet a day. 2. Tablet Autrin 1 tablet once a day.


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Hello doctor, I am a 25-year-old male. I am straight but yesterday I had anal sex with my friend. I feel I took wrong decision. It is remembering me a lot. I want to forget that. My mind is not concentrating now. Kindly help.


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Hello. If it has been done against your wish, you can take legal help. Are you intoxicated that time, or under any threat? Is there any injury or pain? Have you used condom? If done with your consent, just driven by impulse, not need to get in guilt. Some time accident happens. Forget it like a nightmare or just an accident. In accordance with forgetting this try to involve in other pleasurable activity, be with a friend, take proper sleep and healthy diet, can take low dose anti-anxiety drug from your doctor.


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Hello doctor, I am a 33-year-old male with height 180 cm, and weight 85 kg. I always been healthy. I do not have symptoms of depressions. I took Risperdal to treat minor vocal tics, and I have OCD. Now I have been off Risperdal for five months and still no libido, no sex drive. I searched for post-SSRI sexual dysfunction (PSSD). Why do no doctors recognize this? What is the solution now? I took Risperdal three times for three months each time for the past two and a half years (on and off). I took Risperdal three months before. Symptoms are no libido, no sex drive, and no feelings for sex. I am not taking any other medication (never took any). Why is everyone ignoring PSSD? What is the treatment?


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Hello. The drug you used Risperdal contains Risperidone an atypical antipsychotics and it has an effect on libido, but it will wear off when you stop taking medicine. So we need to find other reason causing low libido such as, 1. Decreased sensation in your penis. 2. Fear of failure. 3. Low self-esteem (chronic masturbation). 4. Homosexuality. 5. Religious constraints. 6. Long term illness. 7. Negative attitude towards your partner. 8. Hormonal issue. 9. Diabetes and hypertension. These are other issues causing low libido. If you can share details regarding the above reason, we can work on your cause.


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Hello doctor, I think I have balanitis, due to itching I have got rashes on the penis foreskin. I am having difficulty on retracting the foreskin, and the foreskin has formed a rubber band like structure at the tip of the penis. There is also a little bit of redness on the tip of the penis and inflammation too. Lately, I have been feeling inflammation of the glans.


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Hello. 1. Yes, it is balanoposthitis (balanitis), most probably candidal balanoposthitis. 2. Do you have a history of sexual exposure recently? And if yes, does your partner has genital itching or vaginal discharge issues? Take the following medications with your doctor's consent. 1. Tablet Fluconazole 150 mg. Take one tablet today and one after a week. Do it for your sexual partner also, if any. 2. Apply Candid cream twice a day. 3. Tablet Levocetirizine 5 mg once at night. Do it for 10 days.


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Hi. Most common reason for bleeding from the ear is due to trauma. There is nothing that you need to worry about as this is extremely common. Make sure you do not use earbuds as they often traumatize the ear canal or eardrum and introduce infections. Please do not use headphones or earphones as well, until it heals. Make sure you keep the ear dry, make sure no water enters the ear at any cost. For now you can apply Ciplox (Ciprofloxacin) ear drops three drops thrice a day and take tablet LCZ (Levocetirizine) 10 mg one tablet at night after meals for the next one week (this will reduce any itching). Make sure that there is no pus like discharge from the ear because in such a situation, the infection of the eardrum is more likely and will require systemic oral antibiotics. I hope this helps.


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Hi doctor, Last week, I was bitten by red ant. Within 5 minutes I was collapsed and immediately rushed to the hospital. My BP was low at 80/60 mmHg. It was detected as anaphylaxis. I hereby attaching the treatment sheet for your reference. Six months ago, my 2 year old son expired due to unknown insect bite. We did not know about anaphylaxis at that time. What type of treatment should I get further for anaphylaxis?


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Hello doctor, Recently after watching a video of a young person dying of heart attack, I have developed a fear of death. Although I am young and have no heart problems, I tend to think about it all the time. Please help me to get rid of this.


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Hello. Here are two kinds of fears or phobias. 1) Temporary. 2) Permanent. Temporary lasts for few days after you suffer or witness some traumatic thing. Permanent ones would slightly fall under some psychiatric issues worth paying attention. I would recommend you to wait for some time. Keep yourself busy with positive and productive things and try to be in the company of family or friends. Try deep breathing, meditation and running. Everything should be settled by two weeks. If it does not, then consult a psychiatrist for proper evaluation and treatment.


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Hello doctor, I have pain at the right side near the penis for 20 days. MRI done on pelvic region showing infective etiology likely, there is thickening of right side epididymis, and vas deferens, right side seminal vesicle is thickened. Mild hydrocele on the right side. A thick-walled, 22.5*21*34 mm complex cystic area seen in the right inguinal region just posterior to and abutting the spermatic cord adjacent to the root of the penis. Current medications are Naprosyn 500 mg, Omeprazole 20 mg, Chymoral forte tablet, Methylcobalamin, Alpha Lipoic Acid, Folic acid, Pyridoxine hydrochloride and Oxidation plus capsule.


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Hello. It is the infection involving right testis, right sperm tube and both sides of groin lymph nodes. Please get a urine routine and culture test done. From the list of medications, I do not see any antibiotic. I suggest you start capsule Doxycycline 100 mg twice daily, to be taken for 14 days with the consent of your treating doctor. Is there any recent history of sexual exposure? You can contact me in about five to seven days after getting a sonography of right inguinal and KUB region (kidney, ureter, and urinary bladder). Take care.


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Hello doctor, I had done first IVF last year, but it failed due to a bad quality egg. Embryos were not developed after two days. AMH level is 1.52, and the egg count was low. On consulting another doctor, she suggested to go with PRP injection to rejuvenate the ovary, so that egg count and quality will increase. I am afraid if PRP will cause any harm to the ovary? Are there any issues to try PRP?


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Hello. You have been wrongly guided by your doctor because there is no apparent need for PRP (platelet rich plasma) therapy and injection into ovaries to rejuvenate the ovaries to produce better quality eggs. The therapy modality is relatively new and not sufficient studies have been done yet on them. It is being done for women with really low antral follicular count and AMH (anti-mullerian hormone) less than one and failed two natural timed intercourse and six IUI (intrauterine insemination) and one IVF (in vitro fertilization) cycles. You were directly subjected to IVF cycle, which was wrong without treating the pathology. AMH can be increased with DHEAS (dehydroepiandrosterone) therapy which is oral supplementation along with low dose OC pill (oral contraceptive) therapy for two months. That improves the quality and also the chances of natural conception. Also, another concern is a bicornuate uterus, which has their own demerits for natural conception so that IUI can be offered for conception at least for six cycles, post-therapy. If succeeded, then the bicornuate uterus is unable to sustain the pregnancy for the complete term, and often preterm labor occurs giving birth to a preterm baby. So weigh this complication as well in your mind. You can either opt for Strassman's operation first to increase the size of the uterus by joining them together and then try after a year or take the risk of IUI or IVF and accept complications associated with bicornuate uterus itself. You have to think and make a decision. PRP is the last line of therapy, not primary, in my opinion.


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Hello doctor, I want to ask is it possible for me to transmit HIV through hand cut, (I have attached a picture) because I had anxiety when shaking hands. I am almost certainly HIV negative according to tests, but still anxious. Kindly advice.


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Hello doctor, I am 43 year old. My weight is 83 kg, and I do not have blood pressure. My fasting sugar is 102 and post prandial is 87. Why is it so? It is happening for the last three years. I am not able to reduce weight inspite of all exercises, and I eat just regular home meals with calorie consciousness. I am currently on 10 mg statin alternate days for cholesterol. Kindly help.


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Hello. There are a few reasons. 1. Pre-diabetes can have such results which means you are more prone to get diabetes. Increased PPBS (postprandial blood sugar) means your pancreas is working very hard to reduce your sugar. It is overworking where it will deplanes beta cells in pancreas soon (beta cells present in the pancreas secrete insulin to maintain blood sugar). 2. Wrong blood report, take the report in a NABL (national accreditation board for testing and calibration laboratories) lab. Regular exercise and diet will help you. Meet a nutritionist and get a diet chart. Get a personal fitness trainer. If these are not working to reduce your weight, then we can think of blood investigation and medical treatment. 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 was hoping someone could help me determine what these newfound bumps on my penis are. I have not been sexually active for the past eight months. But recently I have seen three bumps appeared on my penis. They do not cause any discomfort or itching, but I am concerned. They are not in the form of clusters, and there is no discharge from it. But they appear to be red.


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Hello doctor, I am a 40-year-old female. I went to my doctor a year before because I had a little blood in my urine when I wiped. He did a urine analysis, and some blood work and everything came back fine. There were no problems until three days ago. I peed then a few minutes later it felt like it still had to go so I went back to the toilet but I just got only blood. There was a lot this time, and it was fresh blood and small clots. It is hurting while passing the blood but that is all that came out though I had just emptied my bladder a few minutes before that. The only other symptom I seem to be having is all of a sudden there will be an immediate need to pee out of the blue but then when I go it is not a full bladder of pee just like half but it the onset was very sudden, or I am going to pee my pants. These are my only symptoms. I do have a long history of stones, but I am confident this is not due to that, because I have had blood from stones but not this amount of blood. And every time I have ever had a stone, it hurts worse than childbearing, and I am not in that kind of pain. I feel whatever is going on is the same thing I went to the doctor last year, but he found nothing. What is likely to be wrong with me? I am currently on Coumadin, Lanoxin, Coreg, and Propylthiouracil. Laboratory tests performed are urinalysis, hemoglobin a1c, CBC (complete blood count), fasting lipid panel, and fasting glucose.


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Hello. A bladder infection (cystitis), stones and overdose of Coumadin (Warfarin), all three can be the likely reason for your bleeding. In case of any such bleeding, an ultrasound is a must. I prefer to start with a short course of antibiotics (mostly Nitrofurantoin and Cipro or Levofloxacin are given) for five days depending on sensitivity patterns. Blood clotting parameters need to be checked to see if you are on the overdose of Coumadin. Ultrasound is a must to rule out any other serious causes of bleeding like a tumor. Since antibiotics are not available over-the-counter in your place, you need to get back to your general physician. Moreover, even for getting an ultrasound and clotting parameters to check the overdose of Coumadin, you need the help of your general physician. Please do at the earliest.


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Hello doctor, I have been taking Zoloft 25 mg and Ativan 5 mg one or two tablets to one tablet prn which I rarely take for anxiety. I take Tapazol 2.5 mg for hyperthyroid, TUMS two or three a day, Pepcid AC, vitamin D, B12, and Ventolin inhaler. I have been taking Zoloft and Ativan for 24 years. Four Psychiatrists and three medical doctors approved Ativan when I was diagnosed with anxiety. I worked for a psychiatrist for years, and he said I was merely cyclothymic if anything and stress. What is bipolar affective?


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Hello. Tell me one thing, since how long you have these thyroid nodules? Because some times symptoms of anxiety and restlessness might be due to hyperthyroid state. Is there any family history of any such kind of illness? Is there any change in functioning, sleep or appetite habit? In cyclothymia, there is an alternative period of depression and mania, but none of them is in full symptomatology, which means your functioning is not affected, but you can have distinctive period of euphoria and depression. Take a healthy diet, avoid junk foods, have proper sleep, do moderate exercise, follow relaxation technique, yoga and meditation may help you.


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Hello doctor, I think I got balanitis. Which cream should I buy? I had sex five weeks ago without protection. Painful peeing lasts for two years but not as strong as this time. Sores came out after having unprotected sex.


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Hello. First of all, you need to get blood tests for sexually transmitted diseases like VDRL (venereal disease research laboratory), HIV and HSV (herpes simplex virus), as the act may cause herpes simplex or syphilis. I would start with a combination of antibiotics like Doxycycline and antiviral pills like Valacyclovir. However, in your place, you need to get in touch with your general physician to undergo the necessary tests. Ointments alone will not be sufficient for treatment. A combination of Acyclovir ointment and Fucidin H cream (Hydrocortisone and Fusidic acid) as a thin layer may be applied for three days. Meanwhile, get in touch with your general physician. Avoid sexual activity until the ulcer is treated. Syphilis and HIV test to be repeated after three months.


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Hello doctor, How can I take care of toothbrush health? How often to change toothbrush heads or disposable toothbrushes and the negative effects of not changing them often?


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Hi. Dentists recommend a change of toothbrush every six months. But this toothbrush health depends on patient's brushing habits too. Like if a person does not follow proper brushing techniques and brush his teeth vigorously, or maybe he is suffering from any gum disease and he is brushing more often then he must change his toothbrush more often like at every 2 or 3 months. Usually, by six months the bristles of toothbrush start weakening, are not performing their function well, some bacterial flora may start growing at bottom of bristles or at back side of toothbrush head where tongue cleaner is given. If such yellow or brown stains start appearing at some surfaces of toothbrush then toothbrush needs to be changed immediately. At toothbrush replacement, Miswak is the best recommendation. It is like a small bamboo stick and you can easily cut off its bristles after brushing every 2 or 3 days later and it leaches out antibacterial ingredients and has many good affects for your health too. Like it is a cure for all gum diseases.


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Hello doctor, I am 35 years old and I had sex with my partner last month. My expected period date was a week later. Still, I did not get my periods. I have tried testing pregnancy strips the result was negative. I consumed Regestrone tablets for the past four days. We do not want to have a baby because of the family situation. I want to know if I am pregnant or not. If pregnant, how to start the abortion procedure?


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Hello. If the urine pregnancy test was done after eight days post missed menses was negative then you are not pregnant. However, to be double sure, you may opt for a serum beta hCG test, where if the hCG levels are less than 3 mIU, then you can be sure that you are not pregnant. As you have taken Regesterone for past four days now, so just continue for another day and then stop, if you intend to seek a withdrawal bleed. The bleed shall start in next 3 to 5 days post stoppage of Regesterone. Once the bleed starts, it will again indicate that you are pregnancy safe and you would be starting a fresh cycle. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am having Kalarchi choornam for cysts in my ovary. Is it effective for a fimbrial block in fallopian tube as well? Is it possible for me to get pregnant going on this choornam?


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Hello. Kalarchi choornam is a Siddha medicine used to treat ovarian cysts. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Fimbrial blockage of fallopian tube mostly occurs due to ovarian cysts because of multiple large-sized ovarian cyst plugs in the fimbrial opening of the fallopian tube. Due to continuous use of this Kalarchi choornam, it reduces the size of the ovarian cyst and helps to remove blockage as well. So there is a hope to get conceived in future. For more information consult an ayurveda specialist online -->


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Hi doctor, I am a 44 year old male. I have itching on the head of the penis and the foreskin. It started about 3-4 days back. But now it seems that I have symptoms of balanitis. I found white substance under the foreskin. There is also some minor tear which make it difficult for me to move my foreskin. I have applied Candid cream for that. Please guide me.


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Hi. There is a difference between Candid cream and Candid B cream. This seems like you are having candidial balanitis. Please apply Onabet cream (Sertaconazole) twice daily for a week. Wear loose cotton underpants. Do not wash your foreskin everytime you use the bathroom. Keep the area dry. Also get a fasting blood sugar level done. After a week you can take a follow up consult with a dermatologist online -->


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Hello doctor, My wife is 25 years old and she had her period on the 14th of last month. On the 1st of this month, while having intercourse, unfortunately, the condom broke. She had taken I-pill within two hours. Can you please advise if the tablet will work or not?


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Hello. I have gone through your history and understand your concerns. As you had I-pill, the chances of pregnancy are not there in your case. Delayed menses, if any, are due to hormonal imbalance caused by I-pill. Just wait and watch for your menses. For more information consult an obstetrician and gynaecologist online -->


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Dear doctor,I would like to know if I can take kalarchi churna. I have PCOS with irregular periods and ovulation issues. I was on Clomid stimulation which was giving prompt follicle growth and ovulation but could not conceive. Now I am given FSH injectables for stimulation. Can I have kalachi churna when having these injections? Will they interfere with follicle growth? Also, my testosterone levels are high. What to take to control that?


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Hi. PCOS (polycystic ovarian syndrome) is not a single disease, it is a group of diseases. It occurs due to hormonal imbalance, development of immature ovum due to hormonal imbalance and converted into a fluid-filled cyst. It leads to irregular menstruation and raised level of androgen hormones.  It can be managed through ayurvedic medicines and yoga practices. Kalarchi choornam is a Siddha medicine. It is widely used in PCOS. You can take this 2 g twice a day after meals. Do regular Kapalabhati and Mandukasana as well as pranayamas like Anuloma vilom, Nadi shodan and Bhramari. It helps to improve your metabolism. Avoid spicy and fried junk foods. Eat fibrous foods and fruits as well as green leafy vegetables. Drink plenty of water. For more information consult an ayurveda specialist online -->


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Hello doctor, I need an urgent help. I was on my fifth day of my periods and I made out with my partner. I had my pants and my panty on and he had his penis out. He ejaculated on my pant, and I saw that some portion of my panty was wet as well. And I felt wet in the skin of the lower portion of abdomen, where the vagina does not actually start, where it is only the human skin. I was very scared of it and I took a pill within one hour. And, two weeks later, I had the dark brown fluid, which ended in three days but it is not a very heavy flow and sometimes the thin tissue-like red stuff came out while peeing (like what happens during periods). So I guess I am alright? And there is no chance of pregnancy right?


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Hello. How are you doing? I do not see any reason for you to worry. Let me start by giving few basic facts about the period. Usually, ovulation occurs on the 12th to the 16th day of periods and life of the egg is 24 hours. The life of the sperm is 72 hours. So there is no chance of the egg being available on day-5 of periods. The sperm will not survive until next ovulation. Just then, your period would have stopped, so even the inner lining of the uterus would have been so thin and unfavorable for a possible pregnancy. So, the pill was not needed, but what you did was absolutely right as had it been a week later you had a chance of pregnancy. The pill was taken at the right time. This pill is progesterone hormone in high dose. This suddenly increases the inner lining of the uterus and makes it unfavorable for a possible pregnancy. But being a single dose of the pill, the thickness will not stand, so it will break down and you will get periods within seven to 10 days. As there was already no inner lining, the bleeding you noticed was very less. Usually, the bleeding will be thick, dark with fleshy streaks, and slightly painful. There is absolutely no chance of pregnancy. The next period will be one month after this bleeding. So just relax, everything is fine. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am 39 years old. I got a master health checkup done last week. In the blood report, RBC smear shows mild anisopoikilocytosis with normochromic red cells mixed with microcytic, hypochromic red cells, and no hemoparasites. I am attaching my test report. What is the treatment for this?


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Hi. I have gone through your test report (attachment removed to protect patient identity). For more information consult a hematologist online -->


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Hello doctor,I have severe pain and swelling in the back side of the right knee. My MRI was inconclusive. Please explain.


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Hello. I viewed the MRI of you knee (attachment removed to protect patient identity) and there are suspicious mild thinning of the articular cartilage in the bones of the knee and minimal fluid in the knee joint area. These changes are slight and not likely to cause any severe pain in the knee. The other causes of a severe pain surrounding the knee at your age can be due to changes in the blood flow in the arteries and veins. You may discuss with your doctors and get a right lower limb arterial and venous doppler test done. This will tell if there is any block in the vessels or a clot causing the pain. This kind of pain is felt in the muscles and soft tissues of the leg.


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Hello doctor, I am a 38-year-old female. I have anxiety, stress, breathing difficulty, dizziness, and, loose stools. Also, I am not able to eat. Currently, I am not under any medication. But a few years back, I had a medicine called Typlin C. Kindly help.


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Hello. Your symptoms could be related to a panic disorder. For this reason, I would recommend consulting with a psychologist or psychiatrist. Starting Typlin C again or another type of antidepressant (SSRI) may be necessary. I would also recommend checking thyroid hormone levels for possible thyroid gland dysfunction. In the meantime, I recommend avoiding coffee intake and start practicing yoga and meditation. Recreational sports can help too. I remain at your disposal for any further questions whenever you need.


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Hello doctor, I have 27 days cycle. Last month 23rd was the first day of my periods. I had unprotected sex. There was no ejaculation, but it just touched my vagina. For safety measure, I took I-pill in two hours, so my periods continued for almost eight days. Today is my date of periods, but still, I did not get. I am a little nervous because I got my PMS also. Kindly help.


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Hello. I have read your concern. It is a common side effect of I-pill to have prolonged menstruation and a delayed time for the next cycle. The emergency pill contains a high amount of hormone progesterone which prevents ovulation and at the same time hinders the usual period. If you want a regular cycle and not worry about getting pregnant, it is either you get birth control pills or have a copper IUD inserted. For now, you have to wait for your period. By the way, you will not get pregnant if it just touched the vagina.


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Hello doctor, I have severe anxiety problems which cripple me. I feel trouble in concentrating on my studies and other daily activities. I have PCOS and suffering from depression. I am an introvert, and my body is swaying all the time. A feeling of constant motion present like a boat ride. What can I do to live a better and happy life? How do I get rid of the anxiety? Last time when I had anxiety and depression, I lost 15 kg weight. Also, my hemoglobin and other vitamins levels were reduced. I am currently under Shelcal 20 and Autrin. In the past, I was on Venla 25 g.


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Hello. You should work on your weight loss. It will help you with both your PCOS and depression. Do the daily exercise for 30 to 45 minutes. Do meditation for 20 minutes daily. Avoid junk foods, eat healthy joint cooked foods. Take enough 6 to 7 hours of sleep. Spend quality time with family and friends. Spend time for creative hobbies like read good books, write journals, do paintings, etc. Live your life, do not just spend. Take a cold shower in the morning and drink enough plenty of water.


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Hello doctor, I have taken EllaOne once as the condom has split. If I wanted to have sex again with a condom on, would I need to take another EllaOne pill?


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Hello. I can understand your concern. EllaOne (Ulipristal acetate 30 mg). It is rarely used as an immediate pill and you took it after condom split. Levonorgestrel is an instant pill. But there is no issue as both are potent drugs to prevent pregnancy. A second tablet is only needed if vomiting occurs within three hours. Seizure drugs will decrease its efficacy and 0.9 % to 2 % is the failure rate. Adverse effects are nausea, headache, and dysmenorrhea. Menstrual bleeding for the next period may be earlier or later than expected and you can use a condom for next time sex. There is no need for another EllaOne. 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, My vagina has cysts and a cut on the inside. I have PCOS and the cysts never hurt until now. I also never have a regular period. And I want to know how I can increase my chance of getting pregnant.


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Hello. If you are planning to get pregnant at this time, you would need assistance from Ob-Gyn. She can give you pills like Progesterone to regulate your menses and have you bleed regularly. By doing this, timing interval when to appropriately have an intercourse would lead to better chance of conception. Once she has established your bleeding pattern, for a month or two, she can give you fertility pills. This are Clomiphene pils which will stimulate your ovaries to actually produce an egg or help you ovulate. Because you have to understand that PCOS patients have difficulty getting pregnant because they do not have regular periods and they do not ovulate.


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Hello doctor, I would like to know, can cortisone help if taken before transferring an embryo? And if it can help so, in which way?


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Hello. Yes, cortisone can increase the chance of getting pregnant. It decreases ACTH production (adrenocorticotropic hormone) and increases pituitary gonadotropin release, thereby increasing the chance of pregnancy. If you have a doubt then get back to me.


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Hello doctor, I am having hot and cold sensations in lower extremities for about a month. Chronic back pain for many years but more recently tingling in legs. I had MRI done today and saw this spot within one of the vertebral bodies that looks to be a calcific and circular lesion.


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Hello. There are two to three hyperintense (white) areas in the L1, L3, and L4 vertebrae. There are likely hemangiomas and are benign findings and not causing your problem. This is not a calcified area and is a common finding in many individuals. This is not of concern. The real issues are due to the degenerative disc changes at L1-L2 to L5-S1 disc levels. The discs are hypointense (black), and there are disc desiccation and mild posterior disc bulge. You can observe that there is neural foramina compromise in L2-L3, L3-L4, L4-L5, and L5-S1 disc levels. There is pressure on the nerves, and that is the reason for your abnormal hot and cold sensations and the chronic low backache. There are mild osteophytes in the lumbar vertebrae and mild endplate degenerative changes in the opposing end plates at the level of L5-L1 disc level. There are changes in the bone due to lumbar spondylosis.


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Hello doctor, I had inflammation inside the nose and ear clogged. I had water in the ear, and it went away, but I still feel some balance issue. I am currently under nasal steroid spray.


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Hello. I need some details to understand the problem. Do you have postnasal discharge, if so what is the color of it? Do you have a nasal blockage? Do you feel better with corticosteroid spray? Please describe your imbalance. Does it look like spinning, a sensation of rotation, or just dizziness but you can still walk independently?


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Hello doctor, My 2-year-old baby has pus (photos attached) coming out from her eyes since morning. After cleaning the discharge, it comes back again in 30 to 40 minutes. She has no fever, and is playing and feeding well, except the irritation she is feeling in her eyes due to pus and rubs eyes occasionally. Kindly suggest is this a cause of concern. How should we proceed with the treatment?


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Hello. She has got an infection in her eyes, (attachment removed to protect patient identity) and she needs antibiotic eye drops. Start Tobrex (Tobramycin) eye drops, one drop four times a day after cleaning her eyes. Please wash your hands after touching and cleaning her eyes, use a separate towel for her to minimize the risk of infection spread to other members of the family. It is contagious (spreads from one person to others). So treat her with antibiotic drops and protect the rest of the family. It will start improving in a couple of days. You are most welcome for any queries. Tobrex eye drops, one drop four times a day. Protect others from infection spread.


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Hello doctor, I have mango allergy, and I am wondering if mango concentrate can cause an allergic reaction. I had mango juice, and I did not break out at all, but last year I had an allergic reaction that was from mangoes or peal, that were hives and swelling. Before I turned 18, I was eating mangoes, but after I turned 18, I broke into an allergic reaction that consist of hives and swelling and my chest was tight.


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Hello. You need to identify which part of the mango are you allergic to and avoid it. Is it the juice or for the peal? Also, any particular variety of mango needs to be identified like banganapalli, alphonso, etc. If recurring with all the variety of mangoes then try to avoid all mango varieties. Keep antihistamines tablet ready if you get an attack of the hive while having mangoes again. Also, the age-dependent development of allergy is difficult to explain. It might be you have become symptomatic after the period.


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Hello doctor, I had severe itching on the part of my scalp with some blackish color on the area during last month. I applied Eberclin M cream to get relief of the itching, although the cream was not supposed to be applied on the scalp. But after applying just for two days, all the hairs surrounding the area where I used the cream have gone. Surprisingly, the hairs of the main itching area where I applied the cream was not that affected. I consulted a local physician, and he told me that it might be due to the strong tendency of the cream which burnt the area or it might also be due to alopecia areata. He prescribed me a daily shampoo, R89 drops, B and T Zauberol Premium hair oil. For the past week, I am going with these medicines. However yesterday I noticed that one or two hairs here and there are regrowing in the area, but not all the hairs. I am also losing my hair on both sides of the front (forehead), in the last couple of years. Please suggest on both the matters and will it be possible to get back my hairs.


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Hello. The side effects of the Eberclin M cream (Eberconazole+Mometasone) are skin thinning and dermatitis. Please do as I say. 1. Externally apply hibiscus flower oil to the scalp (or) rub the flower directly on the affected area daily, if possible. 2. Internally take homeopathic medicine, Graphites 30, two doses at bedtime, One today and second on the fourth day. One dose means ten pills. Just chew the medicine, no need to take water along with medication. Stop all other medication. Please inform me about your life next time. Are you under any stress or personal loss, etc? Alopecia areata. No combing on wet hair. Please inform me after seven days.


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Hello doctor, I am an 18-year-old female. I am experiencing a brown discharge whenever I am aroused. This has been going on for about a week and a half. My partner and I always use condoms and I have the birth control implant. It might be wrong. I might have bacterial vaginitis. There is no odor or itching.


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Hi. I can understand your concern. The brownish discharge you are having could be due to: 1. Side effect of implant leading to irregular spotting. 2. Local lesions like cervical erosion. 3. Rarely vaginal infection, etc. To find out the exact cause of the problem, please consult your gynecologist once and get examined. By clinical examination the possible cause of your problem can be identified and treatment can be taken accordingly. In case of side effect of implant, antifibrinolytics can help. In case of erosion or infection, you may need antibiotics.


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Hello doctor, My 12 months old baby girl got high platelet in her anemia blood test. Hemoglobin and WBC are normal, her platelet was 1170. After three days we made a test again and got the result 960. What can I do now, baby is fine. No unusual symptoms. Sometimes, she gets cold and fever but that is normal I guess. Is there anything to worry?


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Hello. Your child's liver, spleen and lymph nodes should be palpated to check for any enlargement, if present. The thrombocytosis is usually considered reactive when decreasing with the time. Your child's platelet reduces in three days so mostly it will be reactive secondary high platelet for which no specific treatment needed. But you need to repeat your child's CBC again after one week. If after one week it remains high, then you should consult hematologist or pediatrician for detailed evaluation as per my opinion.


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Hello doctor, My wife and I had some argument about my past. I had lied to her about the number of sex partners I had. That hurts her because she explained that her perception of me was built on the fact that she knew that I only had a few sex partners. We have been discussing this for months, but now after having these discussions and arguments, I realize that when we are to have sex, I get anxious. I will get an erection, but when its time to enter, it falls. I want to know, how to get my mind to a place of not over thinking so that I am not distracted. Kindly help.


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Hello. I am happy that you did understand that the problem behind your erection is, the problem is related to stress and anxiety which is stemmed out of the differences between you and your partner. That itself is the first step of the problem solver. Now the remedial measures are, 1. Do not attempt to have sex when you have the thought and related stress in your mind. 2. Start relaxation breathing for 10 minutes at least once per day. 3. Start physical exercise for one hour daily 4. Write down the cause and effect of the problem you are now facing with all the details. Then clear it logically alongside what you wrote. You may have to write this for two weeks to get the desired result. Take care.


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Hello doctor, Is it possible for implantation to take place after 14 days of conception? I had flow on the exact date of my period for three days, but it was lighter. I used three sanitary pads. But next month I missed my period. I do not have any pregnancy symptoms. My TSH is 10.5. Kindly help.


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Hello. Usually, it would take seven to ten days before implantation happens. The fertilized egg (conception day) will have to develop first into blastocyst stage and travel down to implantation site. The actual duration cannot be exact, but it may extend to two to four days more. So the answer is yes, it is possible that the implantation may happen 14 days after conception. In your case, it may not automatically mean implantation since you also have elevated TSH which can mess up with your hormones. I suggest you take a pregnancy test and if it is negative, then the period delay is just secondary to thyroid hormones.


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Hello doctor, I had chest pain very lightly in different areas of the chest. The pain was not continuous but occurs only sometimes during day or night but not in the sleep. I have taken an ECG and lipid profile test, but both are normal. My doctor advised me to take Ecosprin on daily basis life long. Kindly advise on this. I have a habit of smoking 7 to 8 cigarettes per day. Due to gastric problems, I felt this pain, but after taking gastric medicine, it will disappear. The gastric drug that I used was Atorva for cholesterol, but not now. My cholesterol level is in the normal range. Total cholestrol is 191 and triglycerides are 177.


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Hello. For chest pain, I advise you to have treadmill test and exercise tolerance test (ETT), in which you have to walk and run on a treadmill and simultaneously your ECG and blood pressure recorded. If chest pain is due to heart, it will be confirmed. Keep taking Statin (atorvastatin) but no need of Ecosprin (aspirin) according to new guidelines. For on and off chest pain, take pain killers such as Paracetamol. Have an ETT done and send me the report so that further planning can be done.


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Hello doctor, I am a 30-year-old married woman. I have got my last period before two months. I am having nausea for a few days. I have tested through pregnancy kit, and it is negative thrice during these two months. What should I do? Is there any blood test or other way I can check what is wrong?


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Hello. I can understand your concern. Irregular periods can occur due to many causes like stress and strain, dietary changes, etc., leading to hormonal imbalance. General conditions like anemia, thyroid abnormalities, etc., can also cause irregular periods. To find out the exact cause of the problem, please go for a blood test to check pregnancy which is more accurate than a urine test. If that gives negative result, pregnancy is almost ruled out. The other option is ultrasound, which helps in ruling out the pregnancy and also to find out other possible causes of irregular periods like PCOD, etc. Hope I have answered your query.


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Hello doctor, I would like to know why my veins are so visible. I have fair skin which could be the reason, but I see a lot of white people whose veins are not noticeable. And I am talking about usual green or blue veins, not spider veins because I am only 20. Does it have to do anything with my health? Is there a treatment? Which doctor am I suppose to see?


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Hello. I have gone through your case (attachment removed to protect patient identity). Since you have not taken any treatment for any diseases and almost all veins are visible then you need not worry. This phenomenon is exaggerated in some individuals. Surely this will not do any harm to your health, as these are visible for a very long time and they will persist for your life. One more thing veins of feet are becoming more prominent because feet are dependent areas. When we stand we exert all pressure on feet. As a result blood flow to vessels here increases, and it becomes more prominent. You do not need to see any more doctor except reassurance.


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Hello doctor, I have elevated optic disc with blurred edges only in the left eye, that was discovered on routine eye examination. I have developed headaches in the last few weeks. If this was papilledema would it be bilateral?


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Hello. Papilloedema is always bilateral. It is due to increased pressure in the brain. If it is unilateral, it is called papillitis, that is due to underlying inflammation.


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Hello doctor, My mother is having black circular patches on her legs. What could be the reason? Someone said it could be due to improper circulation of blood in the lower part of the body. It usually happens when the blood becomes thick. Can you please help me to understand the reason behind this? My mother is suffering from a cervical problem also. Please share your valuable advice and opinion.


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Hello. The most common cause is old age. In old age, small vessels become fragile and rupture, leading to blackish bruises, common in lower limbs but can occur anywhere in skin. Another cause is medicines. If a person is using drugs called steroids or anticoagulants or antiplatelets, then such bruises can occur. Another cause is trauma. In old age, an only minor injury can cause bruises as vessels are fragile. No relation to what you called thick blood or so. Rare causes are some disorders of the coagulation system, platelet function, etc. Is she suffering from any chronic disease or is she using some medicines? Please give a complete history and also send pictures of bruises so that I may guide you properly.


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Hello doctor, I have an obsessive compulsive disorder. When I was taking Uvox for four years, it was all fine. Now it relapsed, and I am taking Uvox before I used to take Stalopam. Can I get back to my healthy life and go office rgularly where I have to do brain work for nine hours? Please let me know. When I will get my healthy life back?


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Hello. OCD responds well to medication (SSRIs - selective serotonin reuptake inhibitors) and psychological therapy (CBT - cognitive behavioral therapy). I presume you are on Fluvoxamine which is useful in OCD. You need to be monitored by your doctor to optimize the dose and monitor for any side effects. If there is no adequate response, alternative SSRI like Sertraline can be tried. Once your symptoms are under control, you can continue to work and function normally. There are lots of people with OCD who are on medication and continue to work well. Also, try to have CBT for OCD which will help to prevent relapse in the future.


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Hi doctor, My wife is having swelling over the collarbone and back. Our doctor diagnosed rheumatism after blood test. Now, she has pain in ribs when she carries our 2 year old son or any weight. Our doctor had prescribed Bon-DK, Bon-K2, etc. How long will it take to recover? Is this a serious problem? Will this get cured? Please explain.


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Hi. Anti-CCP, ANA and serum uric acid. 1. Rheumatoid arthritis. 2. Soft tissue rheumatism. 3. Seronegative arthritis. For further information consult an orthopaedician and traumatologist online.--->


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Hello doctor, I am an 18-year-old male who is around 5 feet 5 inches. My issue is that my penis does not hang down normally, it sticks out when flaccid. Also my testes do not hang down and I am not sure if I have testes at all.


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Hi. I can understand your concern for your symptoms. Testes will be inside scrotum like small balls in small sack. Depending on blood supply and temperature, the scrotum hangs and constricts. If you have doubt, warm your hands and slowly massage to find out your testes or if you are still worried, then you can always do an ultrasound scrotum and find out the pathology.


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Hello doctor, If a girl has sex 2 or 3 days before her periods without any precautions, should she be given preventives or would there be any fear of her being pregnant?


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Hello. If the woman is regularly menstruating, meaning she has regular monthly interval of 28 to 32 days, she will not get pregnant three days prior to having sex. Her ovulation would have happened midcycle and that would be her fertile cycle, it will be within days 10 to 20 days of the cycle. So assuming that she menstruated at day 28 interval, then her three days prior would be day 25, and if it is 32 day interval, it would be day 29. She will not get pregnant at that time.


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Hi doctor, I am a 25 year old female with no allergies, smoking and drinking. I am suffering from anterior tibial tendinitis. I first began to feel the throbbing pain in my foot a month back. I was told that I have tendinitis. Last two weeks, I have worked for 12 hours a day with no day off was a big contribution for this medical condition. Anterior tibial tendinitis limits my activities by making it hard for me to walk or stand during long periods of time. I did not have any medical tests done. A physical examination of my right foot and ankle was done last week. I received a prescription for an anti-inflammatory pill called Naproxen. I was advised to take this 500 mg pill up to two times a day to help with pain but the pill must be taken before the pain begins. I was also advised to continue wearing supportive shoes, insoles, ankle supports and ice my foot for approximately 20 minutes whenever I feel the pain. I can do other activities that I do not put so much stress and strain on the foot. I was out a total of 3 days because of this condition. I did call my employer and let them know what was going. I also bought to their notice that I would be out for the next 2 days due to this medical condition. I did my research on this medical condition looked up information on the computer about tendinitis. When I looked up this information I was advised to cease the activity which caused tendinitis. I also looked up the short-term and long-term effects of this medical condition. I have documentation to prove that I do have this medical condition. Shall I apply for leave? Or should I quit my job?


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Hi. No, you need not have to quit your job. What you can do is that you can get an ultrasonography (USG) of the tendon done which will show you the inflammation and it will provide you with the documentation of anterior tibial tendinitis. With this documentation, you can apply for about 3 weeks of leave. The leave you got was only for the emergency department. You can visit the OPD (outpatient department) and do a USG scan, document it and apply for further leave. Meanwhile, you can use Naproxen as prescribed to you. Do hot fomentation now over the affected area thrice a day and limit your activity to give rest to the affected part. Also a removable walking cast is going to help you a great deal to recover from this condition sooner and present worsening of this condition which will lead to chronic anterior tibial tendinitis.


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Hi doctor, My father is 76 years old. He has been in ICU for two days as he was diagnosed with LRTI (CAP - community acquired pneumonia). Four years back he had TB. His vitals such as BP, temperature, renal and heart tests are fine. He is not responding to antibiotics and his condition is deteriorating. His saturation has dropped to 82% and put on oxygen. On the third day, he was given Amoxicillin 1000 IV and 5x nebulization and then switched to Piperacillin-tazobactam IV which I have read is for Pseudomonas. Pseudomonas aeruginosa is a commonly acquired hospital bacterium. Doctors admit they have not identified the bacteria yet from the sputum culture and told it will take more than 5 days to identify the bacteria. Please help.


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Hello. Your father is suffering from acute exacerbation of COPD (chronic obstructive pulmonary disease) with CAP (community acquired pneumonia) and sepsis. Currently he is on appropriate antibiotics. But, he needs systemic steroids to cope up the exacerbation along with inhaled steroids. Though his x-ray (attachment removed to protect patient identity) appears normal, CT thorax is suggestive of bilateral consolidation. Sputum culture should ideally tell us the exact bacteria and sensitive antibiotics for it. Supportive treatment like nutrition, supplemental oxygen or noninvasive ventilation must be given. There is no worry as other vital organs are functioning normally. But, definitely he will take time to recover from this exacerbation. He also had tubercular effusion 5 years back, but now it does not seem to be a relapse of TB (tuberculosis). So, no anti-TB medicines are required at present. Definitely it is CAP with COPD exacerbation. Even after he gets well, he should take consultation from pulmonologist for inhaler treatment. Sputum culture report should be sought for at earliest or if not available, fiberoptic bronchoscopy can be performed for taking endobronchial sampling for cultures. Steroids should be tapered in appropriate doses. Bacterial Infection. Sputum culture or bronchoscopic sampling for culture. CAP with sepsis. COPD exacerbation.


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Hello doctor, I got married 2 days before. My penis got erected while doing foreplay. However, after some time penis gets loosen and become small. So, could not penetrate my penis. Is there any issue in my health? Or is this due to first time fear? How to approach this? Please advice.


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Hi. Since you got proper erection during foreplay and there is no history of difficulty in erection it was the result of performance anxiety. This generally occurs in first timers and especially in young age. I do not think you need to be concerned at this level as occasional failure is rule rather than exception. Almost all men report such problem in erection psychologically on certain occasions without suffering from any disorder.


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Hi,Could you please review the attached photos and x-ray taken before treatment, post root canal and post temporary filing. Please let me know whether a post is required. Or is core filling with crown sufficient?


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Hello doctor, My wife is 24 years old and her height is 4'10" and weight is 61 kg. She is a bit overweight and also has PCOD problem. We got married 2 years back and she cannot get pregnant. Please send the diet chart to reduce her weight. What are all the foods that she can take to improve fertility? Thank you and looking forward for your reply.


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Hello, Welcome back to icliniq.com. Thanks for your query. From your information, I got to know that she is obese. She needs to reduce approximately 6 kg. It is too much weight for her height but no worry she can reduce it by diet and some exercises. She needs very low calorie diet of about 1200 kilocalories a day. Rice intake has to be as low as 50 g as well as 50 g whole wheat. Carbohydrate group not more than 150 g. Only brown rice, brown breads, and more fiber containing products like whole grains to be taken. Take more vegetables from gourd family and 300 g fruits have to be taken. Reduce sugar intake to minimum 1 teaspoon per day or have less sweets. Avoid the following food items: She can take the following foods to reduce her weight: Should not sleep at daytime, maximum keep working and follow dynamic lifestyle. Yoga or mild home based exercises are very helpful. If she is not serious about her diet, activities and lifestyle then she would face more complications. Improper food habits and improper meal planning. 1. PCOD (polycystic ovarian disease). 2. Food habits. 1. Junk foods. 2. Foods containing high carbohydrate. 3. Wrong foodings. Very low cholesterol and a bland diet. Proper small but frequent balanced diet to be followed.


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Hi doctor, I have very small red blisters on the glans and corona with lot of itching. For that I have used Acivir ointment. There is temporary relief but it reoccurs. Please help.


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Hi. Small red blisters on the genitalia usually occur in herpes virus infection. But they are associated with pain and burning. You are complaining of itching which is unlikely for herpes infection. I would recommend you to upload the photographs of the blisters, so that I can have a clear picture of the condition and can guide you accordingly. What is the duration of the blisters? Are you sexually active? If yes, any similar history in your sexual partner? Do you have diabetes or any other ailment? Are you taking any medicine for some other ailment?


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Hello doctor,I am using Minoxidil for nine months now for the bald patches on my head. A little progress was seen between 3 to 4 months but no progress recorded afterwards. Can you suggest me what is wrong or if I should change my prescription?


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Hello. 1. You can use Minoxidil for androgenetic alopecia and it takes times in a few people to gain full results. Sometimes there can be shedding of hair in between but you will recover from it if you keep using it. So stick to it.  2. You can also add tablet Finasteride 1 mg daily which is the only approved oral medications for androgenetic alopecia.


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Hello doctor, I am 33 years old, male. I am diagnosed with right adhesive otitis with left SOM. Already mastoidectomy was done in right ear nine years back and two myringotomies in right ear when I was 4 and 7 years of age. I have CT scan report, audiometry, impedance test results.


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Hi, Welcome to iclinq.com. Can you upload audiometry report? What are the complaints now? Is there discharge or hearing deficit? Any pain or giddiness? Nose CT seems fine (attachment removed to protect patient identity). Ear shows mastoiditis. Have they done an ear under microscope examination? If it is a clearly diagnosed adhesive otitis media supported by audiometry it will need surgery. But which ear to be done first will depend on audiometry. Is there any nasal complaints?


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Hello doctor, We had unprotected sex and after that took an I-pill within an hour. After 6 to 7 days, she had spotting for 2 to 3 days. It is almost six days up. There is no clue for periods and she is also suffering from cramp, vomiting and nausea. But we have taken test for almost four times. It is always negative.


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Hi. I can understand your concern. As she took emergency contraceptive pill within one hour, the possibility of pregnancy is less. The bleeding she got after 6 to 7 days could be withdrawal bleeding due to emergency contraceptive pill. As she disturbed natural cycle by taking pill, now it may some time for regularization of cycles. And next period may come after one month of spotting. Cramps, nausea may be due to some other causes like infection either vaginal or gastric, renal related, etc. Clinical examination and ultrasound will help in finding out the possible cause of the problem and treatment can be taken accordingly.


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Hi doctor, My friend is going to adopt a 6 months old female child. Certain routine tests were performed on the child. I have attached the reports for your reference. The Hb electrophoresis for thalassemia screening is showing an abnormal hemoglobin pattern. The treating pediatrician is not sure about the prognosis that is whether the child will be symptomatic and transfusion dependent. Presently, the child is asymptomatic except for mild splenomegaly. Please suggest about the future prognosis of the child to facilitate the further course of action.


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


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Hi doctor, I have been diagnosed with chicken pox. However, I am skeptical because not only the red bumps are not nearly as prolific as normally seen in chicken pox patients but they also are not itchy in the slightest. Could this just be an outbreak connected to spring allergies or is it just a mild form of the pox?


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Hi. I have gone through your case. Firstly, yes this is a mild form of chickenpox which occurs in those individuals who have very good immunity. But important thing in your history is that you already had chicken pox in your childhood. Once after getting chickenpox, it is extremely extremely rare to have it again in life. It can occur again but it occurs in severly immuno-compromised patient and presentation is very severe. However, you have described some mild diseases. In the end you are not having chicken pox but anything can be said after seeing your picture.


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Hello doctor,I have got some white spots inside my cheeks and some sores on my tongue and bottom lip.


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Hello. I have gone through the photos you have provided and noted the sores and white spots inside your cheeks. There are a few explanations for those: 1. Eating or drinking hot foods, drinks, drinking carbonated drinks.  2. If you have experienced flu-like symptoms, it is due to acute viral infection. That might take a few more days to get completely healed. Avoid drinking too hot foods or drinks or carbonated drinks. Keep good oral hygiene. Apply oral antiseptic four times daily. Apply Glycerin of Borax on the sores. If they hurt, can apply Diclodent (Diclofenac) spray orally. If no improvement, then, should consult further with ENT specialist.


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Hello doctor, I was taking cocaine and alcohol once a week for 20 years. On the first of this year, I started getting a cough and breathlessness. I continue to do my binge until four weeks ago when I was diagnosed with mild left ventricle dysfunction. I then had a chest CT scan and lungs come back clear. I had an X-ray another day, and I have got an enlarged heart. I have no family history of heart problems. I know this is done through cocaine. I have been clean for four weeks, but I am still experiencing breathlessness. Can you please tell me if this can get better? If so how long does it take? Because I have no improvement and I have been working out too for the last four weeks.


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Hello. Your reports are showing mild LV dysfunction (left ventricle) with no lung disease (attachment removed to protect patient identity). LV dysfunction is likely to be related to drug abuse. Still, it will be useful if you provide your ECG and echo cardiography report. If you stop taking these drugs and take medicines as suggested your symptoms are likely to improve. Duration of improvement varies with each patient depending upon the damage to the heart and compliance of the patient to the prescribed medications.


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Hello doctor, My finger had a drop of precum, and I touched my partner’s vagina indirectly through her cotton panties. Will she get pregnant?


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Hello. I can understand the concern. Precum or pre-ejaculatory fluid also contains sperm to make a female pregnant. If your sperm has reached inside her vagina by any probability, there are chances of pregnancy. Also to be noted she should be in her fertile period (10 to 15 days from her last menstrual period) to get pregnant. If you are anxious, and if it is within 24 hours you can go for an emergency contraceptive pill (I pill). 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 m a 26-year-old. I do not have any job now. I worked for a project of a private company. Then I tried some other posts, but nothing worked. I was good at studies, so I decided to prepare for a government job. I have a fiance. He is too preparing for the government job. I do not know what my father needs? He always shouts and this the third time when he beat me. For no reason, he has his inner frustrations. My fiance says I cannot marry you until I get a government job. I like to paint sometimes. What should I do? If you can help, I will be very grateful to you.


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Hello. You should try your freelancer if you can do. Create your own business, do not get worried about a job if you do not get it. Be hopeful and relax. Everything will be fine. Do exercise daily for 30 to 45 minutes and lose your weight which will help for even PCOD. Do meditation for 10 to 20 minutes. Spend time for your creative hobbies for 20 minutes like do painting as you enjoy. Do not overthink. Ask your father about his problem. Now you are not a child, talk openly and be assertive if you need to be. Do not be afraid of anyone in life. Live your life, not just spend. Do not think even about your marriage with your fiance. Just wait and watch. Do not be insecure. Make your self capable enough to do anything.


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Hello doctor, I do not know where I should start. How will I tell you what exactly I feel? As I do not know either I was happy or sad, I cannot express what I think. I do not want to live, and I do not like to talk with my best friends, the family. They, ask me something about which I need to answer. I feel irritated and angry, and that makes me tired to reply to them. When I sleep at night, I sleep correctly on time, but I woke up daily at midnight at least 2 to 3 times at night daily. I fall asleep daily in the afternoon as well if I sleep midnight I woke at 11 am on the next day. And again at 2.30, I fall asleep. And the same problem is I woke up in the middle of my sleep. This becomes a routine, and I do not know why I hate myself? But I hate my face when I see myself in the mirror. Please help.


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Hello. All problem you mentioned are core symptoms of depression are sadness, low mood, lethargy, disturbed sleep, low self-esteem, irritability, suicidal thoughts, decreased concentration. I think you should consult a psychiatrist, personally. Usually, there is insomnia in depression, but some time hypersomnia also possible in atypical depression. You do not need different medicine for all of your problem they will be solved just by antidepressant medication. No need to get panic and getting rid of depression is not so severe nowadays. Various new antidepressants and psychotherapies are present. If any stressors present try to remove it or decrease impact in life, improve your coping. Moderate exercise, yoga, meditation may help you. (rule out the medical cause by an investigation like CBC, TSH calcium B12, D3 level).


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Hello doctor, I have a toothache, and my mouth is swollen which I can feel it in my face. When I press my mouth, I noticed little pus coming out. Kindly help.


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Hello. It is a case of acute alveolar abscess from a tooth infection. Let me check your attachments (attachment removed to protect patient identity), and I will advise and initiate treatment protocol accordingly. I checked your attachments. Your teeth are carious and grossly decayed, and due to that, you have developed an infection which resulted in swelling in the gum region and adjacent areas. Right now you take antibiotics Amoxycillin 500 mg three times eight hourly for five days and tablet of Paracetamol 500 mg, Acelofenac 100 mg Serrapeptase 15 mg or Zerodol SP (Aceclofenac, Serratiopeptidase, Paracetamol) twice daily for five days. You also add Pantoprazole 40 mg once daily for seven days. You also maintain good oral hygiene and try salt gargles three times but only if you are not hypertensive. However, the final solution lies with the extraction or removal of these teeth.


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Hello doctor, I am having some internal pain on the penis and it is a bit stronger when I have erection. No bruises, or pus during urinating. I am male, 34, 1.72 m and 80 kg.


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Hi. I can understand your concern for your symptoms. Pain during erection can be due to: 1. Infection - common cause is urinary tract infection, other sexually transmitted infection. 2. Balanitis - inflammation of gland penis, tip of your penis can be due to allergy of infection. 3. Prostatitis - inflammation of prostate gland due to infection or injury or inflammation. 4. Urethritis - inflammation or infection of urethra. 5. Renal calculi  can cause painful erection. 6. Peyronie's disease - scar tissue inside the penis causing painful erection. 7. Neuropathy due to diabetes. Kindly share more details regarding above information and we can work on your treatment.


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Hello doctor, I am a 19-year-old. I have never had acne problems. Recently I can see acne around one side of my mouth. It has been going on for a few months. I have tried every face wash, creams, toners, etc. I have an extremely irregular period. I am not on any medications. Does it have anything to do with my periods?


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Hello. 1. Yes, it can be related to your irregular cycles also. 2. For that, you should consult a gynecologist. I am writing you the medications for this for now. A. Capsule Doxycycline 100 mg once a day. B. Adapalene and Clindamycin gel apply once at night on acne, do not rub it and wash after one hour. Do this for 15 days.


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Hi doctor, I have been suffering from fatigue for more than two years now. I am a 34-year-old otherwise healthy male, all blood, hormone, vitamin tests have come back perfect. However, it started after a long and intense panic disorder, which lasted for months and almost drove me to suicide. What saved me was a medicine called Clonazepam. It helped immediately. I used it for a month and then tapered off without any side effects. So I was wondering that could prolonged intense stress like that induce some damage to the brain or nervous system which can result in chronic fatigue? If so, what are the things I could try to solve this problem?


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Hello. I can understand and empathize you. During a panic attack or any stress, our adrenaline level is so high. This is the hormone for fight and flight and to relieve from this condition, Clonazepam acts as a relaxing agent. This is normal for any person and this medicine cannot affect the brain. Due to chronic stress, our serotonin level goes down so that some medicine maintain that level. No anatomical changes occur during stress in the brain. There is no damage in the nervous system. During depression and stress, fatigue is common. So do not bother about that. Start medicine. You will get relief soon.


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Hi doctor, My voice is very low. I am not able to scold or intimidate anyone. When my friends abuse me, I am not able to reply them. They take advantage of me. They never heed my words. Sometimes, I feel much worried about it. I also hesitate and vibrate while talking. People keep me down with their voice. I am not able to cope with them. My friends suggest me to increase my pitch. Sometimes, I am not audible to my friends also. I have this problem since my childhood. I am having some fear to speak to people and even my friends. Give me some tips to improve my speech and articulation skills.


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Hello doctor, I have itching all over the body and different part itch at different time. And whenever it itches skin becomes pink like you can see in the photo attached. Also whenever skin itches I have some pain or movement in the stomach, I also have pain during bowel movements. What is the cause and medication for this and how to prevent it in the future?


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Hello. Your history and clinical images are more in favor of acute urticaria. It is an immediate kind of skin allergy, and once it starts, it usually tends to last 4 to 6 weeks if appropriately treated. You could even try to identify any possible exacerbating factor. The usual ones are pain killers, flowering plants, pet animals, artificial colored food items, nuts, seafood, cement dust, etc. You can start taking tablet Allegra 180 mg (Fexofenadine) once daily in the morning, and tablet Teczine 5 mg (Cetirizine) once daily in the evening for three weeks regularly. You can apply Calosoft lotion at sites of itch.


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Hello doctor, I have shortness of breath on exertion and episodic mild muscle weakness for about one year. It worsens with fatigue and particularly ptosis. Kindly help.


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Hello I saw the chest x-ray posteroanterior and lateral views (attachment removed to protect patient identity). The findings are, 1. There are mildly prominent lung markings in the bilateral mid and lower zones. The upper zones are clear bilaterally. 2. There is no pleural effusion. 3. The cardiac size is normal. 4. The retrosternal space is normal. 5. The posterior costophrenic recess is free. The above findings can be due to mildly hyperactive airways. HRCT chest scan may be done if there are abnormalities in lung function tests. Please avoid any pollution area or dust exposure. For muscle weakness and ptosis, please get tested to know if you are having myasthenia gravis, the most common cause for ptosis and muscle weakness.


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Hello doctor, I have been experiencing anxiety for a few years now. It started with a few random anxiety attacks, and soon it spread. I find it hard to leave the house on my own due to this. I feel ashamed, and my self-esteem is very low. I am usually a proud person, very independent, determined and self-sufficient, but this issue has impacted my life negatively. I find it hard to socialize now due to shame about the anxiety symptoms showing up and this led to shyness. I feel depressed and have low energy. I do not enjoy the things I used to enjoy anymore. I had some significant losses and failures in my life in the past few years, and I think this might also be the cause for all this. The anxiety symptoms are pretty much like panic. I get heart palpitations, cold hands and lots of muscle tension, especially in the neck, face, and eyes. If I feel very nervous, my neck gets so tense that it twitches. I also experience lots of self-criticism and guilt because of this. I have high expectations of myself and consider this problem to be unacceptable. I tried many of the common homeopathic remedies for this (such as Ignatia, Staphysagria, Arsenicum, Sulphur, Graphites, Pulsatilla, Calc Carb) and nothing seems to help except for Aconite 200. The problem is that Aconite only helps temporarily. I need something that works more long-term. Is this something you can help me?


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Hello. After Going through the details, I could narrow down to three medicines namely, Ambra Grisea. Hyoscyamus. Baryta Carb. I suggest you start with Ambra Grisea 1 M one dose and wait for 7 to 8 days. If you feel a change, then you can wait and repeat the medicine only when required. Also if it helped and then stopped working, then you can go for higher potency like 10 M. If it does not help then go to the Hyoscyamus and then Baryta Carb the same way as the first one. If in case it helps. I would surely like to know the follow-up. With regular follow-ups and it can be managed more efficiently. Some losses in the past few years. None advised. Ambra Grisea, Hyoscyamus, Baryta Carb. Regular follow-ups about the action of the medicine are appreciated for at least at 10-15 days.


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Hello doctor, I am a 33 year old male. I am having regular water retention problem, specially on the abdomen region. It fluctuates quite a bit and so does my weight on the scale. Sometimes there is a lot of discomfort to even wear normal trousers on certain days. This however is most prominent on the days after consuming alcohol the previous night. This has been there for the past 3-4 years, but recently I have observed that this swollen abdomen region remains for couple of days. I have had a thyroid test last month which was normal and general health checkup every year including ECG has always been normal. I am not under any medication and no known ailments. I should also add that my LFT test was done about a year back and that was normal as well. It is just too uncomfortable on certain days to wear the usual clothes (trousers) and I would like seek a permanent solution to this problem. Kindly advise. Thank you.


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Hello. First of all we have to find the cause for this. If no cause is found then we would call it idiopathic. I would recommend you following investigations: You should avoid alcohol, take low salt diet and do regular exercises.


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Hi doctor, I have a big problem in terms of loosening of upper and lower eyelids. Please check the attached pictures. I have been wearing rings on my fingers which have created pressure on my eyes and l believe have led to my condition. I am extremely worried as nonverbal communication is affected and I am having staring look. My confidence level goes down with this. I have shown to ophthalmologist for sight since the last six months and they have been prescribing drops such as Fusion, Systane ultra, anti-inflammatory eye drops and tablets but my condition is not improving. I have been using cold and hot compress as well and changed my diet. Please advise.


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Hello. I have gone through the pictures (attachments removed to protect patient identity) of your eyes.  As I can see, there is nothing abnormal with your eyes. Cosmetically, there are some fat deposits around the upper and lower eyelids. This condition is not in need of treatment now. If you want to improve appearance, cosmetic surgery can be done to correct the fat deposition. Fusion (combination of Sodium hyaluronate, Carboxymethylcellulose and Glycerin), Systane ultra, anti-inflammatory eyes drops or any other treatment will not help you in any way. Wearing rings is no way related to your eye appearance.


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Hello doctor, I am a 43-year-old male. I have spots and discomfort on the penis head. It has been coming and going for a while. Now some of the spots are more visible if I squeeze the head and it looks like dark specks under the skin. I am using Butenafine hydrochloride, and Cortisone 1%.


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Hi. Reviewing your history and pictures showed (attachment removed to protect patient identity), there might be skin irritation which can be from repeated frictions like masturbation or reaction to the substance used it also can be due to vitamin deficiency or a skin condition like psoriasis, etc. Fungal infection is rare and it does not present as a spot usually it is whitish material and happens in people who are immune compromised like diabetics or people who have HIV infections. Since it is not itchy or painful you should not worry about it and you should not use Cortisone cream as it makes things worse. Keep good hygiene area should be dry and clean. Use nonchemical lubricant like olive oil if you masturbate. If you have changed your soap or shower gel it might be the cause. Take vitamin E and vitamin A to replace your vitamin deficiency. If you are known to have psoriasis then treatment can be by Methoteraxate cream (but only for people who are known to have psoriasis). Follow up is important and please keep me updated for any further queries.


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Hi doctor, I am a 46 year old male. My weight is 74 kg and I am having an excellent physical shape. I think I have some sleep issue. I did not get proper sleep for any days and hence, I feel tired and irritable at times. I am very active professionally and leading very engaging life. I am not suffering from any depression or mental issues. I get a little bit of anxiety at times, but nothing serious that I can feel. What could be the reason for this? What are the remedies? Please suggest me.


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Hi. I have gone through your query and can understand your health concern. For further information consult an internal medicine physician online -->


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Hi doctor, My wife who is 27 years old having cold since 3-4 days. Right now she is having severe earache. I have already given her painkiller like Combiflam and Nicip. Also gave her cough syrup Benadryl. The earache is very severe and she is not able to bear it. Can you recommend some medicine? Thank you.


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Hi. I have thoroughly gone through your case and can well understand your genuine concern. Your wife might be having throat infection which has spread to the internal ear. This infection is causing congestion and severe ear pain. As you have already given her oral analgesic drugs they will take some time to act. I suggest you to use any of the analgesic (pain reliever) ear drops like Otic ear drops (Ofloxacin) which acts internally in the ear and will bring down her pain. Otic ear drops application:


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Hi doctor, My daughter born 7 days back is suffering from meconium aspiration syndrome (MAS). I would like to know, how we measure her growth of lung capacity.


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Hi. In newborns measurement of lung capacity is not as useful as in adults. Important clinical signs of respiratory effort, respiratory rate and the x-rays that had showed the meconium aspiration syndrome (MAS) and also the general condition of baby. These are the important parameters that show the improvement rather than just lung capacity.


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Hi doctor, This is about my elder sister who is 37 years old. She is diabetic since 4 years. I have attached the report and prescription of the same. Please check and give suggestion. Now she is suffering from swollen face. Is there any problem in kidney due to high sugar level?


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Hello. Thanks for the query to this platform. Your sister is a known case of hypothyroidism with uncontrolled type 2 diabetes mellitus. Her sugar is constantly raised throughout the last 5-6 months as shown in the reports. She is on oral diabetic drugs and her blood sugar is not controlled. According to me, she needs to be started on insulin. Insulin is just the replacement for the insulin in the body which our body is unable to make.She is overweight which needs to be looked into. She needs to reduce her weight gradually by going for walk, avoiding lifts, avoid fatty foods, rice and chicken or mutton. As far as her kidneys are concerned, her creatinine and urea are within normal range. Her urine microalbumin is raised which points towards heart and kidney function. She needs to be started on statins after consulting her physician. Kidneys get affected in diabetic patients. Keep repeating her creatinine regularly which will show her kidney function. For now she is on diuretics which will subside her swelling in face. Diabetes. 1. High density lipoprotein (HDL). 2. Low -density lipoprotein (LDL). 3. Very low density lipoprotein (VLDL). 4. Cholesterol. 5. Fundus examination. 6. Two-dimensional echocardiogram (2D echo). Diabetes mellitus with hypothyroidism. Start on insulin with statins. 1. Avoid fatty foods, rice, chicken and mutton. 2. Start regular walking and avoid lifts.


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Hello doctor, My husband was given Zuclopenthixol injections during his stay at a psychiatric hospital and now he feels he has been done lobotomy and a part of his brain is missing. Like his intelligence, sharpness, cleverness, energy levels, etc. he feels the doctor should have diagnosed his mental state before concluding that he needs such level of treatment. His problems were stress-related. And now he feels he cannot get his brain back like before and feels like there is no point living. Kindly suggest what measures can be taken to help him?


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Hello. Zuclopenthixol is an antipsychotic medication prescribed to a psychotic patient or patient of severe depression with psychotic features. It is commonly used to control aggressive behavior of the patient. A decline in cognitive features, slowly are possible with Zuclopenthixol. One thing I want to clarify whether he is sure that lobotomy was done on him or not? You have also mentioned that previously he was prescribed Risperidone. So I think he might have psychosis. A patient of psychosis can have a depressive episode. If currently, he can tolerate Zuclopenthixol depot you can ask about Olanzapine depot which is second-generation antipsychotics and has a less side effect.


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Hello doctor, I have eye allergy from the past 15 years due to vernal conjunctivitis. I am under Cromolyn 0.4 % for it. Kindly advice.


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Hello. Along with Cromolyn, start Moxifloxacin plus Loteprednol eye drop four times a day for three days. Taper it to two times a day for the next five days. Then taper to once at bedtime for the next five days. Also, start Refresh tears eye drop every two hours continuously for a month


