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key: Patient
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Hello doctor,This is regarding a male aged 48 with high blood pressure, diabetes, sleep apnea, and overweight. He has muscle spasms or shakes, drops things because of this, cannot stay awake during the day. It affects his driving and family life. He can nap for a few hours and when he gets up falls asleep on the chair, dozes off during a conversation, eating, and sometimes while standing.


key: chroma:document
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Hello. It is clear that he has obstructive sleep apnea which causes interrupted sleep during the night due to obstruction of the nasopharyngeal air flow. As a consequence, he becomes sleepy in the daytime. Confirmation of the diagnosis requires: Has he done any of these tests? CPAP (continuous positive airway pressure) is helpful in relieving the symptoms. Also, reducing the weight is very helpful. For more information consult a general medicine physician online -->


key: Patient
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Hi doctor, I am a 16-year-old female. My weight is 85 kilograms, and I have a height of 5 feet 3 inch. I have excessive daytime sleepiness for the past three years. It got started in me before three years, and my parents took me to the local GP immediately. They did blood tests and told that I have iron and folic deficiency. But I am still suffering even after the deficiency is gone. I always get sleep during the daytime. I try myself to stay awake for daily activities. I struggle extremely. It is interfering me in my day to day life. When I go to GP, they keep recommending me blood tests. I need a solution for my problem. Please help.


key: chroma:document
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Hi. You have obstructive sleep apnea. Please say about other symptoms whether you had snoring, interrupted sleep, unrefreshed sleep, and morning headaches. If you had these symptoms, it supports the diagnosis. It is a condition characterized by obstruction of upper airway especially during sleep due to narrowing of airway due to obesity. Obstruction of upper airway leads to temporary stoppage of respiration, increased sympathetic drive, and increased pulse rate. Also, another reason for pulse rate rise is deconditioning as you are not accustomed to activities. You can do ENT examination if you have nasal stiffness, and recurrent tonsillitis to rule out the nasal causes of obstruction. You can also do a thyroid function test, lipid profile, sugar, Hba1c, vitamin D, and polysomnography. Polysomnography is a sleep study used to confirm the diagnosis and to know the extent of the disease. CPAP (continuous positive airway pressure) is needed. You have to reduce weight. It is the first line of treatment. You need to have low fat, and a low-calorie diet to lose weight. Secondly, CPAP is a mask and device, and the pressure during inspiration and expiration during sleep keeps your airways patent and avoid this from happening. Also, regular exercise is essential. Chest physiotherapy and yoga will be helpful. So you can follow these steps, or you can visit a nearby sleep specialist or pulmonologist.


key: Patient
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Hi doctor, I am wondering about the connection seen between my excessive fatigue or sleeping issue with cardiac insufficiency. I have excessive sleepiness due to mild sleep apnea. But I have a strange disconnect regarding exertion. Even, a slight anaerobic activity reduces my breath and it takes time to have a standard respiration rate. When I use an elliptical machine, I have trouble in getting my heart rate up to 110 beats per minute. However, when I take Vyvanse, I can easily hit a heart rate of 125 beats per minute. I recover immediately after stopping it. I have a blood pressure of 130 by 88 mmHg. Currently, I am taking Enalapril, HCTZ, Amlodipine, Levothyroxine, and Prozac. These problems preceded my daily alcohol intake and minor cannabis use. Please suggest.


key: chroma:document
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Hi. Yes, daytime sleepiness occurs due to sleep apnea. If it is present in its severe obstructive form, it can cause a host of cardiac diseases like atrial fibrillation, coronary artery disease, and heart failure. The exercise intolerance initially develops the consequence of early heart failure. Also at your age, you may be suffering from chronotropic incompetence, that is, the inability to increase heart rate with exercise, and regular graded exercise will help you. Stay off from alcohol and cannabis.


key: Patient
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Hello,  I'm looking and would like to discuss my treatment options for my conditions.  I've bipolar disorder II, social and generalised anxiety disorders, panic attacks and agoraphobia due to it.  In past, I used escitalopram, venlafaxine, fluoxetine, sertraline, lithium, depakote, quetiapine, risperidone, anxiolytics. Venlafaxine was effective but had to discontinue it due to high blood pressure it caused. Other treatments mentioned didn't work for me. Anxiolytics worked, but now i don't have such options to continue this treatment because I'm getting used to Tranxene.  Currently I'm taking Lamictal 200 mg and 10 mg olanzapine.  I am afraid to go out from my flat, I am constantly alarmed, nervous, anxious, can't eat because of constant lump in my throat. Anxiety is debilitating, I can't work outside my home. At work I get so anxious that I have to take some free days from work, if I don't do that, I vomit from this anxiety.  1) Can duloxetine be effective? Is it common that it can increase pulse and blood pressure as Venlafaxine did? 2) How long does it take for escitalopram to take effect? 3) Can prozac decrease anxiety? 4) Is paroxetine an good option for me?


key: chroma:document
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thank you for taking help from psychiatrist. you should continue medications on which you are stable at present. 1)duloxetine may be good option for you. it does not increases blood pressure. 2)tablet escitalopram takes around 4 weeks for full effect after starting medications. 3) yup,prozac can decrease anxiety but it belongs to same group as tablet escitalopram. 4) yup,paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine. you should follow below advice which can help your anxiety. hope you get your answer. thank you


key: Patient
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Hi doctor, I am feeling tired for a couple of weeks. I do not have the feel of sleeping. I cannot completely open my eyes in the morning. I have a headache and neck stiffness. I went to a urgent care as I had chest pain, they did an ECG and blood test and told me that there is nothing to worry about heart and they told, I may have GERD and gave me some acidity medication. I had a follow up with an ENT as I was having a headache. The ENT doctor told me that I have a sinus infection. I took antibiotics given by the doctor for seven days to get some relief but, still, there is tiredness, feeling of sleepy and some discomfort in my throat and neck. Three years back, I used to have acid reflexes and I used to cough a lot so I developed tonsils. I am not sure what is causing headache and tiredness? Is this anything to do with brain stroke or gastro problems? This is causing a lot of anxiety and stress for me. Currently, I am taking Amoxicillin, Fluticasone, Prednisone, Ranitidine tablets.


key: chroma:document
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Hi. It may be due to sleep apnea or obstructive sleep apnea. Frequent awakening while sleeping that is unidentifiable to the individual himself causes all the discomfort. It is a disease where we cannot sleep well and we will feel uncomfortable and lazy, you will have no energy and daytime sleepiness is very common. GERD can be a chronic issue. It also adds to the symptoms especially as you have head and neck issues. I can see you are already taking some medications for this. If there is no benefit, consult a Gastroenterologist soon. For evaluation and assessment, consult a sleep apnea doctor who would run a lot of tests after careful examination. For more information consult an internal medicine physician online -->


key: Patient
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Hi doctor, I have obstructive sleep apnea and using CPAP for a year. I feel chest pain in the mornings. The same kind of pain is felt whenever I sleep without the mask. My BP, sugar and ECGs were tested before six months back and they were normal. What is the cause and remedy?


key: Patient
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Hello doctor, The patient underwent extensive routine physical examination including MR/CT imaging and laboratory analysis earlier this month. The MR Brain shows evidence of lacunar stroke and ischemic brain changes. Please advise if these might be connected to untreated obstructive sleep apnea (more than five years). If so, some recent research indicates that these cerebral changes might be partially reversible with CPAP treatment. Please let me know your professional opinion and suggested investigations and/or treatment.


key: chroma:document
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Hello. I carefully went through your question and the patient's medical history. I reviewed her medical report and the uploaded brain MRI study (attachment removed to protect patient identity) and would explain that those changes are indicative of small vessel disease, which means chronic gradual blockage of small vessels inside the brain. I agree with you that untreated sleep apnea, for such a long time, can lead to these brain changes. On the other hand, you should know that other risk factors such as uncontrolled high blood pressure, dyslipidemia, diabetes, age, migraine if present, smoking contacts, obesity, sedentary life, etc., also contribute to these changes, besides sleep apnea. Unfortunately, these brain changes are irreversible. This means that adequate treatment of sleep apnea and a better control of blood pressure values or blood lipid profile, will not make them vanish. But, all these measures will help stop the progression of this disorder and prevent further changes to the brain. You should know that sleep apnea is a known cardiovascular risk factor, which means that it contributes to uncontrolled hypertension and atherosclerosis process (generalized narrowing of blood vessels in the brain, heart and other organs). So, I am sure the CPAP (continuous positive airway pressure) device will help stop the progression of these changes. These brain changes in later stages can lead to dementia and depression or gait disturbances. That is why, it is necessary to keep under control all the above-mentioned risk factors (including sleep apnea), in order to stop the progression of this disorder. I would also recommend checking fasting glucose and blood lipid profile every six months, to be sure that she does not suffer from dyslipidemia or diabetes. It is also advisable to take daily Aspirin of 80 to 100 mg (if there are no contraindications to this drug), in order to prevent the progression and further small strokes in the future. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope you will find this answer helpful. For more information consult a neurologist online -->


key: Patient
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Hello doctor, I am a 53 year old army veteran, served for 33 years, who was diagnosed while serving in the army with chronic granulomatous disease and sleep apnea. When I filed a Veterans Administration (VA) claim, the VA rated me for compensation but combined the ratings into one rating. This means that the VA is saying that granulomatous disease caused the sleep apnea. All of my research indicates these two medical diagnoses are completely independent of each other and have no impacts on each other. I am looking for a medical opinion to support my research so that I may submit it to the VA so I am rated separately for each diagnosis.


key: chroma:document
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Hello. Chronic granulomatous disease (CGD) is an immunodeficiency condition where the white blood cells cannot fight the pathogens effectively which cause different types of infections. As for sleep apnea, it is caused by narrowing of the air passages mostly in the nasopharynx area which cause interrupted night sleep, usually the cause is obesity in short-necked persons or hypertrophied uvula. There is no relation between both except in very rare conditions (Kimura's disease) where CGD causes hypertrophy of the larynx. Please provide me with some photos of your neck and inside your mouth to see if there is hypertrophied uvula. Sleep apnea is usually associated with hypertension and severe headaches. Do you have any of them? Revert with more information to an internal medicine physician online -->


key: chroma:document
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Hello. I understand your concern but there is no attached photograph in your message. I need to see the picture of the affected area to make appropriate diagnosis and to suggest you the appropriate treatment. Kindly send the same.


key: Patient
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hi. I am a male aged 52yrs weight 80kg diabitic my doctor has recently advised me gabapentin nt 400 for neuropathy earlier i was on pregab150 so while checking about the reviews from the patients on net i found that 99% were against gabapentin which confused me and thought to have a 2nd opinion kindly advise


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Hi. Welcome to icliniq. I am Dr Anshul Varshney for your help. It's an excellent drug. Infact it's an elder sister of Pregabalin only. Gabapentin is little more potent then Pregabalin. Only possible side effect of that drug is dizziness but since your mother has been on Pregabalin 150 mg then Gabapentin should suit her. Gabapin NT also contains Nortryptilline, which helps further in neuropathic pain. Dear, if you will check side effects / reviews of any drugs you would get for all. If in doubt, discuss with your doctor once again being empathetic. I use this drug very often and most of the Diabetologists use it. So, I would suggest you to start it and see if she gets any adverse effects, we can go for other options. Though to be very honest we don't have much options other then Pregabalin or Gabapentin in Diabetic Neuropathy. I hope it helps you. If you have any further questions please ask me.


key: Description
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Q. Is it serious to have mild cerebral edema, with facial fractures and post-nasal drip after accident?


key: Patient
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Hello doctor, A 23-year-old male patient hit with bike accident, fell on back side of head, CT scan reports reveals mild cerebral edema, with some facial fractures, currently patient is having blood clots discharge as post-nasal drip, and not associated with headache, dizziness, seizures, fainting, etc. Please let me know the cause for blood clots discharge as post-nasal drip and is mild cerebral edema complicated?


key: chroma:document
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Hello. I have read your concern. You might be worried of the cerebral edema if this will cause any harm. A repeat 48 hour CT scan if with any signs of wakefulness deterioration is warranted if that ever happens. The blood clots is a sequelae of the trauma to the face. Most commonly this is part of the superficial veins near the nostrils called keisselbachs plexus. This will heal. Give it 2 to 3 days until it gets crusted by itself with the help of the antibiotics to lessen chances of infection. If the CT scan is normal other than the mild cerebral edema is seen, then no further medical and neurosurgical procedure is needed. The zygoma fracture and orbital fracture is also not worrisome if does not cause any deformity (like a protruding bone), and does not need any procedure for it if it does not obstruct your visual field or puncture the globe of the eye. I agree with antibiotics and saline spray three times a day. It would also help taking some Ibuprofen to lessen the inflammation and swelling, if taken every eight hours.


key: Patient
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Hello doctor, I daily take Pristiq antidepressant tablet 50 mg, which doctor had prescribed since a year. Now I am tapering the tablet gradually as per doctor's instruction. The first week every other day and second week every two days and the third week every three days. And now this is my fourth week, and I am off completely. So my question is, can I use 5-HTP supplement tablet? So that my withdrawal symptoms will be less. And when I can take 5-HTP? Withdrawal symptoms are scary to me, and I want to completely stop this Pristiq because I tried many times to get it off, but unfortunately, I cannot. I had withdrawal symptoms, brain zaps, nausea, and diarrhea. I have some supplements like fish oil, b12, and 5-HTP but still waiting for a doctor advises.


key: chroma:document
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Hello. As you are tapering your Pristiq (Desvenlafaxine), there will be no withdrawal at all. You need to restart because of anxiety or depression disorder, not because of withdrawal. 5-HTP (Hydroxytryptophan) is not FDA approved and no guideline for it to how to use and when to use. It is a supplement product, but not a medication to treat. You should follow depression and nonpharmacological management. Do exercises daily for 30 to 45 minutes like walking and practice meditation for 20 minutes daily. Eat healthy home cooked foods, avoid junk foods. Spend quality time with friends and family every day. Spend time for creative hobbies like reading good books, writing journals, painting, drawings, and learning new skills or language or musical instruments. Have enough of 7 to 8 hours of sleep daily. Avoid tobacco or alcohol or any substance abuse. Live your life, do not just spend it. Be bold and confident.


key: Patient
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Hi doctor, My son who is 11 years old now has a undescended right testicle. Ultrasound determined that it was in the inguinal canal when he was 8 years old. We have been waiting for it to come down, but it has not. Does the surgery to correct the testicle improve fertility? Or does it lessen the chance of malignancy? I would like to monitor through ultrasound. I am wondering what your thoughts are on this course of action.


key: chroma:document
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Hi. I suggest that surgical correction should be done to bring it down as low as possible. Reason being, it permits self palpation of testis for early detection of any tumor. Frequent ultrasound is not feasible or practical to think of. Self palpation can be done every day. Ultrasound cannot be done every day. Surgery is a minor one. If it is already shrunken, in my opinion the surgeon may suggest removal of it. Do not be afraid and go ahead.


key: Patient
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Hi doctor, My son is 20 months old. In polio campaign he was given 3 drops of OPV instead of 2 drops. I am worried about the extra drop given. I could not find any recommendation of WHO or UNICEF for minimum and maximum dose of OPV drop in the internet. Please help me in this matter. Thank you.


key: chroma:document
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Hi. An extra drop of OPV (oral polio vaccine) should not cause him any problem. These are live attenuated vaccine and thus virus does not cause any illness. Case report of them are very rare and usually with faulty vaccine preparation. Also, this was his booster dose. It would only help in giving immunity to polio.


key: Patient
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Hi doctor, Just recently I have noticed some weird breakouts around my chin area. I am not sure when they started. While I do from time to time experience acne, I do not think what I am experiencing on my chin is not an acne breakout. Because there is no white head or black head present. They are not popable. The only change in my diet is I have been enjoying an occassional glasses of wine after dinner. I have also started eating mozzarella cheese, which I have not eaten before. Thinking that it was perhaps linked to hormones. I have restarted birth control three days ago after a 4 month hiatus. Please help.


key: chroma:document
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Hi Welcome to icliniq.com. I have reviewed the attached photographs (attachment removed to protect patient identity) and according to me they are papular lesions of acne. They are not blackheads or whiteheads. I would recommend you to continue with the birth control pill besides applying Benzoyl peroxide 5 percent gel on the pimples twice daily. Follow some tips to avoid pimples such as keep your face dry, avoid applying oily creams and moisturizers, avoid oiling of scalp, use cosmetics labelled as non-comedogenic and reduce the intake of sugary foods. 1. Hormonal disturbances. 2. Seborrhea. Acne vulgaris.


key: Patient
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i have blood in my stool but no pain . I m suffering from externally piles. But there is no itching nd pain in that.. Almost from a week blood is regularly going through out stool...


key: chroma:document
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Hello. I welcome you to icliniq. The external hemorrhoids can cause bleeing and pain when they are enlarged or secondrary to constipation which produces an abnormal pressure over anus causing swelling of piles. The definite therapy is surgery, however if certain lifestyle modification are employed the anal hemorrhoids can reasonably be controlled. These life style modifcations are I hope this will solve your problem. anal hemorrhoids as above can follow up after 7 days of treatment


key: Patient
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Hello doctor, I recently went off my medicine Celexa, that I was taking on for over 10 years. I went through a lot of trauma in the past 4 years. I was just starting to do better and was using natural supplements. 5 months after going off medicines, I moved to a different town where I had to look for a new job and stress from all that and being triggered by previous events from past put me in a lot of stress. I suffer from PTSD, anxiety and depression. I went back on Celexa few weeks ago and had severe reaction. I even lowered the dosage and still had bad reaction. So, GP switched me to different medicine. I am now on Effexor 75 mg. My doctor does not feel comfortable dealing with my psychiatric medicines herself. Hence, I have been on 5 week wait list to see a psychiatrist and been on 75 mg of Effexor for just over 2 weeks. Anxiety has subsided slightly and I am no longer vomiting due to anxiety or having any chest pains. But, I am scared all the time and have worried anxious thoughts all the time because of which I cry, and my appetite has decreased. I feel very hopeless and lack energy. I do not know how I can deal with all this. I am feeling isolated from my friends and supports where I used to live. Hence, having hard time finding a place to live where I was before. I am not having any idea if these medicines are working and no one to properly monitor them. I am feeling very desperate and scared. Please help.


key: chroma:document
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Hello. I have gone through your query in detail. I can understand what you are going through and you have my sympathies for the same. Though your mental health is quite disturbed right now, you have many reasons to be optimistic as far as your anxiety, depression and post-traumatic stress disorder is concerned. First thing being, that you were doing good on high dose Celexa (Citalopram), which means that your illness responds, once you have attained sufficient dose of a suitable drug. Secondly, currently your anxiety symptoms have reduced to some degree, but there are remaining symptoms which are because of depression (anxiety itself could be a symptom of depression to some extent). You might experience some anxiety initially when increasing the dose. For which you can take tablet Ativan (Lorazepam) when necessary. Once your depression improves, you will find a lot of your problems disappear on their own as they are directly or indirectly related to depression. Take care. Life stressors and changes. Major depressive disorder or PTSD or generalised anxiety disorder (GAD). Optimization of the dose of current medications.


key: Patient
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Hi doctor, Three years back, I had headache and head numbness for few days. I consulted a doctor and got a thyroid test done. That time my TSH was 3.7 and he prescribed me Thyronorm 25 mcg. He told me to discontinue it when my TSH level comes back to 1.5. Now, for around 11 months I am having body pain, hand numbness, dry and itchy skin, hair fall, rashes on neck and hands and bowel movement issues. TSH - 4.58, total T4 - 7.50 and total T3 - 0.91. This is my recent thyroid result. Apart from these all the blood and scan reports are normal. I have left side back pain also. But, still the doctor says that the thyroid results are normal. Please help me.


key: chroma:document
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Hi. Your symptoms fit into thyroid disease but your thyroid report is absolutely fine. A normal thyroid report rules out thyroid disease, unless you are presently on Thyronorm. So, we need to find other cause for your symptoms. Body pain and numbness could be due to nerve problems, vitamin B12 or D deficiency and diabetes. Your reports say that you are not having diabetes. But, I do not see any tests done for vitamin B12. So, kindly get the vitamin D tests done and revert back with report. Hair fall could be due to hormonal imbalance or due to stress. Is there any kind of stress in your life? I recommend you to get serum testosterone and serum DHEA (Dehydroepiandrosterone sulphate) levels tested and revert back with report. Regarding rashes kindly upload the picture so that I can give better opinion on that. You mentioned about bowel movement issue. What exact problem you have with bowels? Constipation or loose motions? Kindly revert back with the details asked.


key: Patient
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Hello doctor, My father, aged 70 years, lost five kg of weight in two to three months. Usg and CECT confirms a right renal mid-lower polar well defined large 11.3*10.6*12.0 cm soft tissue density homogeneously enhancing mass with internal regions of non-enhancement is observed with no obvious calcification or fat content. The lesion appears to be containing renal fascia with increased peripheral vessels likely mitotic mass lesion of the right kidney (RCC). The right renal vein and IVC is patent. The mass is seen to indent the right psoas muscle, but a flat plane with the adjacent structures is nearly maintained. The urine test and renal functions are normal, and there is no evidence of metastasis. Kindly tell me if it is benign or malignant, and what are the possible line of treatment? Please help.


key: chroma:document
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Hello. As per the report, it is renal cell carcinoma (RCC) and it requires further evaluation. In the treatment of RCC, first of all, surgery is needed to remove the tumor and if required the kidney too. Then after confirming the diagnosis on histopathology, chemotherapy, or radiation is required. Please consult an oncosurgeon immediately. I hope it helps you. If you have any further queries, please ask me.


key: Patient
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Hello doctor,My son is 5 months old. He can hold his head during tummy time and turn his head in both directions. But when we make him sit, he usually looks in one direction. He has a flat head on one side. Does this mean he has torticollis?


key: chroma:document
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Hello. A child with torticollis will not be able to make much neck movements at all, in any direction or position. The very fact that the child can look in both directions during tummy time is suggestive of the child not having torticollis. As regards to the flat head, some kids have it but do not worry. Also, with regards to the child looking in one direction only while sitting means that the child requires a little bit more strength to turn his neck (which should develop with time).


key: Patient
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Hello doctor, I am 22 years old and I have blurred vision in my left eye. It started when I was 17-years-old. I also have an allergy in my eyes. I consulted with the doctors, and they suggested lasik surgery for me.


key: chroma:document
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Hello. If you have allergy problems, then you are not an ideal case for any refractive surgery procedure like Lasik (laser-assisted in situ keratomileuses). First of all, the actual cause of blurred vision is needed to be diagnosed, whether it is a refractive error or you need glasses. Then to get rid of glasses Lasik is one option. But if your cornea is affected due to allergy (allergy can affect cornea) and the clarity is changed, then Lasik might not help. So you need to get an eye examination from a specialist and then get diagnosed for the exact cause of blurred vision. You can send your prescription if you already have consulted to an eye specialist. Then we can discuss the appropriate treatment option for that cause. You are welcome for any queries.


key: Patient
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Hello doctor,I had a miscarriage at 5th weeks before a month. I did a pelvic ultrasound, and the doctor said everything was fine. I would like to know the possible cause and how to avoid them? As I am ready to try for a baby again.


key: chroma:document
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Hello.  First trimester miscarriages are very common, and mostly they are due to underlying abnormalities in the baby which are not diagnosed on ultrasound, and the most common cause is chromosomal abnormalities. So nothing to worry about and you can try for your next baby and keep taking folic acid meanwhile. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


key: Patient
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Hello doctor, I have several questions. Please clear my doubts and tell whether they are myth or fact. Is masturbation harmful? Is hair fall associated with masturbation in any way? How frequent can one have sex? I am having sex with my partner daily and even twice a day sometime. Is it harmful? When I do fast, I ejaculate in some 3 to 4 minutes and I am not able to satisfy my partner. Am I suffering from PE? If yes, then what should I do? Is it necessary to pull the foreskin back before inserting my organ? I have only one partner and she is also loyal. Is there any issue with unprotected oral sex? We have been doing unprotected oral sex for the last 8 months and there is no problem so far. Is it harmful if we do anal sex? Thanks a lot in advance.


key: Patient
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Hi doctor, I am 29 years old. I am suffering from itching genitalia for over 5-6 years and the severity would range from low to medium. It is mostly due to sweating in that area. I used to apply itch guard for a few days and it used to get fine. Now, over four to five months I have severe itching on my genitals that is in the penis, testicles and also the area below. I am using Candiderma powder frequently. But, when the problem increases I apply Quadriderm ointment at night for 2-3 days. There is also a lot of flaking and cracking of skin. I have attached the pictures of it. I usually end up itching while sleeping too. What can be the problem? What medication and precaution should I take?


key: chroma:document
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Hi. Your problem seems to have lingered on to become a chronic hyperkeratotic scrotal eczema. This is a result of your hyperallergic tendency, constant scratching, sweat induced maceration and intermittent but incomplete treatments with suboptimal medicines. Till you revert with the answers, I advice you to do the following: 1. Sweating. 2. Tight undergarments. 3. Constant scratching. 4. Application of inappropriate creams intermittently. 1. Blood sugar levels fasting and postprandial. 2. Serum levels of IgE antibodies. Follow up in two weeks with pictures to a dermatologist online.--->


key: Patient
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Hello doctor, I did an abortion seven years before, and I have not got any complications since then. But I was reading about the perforated uterus, and now I am worried. I do not have any medical issues, and my concern is that I am getting scared I might not be able to conceive again.


key: chroma:document
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Hello.  Thanks for sharing your concern, and it is quite understandable. Uterine perforation usually occurs if abortion is being performed by the use of sharp instruments and vigorous curettage. If the abortion was undertaken with medicines only then, there is no such chance of perforation. Secondly, if perforation was being there, it might have caused your symptoms like pain, fever, bleeding, etc., if it was of considerable size. So if there was not any problem after the abortion at that time, it means that there were no complications associated with it. So you need to relax now as there is nothing to worry about your fertility. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


key: Patient
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Hello doctor,I had a cold sore arising on the border of my top lip and tried to stop it with alcohol and tea tree oil. The sore did not form, but I was left with a burn from the oil, and I pulled off the burned skin, leaving a small circular open wound. After healing, it started pink, but now it is whitish and sunken. It is hard to cover with makeup. This happened about three weeks ago. Will this heal back to normal skin color? If so, what can I use on it to even it out and speed up the process? The hole is tiny, like the size of a pimple.


key: chroma:document
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Hello. I have gone through your case. First, you need to understand that it is normal skin response to heal with either hyperpigmentation or hypopigmentation (white color as in your case) whenever it gets trauma (burn or insect bite). Most of the time, lesion heals within four to six weeks. But if the wound is depressed as you have described then it means the scar is formed and unfortunately such injuries are sometimes permanent, but still, some do show response to the laser treatments. Please always try to send a picture for opinion. My advice is according to your description.


key: Patient
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Hello doctor I have history of Thyroid and PCOS, i am taking 50mg of eltroxin. my period is delayed by 6 days .when I tested preganacy test after 4 days of period days two lines are showing but not clearly. please suggest me can I go to doctor for a checkup or wait for 1 week for clear result. or what type of precaution I should take during pregnancy?


key: chroma:document
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Hello, Welcome to Icliniq. I see than you haven't mentioned the date of your last menstrual period. Ideally, if you have had a regular 28days cycles, the urine pregnancy test is usually positive by the time you skip your periods. Delayed ovulation can be common in PCOS, So, I would suggest you to recheck your home pregancy test with an early morning urine sample tomorrow, and exactly at the time interval at which the result has to be read as mentioned on the kit. Sometimes if seen very late , the evaporation line also may seem as faintly positive which is actually a false positive. Early morning urine sample is supposed to be having concentrated levels of the Beta HCG hormone which is detected on the pregnancy kit. So recheck again tomorrow with a morning sample of urine. If you donot have any pain or spotting, you can visit your Gynaecologist at ease, may be in a week, and get an ultrasound done for pregnancy viability and localisation. Meanwhile continue taking folic acid & Eltroxin Medications & recheck your thyroid levels as during the pregnancy the dose may have to be changed due to increased requirements in pregnancy. Hope this helps. Please feel free to revert back anytime for any further queries or Information. - Continue Tablet Folic acid 5mg daily once till 14weeks. - Continue Tablet Eltroxin 50mcg daily once. - Avoid sexual intercourse in the first 4months of pregnancy.


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Hello doctor, Having painful sex six weeks postpartum and five weeks after my obgyn had to suction blood out of my uterus because my cervix closed too soon. Wondering if this is normal or if I should set up an appointment to be checked out. I am female, 23 years old. I am 5 feet 9 inches tall and weigh 300 lbs.


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Hello. Yes, it is normal, sometimes body takes a little longer time to heal especially if there was instrumentation being done with the uterus. If you do not have any pain otherwise or any never, discharge or excessive bleeding then you do not have to worry. It is just that your body is not ready yet to bear sex. I would suggest you to wait for one more week or so and see how the condition stays and even then it is the same then please do not forget to book an appointment with your local doctor.


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Hello doctor, Last one week, I am having issue with my erection at bed time. I am 35 years old. Please suggest me some medicines to be taken at bed time to make a relation with my wife without any problem. I am feeling very bad at bed. I have used an oil one week ago. Since then, I am having erection problem. Please suggest me some curable medicines right now.


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Hello. Eerectile dysfunction has many causes and I would suggest you to get yourself fully assessed by some local expert before proceeding to further management and avoid self-medication. Now coming towards your problem, erectile dysfunction can be caused by diabetes, hypertension, anxiety and high cholesterol even and with increasing age and heavy smoking. So if any of these is the case with you? If yes, then you have to first eliminate those factors first. Maintaining a good diet and exercise may help resolving the issue. Thirdly, a product known as Natural Viagara is available in market. Its safety has been approved so that can be used as well but it will not relieve the actual underlying cause which is utmost important to consider.


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Hello doctor, I think I have ADHD. I am a teen and cannot go to a psychiatrist as my family does not believe me when I tell them and even claim I pretend to have the symptoms. I think there is something wrong with me and want to know.


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Hi.  To answer your question regarding ADHD: Most people with ADHD will have displayed signs and symptoms of the disorder from a young age, usually before 12 years old. In this case your ADHD will usually have been noticeable and picked up by teachers or parents at a younger age. However, many cases can be missed and only picked up later. In this case I recommend referral to a general practitioner who can more reliably assess the situation. A referral to a psychiatrist can always be made, if necessary. This is also bearing in mind that there can be multiple reasons why you might find difficulties concentrating. Therefore, it is better to proceed slowly and start with a GP consultation before jumping into any treatment of ADHD which can involve powerful medications that can have serious side effects. A screening test for ADHD like the Conner’s test filled in by both the child’s teacher and parents. To be seen for a thorough examination by a family practitioner. If there is evidence of potential ADHD, then referral to a psychiatrist or child and a dole scent psychiatrist would be the next step. As per the findings of the GP or psychiatrist. The young patients symptoms should not be completely ignored and a proper thorough investigation should be done in order that something potentially serious is not missed.


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Hello doctor, I am writing a fiction novel about scientific abnormalities. I think there is no better professional than a doctor to ask this. What would happen if a tumor is left untouched in a human? What happens after the tumor takes over their life? Would it eventually conquer all of the victim's body? What would be the end result? Would it count as a separate organism once it overtakes the body? This question is not meant to disturb your work, it is only for the development of ideas. If you find this question unethical or offensive please ignore it.


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Hello. Tumor basically consists of cells with unregulated capacity to multiply and spread. So, if tumor is not removed, then its size keep on increasing. Also, it spreads to different organs through blood and other tissues, and occupies other organ as well. So, normal tissues or organ throughout the body is invaded by tumor cells which cannot carry out the normal function of the organ, so organ failure ensues. So, one organ failure leads to other and eventually heart stops and person dies. So, human body is invaded by cells which causes dysfunction in the body and eventually body stop working (means death) before going ahead. But, we cannot consider it as separate or new organism because new cells are not functional and cannot form organs to make a new organism. For imaginary purpose, you can think in a way you mentioned of transforming or replacing one individual with other or person who has acquired some new characteristics due to tumor cells, etc., but does not occur in reality.


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Hi doctor, This is really nerve racking but I noticed these growth on my shaft (fold area) that are very small and round. They tend to itch quite often especially when touched. I have attached a picture. I am afraid it could be genital warts. I last had sexual encounter with a female escort earlier this month. We kissed, rimmed her anus and I used condom for vaginal sex.


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Hi. The last picture shows a genital wart-like lesion (attachment removed to protect patient identity). They are treatable too, they would require a physical ablative therapy like cryotherapy or radiofrequency removal, which can be done in a skin clinic. Warts are not usually itchy. If you have itchy, scaly lesions, better to complete an antifungal treatment and then go for wart removal.


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Hello doctor, I have hard erections for a long time, and I have to take Viagra to have sex. After having Viagra, the problem is that I have a mild headache. I have been searching for some herbal supplements for long and do not know whether they are safe or not. Could you please suggest a more sustained therapy. I am not having any other medical issues other than once I have had a kidney stone.


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Hello. According to your complaints, you may have erectile dysfunction (ED). Reason for erectile dysfunction includes, 1. Decrease sensation of the penis that can be due to infection, diabetes, spinal injury, and recent masturbation. 2. Stress due to work or family related and night duties. 3. Depression, varicocele, homosexuality, and religious constraints. 4. Fear of failure - having one episode of ED once may make you feel you will end up with ED. 5. Low self-esteem (chronic masturbation). 6. Long term illness like cardiac disease, thyroid disease, kidney disease, and any other disease with long term medication. 7. Negative attitude towards your partner. .8. Hormonal issues like a thyroid issue, low testosterone. 9. Long term drug usage. 10. Diabetes and hypertension. You have to check doppler penis, USG pelvis and scrotum, blood pressure, RBS (random blood sugar), Free T3, T4, and TSH (thyroid stimulating hormone). Share more details regarding the above reasons, after which we can work on diagnosis and treatment. Yes, Viagra (Sildenafil) can cause headache, but regular use will not have that effect. It can be used for temporary purposes. Identifying the cause and treating it will help you. Regarding herbal medicines, it depends on the company that makes it.


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Hello doctor, I have been suffering from alternate loose stool and constipation, with the feeling of incomplete evacuation of bowel with abdominal pain for the past five to six months. I feel it is IBS. Kindly guide.


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Hello. Indeed, your symptoms seems to be IBS (irritable bowel syndrome). However, further consultation with a gastroenterologist, running colonoscopy, and abdominal ultrasound are highly recommended to rule out organic problems first. Stool analysis, culture, and sensitivity testing are recommended to rule out candida overgrowth or other infectious diseases. With regards to treatment strategy, until you get the tests reports, I can only suggest to,


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Hello doctor,I want your opinion on who is the best person (or where to start) for diagnosing and treating ADD in a 12-year-old child. The information and opinions are mind-numbing and confusing. I have the choice of taking my daughter to a pediatrician or a psychiatrist, after having her tested by a psychologist for school performance related issues. The resulted report indicates that she has serious trouble in concentrating (we knew that) and that she is exhibiting anxiousness (we knew that too). She is currently taking 20 mg Ritalin LA, and we need to re-evaluate the medication.In your professional opinion, where should one start? Will it be sufficient taking her to a pediatrician to re-evaluate the medication, or should I take her to a child psychiatrist for a full evaluation?


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Hello. You have asked a very pertinent question. I am not sure about the medical system in your area. Usually, young children in primary school are seen by pediatricians. Once they move to secondary school and if they have any co-morbid conditions like depression or anxiety, they are usually seen by child psychiatrists. But this arrangement is not universal, and there are huge variations. Both developmental pediatricians and child psychiatrists have the training and expertise to assess and manage ADD or ADHD (attention-deficit hyperactivity disorder). So if you are comfortable with your current pediatrician, discuss your concerns with him or her about your daughter's anxiety. If appropriate, they can refer your daughter to a child psychiatrist. Perhaps your daughter's response to Ritalin LA (Methylphenidate) and tolerability needs to be reviewed, and dose has to be titrated accordingly. If there are any emotional difficulties, she will benefit from pastoral support at school or some counseling. If emotional problems are severe, getting a child psychiatrist opinion may be sensible. Also, we have to remind ourselves that the management of ADD or ADHD is not medication alone. Your daughter will benefit from individualized support to help with her school performance. Her self-esteem should not be affected by ADD. Let her enjoy doing activities which can provide positive experiences. If she likes sports or drama or any other similar field, let her have regular time for pursuing her interests.


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Hello doctor, I am suffering from depression. I am having feelings of mild depression, but I do not know if I am actually depressed, but here is a bit of my life since I was a boy. I lost my mother when I was very young and did not have any memories of her. I grew up with my dad and my siblings, but I have always felt different, alone, cursed, and forgotten as nothing seems to work for me. Never felt loved, my dad was addicted to alcohol and, and most of my family members abandoned me till date. I struggled with the feelings of worthlessness daily as I grew up. I have little or no friends as I grew up, I had a lot of suicidal thoughts. My self-esteem was too low, had a dislike for myself, not able to express myself. I am short-tempered and a little caring same time. When I was 20, my feelings got worst, and I cried every day at night. I have extreme mood swings because when I am around people, it seems I am happy, but when I leave, I return to my hole. Kindly help.


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Hello. You have described facing several adverse childhood experiences like losing your mother, and indifferent father addicted to alcohol and lack of loving support while growing up. These adverse life events could have potentially affected your feelings like, making you feel low, affect your self-esteem, and cause suicidal thoughts. Anyone in your situation would have probably felt the same. It is good to know that you had some support from a friend before. It is important not to isolate yourself when you are feeling like this. Try to meet supportive people regularly. If you are in education or doing a job, try to speak to a senior person and see whether they can be a mentor to support and guide you. If you are spiritual, try visiting holy places regularly if you find it helpful. You have said that you feel happy when you are around the people and low again when lonely, this is understandable. People feel better in practical social situations. You will also benefit by consulting a doctor who can do a full assessment of the nature and severity of your symptoms, and it will clarify whether you have clinical depression. Try to speak to your friend and family and make sure you get help. You may need some counseling support or therapy to help you move forward in life. Equally important is self-help measures like eating healthily, sleeping well, exercise regularly, keeping yourself gainfully occupied, and having positive social relationships.


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Hello doctor, Five months old baby suffered from loose motion and fewer doctors gave Ofloxacin 50 mg and Flagyl 200 mg syrup. They told to give 3 ml three times a day, each syrup for 5 months old. Is this dosage correct?


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Hi. The dose specified above is too much and unnecessary for a child so small as 6.8 kg. It is advisable instead to just give the child Enterogermina 1 capsule twice a day for five days along with ORS with the passage of each loose stool. As for the fever, you can give syrup Crocin (125 mg/5 ml) 3.5 ml (six hourly) if temperature is above 100 F. Also, give ORS 70 ml with passage of each loose stool. Watch for dehydration. If worsening, please show to a pediatrician.


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Hello doctor, Four months back, I had protected sex with a massage girl. She gave me body to body massage, and then performed oral sex and vaginal sex while I was wearing a condom. I was wearing a condom throughout the whole time.There really was no kissing. Maybe one or two kisses on her neck. Some skin to skin contact. 1. What are my risks for contracting a STD (specifically which ones)? 2. What are my risks for contracting other STDs? I am tested HIV after 4 and 12 weeks with fourth generation test CMIA method, it is negative. 3. A small bean size cyst or lipoma is existing from three months onwards and still exists. Is it related to any STD?


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Hello. Skin to skin contact can lead to genital warts and genital molluscum contagiosum in the area of direct contact, which are viral infections. I cannot quantify the risk exactly but can tell that you will get these only if she had these active lesions at that time. No chances of HIV, syphilis, hepatitis, if no mucosal contact or blood contact. You need to send me the photograph of any skin lesion to comment on that. Take care.


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Hello doctor, I have been depressed since a few months and I want it to end. I am really tired of it and I feel like I am a failure. How can I get through depression?


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Hello. Do not worry, treatment is possible. Daily excercise and a balanced diet rich in antioxidants and omega fatty acids is known to help. Share your feelings with family and close friends as sharing helps a lot. Meditation daily for at least half an hour in the morning helps you relax and eases your anxiety. Consult a psychiatrist in person for detailed evaluation and treatment.


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Hello doctor, I am 34 years old, male and I am suffering from high BP and my creatinine level is 1.57. I am daily walking, my ankles are swelling once I get up from bed. So, now I have stopped. If I have to walk, up to how many kilometers can I walk, what kind of food I should take, whether this disease is curable? Please give me suggestion.


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Hi. I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). Your weight is also slightly high. So you also need weight reduction. So avoid oily and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Take more fruits and salads. Strict salt restriction in diet. Daily walk for 2 km. With proper blood pressure monitoring, weight management, your creatinine can be reduced.


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Hello doctor, I am aged 46 years. I am having a HbA1c of 7 (recently tested a few days back) and has a problem of tearing my frenulum during intercourse with my partner. I have consulted two urology doctors. The first one says I need a circumcision as there are frequent infections in glans due to sugar levels. Whereas second doctor recommends a frenuloplasty. I am confused. The first doctor says since I have frequent infections due to frequent raised sugar levels, I get smegma quite often in my glans. Please advise me if I need to go for the frenuloplasty or circumcision.


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Hi. First of all, I appreciate you for providing elaborate history which will help in making diagnosis and advising treatment plan. Now, coming to your health query, I can understand your concern and will try to help you. Your diabetes is quite well controlled as per your HbA1c. However, the cause of tear in frenulum occurs due to short frenulum and not always due to infection. Though chances of infection are high in diabetes, usually it causes balanoposthitis and difficulty in retraction of foreskin, which is not the case with you. Smegma is normal secretion under the foreskin and is not a cause for concern, as long as you keep cleaning it. As far as proposed surgery is concerned, though frenuloplasty is sufficient surgery for short frenulum, circumcision can get rid of both short frenulum as well as smegmatic collection under foreskin. Hence, my advise is circumcision.


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Hello doctor, I had sex with a sex worker a day before yesterday. But I told her not to remove her dress because I did not have a condom. Then I had a hug and allowed her to suck my penis for five minutes. While doing, she told me that my liquid is coming in her mouth, and so I stopped. After that, I sucked her breast some time. I do not know either milk is coming or not. Then finally I told her to do hands blow job after which I ejaculated. My question is the next day I got a red pimple in my inner thigh on both sides and is getting irritated. Why is it coming suddenly? I feel it may be an indication of HIV. It happened only after the incident. I was thinking in two ways. Could it be due to my liquid which went inside her mouth, if she has an infection? Or maybe due to that, I have sucked her breast I felt I might have drunk her milk. Is this an initial infection of HIV? Kindly look at my attachment. Please advice.


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Hello. As per your exposure, you seem to be safe from HIV. The thigh lesions are not due to HIV (attachment removed to protect patient identity). It could be due to other causes. Do you have any symptoms like pain, itching, etc.?


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Hello doctor, I have tingling left arm. Thumb and index finger are somewhat numb. Skin lesions infect arm. I was told that they are not shingles. Bone at base where skull and spine meet is stiff and sore. On no medication. Taking Ibuprofen for pain.


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Hi. Tingling sensation in the left arm can be due to nerve compression in the neck or in the arm. You will need a thorough physical exam followed by electroneuromyography study of the arms and legs and if possible, MRI of the cervical spine. Meanwhile, do not lift heavy weight and bend forward.


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Hi doctor, My fiancee and I had an unprotected sex two months back, and after 3 to 4 hours, she took an emergency contraceptive. Her last period started three months back, and she took the pill (Unwanted 72) on the sam day after sex in 3 to 4 hours. I did ejaculated outside. After 7 to 8 days of taking the pill, she had cramps and bleeding like periods, and after 10 to 12 days, again cramps and bleeding like periods happened and today, her period has not come. Is that a sign of pregnancy? Is there any possibility of delay in periods? Please help.


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Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. There is nothing to worry about. However, if you have a doubt, then get back to me. Take care.


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Hello doctor, I am a 17-year-old male. I have been masturbating for three to four years. I am too much addicted to this habit and porn. I cannot remember how many times I do it a day. It has ruined my life. I was a topper in studies, with good physical and mental fitness three years ago. But now my whole health and study are destroyed because of this habit. I am suffering from fatigue, depression, hypersomnia, mental stress, etc. I forget things very quickly. I cannot concentrate on anything, and I usually spend my day alone, staring at my mobile. I am very worried and stressed. I want to leave this habit forever and be physically and mentally fit again. My confidence level is very low. Please help me.


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Hello. This is not an issue that you can feel comfortable by sharing with someone else. For porn addiction, or any other addiction, please work cyclically. If we want to come out of it, then we need to break the cycle. For example, have a count of how many hours in a day, and at what time do you watch porn? If it is for 4 hours, try adding one thing in your life which you can do for 30 minutes, like exercise or playing with friends. From tomorrow for the next seven days, do that for 30 minutes. Then next week increase the time off the screen and slowly build other habits which can use your time and keep you distracted. It will take some time, but you will come out of it if you work hard. You can always share your progress or concerns.


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Hello doctor,I have a spot on my cheek and I am diagnosed with adult acne and mild eczema. Is it anything to be concerned about?


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Hello. I understand your concern. You have both eczema and acne it seems. But medicines for both are different. Use the following medicines for eczema. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Mometasone 0.1 % cream local application twice a day. 2. Cetaphil moisturizer for body twice a day. 3. Tablet Desloratadine 5 mg twice a day. For acne use the following medicines. 1. Fixed combination of Adapalene 0.1 % and Benzoyl peroxide 2.5 % gel for local application at night. The gel needs to be applied very gently as spots on acne and a thin layer over the acne-prone site, and it is not to be rubbed. It can cause mild irritation upon initial use, which can subside with continued usage. It is nothing to worry about. Use the medicines given above. It should decrease in two to three weeks after which you can follow up again. It does not look like anything that should raise your concern. The spot appears to be an excoriated lesion of acne. Is there anything specific you wish to ask that is bothering you? I would be glad to clarify your doubt.


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Hi doctor, My father is having enlarged prostate and has to undergo prostatectomy surgery. But, it is getting delayed due to ITP (idiopathic thrombocytopenic purpura). Right now he is under urine catheter. From past 12 days he is using Silodal-D 8 mg. Doctor said that after 20 days the prostate gland will reduce. Through ultrasound test we came to know the size of prostate enlarged is 54.6 cc. My doubt is, if it is enlarged to 54, is it possible that it can reduce through tablets? Or is it a must to undergo surgery? Right now the platelet count is 40,000. Please suggest a solution for this.


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Hi. Your father was on medication and has history of urine retention in the past. Currently, he is on catheter. Chances of medical management will not be successful. He needs surgery of either TURP (transurethral resection of the prostate) or HoLEP (Holmium laser enucleation of the prostate) for prostate. Size is never a criteria for surgery. Enlarged prostate can shrink by 30% if Dutasteride is given. But, this does not guarantee that the patient will become catheter free. However, it reduces blood vessels in prostate and helps decrease blood loss in surgery. Dutas-T (Dutasteride and Tamsulosin) also contains similar medicines as Silodal D (combination of Dutasteride and Silodosin). His ITP needs to be tackled and with all due precautions and keeping platelet concentrates on standby. He can undergo endoscopic surgery with due risks. Laser surgery - HoLEP will be better for him if available.


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Hi doctor, I am a 48 year married male suffering from quick ejaculation. I do not have diabetes or BP issue. Please help.


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Hello. Premature ejaculation is defined as ejaculation with minimal sexual stimulation, before the patient desires and before or within one minute of penetration. Frequently, performance anxiety could be a cause of premature ejaculation. In that case, you can take deep breathing for two minutes before sex. It will relax you enough. If you still feel anxious, you can take tablet Alprazolam 0.5mg half an hour before sexual activity. Remind yourself that you are having sex for mutual pleasure and relaxation. It is not an ordeal or duty where you are supposed to be the performer. There are many ways to treat premature ejaculation if it is not possibly due to anxiety. 1) The first technique is known as squeeze technique. In it, when you reach close to orgasm, you or your partner should squeeze on the ridge between the glans and the shaft of penis till the erection subsides. Then begin with your sexual activity once again. Repeat this a few times before you finally ejaculate. This will increase your time of ejaculation and also give you some voluntary control. 2) The second option is you can use Lignocaine spray (Shotmax spray). Spray once on the glans penis 15 minutes before sexual activity. It will reduce the extra sensitivity of the glans to normal level. You can also use 2% Lignox jelly (Lignocaine) instead of spray. 3) The third option is you can take tablet Dapoxetine 30 mg one hour before sexual activity. These techniques are sufficient to treat majority cases of premature ejaculation. 1. Anxiety. 2. Sensitive glans. Premature ejaculation. 1. Treat performance anxiety. 2. Squeeze technique. 3. Lignocaine spray. 4. Tablet Dapoxetine.


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Hello doctor, My wife aged 27 years is going through her 5th month of motherhood. Before delivery she was looking good and also her skin was fair as well as good. But now her skin got darker, there are some spotting on her face and also dark circles around both the eyes. Kindly help to improve her appearance. Thank you.


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Hello. These changes are all due to hormonal changes which occur during pregnancy. So, it is very difficult to treat. It is better to avoid any treatment during this period. Many drugs cannot be given during pregnancy as it can affect child. Moreover, these changes many times subside after pregnancy or lactation period. So, counseling her is the best choice. Use a safe soap or cleanser like Cetaphil to wash face. She can use sunscreens like Shade lotion 2-3 times a day. It helps to prevent darkening of skin. Ask her to take nutritious diet as recommended during pregnancy. Do not strain or rub the eyes and give rest to the eyes. Check if there are any refractive errors of eye.


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Hi doctor, I am a 25 year old man. It is about 4 years that I am experiencing chronic sputum production which I feel is originated from my nasopharyngeal or oropharyngeal region. It does not pain or itch and the quantity too is less. In the first year of its development it was mostly white in color but sometimes yellow and difficult to remove. Many of my doctors did not take it serious and just adviced me to wash regularly with normal saline. It gets a little bothering sometimes especially in morning after waking up or late at night or after eating some special meals or juices like orange juice which are sweet, but I think it should not be an allergy. It does not go inside my stomach by swallowing my mouth secretions and are very difficult to get out. All my other hematology, biochemistry and hormone profiles have been normal during these 5 years. I am having issue only with the sputum. It was cultured once, but no bacteria was grown. Please help to get rid of that. Thanks for your advice in advance.


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Hello. This is post nasal drip. It has a multitude reasons for its evolution and for disturbing all over this long period.  Nasal septal defects like deviated nasal septum (DNS), stones in nose and polyps in nose are some of the reasons. Long-standing Inflammation of sinus mucosa around nose also causes such issues. Chronic tonsil infection, pharynx infection or stones on tonsils may be other causes. 1. Radiologic investigation for anatomy of nose and paranasal sinuses. 2. CT scan is mandatory. 1. You need to consult an otorhinolaryngologist for thorough evaluation. He may need to go for urgent sputum culture and sensitivity testing and an antibiotic accordingly if bacterial infection is the cause. If fungal infection, antifungals are needed then. Viral does not remain so long usually.  2. If anatomic defect is found he may go for a surgical repair.  3. Medication may be decided according to ENT evaluation because in such chronic cases hit and trial method is not acceptable for treatment.


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Hi doctor, I had unprotected sex approximately 18 hours ago. I am worried if I should take I-pill. I am already taking medication for PCOD since one year. There has been some improvement and my period is due in a day or two. The medication that I am taking is Calcarea phosphorica 200 and Jonosia Ashoka. I am a 22 year old female and my weight is 63 kg and height is 4'11". Should I take I-pill? Does it have any serious long-term effects? Also tell me if taking I-pill would worsen my PCOD problem? Please suggest few other safe contraceptive methods other than the general contraceptives. I had done lower abdomen ultrasound about four months back and the doctor observed small cysts. Thanks.


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Hello. As you are a known case of polycystic ovary syndrome (PCOS) there are chances that you may have delayed ovulation ad hence delayed menses. So, you must take an emergency contraceptive pill within 72 hours of last intercourse. Again you are on homeopathic medication which would have its effect for long-term and will not offer you any immediate protection.After the I-pill you should expect your menses in the next 7 days. If it does not occur, then you should rule out pregnancy with a serum beta-hCG test. Besides oral contraceptive pills (OCP) the best contraception for you would be a depot injection or a Norplant (Levonorgestrel) hormonal contraceptive. But, as you are a case of PCOS, hormones should be avoided and condoms should be used as barrier contraceptives.


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Hello doctor,I am 24 years old. I have over imagination problems since when I was a child. I imagine that I am a winner and what I want and where I want to go. Still, I am facing these problems in my job, education, and personal relations. I imagine all my favorite, but in realities, it is not, what I am doing. I felt guilty about what I thought. Please help. How could I stop this over imagination problems?


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Hello. The problem of excessive imagination occurs because imagination is one of the defenses used by the brain to overcome day to day stresses. Also, it prepares you for the future and motivates you. But if it is excessive and causing problem, then you may use some behavioral measures to overcome this. 1) Make a schedule. 2) Involve yourself in positive distractions. 3) Tie a rubber band on your wrist and pull it whenever you are going into the imagination too much. You may seek the help of local psychiatrist if it does not work.


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Hello doctor,My brother has thalassemia intermedia. His Hb is between 7.8 to 9. Please suggest how soon he can recover from this.


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Hello, Welcome to the icliniq.com. Thalassemia intermedia is severe as compare to thalassemia minor. In this condition, episodic blood transfusion is needed, especially during childhood. Your brother can be prescribed iron tablets if there is no improvement then blood transfusion might be required. I hope I have answered your question. Let me know if I can assist you further.


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Hello doctor, I am 35 years old. I have migraine problem from last one year. I took Sibelium 10 mg. But I noticed after taking these medicine that my memory has become weak. Before, I had good memory.


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Hi. Sibelium (Flunarizine) 10 mg is a good medicine for migraine but probably has not been quite helpful for you. You can consider taking tablet Betacap Plus (40+10) once in the morning regularly for a month. At times of severe, unbearable pain, you can have tablet Naxdom 500 mg SOS after food. Also, since you have migraine, it is necessary for you to know your triggers and avoid them. For example, some people have migraine when they go out in the sun, some due to loud sound or flashing lights and some due to spicy food. Understand what triggers migraine attacks for you and avoid that. Regular exercises, yoga and meditation will also help reduce frequency of your migraine. Take care.


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Dear doctor, I had a small stiff boil in the middle of my eyelid for months. Then it disappeared and another one appeared in the outer corner of the same eye (right eye) and kept getting bigger and smaller and still has not disappeared. Then, about six months later, when I blinked it hurt, and I felt another boil under my eyelid and when I looked it was full of pus and I did not disturb it. The next day when I woke up, my whole eyelid was swollen and hurt really bad. But the pain went down in three hours or so. I then realized that another boil was inside my eyelid. The boil burst by itself though and now I have three boils in my eyelid and the third one is in the inner corner of my eye. Is this serious?


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Hi. Your history indicates recurrent inflammatory swellings of the glands of the eyelids in the form of hordeolum/stye (focal infection of the glands of the eyelid). Since these swellings are recurrent and multiple, you require evaluation to treat the underlying predisposing factors. However, no need to worry as this is not a serious condition. The treatment for hordeolum is the use of antibiotic eye drops or eye ointments and anti-inflammatory drugs. Applying hot compression provides symptomatic relief. The common problems that need to be ruled out are refractive errors, blepharitis (chronic inflammation of the eyelid) and systemic conditions like diabetes. Consult an eye care ophthalmologist online regarding further investigations -->


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Hello doctor, My question is that if one has sex with a partner who has never had sex before, not using a condom, can he or she still get HIV/HPV or any STDS.


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Hello. No, if you had sex with someone who has never had sex with anyone else before you then you cannot get an STD. STDs are only transmitted from an infected sexual partner. So, if it is the first time sex for someone then obviously that person has never been exposed to STDs. For more information consult a HIV AIDS specialist online -->


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Hello doctor, About two years back, I had an arthroscopic surgery (OCD MTD) for my ankle because of a previous injury. At first, my ankle got better, but now it is starting to get worse. As I am experiencing a lot of pain and difficulty in walking, I got an MRI done. Please see the results. Can you tell me what they mean?


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Hi. Previous injury. 1. MRI images. 2. X-rays and clinical pictures. Revert back with the details to an orthopaedician and traumatologist online.--->


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Hi doctor, I am a 13-year-old male and I have had semen leakage for about three months. I think it is from weak nerves because last year, I would masturbate a lot but then I stopped because it was becoming painful and I was embarrassed. Then about three months ago, I watched something inappropriate and I ejaculated without doing anything. Then a week later, I started to have semen leakage every day about three to four times a day. I am just very worried and I just want this to be cured and go away. Also, could this affect my eyes in any way? Please help.


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Hi. Let me tell you that the symptoms described by you suggest that you have a nightfall problem. The high quality way to deal with dusk is the use of herbal or selfmade remedies. There are no aspect outcomes for such remedy methods. You ought to have yogurt at least two or three bowls a day. Avoid looking at porn as plenty of porn arouses you sexually. So it is recommended now not to watch porn. Sage tea – having two cups of sage tea a day will limit the probabilities of nocturnal emission. Gooseberry – popularly recognized as amla acts as an anti-oxidant and helps in lowering the nightfall. Gradually the moist goals trouble will be solved. Bathing – it is a recommendation to take bathtub earlier than you go to bed. It helps you have a sound sleep. A sound sleep is very vital for averting nightfall. I hope this helps.


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Hello doctor, We had an unprotected sex on 13th day of her period. She took Ipill 19 to 20 hours after sex. Now on period due date she got light bleeding for two days. According to her, she always gets her bleeding only for two days. 28 days cycle. Before sex she got periods on 21st and after sex she got it on 19th of next month. Any chance of pregnancy?


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Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The bleeding could be because of hormonal changes due to the pill you have taken, it is withdrawal bleeding. So relax and do not worry. However, if you have a doubt then get back to me. Take care.


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Hello doctor, If the stroke has occurred in the left side of the brain, we know the patient's right side of the body would be weak and numb. But when the patient's right side of the face is also numb, is this also because of the stroke on the left side of the brain?


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Hello. Please let me know if you have any other questions. For more information consult a neurologist online -->


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Hi doctor, I am spending sleepless nights. I am struggling to fall asleep and often get disturbed by dreams. I feel restless legs throughout the night. The next morning when I wake up I feel fatigue. I am addicted to Benadryl to get sleep. But, I am trying to avoid it now. Please guide me for a sound sleep.


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Hello. As per your complaints, it seems that you might have developed dependence on Benadryl. And it is quite possible that due to this dependence you might be having these symptoms. Benadryl is basically a Codeine-based cough syrup, which is an antitussive agent OTC (over the counter) drug used to suppress dry cough. Codeine is a psychotropic substance which belongs to opioid group which is known for its dependence producing properties. Hence, due to long-term self-medication codeine cough syrup produces physical dependence. In the absence of it, body will crave for it and will produce withdrawal symptoms in the form of body aches, restlessness, palpitations, sweating, rhinorrhea, lacrimation, agitation, perspiration, vomiting, shivering, yawning and rarely fever with visual disturbances. Hence, in your case there is a strong possibility that you might be having withdrawal symptoms. But to confirm that, you have to tell few more details, We can conclude whether it is of opioid dependence or not from the answers given by you to the above questions. If it comes out to be opioid dependence, then we have to start with substitute treatment for opioid in the form of either Buprenorphine or Naltrexone, along with symptomatic management. Revert back with the answers for the above questions to a sleep medicine physician online -->


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Hi doctor, I have a boil on my inner thigh, which keeps recurring. I have had a boil in the same spot before. When I popped it went away, but now it has come back. It is also very painful. Please help.


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Hi. I have read your query. It seems that you are having furunculosis. Boils (also called furuncles) are a deep bacterial infection of hair follicles. The cause of recurrence may be Staphylococcus aureus, which is most commonly carried in the nostrils, armpits, between the legs and in the cleft between the buttocks. It may be transferred to other sites from the nostrils through the finger nails. General measures to avoid the recurrence are as follows. Regarding treatment, I suggest oral antibiotics like tablet Augmentin 625 mg (combination of Amoxicillin and Clavulanate potassium) if you are not allergic to penicillin group. Take one tablet thrice daily for five days. Also, my suggestion is to apply Mupirocin twice daily for five days. Consult your doctor, discuss with him or her and take the medicine with consent. For further information consult a dermatologist online -->


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Hi doctor,Yesterday I had to have a frenuloplasty. I had to have a general anaesthetic. I woke up and never got any advice off the urologist because I never saw him after the procedure. The nurse who discharged me told me to take off the dressing in the morning and wash the wound and the foreskin twice daily. My concern is today I noticed my foreskin has become swollen and looks similar to a balloon. The stitches are preventing me from pulling my foreskin back over the glans. So, it has been retracted all this time. Is the swelling normal and due to the incision or is it not normal? Also, am I suppose to keep it pulled back or do I try to push it back over the glans? My glans is very sensitive. So, it feels like an electric shock every time I move.


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Hello. You have very likely developed a paraphimosis. It would be more clear if you share a picture of the penis. You are supposed to keep the skin in front of glans. If it is painful to roll the skin over the glans, I suggest using Lignocaine gel and pull it front. After that, the swelling will slowly subside. If red discoloration also is present, then it can be a hematoma. Please share a picture. Revert with more information to a urologist online -->


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Hello doctor, I had my first heart palpitations two years ago. One doctor prescribed me Ciplar LA 20 and Ecospirin 75 for three months. The doctor also suggested Dilzem or Flecarite on SOS basis. I got palpitation even after having the above medicines. Dilzem worked on as needed basis but since it was a strong medicine, I stopped taking it. After one year, I got all the tests done again and irregular heartbeat got detected in Holter monitoring. I have attached the reports. Currently, I am on Concor 5 for two weeks starting two months ago. There are around two episodes per week but with this medication, duration and maximum heart rate have been controlled. Attached is the latest Holter monitoring test before 48 hours and 2D eco test reports. I need an opinion on:  Can food allergies cause arrhythmia? I noticed palpitations just after having food items with cheese. Any test recommended to find out food allergies causing palpitation?   What are the long-term side effects of medicines?   What is the success rate of cardiac ablation? If required, should we go for burn or freeze ablation?


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Hello. You are suffering from paroxysmal atrial fibrillation and intermittent ectopic. Food allergies will not cause this problem but if you take spicy food, have lack of sleep, mental or physical stress can aggravate the problem. Usually, these medicines have no or little side effects. But at the same time, you need to take medicine. Radiofrequency ablation is safe and effective. The success rate is 60 to 70 percent. You need to discuss this with a specialist cardiologist and with an electrophysiologist. You need to continue the medicines on a long-term basis. Concor (Bisoprolol) is a good drug and Ecosprin ( Atorvastatin and Aspirin) after food is good enough. I hope you don’t have thyroid problem. For more information consult a cardiologist online -->


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Hi doctor, Last week, I had a sexual encounter with a girl. I did not have any penetrative sex, but I rubbed my penis against her vagina for two to three times. There was no vaginal fluid contact also. I did not have penetrative sex, so I did not use a condom. So, I am worried whether I am exposed to HIV, and I am thinking of getting tested. But on the internet, I read that the tests are accurate after three moths only. I came to know about HIV RNA test, and I am thinking of getting tested for it. Can I go for that test now? Is a doctor's prescription required? I want to get tested after 10 days. Please tell me if it is reliable or not? If reliable, where should I get it tested?


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Hello. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->


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Hi doctor,I have a quick question. I have fatigue, some soreness in my throat. I might have a high temperature and some dry lips (dehydration). I also am worried because I had a handjob from a stripper about two weeks ago. We did not have sex but she did spit saliva on my penis. There was some rubbing from her ass on my penis but we did not have anal sex. I am not sure if I should be worried about HIV. I am not sure if I really have a fever and if I have something from the flu season.


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Hello. I have noted your concern. A handjob is not a risk. Saliva is not infectious unless it has blood contaminated from bleeding gums or open sores in her mouth. Anal rubbing without actual penetration is not a risk unless she had open weeping sores in the perianal area or anal rim. Otherwise contact with outer perianal skin is not a risk for HIV (human immunodeficiency virus). Regards. For more information consult an HIV AIDS specialist online -->


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Hello doctor,I am a 27-year-old male with no history of joint issues. Can stress and anxiety cause joints to pop? I was okay last month but this month it has been really stressful for me and I know my hands feel stiff and all my joints pop. When I raise my arms, one can hear the tendons stretching like rubber bands. When I rotate my legs, my hips pop. They make pretty loud pop with no pain at all. My elbows sometimes pop, not often. I have no disease that I know of. Can this be caused by stress and depression? Please help.


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Hello. Random clicking and popping joints is a common occurrence and as long as there is no associated pain or swelling, there is nothing to worry about at a young age such as yours. Excessive stress and anxiety can make your muscles taut. This can happen during periods of depression too. When you move any synovial joint around, the taut muscles around these joints cause the popping and cracking. You can try gentle stretching exercises every morning. This will help relax your muscles and subsequently relax your joints. For more information consult a family physician online -->


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Hi doctor, I am a mother of a 16 year old boy, who is 5.9 feet tall. He has white spots on the back of his throat along with swollen tonsils. He does not have a fever but finds it hard to swallow. Is this strep infection or what is it? He had the same before, and it was told as thrush.


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Hello doctor, It has been weeks since I have been feeling acid reflux with symptoms of heartburn and back pain. I have been taking Kremil-S and Omeprazole. Lately, I am experiencing diarrhea. I hope you can help me.


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Hello. I have reviewed your history as well as the medication profile you just shared. (attachment removed to protect patient identity).  So the part of the problem is secondary to the medicine you are taking such as diarrhea which tends to occur secondary to Kremil-S since this medicine contains aluminum and magnesium both could cause diarrhea. I want you to stop it now. In addition, Senokot also causes diarrhea. I am afraid that your initial physician has given you both these medicines for constipation or for stomach pain? You should stop it as well until your diarrhea gets better. Omepron (Omeprazole) is a generic medication but there are many which are now available with good effect. I recommend you to switch to capsule Esomeprazole 40 mg. Take similarly as you were taking Omepron before breakfast in the morning. If this dose does not help increase the dose to twice daily before the meals. Let me know in a few days if symptoms persist, I may consider adding other medicines for you if it does not work in your case. Gastroesophageal reflux disease. Dyspepsia Follow up in three to five days.


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Hello doctor, I am 30 years old. I am in my first trimester of pregnancy. My 10 weeks 4 days ultrasound showed a very healthy baby of 36 mm with movements and strong heart beat. It is great news. It also mentioned that anterior placenta extending on the lower end. My gynecologist did not seem concerned at all and even never mentioned it. But, what does it mean? Is too early to judge? Or is there some precaution I must take? Thanks in advance.


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Hi. It is too early to judge about placental position. Secondly with growth of baby, placenta normally moves up. So, there is nothing of concern right now. Regarding precautions, low lying placenta which is also known as placenta previa may sometimes bleed (manifests as vaginal bleeding) with sexual intercourse. You have to keep this fact in mind if you experience bleeding. You can avoid intercourse to avoid bleeding, though it is not a must. Sexual abstinence not compulsory, as the placenta is just extending on the lower end and not of serious type which covers internal opening of the cervix. For further information consult an obstetrician and gynaecologist online -->


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Hello doctor, I am a 25 year old male. I am 91 kg, and my height is 5 feet and 2 inches. My cholesterol levels are high, and I am over weight. I have hypertension, and I am taking tablets for cholesterol. I need a Paleo diet chart. Please help me. I am attaching my recent reports.


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Hello Welcome to icliniq.com. I went through your reports (attachment removed to protect patient identity) and saw a marked elevation of cholesterol levels with low vitamin D levels. So, it is very much necessary to take up a strict diet so that you get all your vitals to a near normal range. For more information consult a nutritionist online -->


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Hello doctor, I have anxiety and panic attacks from last six years. My doctor prescribed Nexito Forte 10 mg. My doctor tapered the tablet to Nexito Plus 5 mg three years back. My questions are: Is the relapse due to decreasing the dosage? Should I increase it again?


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Hello. The dose of the particular drug depends upon many reasons. So, it is difficult to tell that this dose is effective or not for the particular person. Now coming back to your questions, first Nexito Plus (Escitalopram and Clonazepam) has only half of the dose compared to Nexito Forte (Escitalopram and Clonazepam). So, when tapering the dose, few persons may relapse. If you develop the symptoms of anxiety, you need to increase the dose again. And it is quite difficult to predict who is going to relapse. Secondly, as the Nexito Plus has a lower dose of the drug, it is quite prudent that it may not be effective in all persons. So, increasing the dose is a good option. Similarly, when one is tapering the dose, some symptoms may reoccur. Then one has to slow down the pace of tapering as to avoid the relapse. So, if you are stable on Nexito Plus, then no need to increase the dose, but if you have symptoms then you need to increase it. The dose is basically changed according to the response and side effects, one is tolerating. It is individually designed to meet the requirements of that particular person. Thanks and regards. For more information consult a psychiatrist online -->


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Hi doctor, My blood reports show high monocytes and eosinophils for over two years of span. I feel there is no energy, muscle spasms, splenomegaly, muscle pain, and malaise. I am seropositive RA. But, my CRP and ESR are normal most of the time.


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Hi. Rheumatoid arthritis is one of the causes for high monocyte count and multisystemic involvement. Hence, treatment for that is nonsteroidal anti-inflammatory drugs and disease modifying drugs like Leflunomide, etc. The high eosinophil count causes include allergy, parasitic infection, skin conditions and pulmonary eosinophilia, etc. According to the cause, the specific treatment can be given. For allergy, antiallergic medication like Fexofenadine is useful. For further information consult a hematologist online -->


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Hello doctor, My 64 years old mom was recently diagnosed with ovarian cysts and is undergoing a hysterectomy plus oophorectomy two days later. During the same routine health checkup when her cysts were diagnosed, her urine report showed RBC of 6 to 8/hpf. Is this a possible UTI? And if it is, why should not our surgeon correct it before the operation? I asked him about it, and he said it would be taken care of when she gets admitted. I wonder why? I am particularly more worried about it because she also has a left artificial hip from the past two years which should not catch any infection. I remember her orthopedician asking for a urine culture a few days before her hip replacement and giving her antibiotics for the UTI immediately after that surgery. So, why is this surgeon not bothered to correct the UTI pre-operatively?


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Hello. RBC (red blood cells) in urine does not mean UTI (urinary tract infection). Pus cell in urine indicates UTI. Up to five pus cells per HPF are normal. 2 to 4 is in your case. So, it is not UTI. There are many causes of RBC in urine. Is she on any blood thinners, like Ecosprin (Aspirin) or Clopidogrel which can cause mild RBC in urine. So, that might be the cause and not UTI. For more information consult a urologist online -->


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Hello doctor, I am 33 weeks pregnant. In my previous pregnancy, I had a c section at 33 weeks as my water broke. Presently, I am taking Aspirin tablets daily. My doctor prescribed it. But I have a doubt that will it cause excessive bleeding in my delivery? As I am near to delivery is it safe to take these tablets? I am currently taking Ecospirin 150 mg, Diamet Metformin 500 mg, Orotate 3D, Folsafe D, Wysolone 5 mg, and Iron tablets.


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Hello. I totally understand your concern, but please do not be stressed. All you need right now is to relax, keep calm, and take some rest. Yes, Ecosporin is totally safe during pregnancy, and mostly your gynecologist will continue it until 36 weeks at least. But I would like to know the reason for starting Ecosporin and also the steroids ( Wysolone) because you have not mentioned it (could be related to previous pregnancy events which need to be known in detail). And also if you go into labor you can stop it then, the effect usually does not last more than a day, and the dose that is given in pregnancy is very low. So definitely there is not much risk of bleeding. I hope this helps.


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Hi doctor, I am allergic to pollen and I am suffering from hay fever. I have been sneezing because of it. In the mornings I see a bit of phlegm with a little bit of red blood in it. Also, it is seen only in the morning. Is it related to allergy or something to worry about? I am reasonably healthy and my CBP is normal, which I got it done a month or two ago. I am low in vitamin D and vitamin B12 and taking some vitamin pills for it. Other than this I do not have any health issues. Please suggest me.


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Hi. Yes, it is related to your allergy. Sometimes, with excessive sneezing you may have this capillary bleeding. Nothing to worry as it is coming only in the morning associated with sneezing. Try to avoid contact with pollen. I suggest you to use antihistamines and leukotriene inhibitors, tablet Allegra 180 mg (Fexofenadine) once a day and tablet Montelukast once a day. Sometimes you may need to use steroids if symptoms are severe to evaluate. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. Do you have any cough or throat pain? Get a chest x-ray posteroanterior (PA). Check blood for bleeding and clotting time. Get a detailed check of your nose and throat by your medical practitioner to see any nasal polyp and other things. Revert back with the answer to the above question to an internal medicine physician online -->


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Hello doctor, I had a CT scan done yesterday for something else (nothing serious). They did say there was a 0.3 cm superior right lower lobe pulmonary nodule. Minimal bibasilar atelectasis. No focal consolidative opacities and no acute abnormality in the lungs. The doctor said since I am not at high risk due to size. I have never been a smoker, and because of the tiny size he did not think I need a follow-up, just with PCP. I wanted a second opinion on this.


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Hello. Any past history of pnuemonia, bronchitis, or any history of tuberculosis? Connect me with details for full evaluation and management.


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Hello doctor, I have a loose vagina and I am 20 years old, female and I am sexually active. I used to have sex always with toys so it became loose. Please help me. I need to tighten my vagina again. Once I used Everteen vaginal tightening gel for a month and I stopped its use as I was afraid of its use.


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Hi. The Everteen vaginal gel is an herbal product used for the same purpose but the efficacy of this is not well established. This may help some but not all. Kegel exercise are a good option for you. You can do this exercise daily and will see good results. As of now stop using toys or atleast stop bigger toys so that the benefits of Kegel exercise are maintained. If the hymen is torn then there is a procedure called hymenoplasty, which can restore the hymen. This is a surgical procedure. For more information consult a psychologist online -->


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Hello doctor, I am a 36 year old male. I have been having knee buckling problem for some time. The problem started in the right knee about four years back and since then I have stopped sports. However, at times during some movement or jerk, I get this buckling problem and pain for two to three days. About two weeks back, I had a similar problem in my left knee as well while trying to jump and take a photograph. It is paining since last two weeks. I have attached the MRI and CT scan reports. Do I have to go for a surgery? Or can it be cured with exercise and physiotherapy? My weight is 97 kg and height is 5'9".


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Hi. I have gone through your history and the reports attached here (attachment removed to protect patient identity). For further information consult an orthopaedician and traumatologist online -->


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Hello doctor,My Hb is 15.8 but HCT is 49.2 and total RBC count is 5.63. What is the reason? I fear about polycythemia. Is it possible to reduce HCT?


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Hello. If you are a smoker, then stop smoking. At this stage, secondary polycythemia is more common than primary and smoking is the most common reason for secondary. For further queries consult a hematologist online -->


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Hello doctor, I am a 22-year-old male. I have been getting hips, legs, knees, and back pain issues when masturbating. I usually masturbate four to five times a week, sometimes I can go two to three days without masturbating. I have cracking noises in my hips and knees and my quad muscles feel over stretched and tight. This problem has affected me and I am very limited in performing any activities such as sports. I am not physically active anymore, I used to play sports regularly but since I started having so many problems from the waist down, I stopped. Also, I get pain even when I am standing, sitting, or driving and get pain in the morning after waking up. I live abroad and to get any medical attention requires months of waiting. I currently have an MRI booked in five months but my symptoms are getting worse day by day and I do not have the patience to wait until then. Is masturbation the reason for my problems? How can I fix these issues and get my life back to normal? Is MRI necessary? If not, what do I need instead? Please help.


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Hello. Sorry about your health condition. Masturbation usually may not cause weakness or muscle problems. So do not worry, the possible causes for your problem is 1. Panic attacks or anxiety which lead to increased tension in muscles. 2. Hypocalcemia. 3. Fibromyalgia. 4. Hypothyroidism. 5. Vitamin D deficiency. 6. Rheumatoid arthritis. 7. Myositis. Still, many possibilities are there. So use vitamin E capsule like Evion 400 mg twice a day for two weeks. Use tablet Aceclofenac 100 + Thiocolchicoside 4 mg twice a day for five days. Avoid excessive masturbation as it may lead to penile mucosal injuries, lack of sex drive, etc. Eat more green leafy vegetables and fruits. Do yoga and meditation regularly to release your muscle tension. Get done hemoglobin level, thyroid profile, serum calcium, and vitamin D levels. Also, do RA (rheumatoid factor) factor, ANA (antinuclear antibody), ASO (antistreptolysin) are also useful. If symptoms are not improved please consult with your physician or rheumatologist, he will examine and treat you accordingly.


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Hello doctor,I had sexual intercourse last night with protection. Immediately after, I went to take a shower and I see that my left labia majora is swollen but painless. It is kind of weird to walk lie down or sit. It was only my second time having sex. What should I do? Is this a dangerous situation?


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Hello. How are you doing? I do not see any reason for you to worry. Hope I have clarified your query. Do write back if you have any more queries. All the best. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, I had very dark complexion in the past. But after consuming antioxidants like Vitamin C, E, Glutathione and Alpha Lipoic Acid my skin has lightened up about two to three shades. It has been very helpful but I still need to get lighter. Is it safe for me to get IV Glutathione? I have heard it absorbs quickly and gives results within one or two sessions. Other than that what can I do to lighten my skin?


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Hello. Injectable Glutathione is not FDA approved. Still, it is used by many people to reduce the skin tone by two to three shades. It is a once-a-week injection for four weeks, then once in two weeks for four weeks. If there is no response after three to four sessions then further treatment should not be taken. I personally would not advise taking IV Glutathione as the results are not permanent. Skin color changes back to the normal tone after three to six months of stopping treatment. For more information consult a cosmetologist online -->


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Hi doctor, I am a 18 year old female, who is suffering from coughing fits and severe tonsillitis. The coughing fits only come when I am lying down, and I bring up mucus which kills my throat.


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Hi. Sorry to hear that you are not feeling well. For further queries consult an internal medicine physician online -->


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Hi doctor, I am 22 year old female, and I am getting married this month, and I am going for my honeymoon. So, I want to delay my periods without any side effect. I am still a virgin, so I do not want to ruin my honeymoon. So, please suggest the best medicine. When to start taking it, in what dose, and when to stop it?


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Hi. Let me start by congratulating you in advance for your wedding. There are many methods, all using hormones, to either prepone or postpone the period. I would like to suggest the simplest and the best method. I would not confuse you with too many dates, as these hormones have to be taken on time without fail, any failure can cause bleeding in between. Try taking oral birth control pills or contraceptive pills, like tablet Duoluton-L or Dear 21 or Novelon or Ovral G or Intimacy plus 3. Have one tablet at night now onwards for 21 days, and without giving a break, start the next packet. Take it until the date you want to postpone the periods, and you will get your period 4 to 7 days after stopping the pill. It is also the best contraceptive method for a newlywed couple. You will have 100 % protection and no trouble with sex. In such a case, you will have to take it cyclically from the first day of bleeding.


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Hello Doctor, I am 19 years old. My teeth are yellow from childhood (from 10 years of age). A black layer is formed at the backside of teeth. When I see my teeth it seems very dirty and too much of creamy layer is formed on my teeth especially in lower canines and lower incisors. In the lower teeth, yellowness is 'V' shaped and in upper incisors the creamy layer is much lesser than the lower ones. The creamy layer gets removed by using my nails on that, but toothpowder is not able to remove that yellownees. I am feeling very sad while seeing my dirty teeth. My molar and premolar teeth have a black spot on them and people told me it is eaten by tooth worm. Is it true that tooth worm damages the teeth? When I contacted a local doctor he did scaling procedure. Just after scaling procedure, all the yellowness was clear (almost 80%) and black layer at the backside was also clear. I became very happy by seeing this. But about a month after scaling, my teeth again turned much yellowish and looks very bad and black layer at the backside of teeth also started appearing. Is scaling only a temporary process and is it complete wastage of money? For clean teeth, is there any permanent thing which will make our teeth very much white and glowing?


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Hello. Yellowing of teeth is mainly due to one of the following or a combination of these: You have given an excellent description of the clinical condition of your oral cavity. From your history it is very clear that, the yellowness of your teeth is due to plaque and calculus deposits. Plaque as you have mentioned is yellowish and creamy. This gets partially removed with brushing. Calculi are hard deposits either yellowish, greenish or sometimes blackish in color. They are firmly attached to the teeth and do not go off with brushing or tooth powder. Even the abrasiveness of the tooth powder cannot remove the calculi. During childhood due to improper brushing there are chances of plaque and calculus formation over the teeth. Because children at this age tend to be playful and do not concentrate on oral hygiene. "Tooth worms" as people say are nothing but bacteria that affect the teeth. These bacteria act on the teeth and cause demineralization of the teeth and lead to tooth decay and cavities. The lower incisors and canines are more prone to plaque and calculus deposition (v shaped deposition in accordance with the tooth morphology) due to inability of us to reach the inner sides of these teeth while brushing. At this age of yours, these deposits may be due to: Dental scaling is the procedure that removes plaque and calculi. But it does not mean that these deposits will not come back again. Continuous oral hygiene maintenance after scaling is mandatory to prevent recurrence of plaque and calculi. Hence, scaling is not a wastage of money, it is an investment to prevent one's teeth and gums from infections and thereby increase the life of the teeth. So, a permanent solution for your problem is to follow these steps to maintain oral hygiene: And finally, pearl white color of the teeth indicate that they are unhealthy. Teeth which are slightly yellow, without any deposits on them are said to be healthy. Hope this answer helps you. Consult a dentist online for further follow up -->


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Q. I have increased twitching in the left thumb. Is that a sign of cervical disc herniation worsening?


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Hello doctor, I am a 32 year old female with asthma. I have cervical disc herniation for 10 years. Over the past 5 months, symptoms were back with tingling, weakness and shooting pain in arms. I tried medications like Celebrex, Lyrica and also massage, physiotherapy, chiropractor and acupuncture, but the symptoms are getting worse. I did an MRI neck around 3 weeks ago which showed straightening of cervical spine due to muscle spasm. MRI indicates cervical spondylosisdeformans C5-C6 - broad-based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT]. Posterior osteophytes were also mentioned. Now, for the past 2 weeks, I have increasing twitching in the thumb especially left which is becoming almost continuous. Is that a sign that the disc is worsening?


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Hi. A herniated disc in the neck can cause three potential problems: As long as you do not have spinal cord dysfunction or significant weakness due to nerve compression, then you can try nonsurgical treatments like physical therapy, pain medication, or steroid injections. If you continue to have significant arm pain or neurological symptoms for more than 6 weeks or develop weakness then you may need surgery.  An EMG/NCS (Electromyogram/Nerve Conduction Studies) test looks at the function of your nerves in the arm. It might be helpful if you get this test done to confirm that the MRI findings and pain you have correlate, before deciding whether to undergo surgery.


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Hello doctor, I have had sores on the back of my tongue for weeks now. I have a pain in both ears that comes and goes. I also occasionally have a feeling of something in my throat that will not clear by swallowing. What could possibly be going on and who should I see for this?


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Hello. A chronic throat irritation with an enlargement of lingual tonsils that feel like sores in the back of your tongue, foreign body sensation in the lower part of the throat and recurrent ear pain are usually symptoms of reflux laryngopharyngitis, which is a type of acidity related disorder. Usually, it occurs because of untimely eating habits, stress. lack of sleep, etc. The treatment includes anti-reflux medications and lifestyle modifications. Have your food at proper timings. You should not sleep immediately after dinner. Wait for at least two hours before you go to bed. For more information consult an ENT otolaryngologist online -->


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Hi doctor, I have a lower wisdom tooth that has been infected chronically for well over a year. I also have an upper molar that is broken decayed and has been like this for years. The wisdom tooth oozes green pus if you apply pressure with a cotton swab. The decayed tooth is mildly painful. I saw my dentist a few days ago, who did not seem overly concerned. She slightly cleaned the gums around the wisdom tooth and prescribed me Cephalexin and sent me on my way. I have been taking Cephalexin for a few days, and yet the tooth is still oozing. My throat is red and irritated, the gums inflamed and there is no swelling in the mouth. Also, my nostril on that side is tender and painful. I am severely worried about the infection spreading to either my heart or my brain. In fact, I read an article a few days ago about a 26 year old who died from a tooth infection spreading. I do not have a fever. I have mild nausea. It is tender on that side of my jaw. The dentist had said the next thing she could give me was Clindamycin, but I have a fear of the side effects of that medicine. I already have heart problems and mild stomach issues. I have read that Clindamycin can cause severe gastrointestinal problems and arrhythmias. She also suggested Zithromax, but I have had heart palpitations while on that medication as well. I am having the teeth removed by an oral surgeon in two weeks, but am afraid of dying from infection before then. What are my options? What is the best course of action? Are there other antibiotics for this? Am I dying from the infection already? Any of your advice or help is appreciated. My other possibly relevant health history is as follows: I have high blood pressure, tachycardia, high cholesterol and mild PVC's. I had a MRSA infection in my arm 10 years ago. I have many strep throat infections every year and frequent sinus issues. Also, I would like to mention that when I took smoothed Cephalexin capsule with a sip of water, I got a random salty taste in my mouth.


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Hi. I have read your complaint and the relevant details. Please do not panic relating this to death. Maintain good oral hygiene for this two weeks. Revert after a week of extraction to a dentist online.--->


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Hi doctor, I am a 49 year old female. I have been checking my PPBS at home. But, there is a bit ambiguity in my results. My PPBS after two hours shows around 210 and if I check after three hours my PPBS levels up to 140. So, kindly please let me know that which test result am I supposed to consider. My fasting blood sugar level is usually 120. I am not taking any regular medications. I have been noticing the variations since past one month. I am not prone to any diseases or surgery. My BP and cholesterol are also normal.


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Hello doctor, The last you gave me an answer for my query but somehow I could not send you pictures and I am sorry for that. I have a vein on the left side of my penis which is totally visible. It is not a painful one but its totally visible even in a flaccid state also. I need to correct it before marriage. Please help me. I am sending pictures for your reference.


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Hi doctor, My last period was on 25th February 2020. I have done urine test twice at home and it is positive and I do have other symptoms of pregnancy. I am sure that I am pregnant. Due to Corona situation, I am afraid to get out and do other tests and see the doctor. I do have a dry cough for the last one month and some time with white mucus. Mostly when I eat rice, and spicy food my cough starts. I have called a gynecologist and she told me to have Adovas after lunch and Duvent (Rupatadine 10 mg) after dinner for seven days. After seven days, I called her and told her that I feel a little better but not stopped coughing and she advise me to take Adovas only three times a day. I did and it did not help me at all. I called her again and she advises Montelukast 10 mg after dinner and its also not working. It has been four days since I took Montelukast and I feel like I need to deep breath when I take it. I have only cough, no fever, no pain, no breathing problem, no headaches, and no running nose. As you know in this Corona situation I cannot go out with a cough to get other tests or see a doctor for my pregnancy advice and lab test. Would you please help me advising good medicine so my cough stops. Other than the above, I am taking Folic Acid 5 mg two times moring and evening as she told me do I need to take anything else for my pregnancy at this moment. Please help.


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Hi. Congratulations on your pregnancy. Let me tell you in the first three months of pregnancy vomiting sensation, gaseous state, mood swings, breast, and back pain are common. I understand it is not possible to have a consultation now. For cough, do stream inhalation three times a day, tablet Azithromycin 500 mg twice daily for five days, syrup Dextromethorphan / Guaiphenesin combination 5 ml twice daily for five days. (We get it as syrup Ascoril in India). You will be fine. Folic acid is a must once a day till your pregnancy, and tablet Doxinate (Doxylamine) twice daily before food will prevent nausea and vomiting.


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Hello doctor, I have a problem with my throat. Can you check the bumps present above my tonsils in the throat? I have attached my complete blood count report. I also have lymph node raised in the neck on the right and left side shoulder, so my body is fighting with something. Current symptoms are sore, redness, inflamed throat, and tight feeling when I swallow. Is left tonsil lower than right? Also, I feel dry throat all the time. These strange bumps circled in the picture along with red throat are my concern.


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Hello. From the picture, I can see a slightly congested posterior pharyngeal wall along with tonsillar region (attachment removed to protect patient identity). The bumps you are referring to are small tonsillar cysts which do not carry any significance. They are benign and are not a cause to worry. The tonsils are only slightly enlarged and hence do not need any removal.


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Hello doctor, I am a 35-year-old female. My weight is 91, and I have three children. I am not having my menstrual period for the past four years. After running some tests, doctors confirmed it is high prolactin, and gave me drugs, but it did not help. I want to find out if there going to be any damages to my health because of this? What can I do?


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Hello.  It points out that you had early menopause, which occurs in 5 to 10 percent of women at age less than 40 years of age. And yes it has adverse effects same just like menopause in another woman at the usual age. So you must consult your local doctor and get a prescription for HRT (hormonal replacement therapy) which will result in monthly cycles as well as protect you from developing early osteoporosis. You have to continue taking it until the natural age of menopause. 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 28 years old. I had no periods for the past five years, after giving birth. I suspect hypothalamic amenorrhea. I had one round of Clomid during my ovulation period, but I had no pregnancy. During the last few months, I stopped my exercise, and so I gained weight. Can I try naturally and see if my body will ovulate on own or should I continue with the Clomid?


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Hello. Just by using Clomid (Clomifene) or Letrozole, you may not have your periods. Did you have any significant bleeding post delivery? Your weight looks fine. No periods for five years is too long, and present hormone levels will be unknown. I suggest you have any of the birth control pills of 21 twice a day for 10 days. Throw away the 21st pill. No matter what the cause is, you will have periods within 7 to 10 days of the last medicine. On day three or four of your periods have serum FSH (follicle stimulating hormone), LH (luteinizing hormone) and AMH (anti-Mullerian hormone). This will give you an idea of follicle reserve and also if any central cause present. If both these are normal, you can start Clomid or Letrozole from day three or four and will have a much better result. I hope I have clarified your query, do write back if any more questions and for your feedback.


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Hello doctor,How accurate is the HIV Ag/Ab test at 40th day after exposure? I know I should retest after three months, but could the symptoms show up, and the antibody is still hidden? Please give me an explanation.


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Hello. The window period of the Ag/Ab test varies from 18 to 45 days. Therefore a negative test at six weeks (42 days) would be considered conclusive in 98-99 % individuals. However, a negative test at 12 weeks is still considered the golden standard (conclusive in 99.9 % of individuals). CDC (centers for disease control) recommends that a negative Ag/Ab test at six weeks is good enough to rule out HIV. Take care.


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Hello doctor, I had a positive urine ovulation predictor kit test before four days. I visited the clinic for a follicular scan on that day, and I believe there was a rupture of the follicle. I want to know if I have fertile days left after follicle ruptures or there is no chance? We did not have intercourse before follicle rupturing.


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Hello. Follicle rupture is the right time for planned intercourse. So please go ahead and plan for pregnancy. However, if you have a doubt, then get back to me. Take care


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Hello. I welcome you to icliniq. First of all try to reduce your weight. At most times, it is the obesity which has been causing problems. The bleeding while passing stools can be secondary to anal fissure, hemorrhoids, rectal ulcer due to difficult defecation. For better clarification and confirming the diagnosis I need to know more about your symptoms- such as how exactly the amount of blood it is? Does blood form a streak over the sides of poop? How painful it is while passing stools? and does it causes pain or burning even after 1 hour of opening your bowel? and Do you have constipation? No. of stools in a week? If you could answer me for above question, I would be in better position to tell you what it is exactly. Considering a possibility of anal fissure, I recommend you to apply Diltiazem gel 2 % over the bottom with a finger 3 times daily, and start taking ispagol husk 2 table spoon full in glass of water daily irrespective of constipation or not. Take at least 2 to 3 liters of water/fluid daily. Reduce weight by brisk walking 150 min/week and reduce caloric intake. As mentioned above Mentioned above As mentioned above


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Hello doctor,I am a female nearing 40. My partner and I are sexually very active. A year ago, I was diagnosed for PID, and pap smear revealed nothing else. We both got treated and were fine for a few months. I am very clean, often wash before and after the act. We are both into oral too. Since a few days, I am having excessive discharge (no smell or pus) which is almost white, burning at the tip of my left labia and pain in the lower abdomen.There is no burning sensation when I pass urine. After meeting the burn comes up. I do not use perfumed soaps, but I use a feminine wash. Is this PID again or something else? My partner is fine, and we use protection during this time. Can you suggest some medication? And what could this be?


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Hello. Based on the symptoms you described, it appears you must be having yeast infection like candidiasis. I would suggest you take a tablet Fluconazole 150 mg by mouth single tablet for you and your husband. Clingen forte vaginal pessary to be kept vaginally every night for six nights. If there is still no improvement, you can consult your gynecologist for examination and do pap smear and ultrasound if abdominal pain persists.


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Hello doctor,I concern that I have angle-closure glaucoma. I took a strong sleeping pill called Trazodone one night and woke up with a decreased vision in the right eye. My left eye became bad three weeks later. It has now been three months with no improvement. Fundus and other clinical examinations are normal. However, an OCT showed nerve fiber thinning and ganglion cell thinning.


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Hello. I reviewed your reports with patience. OCT (optical coherence tomography) of optic nerve head is normal. Your vision, color vision, visual field, and intraocular pressure are normal. I do not think you have any glaucoma. Please feel free to ask your queries.


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Hello doctor,I have inflammation of the penis head and small red bumps on the outer edge of the penis after sex and masturbation. The bumps occur and disappear after a few days. I have been using antifungal cream for about a month and also took antibiotics. It looks like it has vanished but occurs back very irritated after masturbation. I believe it could be balanitis, but that is a self-diagnosis.


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Hello. I understand your concern, but there are no attached photographs in your message. I need to see the picture of the affected area to make an appropriate diagnosis and to suggest the proper treatment. Kindly send the images.


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Hello doctor,I have been having some chronic abdominal discomfort in my stomach, and occasionally in my chest for several weeks. Also irritable bowels. Before this, I took a six-week course of Ampicillin for what was perceived to be prostatitis. Had an abdomen CT scan with contrast because of testicular pain and right varicocele. My question is, would colon cancer be seen on pelvic CT scan?


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Hello. I do not know why you are getting worried about colon cancer? These are not symptoms of colon cancer. As far as your query is concerned, colon cancer may or may not be detected on CT scan based on the stage of cancer. But in most cases, one can see abnormal growth over there. A colon cancer diagnosis is made on biopsy done by colonoscopy. I feel your symptoms are more related to irritable bowel syndrome. Try a good probiotic like cap VSL 3 (live freeze dried lactic acid bacteria and bifidobacteria) that would help you in regaining normal flora that might have been disturbed as a result of antibiotic intake. I need to know if you have any blood in stools, weight loss, or anemia?


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Hello doctor, I got drunk and had one-night-stand with an escort. We used a condom, but I did not erect fully when inside her, but I still ejaculated. I am concerned that I could be at risk. I believe the head was covered at all times even though I went soft.


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Hello. I understand that you are concerned, but if the mucosal surface were not in contact and there were no open wounds in contact, then it is not possible to acquire STDs (sexually transmitted disease) like HIV, syphilis, herpes, etc. But the STDs like genital warts, or genital molluscum does not need to have mucosal contact as mere contact of the lesions on genital skin can lead to spreading of these STDs. But if you are sure of the fact that there were no visible bumps like wart or molluscum, then that too is unlikely.


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Hello doctor, I am 24 yrs old female...my height is 156cm and I weigh 91kg... I had two abortions...and still no baby...yesterday night I had some blood on my stool...and earlier for few months I had gas problems... usually, gas comes for many times in a day...also, I feel like gas is stored in my abdominal area and feels like to visit toilet often... Feeling heavy in my lower abdominal area, for me It feels like gas... yesterday one time I got some blood on my stool and today I didn't get any blood... but my abdomen feels heavy...and it creates discomfort...what is my problem and what I need to do to get relief from this doctor? Will you please suggest me some opinion? Please doctor...


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Hello. I welcome you to icliniq. Actually the chronic problem of gas you mention is common in some one with overweight to obese-as in your case may be. Since your weight appears to be way beyond normal and this has definitely health consequences if not controlled. The blood in stool you mention, is somewhat alarming, and requires a thorough in person examination of the bottom, and looking for the causes such as anal fissure, hemorrhoids, to some serious disorders like inflammatory bowel disease. To summarize I want you to go and meet a gastroenterologist in your local area and get yourself examined to determine the cause. For your and foresee physician's ease just discuss above mentioned causes with him or her. So to finalize, the gas problem is benign (non alarming), but the blood you mention is alarming and need to be investigated. I hope this will help Small intestinal bacterial overgrowth Follow up after getting examined by physician in person


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Hello doctor, Two years ago, I suffered from a miscarriage and had undergone D and C. I am suffering from hypothyroidism and on Thyronorm 75 mg, and now the levels are normal. After six months of D and C, I got pregnant while on ovulation induction treatment, and unfortunately, that was an ectopic. My right tube is now blocked as I had undergone surgery. The tube is not removed, but the tube is blocked. It has been a year since I had surgery. I am trying to conceive, but I am not able to. My doctor put me on Letrozole, and it is my fourth cycle for it. During the first cycle, the ovulation was on left tube with ET 6.5 mm, and I did not conceive. Next two were on the right side, so no chance. Now again luckily it is on the left with ET 7.8 mm on day 16. What are my chances of conceiving, and is there a risk of ectopic again? My left tube is clear HSG test was done. Kindly explain to me.


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Hello. No matter which side the ovulation occurs, the egg will fall into the peritoneal cavity and moves into the available open tube through which it enters the uterus. Since you had one ectopic pregnancy, you have a higher chance of repeat tubal pregnancy. But since HSG (hysterosalpingography) shows a patent tube, you also have a high chance of normal uterine pregnancy. The only chance is to have a pregnancy and have an early scan to confirm pregnancy inside uterus. I hope I have clarified your query, do write back if you have any more questions, for feedback.


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Hello doctor,I have a few questions about glaucoma. I recently had my yearly eye check-up, and my doctor told me that my eye pressure is slightly above average. I know that having a high eye pressure can cause glaucoma, and it leads to permanent blindness. I do not have any pain in the eye, and also there is no family history of glaucoma. So my question is, how do I know if I have glaucoma, and what are the chances of actually getting diagnosed with glaucoma?Is there any home treatments I can do to reduce my chances of getting glaucoma? Any eye drops I can use or any pills or vitamins I can take? My doctor said that just because my eye pressure is slightly above average, it does not mean I have glaucoma. My doctor also said there is nothing to worry about, but I need a second opinion.


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Hello. Over the years, glaucoma definition has changed. Glaucoma is damage to the optic nerve with visual field defects, and intraocular pressure (IOP) is one of the risk factors. Only with high IOP, we cannot label that someone has glaucoma. Because some people have IOP more elevated than normal but still that is not damaging (called ocular hypertension), and some people have normal IOP, and that is damaging for them, so that is labeled as normal tension glaucoma. So IOP only is not determining factor to label glaucoma other important factors are there. Glaucoma evaluation needs some tests like visual fields and OCT (optical coherence tomography) and optic disc. After seeing all test, diagnosis of glaucoma is labeled. Complete eye exam and analyses are needed for diagnosing. Pain is a feature of one type of glaucoma that is angle closure, and most of the patients of glaucoma would never have pain and will be diagnosed accidentally or through routine eye exam or with decreased vision. No medication is needed until the diagnosis of glaucoma is made. Risk of glaucoma is still there even if family history is negative. Especially after 40 years of age, people having glasses (myopes or hypermetropia) are at risk. So I would advise you not to worry and let your doctor decide. If he or she thinks you need some tests, they will advise you and then determine whether you have glaucoma or not. Otherwise, relax and enjoy. You are welcome for any queries.


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Hello doctor, I got married before a month, and we are unable to have sex because of my very hard hymen. Yesterday I got bleeding during sex, and we thought it broke, but it was like a small tear from the side. My husband's penis is above average, and it is very hard, so I get unbearable pain every time, and he is unable to penetrate as I force him to stop. Is there any medicine to tear the hymen or only surgery is the option? Please help us.


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Hello. I can understand your concern. Hymen will not be hard, and your partner needs to understand your vagina, proper foreplay will dilate the vaginal region for easy access. Ask your partner to masturbate for you and increase foreplay. The hymen does not generally break in the first penetrative sex. If your pain persists, it can be due to injury, wait for a week for the hymen to heal. If your pain persists, you can use a painkiller. Increase the foreplay time or masturbation will lubricate the vagina for less painful sex. Use K-Y gel (water based lunbricant), or painkillers if you have any doubts regarding masturbation and foreplay. If all these basic things are fine, we can think of other surgical causes.


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Hello doctor, I am a 40-year-old male. For past five to six years my hairline has reduced drastically, a kind of pattern balding or thinning of hair. So, please suggest whether I should opt for ayurveda, homeopathy, or any other alternative medicine?


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Hello. I understand that hair loss can be quite disconcerting. Please provide me with a few details so that I can prescribe you an appropriate medication. Do you have dandruff or any other kind of disease in the scalp? Do you have any other problem in your body, like anemia, thyroid issues and so on? Are you taking any oral medication for the same? Because there are a wide variety of diseases that can manifest as hair loss. Also, if you could please provide with a picture of the problem, taken in good light and in sharp focus so that I can prescribe you an appropriate medication.


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Hi doctor, I have a history of recurrent early miscarriage (before seven weeks). Investigations pointed to high autoimmune antibodies and high NK cells. With medication, I conceived naturally and had a successful pregnancy. I am now pregnant again (unplanned) and am 7 weeks + 3. I had some spotting and cramping three days ago. The spotting was light and stopped within a few hours. The cramping continued for another day. Blood hCG levels are rising very well and are currently over 83,000. A transvaginal scan yesterday showed the heartbeat and we were told all is well. Today, I had some light spotting (dark brown) and discomfort and passed a brown clot. My query is whether this may have been the cause of the spotting the other day, or maybe this was caused by irritation from the TV scan yesterday. I am concerned anyway and any advice would be greatly appreciated. Current medications: Eltoxin, Prednisolone 5 mcg, Clexane. Sarting Intralipids next week to target NK cells.


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Hi. How are you doing?  I understand your concern. From your history, I do not see any reason for you to worry. This spotting could be from mild erosion on surface of the cervix, which may bleed spontaneously or during sex or due to scan probe. In your history as you have not mentioned pain, I can say for sure that there is no intrauterine blood. Scan also did not pick any hemorrhages (attachment removed to protect patient identity).  The medications you are having is absolutely the perfect ones. Most of the miscarriages before 12 weeks are due to genetic problems. But in the present scan as baby's growth has been adequate, you do not need to worry. This clot could be an implantation bleed. This is normal and nothing needs to be done.


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Hi doctor, I am 23 years old. I am really worried and fed up with my fat thighs and hips. As I am suffering from polycystic ovarian syndrome and I used to miss my menses. Now, my menstruation is regular. But, whenever I skip physical exercise I am sure that I will miss my menses. I think these all are the reasons for my fat thighs and hips. Sometimes, this problem makes me frustrated. Please suggest me some measure.


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Hi. Review with the report and for any information consult an obstetrician and gynaecologist online -->


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Hi doctor, I had a swollen lymph node in my groin and for which I took antibiotics for two weeks. But, there was no improvement. So two days back, I had a biopsy of the whole lymph node. I will get the results in five days from now. I am worried because, now I have another swollen lymph node in the groin, just below the one given for biopsy. When I called my doctor, he said that it is not a typical reaction to the operation. I have an appointment with him in two days. Can you please tell me why my lymph node is swollen again?


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Hello doctor, I cannot concentrate on anything. My mind is not stable. I have my exams in next eight days but I am feelling like I do not want to give it because due procastination, I have not prepared well and it is because I was not able to study but now my parents are forcing me to give that exam and due to which we have an argument and always during that argument, I just want to leave the house. I do want to study but I am not able to concentrate and focus on it. Also, I am suffering from PCOD. Is it the reason for my unstable mind?


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Hi. PCOD does lead to some hormonal disturbance, do you have any symptoms of PMS? Premenstrual syndrome? Because that might be an explanation of your mood swings and irritability. As for the lack of concentration issue, start small with some breathing exercises and relaxation techniques, try guided meditation.  For procrastination, it is often a reaction to stress, because we know the the work is stressful, to avoid it, brain goes on procrastination mode.Start with breaking the task in smaller chunks and do it like if you have to finish two chapters in a day, divide the number of pages per hour, then divide in 30 minute slot. Then just put an alarm for 30 minutes and read. Try this out and let me know if you need anything else.


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Hi doctor, I have got very painful rashes on my left thigh which seems to be going up to my spinal cord. Is it shingles? I do not know but I want a good diagnosis soon. Please help.


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Hello. Yes, this does look like shingles. Please visit a dermatologist on an urgent basis and start on antiviral like Acyclovir or Valacyclovir as soon as possible. Other possible causes for sudden occurrence of such lesions can be irritant contact dermatitis that you can rule out by thinking if you have come in contact with any chemicals or insects on these areas.


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Hi doctor, I seem to have high cholesterol for the first time and high insulin levels. Please go through my reports and advise. Thank you.


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Hi. I went through all your reports (attachments removed to protect patient identity). Only few abnormalities noted. Raised insulin levels indicate that your body is becoming resistant to Insulin. It means that you are at risk of becoming diabetic in near future. The solution for raised insulin level is daily aerobic exercise like brisk walking, jogging, running, cycling or swimming for at least 30 minutes every day. Elevated total cholesterol and LDL cholesterol are seen. Since the elevation is not much, also you are young (in report it was mentioned as 32 years) there is no need to start medication at present. Eat low calorie low cholesterol diet - avoid sweets, carbonated beverages, non-vegetarian food, junk food, cheese, butter and ghee. Eat more of fruits, vegetables and drink plenty of water. And do exercise as advised above. Elevated platelet count with slight reduction in mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) is probably due to iron deficiency. For this the solution is eat iron-rich foods like jaggery, green leafy vegetables, peanuts and dates.


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Hello doctor, I have had ED for several years now. I am able to get an erection but I am unable to maintain it. I have been going to a men's clinic for seven months now and they have done the GAINSWave treatment and implanted a testosterone pellet last week. After all this, there has been no improvement. I have been using the ICI injections and that maintains the erection. Sildenafil is effective sometimes, but not consistently. I have also improved my diet and exercise. I also have delayed ejaculation during this, but in the last 10 days, I am unable to ejaculate at all either through sexual intercourse or masturbation. I have been on SSRIs (selective serotonin reuptake inhibitors) in the past but stopped taking them six days ago. At this point, I am at a loss and would like to get another opinion and some direction.


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Hello. Your lipid values and blood sugar values are absolutely normal (attachment removed to protect patient identity). I would like to say a few points here. Lisinopril HCTZ (Hydrochlorothiazide) is a combo of two drugs in which HCTZ has erectile dysfunction as one of its side effects. Hydrochlorothiazide need to be replaced with a different drug or removed. You are on three antihypertensives Lisinopril, HCTZ, and Amlodipine. Is your hypertension that severe? Testosterone implant may improve your libido but may not benefit ED (erectile dysfunction) always unless there is a gross hormonal dysfunction. SSRI group of medicines are prescribed to delay ejaculation. I do not know why were you prescribed one. That is the culprit which has stopped your ejaculation totally. Better to discontinue it. Instead of Sildenafil for erection, you can try tablet Tadalafil 10 mg (Cialis) after consulting your andrologist. The erectile effects of Sildenafil are short lasting whereas Tadalafil has prolonged effects and one pill on Friday will make you have a wholesome weekend. It may even stop the need to have intracavernosal injections. One investigation which I would suggest you is a penile doppler which gives an idea of blood flow to the penis. GAINSWave is an addon to cure you fast. Penile doppler study. ED.


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Hi doctor, I am 25 years old. For the last one month my hair has been falling out a lot. My diet is vegan. I am eating a wide variety of foods, getting all my nutrients and not lagging in anything. I have got new hair growth on the top of my head and I am not losing it in patches. The loss is all over. Please help me.


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Hi.   Please answer the following questions for more information. Is there any recent stress either mental or physical? Are hairs falling from whole scalp or sparing any area like only in occipital area? Please send the photographs of scalp. Are you on any medication?


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Hi doctor, I am 19 years old. I do not have any sexual desire or libido. I am not getting normal erection. I have done a hormonal test to see if something is wrong. Currently, I am on antidepressant. The clinic said that the results are normal. But, I have a feeling that something must be there. Kindly can you check the results and let me know if they are normal or not. Thank you.


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Hello. Your submitted blood work (attachment removed to protect patient identity) looks normal. I do have some questions for you though. Did you have normal puberty as compared to your peers such as height, shaving, pubic hair, etc? Did you have normal sexual desire and libido in the past? How long has it been since you lost interest? Have you had mumps? Or any other medical problems? Have your thyroid function and prolactin levels been tested? If not get them done. What kind of antidepressant are you taking? Talk to your doctor who is prescribing the antidepressant to see if the symptoms are related to depression or due to the medication you are on.


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Hi doctor, A physiotherapist did some manipulation with my neck and since then when I fall asleep at night, my arms, hands, upper back (area just below the neck) and brain feels weird as if blood supply is cut. This happens several times during the night while I am sleeping and these symptoms go away when I sit for 5-10 minutes. Because of this, I am unable to sleep properly. I want to get Doppler ultrasound of arteries and veins. Please suggest which Doppler ultrasound I should get to rule out the possibility of any obstruction in arteries or veins caused by several jerks, trauma to my neck and rest of the spine that might be causing problem with blood circulation. My whole spine MRI screening shows disc protrusion at L4/5 and L5/S1. Cervical area does not show any significant change. Please help.


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Hello. You have mentioned pain and numbness in your upper limbs after manipulation was done by a physical therapist. You have also mentioned both upper limb involvement which is actually a surprise because normal spinal manipulations should not actually lead to this especially if your cervical spine MRI is fine. To actually find out a cause for both your upper limb symptoms, a detailed neurological examination of both your upper limbs including assessment of motor power, sensory examination and evaluation of deep tendon reflexes, nerve conduction studies and CT angiogram of carotid and vertebral vessels can be done. There is an entity called as thoracic outlet syndrome which can actually lead to your upper limb symptoms, but bilateral involvement is not very common. Can you kindly send me the above mentioned details along with the investigations done by you till now? I can see and advise you accordingly. Also send me your blood investigations done recently as well. Will be based upon the investigation and clinical details as provided.


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Hi doctor, My son is 4 years old. He was only on milk diet till three years. His eight teeth got brown color, when we went to the doctor he suggested for cleaning and filling for six teeth but for two teeth, he suggeested for RCT. My son never complained about pain or swelling. Do we really need to go for RCT?


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Hello. Yes, it is called pulpectomy procedure, not proper root canal treatment as done in adults. Those milk molars have to stay till 10 years of age at least. So, if you want to prevent breakdown of teeth and pain in near future, it is necessary.


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Hello doctor, MOG IgG positive, and NMO IgG negative. Sudden problem in vision of one eye. Age 9 years, female. Treatment IVMP for five days. Please suggest the best possible treatment and please explain about the condition.


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Hello. MOG-antibodies are common in children with acute demyelinating syndromes (like optic neuritis in your case) with both monophasic and relapsing disease courses. MOG is myelin oligodendrocytes glycoprotein normally present on oligodendrocytes of brain, spinal cord and optic nerve myelinated neurons. Many time during viral infection or due to some unknown reason, bodies immune cells falsely perceive it as a foreign particles and attack on it and it will damage the myelin sheeth. Mostly affects vision of eyes, spinal cord function and brain. Diagnosis is made by history and examinations, MRI brain and spine, CSF, NMO, MOG antibodies. Treatment of patients with MOG-Ab-associated demyelination includes management of acute relapses and chronic immunotherapy for those with relapsing disease. Acute phase treatment: Best possible treatment in your case is IV Steroid for five days, already given. But in case severe disease, IV immunoglobulin or plasma exchange for five days, both will reinstall immunity but not indicated in your case as she is improving with steroids. Maintenance with tablet Prednisolone 1 mg/kg/day for four to six weeks, then will slowly taper down and stop. But in case of relapse (further attacks) will have to continue for long time.


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Hello doctor, I had a medical abortion a month ago. My period came 29 days after the abortion. After the period I did an hCG test and it was positive. 37 days after abortion my hCG level is 18.21. After three days, the test showed 17.56. I also did an ultrasound and the doctor said I have 3 mm endometrial thickness on one spot. He prescribed me Duphaston to take from day 15th day to 25th day of my cycle. I am scared to take it and also I am scared that maybe I have some retained products but the doctor said I am fine. What should I do? Is it safe to take Duphaston in my condition?


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Hello. First of all, there is no harm in taking Duphaston in your condition. It is just a progesterone hormonal analog, the same hormone is secreted from the ovaries once the egg is released after ovulation. So there is nothing to worry about taking it. I would like to know what was the indication for checking beta hCG (human chorionic gonadotropin) value at 37th-day post-abortion, when everything was fine, you even got your periods pretty much on time? Regarding your beta hCG value, I would like to tell you that beta hCG may be detected in maternal blood up to 4-6 weeks post first-trimester miscarriage or medical abortion. Did you had a missed miscarriage or was it an unwanted pregnancy that was terminated medically, and at how many weeks of gestation? This is important because sometimes missed miscarriage may harbor partial molar pregnancy which goes unnoticed, as biopsy or histopathological examination is not done for such cases. But yes, any persistence beyond 6 weeks of abortions should be monitored carefully as these may be a hint of development of gestational trophoblastic neoplasia (GTN). As your scan is normal, and also endometrial thickness of 3 mm is also a normal finding, so there is no chance of having any retained products. It would be helpful if you could share the ultrasound reports (pre and post-abortion), and the dates of the events along with the date of doing beta hCG levels to have a better idea of your situation. I would advise you to recheck your beta hCG value again after a week. Please revert back to me with the necessary details I requested you, so that I can guide you further. Serum beta hCG value after a week.


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Q. My fiancee is B positive and I am O negative. Should I expect any pregnancy complication in future?


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Hello doctor,My fiancee is B positive and myself O negative. In the future, will there be any complications in my pregnancy?


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Hello. There would be no complications during the first pregnancy but may occur in the subsequent ones due to isoimmunization phenomenon. It is a problem which arises if the mother is having negative blood group and baby is having positive blood group. But treatments are available, so you have nothing to worry about it. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.


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Hi doctor, I have found that I am very protective over my clothing, food, and friends. I grew up in a household where the food we bought was either on sale or a big deal, despite having money now, when someone eats food I was looking forward to the fact that I get inexplicably angry. My step sister steals my clothing and it makes me have nightmares about hurting her. Something else concerning is when my best friend ignores me for other people it hurts me a lot as I place so much value in everything. I have seen a psychiatrist regularly but this is a question I have never had answered. Is there a way to trace this behavior to my upbringing or prevent it from affecting my life? I am currently prescribed Zoloft and Adderall.


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Hello.  When someone eats food and you get angry, this could be due to part of anxiety. A lot of individuals with anxiety have such kind of symptoms. This is not a thing to get worried. You are on Zoloft which is an anti-anxiety drug and this should help you with time.   When someone steals your clothes and you get angry then this is not an abnormal behaviour. I do not see any abnormality in this. Most of individuals have such kind of behaviour. Getting hurt on behaviour of your friend also has nothing related to your upbringing. Sometimes when we expect from an individual to whom we are close and when he or she ignores us, then it is normal to get hurt. But, if this is prolonged and you feel depressed because of this, then this might be due to some personality issue. You are 19 and at this age, such kind of behaviour is normal. With time you will see improvement in yourself.


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Hi. Irritable bowel syndrome has these symptoms such as decreased sleep at night, depression, musculoskeletal pain or fibromyalgia, decreased sexual performance, and inadequate attention. IBS can be diarrhea-predominant or constipation predominant or mixed. In the case of diarrhea-predominant IBS, it is better to avoid eating vegetables, flour containing products and other foods containing FODMAP (Fermented foods containing oligosaccharides, monosaccharides, and polyols). It is helpful for some patients. After having repeated counseling, they need pharmacotherapy. I advise taking Chlordiazepoxide with Clidinium bromide and a probiotic combination trial. It helps for some persons. In the case of constipation-predominant IBS, I advise stool bulking agents like psyllium husk or lactulose to the patient. For the depression and musculoskeletal pain, I usually prescribe Duloxetine which works better than SSRI (selective serotonin reuptake inhibitors). But in cases when the musculoskeletal pain is not severe, I advise SSRI. Hyperacidity is a common problem seen in these type of patients. Treat with a short course of PPI (proton pump inhibitors) first and then downgrade to Ranitidine after the symptoms get controlled. In some patients, counseling plays an essential role in the treatment of IBS.


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Hi doctor, I had myself tested because I have had a blood transfusion before six years and visit many hospitals for my job. I have no symptoms. I just went to the laboratory and did not understand my results. Can you interpret them for me? Also, can you explain the cut-off value? Thank you.


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Hi doctor, I am 40 years old. I was diagnosed with hepatitis C before 16 years while donating blood. No allopathy treatment was taken till last month. My liver function tests are monitored regularly. Most of the time, the result will be elevated levels of SGOT and SGPT of 200 and 300 respectively. But, it did not affect me in any way. My appetite is very normal and I am a pure vegetarian. In my recent test, I was diagnosed with genotype 1 and the maximum viral load was 12 lakhs. I started on treatment of SOF+LDV. Followed by that, viral load checked after 7 days and 30 days showed not detectable. Also, for the first time my LFT came back completely normal with no elevated level of any enzyme. Most of the research suggests that 8 weeks treatment is fine, if the reports are normal. Should I complete 12 weeks or stop after 8 weeks of treatment? Please advise.


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Hello doctor,I am hepatitis C positive with IgM + IgG of 14.2. This test was conducted five years ago. What is the significance of this? I have full medical test including LFT from two months back including sonography where things were normal. Do I need to worry about this? Does it require a treatment or the count is within limits?


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Hello. You need to get the hepatitis C quantitative assay (RNA level) done and need to get treatment depending upon that. There is no need to worry. Your other labs are fine (attachment removed to protect patient identity). But please be under the strict follow-up of a nearby gastro/ hepatologist. Regards. For more information consult a medical gastroenterologist online -->


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Hello doctor,I am getting stomach problem from the last year after consuming fish curry. I suffered from diarrhea and low-grade fever and after taking multiple antibiotics I got relief but I started to get a new problem. I was getting stomach cramps and diarrhea that happens suddenly after taking meals (especially in the morning). This diarrhea is not 100 % watery but loose and it will not happen daily. After getting diarrhea I will get constipation for many days. I took Rifaximin 550 (TID) along with probiotics for 14 days but I still have a tendency of diarrhea like stomach rumble with the defecating tendency and I get some cramps (sometimes burning pain in the abdomen). Therefore I need to know whether I am getting the problem because of irritable bowel syndrome or is there any infection that is causing this? Do I have to continue taking Rifaximin 550?


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Hello Welcome to icliniq.com. As per the history you have provided, it seems like irritable bowel syndrome. Firstly, you would need to rectify your diet by cutting down on too much fibres, gluten, too much starch, spicy foods or junk, alcohol, caffeine. Increase intake of water, soups, detox drinks, fruits and vegetables and do not over eat or skip meals. Start tablet Pantoprazole 40 mg once daily for a month, tab Vitamin C chewable 500 mg twice daily for one month only after food. Start tablet Dicyclomine once daily for one week and then only when required. Continue with the probiotics. You may stop Rifaximin until you finish the course of the medicines I just mentioned. Lastly and most importantly get a gut investigation done at a hospital. Above all, keep a positive mind and do not worry about it as a problem as there is always a cure for everything. Do follow up and stay healthy.


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Hello doctor, I had an anal fissure six months ago for which the doctor prescribed me Ciplox TZ and SN 15 Plus tablet six days course along with Duphalac Fiber. This cured the fissure and I was having no issues with the bowel movement. Just recently, I did have a slight swelling in the upper lining of my stomach for which I have been taking Pantoprazole as prescribed by the doctor. The swelling or bloating has been much better than before. But I am facing a problem with hard stool each morning due to which I have pain during bowel movement and chance of anal fissure recurring. My questions are:  Is it okay that I take one more course of Ciplox TZ and SN 15 Plus along with the current Pantoprazole medication to take care of the anal fissure relapsing?   Could this be IBS-C (irritable bowel syndrome with constipation)? if so, what is the medicine that has to be taken?  I have heard ayurvedic Dhouti-Yog tablets are good to produce softer bowel and relieve constipation which in turn can stop the fissure from coming back.


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Hello. From what you have mentioned, you have IBS-C (irritable bowel syndrome with constipation) and hard stools. There is no need to take Ciplox TZ (Ciprofloxacin and Tinidazole) and SN 15 Plus (Diclofenac and Serratiopeptidase) again. I suggest you drink plenty of fluids plus fiber-rich diet. I suggest you take Senna tablets before bedtime as a laxative. Colvac (Sodium Picosulfate) twice per day for colics and tummy distension. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Follow up is required. For more information consult an internal medicine physician online -->


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Hello doctor, I wanted to know is it normal for a newborn to have eye bleeding. He is almost one month old. I was surprised that his tears are blood. Should I worry or is that just normal?


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Hello. Such bleeding is not normal. The causes of such an occurrence are varied. A few common causes include a blood clot, a tear in the tear duct, infections like conjunctivitis, and sometimes a cut in the conjunctival lining can also cause this. The best thing, for now, would be not to rub or wipe your baby's eye very vigorously. The pediatrician will evaluate him for bleeding disorders and then have an eye examination as soon as possible. In case you have any further questions please let me know.


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Hi doctor, I am a 26 year old male. I am suffering from stomach problems like gas (excess condition every time), burping, bloating and pain in the chest (sometimes due to acidity). I always feel uncomfortable because of gas problem. I feel like my stomach is full every time. Please help.


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Hello. I understand your concerns. Most probably, you have irritable bowel syndrome, which is a syndrome of nervous bowels characterized by colicky bowels that may cause constipation or diarrhea. It does not wake you up in the middle of the night. Also, it worsens in times of exams or stress or after meals. It is relieved after motions. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an internal medicine physician online -->


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Hello doctor, I am a 17 year old female. My weight is 140 kg and height 5'4". I need your guidance and advice on something that has been going on for a very long time. In the past, I have been a vegetarian, paleo, vegan, etc. And I am currently a vegan because I feel it is the right thing to do. I eat extremely well, always have fruits and/or vegetables with every meal. I am a very conscious and intuitive eater. However, for a very long time now I have been having odd bowel movements. I have rabbit pellet-like stools, and sometimes I never make a bowel movement in a day. It is becoming an issue because for the past few months I have had this problem. I have been feeling extremely bloated and uncomfortable. I never feel hungry and constantly have this fullness feeling and assume that it is because of the problem with my bowel movements. And maybe my bowels are not clear. It is very uncomfortable because I enjoy eating and want to eat and exercise. However, with this constant feeling, I do not really enjoy eating or exercising. I wake up every morning with a bloated feeling in my stomach. I do not know what to do and how to fix and stop this issue and start having normal healthy bowels. I need some advice and really appreciate that you will take the time to help.


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Hi. It is IBS (irritable bowel syndrome). It is a benign disorder, requiring only supportive management to regularize bowel habits. This disorder occurs in many people these days (10 to 30 % population are affected by this). This condition is aggravated by low fiber intake. Advice: It will take time for this disorder to heal. Consult a medical gastroenterologist online for further help -->


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Hello doctor, I am a 32-year-old female. I have a right sided bubbling sensation in my chest and that is rhythmic with my pulse. It started today while at rest. I have a history of endometriosis, sensitivities to NSAIDS (gastric ulcers), and iron deficiency anemia. It almost feels like wheezing, but I am sure that it is not breathing related. There is no pain, but uncomfortable sensation comes and goes and last for about 60 seconds. What could be the possible causes?


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Hello. In your case, severe anemia can cause blood turbulence while flowing through cardiac valves, which may lead to the sensation of bubbling or flowing fluid. Usually, a murmur can be heard with a stethoscope. Other cause may be just bubbling of gases in the stomach, but it is felt in the upper abdomen and can be heard in cases of hiatal hernia. If you tell more details about your symptoms such as when does this sensation occurs, relation with posture, food, activity, any other accompanying symptoms, etc. I can guide you better. If symptoms are recurrent, I advise you to have a chest X-ray and echocardiography.


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Hello doctor, I have tried Lexapro, Wellbutrin, Effexor, and Prozac for anxiety and panic disorder. But I suffer from the side effects of these medications. My biggest complaints were increased anxiety, and panic attacks, along with weight gain (50 pounds), and tachycardia that kept me up at night and freaked me out. So my family doctor sent me to a psychiatrist, and he prescribed Imipramine. I had never heard of this, so I searched, and it seems like weight gain and tachycardia (my two most significant concerns with medications) are common side effects for this medication. I am not sure why he prescribed this one to me, but I wanted to get a second opinion to see if this is a good idea since I already have tachycardia and do not wish to gain more weight. I am scared even to try this medicine because I do not want to go into some weird heart rhythm.


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Hello. I can understand your problem. Imipramine is a tricyclic antidepressant drug, and yes the drug is known to result in side effects like weight gain. But this depends upon the dose, the duration of treatment, patient factors, etc. Lexapro (Escitalopram), Wellbutrin (Bupropion), Effexor (Venlafaxine), Prozac (Fluoxetine), etc., are serotonergic drugs and it is common with these drugs to see increased anxiety for first few days of starting the drugs. In most cases, this rebound increase in anxiety goes by own. So my advice is to continue the drugs even if you see worsening of symptoms. In most cases, after a week of starting the drugs symptoms remit. Imipramine is also the right choice, and the drug causes sedation so you should take medicine in the evening after dinner and should start with low doses. When the drug is started in low doses, then you will not face any rebound increase in anxiety. Kindly get ECG done before starting the medication.


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Hello doctor, My fiance fingered me and I am not sure whether he had masturbated before fingering. But after that I found chocolate like blood spots. I had my periods done before six days. Also, I suffered loose motions day after. And I could see the same colored spots. I am scared if I am pregnant.


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Hello. The presence of clots per vaginum post-fingering can be seen in cases of cervicitis but if chocolate coloured blood spots are seen , it could be collected blood or if you are suspecting pregnancy, then you need to get a urine pregnancy test done to rule out pregnancy. If pregnancy test is positive, then this could be threatened miscarriage.


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Hello doctor,My husband is having some red blisters on the right back side of the body and beside his right nipple for three days. He is having a mild burning sensation when the cloth touches these blisters or rashes. Please help.


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Hello. I have gone through your case. I have two diagnoses in your case. 1. Insect bite reaction, and 2. herpes zoster. Insect bite reaction does not require any treatment, but you need to follow the treatment as early as possible. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Tablet Acyclovir 800 mg five times a day for seven days on following timings, at 6 and 10 AM, 2, 6 and 10 pm. 2. Tablet Cetirizine 10 mg at night for seven days. 3. Fucidin cream (Fusidic acid) two times a day. Herpes or insect. Drink plenty of water.


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Hello doctor, I am a 24-year-old female. I received a second round of a cortisone shot in my wrist on 18th May for wrist tendinitis. During the injection, it hurt much worse than the first shot. I have been told to keep my wrist in a splint at all times. My wrist is still bruised where the injection was given. There is now a bump as well where I have injected hurts when touched. Before the first shot, I had a ganglion on my wrist that popped. I cannot say for certain if the bump is from the injection or the ganglion is back because of the shot. I need to know if this is normal or if I should go to a clinic over the weekend? I am currently on Autumn Wills, Seroquel 400 mg, Lithium 300 mg, and Ativan 1 mg when needed and not often.


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Hello. From the brief history you have given, it seems like there is not much to worry about. First of all, I need to know some more detailed points. Where exactly in the wrist the shot was given? I mean is it the extensors of the thumb (de quervain) or is it for any other finger? Also, do you have thyroid issues? Sometimes when the large volume of fluid is injected into the tendon sheath and surrounding area, due to distension it can cause severe pain and patients do complain of exaggerated symptoms prior to injection. Small vessels must have been punctured (quite normal) which lead to extravasation of blood hence the bruise. It will take a few more days, but both the bruise and the bump should go away. Do apply ice packs there you will get you the necessary relief. Ganglion cysts are notorious for recurrence but highly unlikely to be associated or related to the injection. If you can send me a clinical picture that would be better. Splint is fine but you do need to mobilize your wrist for a very long time otherwise you might end up having stiff wrist (2-3 weeks should not cause any stiffness). Understanding tendinitis is important you need a very specific rehab protocol and few medications and you should feel much better in few weeks time. Did you get your vitamin D levels tested? Kindly revert with the info.


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Hello doctor, my son is 19 months old .... He is grinding teeth most of the time ... Not eating at all...only one spoon after that he has feel of vomiting.... So am giving food with a long interval between every bite... Also we r giving only mashed foods... Previously he was taking 2 idlies.. now even half idli is difficult for him to finish.... One of my friends suggested me to give albendazole syrup ad his symptoms suggestive of worm infestation.... Can i give albendazole syrup ... If yes how many ml and his weight before two months was 9kgs ... Because of lockdown we didn't check his recent weight.... If no what medication can we give ... Please reply am really worried about his eating habits.... He became very thin comparing to before... Thank you in advance....


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Hello, hope you are safe. Thank you for the elaborate history. I appreciate your concern regarding your child. I would like to first tell you that grinding is a common phenomenal in children till 6 years most children outgrow it by 6 years. However at this age if he is grinding you can give him plenty of water  Positive feedback helps. And for more discussion regarding reward and positive feedback you can consult me on phone as it’s difficult to explain those things verbally  As for albendazole, you can give 400 mg once stat dose only repeat at 6 months interval. Regards


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Hello doctor, For almost two months, I am having widespread fasciculations. It started from my right arm and became widespread. After some time, I began to notice my right shoulder, and knee started to get fatigued quickly. I have visited my primary doctor so many times until I was given a referral for an EMG. My EMG test was clean, no form of denervation, and the neurologist diagnosed my fasciculations as benign. But now my muscle twitching is worse. Currently, I am getting constant twitching in my right biceps, and it occurs consistently without breaks. I have sleepless nights. Please help.


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Hello. I reviewed, and I am glad to confirm that we can exclude any possible motor neuron disease, neuropathy, or muscle disorder. I would recommend checking vitamin D, plasma levels for possible deficiency, and thyroid hormone levels for possible thyroid gland dysfunction. Possible treatment options would be Clonazepam that helps to reduce muscle twitching and also calm down your anxiety. You should discuss with your doctor on the above tests and treatment option. I remain at your disposal for any further questions whenever you need.


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Hello doctor, I have severe acne mainly on my cheeks and forehead for a year, and now it continues to get worse, and there are no improvements. No matter how many times I go to the doctors. I am currently taking Lymecycline capsules for a month and the Differin gel at night. I have seen no improvements, inspite of eating healthy food, and drinking more water. I need help because it ruins my confidence and is a daily struggle.


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Hello. During teenage, it is very common to get acne, especially on cheeks and forehead due to several reasons (primarily because of hormonal changes in puberty). It is advisable to wash your face multiple times to avoid the accumulation of dirt, which can lead to blockage of pores, and that results in acne formation. Use of a mild medicated facewash suggested by your dermatologist might help you to get rid of the present symptoms. I hope this helps.


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Hello doctor, I have chest pain, back pain, left arm pain, and slightly shortness of breath for the past two years. The pain remains constant all the time. I also have irritation and tingling for the last two years continuously. I have done ECG, echo, TMT, and CT angiography twice, and everything is normal. What should I do?


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Hello. Your symptoms do not seem to be due to a heart problem. Tingling sensations, irritation, etc., are not caused by the heart. Your symptoms more or less seem to be due to some nerve irritation which may be localized or generalized. I advise you to consult a neurologist for proper evaluation of symptoms. Sometimes nerves got entrapped between bones in the neck or vertebral column that causes pain, tingling, numbness in fingers, arms and hands. If you are a pure vegetarian, there may be vitamin B12 deficiency, which can cause such symptoms. Apart from these, there may be a problem in the peripheral and central nervous system. Therefore I advise you to have a visit a neurologist.


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Hello doctor, My son is 1 year old and has constant cold. I have consulted my pediatrician also. He has been suffering from cold, and wheezing for the past one month. If I use Augmentin Duo, he is getting fever, wheezing and severe cough. So I use Azithral 200, Levolin, and the condition is somewhat fine. But he is not getting complete cure. Please help.


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Hello. Your child may be suffering from what is known as hyper-reactive airway disease. Please get the child evaluated physically with chest X-ray and basic blood tests like CBC (complete blood count) and CRP (C-reactive protein) at least. Based on the reports, if it does not show any infection, you can start the child on a long term course of Montelukast 4 mg one dose at night along with syrup Levolin (Levosalbutamol) based on the degree of coughing. The child may also need intermittent nebulization with Duolin (Ipratropium, Levosalbutamol) and Budecort (Budesonide) as and when the need arises.


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Hello doctor, My father had partial penectomy two weeks ago, and our doctor has suggested for another surgery. I am sending his postsurgical reports. Can you please let us know if surgery is required, and he still have cancer?


key: chroma:document
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Hello. All tumor has been removed, and resection margins are free. But tumor involvement is deep inside, and so the surgeon wants further surgery so that the tumor should not come back after some time. Also, ultrasound reflects a reactive lymph node, and so your doctor might be planning for the removal of lymph nodes. Further surgery is needed to prevent the come back of cancer.


key: Patient
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Hello doctor, A few weeks ago I noticed that my bottom front teeth felt slightly loose. I looked up my symptoms and suspected it might be gum disease because I have always had poor dental hygiene and never flossed. Since then I started brushing, flossing, and using a natural mouthwash three times a day, then I went to the dentist and asked about my concerns. The dentist told me that I did not have gum disease and had nothing to be concerned about and the loose bottom teeth were most likely from grinding. I want to believe him but I also want to be sure he is correct. My gums are mostly pink close to the teeth but farther down they are very red and seem decayed.


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Hi. Let me tell you something. Even I have undergone this situation (personally). There are several types of periodontal conditions, out of which, this is called trauma from occlusion due to bruxism, clenching. Your teeth may loose its normal curves or contour and may even get loose. Primary line of treatment involves splint or night guard, along with minor procedures. You can share a picture by following up and attaching a file. I would be glad to assist you. Many a times, such mobility turns out to be more physiological than pathological (as it turned out for me).


key: Patient
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Hi doctor, When I was younger, I had a bottle rocket blow up in my eye. It left a scar in front of my pupil, so I am no longer able to see out of the eye, and am considered legally blind. My pupil stays dilated all the time, and where it is not able to focus on anything, it wonders to the right. I was wondering if there is any new surgery, that could possibly help.


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Hello. Thankfully only one eye was affected and I hope your other eye is intact and fully functional. Unfortunately, a dilated pupil that does not react to light in the affected eye means that it is no longer transmitting information to the brain and therefore is considered non functional. In most cases those changes are irreversible and the eye is no longer considered a functioning organ. But, hope dies last, and to cheer you up a bit, there are many ongoing clinical researches on the restoration of vision in blind eyes and mainly involve implanting a chip in the retina and connecting it to the brain and although the results are not what a patient would expect, nonetheless it helps the eye detect objects on a very primitive level. As I said earlier, thank God that only one eye was affected and you should take care of it by undergoing a yearly comprehensive eye exam. I wish you best of luck.


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Hello doctor, My mother’s age is 80+ and she had heart attack four times. Two attacks in quick succession a year back and two attacks quick in last one month. Her heart pumping capacity is about 35 % with kidney creatinine 3.4 mg/dl. But it is decreasing now. She never had diabetes. But always when admitted to hospital for heart attack treatment, her sugar level increased a bit and hospital always started giving her Insulin. Last one and half year her cardiologist never advised her to go under any aggressive treatment like doing angiogram and then further treatment like angioplasty and ect. If we go for angiogram followed by further treatment like angioplasty and ring fixing. Will it be safe for her? Will she be able to survive? Traditional angiogram or CT angiogram and then angioplasty or ring.


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Hi.  Although bypass or angioplasty can be done in old age, if the health of patient is promising, but if other health issues are present then it becomes a high risk case. As your mother's kidney function is poor, it becomes very risky to have an angiogram done because even non-ionic contrast medium is detrimental for the kidneys. One possibility is that have her 1 or 2 sessions of dialysis done first, then go for angiography and angioplasty and again have one or more sessions of dialysis in close liaison with good nephrologist. If this is done safely, then next risk is of bleeding. After angioplasty, blood thinning medicines are given for long time, this may cause bleeding problem in old age. Regarding bypass, it is a major surgery and needs general anesthesia, although not impossible in old age but, it depends upon overall health and organ functions of body. Cardiac anesthetist will fully evaluate her before bypass. Third option is to keep her on medicines only without going for any intervention. In my opinion, consult a nephrologist that is there any chance of recovery of kidney function, if no then periprocedural dialysis can be considered.


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Hello doctor, I have very sore area behind the last tooth on my upper right side of my mouth. It hurts terribly to chew and swallow because of the location of the soreness. I am 52 years old and never really had problems with my teeth. Also, the area does not look red or has any open sores, just swollen. It started about two days ago.


key: chroma:document
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Hi. There are three possibilities about this soreness, either there is some problem with the tooth, may be it is fractured. Secondly, possibility is that you may have got trauma due to biting or food like fish sting stuck there. Third possibility is that due to trauma from biting you may have developed an ulcer.  Now if your tooth is carious, fractured, then you may require antibiotics or it may require to be restored or extracted. If it is irritating mucosa around then we need to contour tooth to relieve area. Third, if there is ulcer then you may require the topical gel for one week. You can send photograph of the area if possible.


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Hi doctor, I am a 47 year old male weighing 90 kg with a height of 5'9", suffered with fever as well as cold routinely in the last month. My doctor advised me some blood test as my BP at the time of consultation was 130/110 but I was not having BP problems. The last checkup reveals normal BP 120/80. The antibiotic given to me works and I do not have fever after that. The blood test advised to me by the doctor shows normal reading except creatinine 1.19 and increased uric acid. My uric acid is normally on higher side and I was prescribed Zyloric tablets. Please advise me whether I am having any kidney related problem or not. My BP is normal without medication. What should be my line of treatment ? I have attached my lab reports including KFT, hemogram and urine test. I am worried. Please review the reports and help me.


key: chroma:document
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Hello. I have gone through your reports (attachment removed to protect patient identity). During any acute infection serum creatinine can rise as a result of infection as well as dehydration. For a better judgment you need to get a repeat serum creatinine as well as uric acid done. This should give us a clear idea. In case if it is still high, you would require to get further investigations. So, get the repeat test done and write back to me with reports.


key: Patient
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Hi doctor, Medically, is there a big difference between drinking alcohol by an 18 year old and a 21 year old? Some proponents of lowering the legal drinking age believe it will combat the rising problem of binge drinking on college campuses. From a medical perspective, what are the cons of lowering the legal drinking age to 18?


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Hi. 1. If we keep the legal age and when one is allowed to drink alcohol, there will be fewer damages to the brain development to the young aged people.  2. Alcohol destroys the liver and if we keep a low legal age allowed for drinking, definitely more and more alcoholic hepatitis patients will appear in population.  3. Decreasing the legal age for drinking will have devastating effects on the health of the mass.


key: Patient
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Hi doctor, One year ago, I had massive left-sided pleural effusion with respiratory distress. Pigtail insertion was done and it was indicative of TB. Now, my ATT is stopped. After two months of treatment, my ultrasound report said that pleural thickening is seen along left posterolateral chest wall. Now, I do not have any symptom like chest pain, breathlessness and cough. As I am fit and healthy, I have stopped the treatment. Will pleural thickening get worsen with age? Will the person in question face a higher risk of having lung disease in future? Now my age is 21. Is pleural thickening reversible in my case? I would like to go abroad for job. Will pleural thickening create any problem in my working visa? If yes, what can I do? Please help.


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Hi. Please relax. You have probably healed your TB (tuberculosis) and there is nothing to worry right now.  Pleural thickening has happened as a result of the effusion you had. It is a way of healing which the body does when effusion happens. It will not get worse with age and you will not get TB again. There are no higher chances of cancer also related to that. A large number of people suffer from this and it does not affect life in any way. Thickening usually does not get reversed. It will remain there. The only problem which you might face in visa interview is, if they require your chest x-ray to be done and then thickening will be seen. Now, it is evident that they will get your other tests done to rule out active TB, which should come negative. There are certain countries which bar people who have had TB. But, I do not think such policies are present in working visa. I would recommend you to read the specific country website and also consult some agent about this before you fill the medical declaration. Except for the visa, it will not cause any issue in your life.


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Hi doctor, I had my first appointment with a neurologist this week. I am a 21 year old student. The past several years I have been dealing with shaky hands, worse on my left side, that has continuously gotten worse. I also have hypothyroidism and had hoped that as my thyroid balanced out, the shaking would decrease, but it has only gotten worse and now the shaking often moves up my arms and makes it very difficult to write or work. Within the past year, I have noticed that some of my toes go numb while walking and can stay numb for several days. Recently I have noticed numbness in my right arm at times. My neurologist first thought it could be from stress, but then proceeded to run through a series of tests where he mentioned that the reflexes in my feet were very uncommon and that my pupils also were not working the way it should. He asked about any back pain, I told him I struggle with that as well. He then did a test where I would touch my nose then his finger, I could do it on my right side, but missed every time on the left. He ended up taking quite a bit of blood and asked to get MRI of head and cervical spine this week. He did mention that this could be serious and heavy, but not much else. Currently I am on Levothyroxine. I am starting to get nervous and wanted to see if anyone had any input or ideas about possibilities or conditions that could be wrong with me? Thank you so much.


key: chroma:document
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Hello. Your history is suggestive of neurological issues with very less possibility of anxiety. Following are the possibilities that I can think of : Now to help you better, I need following answers from you. Please think in detail and answer : Have you ever been admitted in hospital for vomiting? Or ever received any injections for vomiting for long? Do you notice any visual issues? Is there any tingling or numbness in legs? Do you have any difficulty in holding objects? Do you experience any cervical pains? Are you suffering from weight loss or memory loss? Have you noticed any other neurological issues in life? Please check with your family for answers that you are not sure about. I mean that any previous significant history of such episodes in childhood.


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Hi doctor, My grandmother is 86 years old. She is having cold since last 10 days that gets controlled with medicines. But, in the last 4 days she has breathing problem and also she is unable to sleep well. She has given blood for testing. Please help.


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Hello. Thanks for writing to this platform. As you said, your grandmother initially had cold and is now suffering from breathing difficulty. It is advised to shift her to any nearby hospital and do a chest x-ray to rule out any infective cause. And also to rule out any underlying obstructive lung disease that could be present. At this age, it is very common to have pneumonia or obstructive lung disease or any other lung disease which causes breathing problems. But, we can make a final diagnosis only after a chest x-ray and some blood tests. Once the diagnosis is made after checking the x-ray, definitive treatment can be started. It is also important to monitor her blood oxygen levels in hospital. Everything can be done easily once she goes to hospital.


key: Patient
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Hello doctor, My 21 months old daughter has scratched herself near her clitoris and I was wondering what is the best action to take or remedy is. Please advice.


key: chroma:document
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Hello. The best thing to do would be to clean the scratch with lukewarm water, dry it and then apply ointment Soframycin locally over the scratch. This application to be repeated thrice a day and it should heal in next 48 hours. Also, it is important that she does not scratch again over it and hence a befitting diaper or small lower can be worn.


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Q. I have taken Invega and it caused erectile dysfunction. When will my body return to previous state?


key: Patient
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Hello doctor, I took Invega for one week. It changed my nervous system and caused erectile dysfunction. My question is, will my body return to their previous state? My movement is not as fluid, and I still have mild erectile dysfunction. Has Paliperidone caused permanent damage to my nervous system?


key: chroma:document
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Hello. I agree with you on the fact that this drug can lead to erectile dysfunction as a known adverse effect. On the other hand, this adverse effect is not permanent, and it is reversible after stopping the drug. So, I do not think that it has lead to any permanent damage. It is just a matter of time, and your situation will improve spontaneously. In the meantime, I would recommend trying Cialis (Tadalafil) or Viagra (Sildenafil) to improve your situation. 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, My baby is 3.5 months old. In my house, they are saying to give urai marundhu is it safe to give? As my daughter is licking her fingers, my mom wants to keep castor oil or neem oil, is it safe to keep it on her finger?


key: chroma:document
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Hello. Urai mathirai or marunthu is safe but advisable only after six months. In case of emergency, you can give within six months. Kids will not lick their fingers as they tend to suck only. Either the kid needs milk, or it may feel insecure in the prolonged absence of mother say more than half an hour. It is a normal phenomenon, so do not worry about that. Do not keep neem oil at this stage.


key: Patient
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Hello doctor, My eyebrow hair root is very weak. After washing my face with water, and after wiping it with cotton cloth, I find 5 to 10 eyebrows are falling daily. Please suggest me treatment (medicine or capsules or oil) for firm eyebrow root.


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Hello. I understand that your problem could be disconcerting and it can be resolved. Do you have dandruff or any other issues over the scalp or your eyebrows? If so, treatment should be directed at that. Also, please attach a photo of the same taken in bright light and sharp focus. We can decide on the appropriate treatment based on the above.


key: Patient
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Hello doctor,I always have dry, sensitive, and irritated skin. My entire life, I have been severely allergic to all nuts and tree nuts. I also have a small allergy to coconut. I notice that all of the skincare products and shampoos I have contains Cocamidopropyl betaine or coco-glucoside in them, which are derived from coconut. Should I discontinue using these products?


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Hello. Allergies are the condition in which your immune system becomes hypersensitive to foreign particles or substances like pollens, dust particles, mites, pet dander, some foods, and medicines, etc. Your immune system is a protective barrier to allergens, which causes harmful effects to your body. So you should be aware of this and try to know elaborately about those factors or allergens which causes itching, trouble, irritation, and red patches, etc. In this situation, you should avoid or protect yourself from those allergens which aggravate the symptoms mentioned above. As well as there is a need to improve your immunity. To do this, you should take Haridrakhand 3 gm with warm milk before the meal and do regular pranayamas like Anuloma Viloma, Nadi Shodhana, and Bhramari.


key: Patient
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Hello doctor, I had a sexual encounter before 11 days. She gave me only a hand release and used her finger on my prostate with a glove on. After a day, I started urinating extremely and frequently. No burning with urination but after urinating, there is a slight burning sensation in my penis, and outside of my anus. This burning occurs mainly while sitting down. I do not frequently urinate anymore, but I still have the slight burning sensation after urinating and while sitting. I got tested for STD, and it was negative. My doctor prescribed me Doxycycline before three days. There is no noticeable difference yet.


key: chroma:document
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Hello. You have acute prostatitis. This could be due to various reasons including retrograde ejaculation, delayed hypersensitivity to the gloves used or bacterial infection. Was your semen or urine tested for a culture?


key: Patient
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Hello doctor, I am a 60-year-old male and I am not sexually active. After masturbation, I use a moisturizing lotion. I developed a sore on the shaft of my penis. It is not painful and does not itch, but there is a slight awareness of sensation. This could be due to the bump catching friction as opposed to the smoother areas. In my lifetime, I had an occasional clogged pore or pimple when I was a virgin. I had examinations and never been diagnosed with an STD or genital warts.


key: chroma:document
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Hello. I understand your concern. Please send the photographs not as collage, but as separate files. It is difficult to appreciate the morphology like this in a collage (attachment removed to protect patient identity). You can send one photo of each of these days separately.


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Hello doctor,I am a 22 year old female. My height is 163 cm and weight is 60 kg. I intend to take on paleo. Please give me your suggestions. I am a vegetarian. If I am eligible for taking paleo, then please give me a diet plan. I have attached my reports for your kind reference.


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Hi. I have gone through your query and reports (attachment removed to protect patient identity) with diligence and would like you to know that I am here to help you. I welcome you to low carbohydrate high fat lifestyle (LCHF). For further information consult a paleo diet specialist online -->


key: Patient
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Hi doctor, I have been following paleo diet for the past 20 days. I have attached my reports here for your reference. Kindly review my report and let me know your feedback.


key: chroma:document
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Hi. Chickenpox and shingles are caused due to the same virus. Chickenpox occurs first and the virus stays dormant in the dorsal ganglia of the spinal nerves. After years or when immunity decreases, the person gets an attack of shingles. Most people get shingles only once, but few can get 2 to 3 times. After shingles no one gets chickenpox.


key: Patient
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Hello doctor, I am a 50 year old male. My height is 5 feet and 10 inches, and my weight is 260 lbs. I am in good health with excellent vitals. My blood pressure, sugar levels, and cholesterol are in exceptional range. I have never been on any prescription pills. All of my routines have been normal and regular and I am currently working on continuing to lose weight by adjusting the intake of calories, but still eating the full range of foods. It has been a safe and gradual process and I am down by 35 lbs over the past two years. I do not exercise now, but I stretch every morning for about 20 to 30 minutes. For the last week, I have experienced pangs of intermittent pain in my lower right side. I would approximate the feeling to be about 2 inches inside my side and just about at the lateral side of my body, perhaps a bit more towards the back. The pain is not acute, nor persistent, and it seems more present once I wake up. It does not bother me at all during the night. My own research does not seem to align with appendicitis or something abdominal, and I am beginning to believe it is a temporary muscle spasm of sorts, primarily due to a lousy work chair which has been a recent change. Again, all bodily functions are normal and I have not had headaches or fever or pain of any kind elsewhere. It is localized and randomly repeats only in the lower right, internal area I have described. I would like to know what is on the field of considerations, serious to not, so I can assess the next steps.


key: Patient
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Hello doctor, I experienced spotting in the last week for three days. It was a small amount of spotting discharge, which was brown with a bit of red. I did not get my period on the actual date. May I consider the spotting as my periods? But it was not the usual amount of bleeding as I have in my period. I only used a liner with it and not may napkin pad.


key: chroma:document
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Hello. Your spotting for the three days cannot be considered as the menstrual period. The usual amount should at least be at 80 ml per cycle, and that would approximate at least 10 moderately soaked pads. Some possible causes would be a hormonal disturbance, and this could vary as far as pregnancy, and hormonal imbalance is secondary to stress, weight loss, current illness, etc. I would suggest you to have a pregnancy test first if it is negative, then you may opt to observe until the second week of next month. If there is no period still, you need to consult your gynecologist to help you with the diagnostics such as transvaginal ultrasound and if no other causes, she may prescribe you with pills to regulate your period back. Hormonal imbalance.


key: Patient
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Hello doctor, I am six months pregnant. I have swollen feet and ankles. It hurts when water runs over them. I also have lower back pain and some dizziness. Kindly help.


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Hello. A pregnant woman usually has edema (swollen lower extremities) especially if she has been standing quite long. However, it is never tender but just heavy. It spontaneously resolves when she places her feet at least two pillows higher than her body or only by little elevation. In your case, we must rule out the possibility of cellulitis. Its is a condition such as how you described, swollen feet or ankle, usually pinkish or erythematous and tender to touch, sometimes warm to touch. Your symptoms are not the usual finding on a pregnant woman and must be seen immediately at the emergency room to give you first aid of a possibility of infection. It is also best that you have your blood pressure taken since the pregnant patient with edema usually has elevated blood pressure.


key: Patient
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Hello doctor, I am a diabetic taking Glimepiride and Metformin. I have developed a kidney stone measuring 1.6 mm and the doctor has advised for a surgery. Is there any non-surgical management?


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Hello. I have seen your report (attachment removed to protect patient identity). It is unlikely that 1.6 mm Kidney stone will come out on its own. You require surgery. There are many options like URSL and PCNL. Which option does your doctor prefer? For more information consult a urologist online -->


key: Patient
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Hello doctor, One week before three kidney stones came out, and I have a burning sensation while urinating after that. I went to the doctor he took some test and told that my creatinine level was 1.6. Is it dangerous? I have hypertension and my value is 150/100.


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Hello. Based on your history you might be having a urinary tract infection. Urine infection is a known complication in patients with urine stones. Do you have other complaints in addition to burning sensation like fever with or without chills, abdomen pain, vomitings, and blood in urine? The rise in creatinine in your case can be due to a pre-existing renal disease due to hypertension, or the current urinary tract infection may also cause this. I advise you to get, 1) Complete urine examination for any urinary tract infection. 2) Urine culture and sensitivity to identify the specific organism causing infection and antibiotic sensitivity. 3) Ultrasound abdomen to look for any urine stones still present. 4) Complete renal function test. 5) Complete blood count. You are welcome back to me with any further queries.


key: Patient
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Hello doctor, My daughter is 4 months old. She is suffering from loose motion for the last two weeks. The doctor already prescribed antibiotic Cefixime, but the condition is not much improved. Now she is pooping six to seven times daily, which contains mucus and color is green. A stool test shows 25 to 30 pus cells. Please advise us what to do?


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Hello. I advise you to continue breastfeeding and prevent dehydration. It is unusual to have bacterial diarrhea in a four-month baby. Are you giving any top feeding? I mean other milk apart from breastfeeding like bottle feed? If yes, then please stop and give exclusive breastfeeding till six months of age. Please repeat stool test for reducing substance if possible. Have you given the rotavirus vaccine? Follow-up with the report. If you feel that she is sick, irritable, not taking feeds or not passing urine or anything unusual, then please visit a pediatrician as soon as possible. Stool for reducing substance. Dysentery or rotavirus. Econorm sachets one (Saccharomyces boulardii) BD (twice daily) for three days, syrup Zinc 2.5 mg once a day for 14 days, and ORS (oral rehydration solution).


key: Patient
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Hello doctor,I am 35 years old. I have the symptoms of a urine infection. But five days after the beginning of the symptoms, I got a urine test, and no bacterial infection or STD were detected. I did an HIV test, which was also negative. The pain is reducing slowly, but I am still not back 100 %. I have no sex envy. What could this be? Could this be a chemical infection or allergy from using hydroalcoholic solution wipes or shampoo on the penis? Could this be a prostate issue?


key: chroma:document
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Hello. By your description, it appears that you are having pain while passing urine. It could be due to infection, stone or simple inflammation. Urine shows bacteria only in case of infection. In the case of stone disease or inflammation, one can find red blood cells or white blood cells respectively. If you are getting relieved gradually with the treatment you have obtained, no need to worry. If you do not have relief even after five days of symptomatic treatment, kindly consider getting an ultrasound abdomen and pelvis with post void residue, which can identify a structural lesion such as stone.


key: Patient
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Hello doctor, My fasting sugar result was 87, and postprandial was 61. Why is it so? I had a usual breakfast, including carbs with some amount of protein. What could be the possible reason? Also, I struggle a lot with weight loss.


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Hello. A slight variation in fasting and PP (postprandial) glucose levels can occur. It is not unusual. Please tell me with the value 61 with food, did you have any symptoms of hypoglycemia? This looks like reactive hypoglycemia, which tends to happen in persons with excess weight plus when one takes too much of sugary foods or drinks like aerated drinks, juices, etc. With a BMI (body mass index) of 33.57 you are already close to grade 2 obesity. Your ideal body weight should be 65 kgs, which means there is an excess of almost 30 kgs. This is one of the reasons for reactive hypoglycemia. It is also an indicator of future development of diabetes. So avoid sugary foods, juices, and sweets. Take a healthy diet, plus make serious efforts to reduce weight. Also please check your thyroid functions.


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Hello doctor, I have an abscessed tooth and have been on antibiotics for three days. I woke up this morning with an extremely swollen face, should I go to the ER?


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Hi. I have gone through your question and I can understand your concern about your toothache and facial swelling. You need IV (intravenous) route antibiotics like Ceftriaxone one gram after allergic test and for that, you must visit either a dentist or an emergency room. After your infection is over either get your teeth root canaled or extracted as per the condition of the tooth and your choice. Grossly decayed tooth. Cellulitis. Periapical periodontal abscess with related space infection. IV route antibiotics after test dose for allergic reaction. Root canal treatment or extraction.


key: Description
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Q. Noticed redness, swelling and pain in the arm after popping a blister in a Meth addict. What to do?


key: Patient
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Hello doctor, My husband is 36 years old. He is fit and healthy, rarely gets sick. But he is a Meth addict. He missed the vein when injecting in top part of his wrist. The injection site looks like a small ant bite. It formed a water blister that he popped and put Neosporin on. But his hand is red, swollen, throbbing and warm. He is in agony. He refuses to go to the ER. Is he in danger of dying? What should I do? How can I treat this?


key: chroma:document
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Hello. This looks like a cellulitis (attachment removed to protect patient identity), it is an infection of subcutaneous tissue. He needs antibiotics and blood test. Convince him for visit. He will need a hemogram test, and blood culture to look for the extent of infection. In treatment, he will need antibiotics like Amoxicillin Clavulanate combination 625 mg three times a day along with some antacid like Pantoprazole 40 mg once a day. For pain and swelling, you can continue Ibuprofen, you can use Magsulf ointment for local application for swelling. He will need higher antibiotics as it appears severe cellulitis. So my advice is to visit ER soon.


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Hi doctor,My 8 year old daughter has had quite severe stomach pain since three days. It started in her naval and now in her lower abdomen on the right hand side. She has had on and off low grade temperature and nausea. She has pain in her legs and some pain in her back. Also she has lost her appetite. We have been to our GP who sent us to our local hospital and they discharged us after blood tests were normal. She did have white cells in urine, and told us to come back if she was in agony. She is still having pain and has temperature. My dad is a retired GP and thinks that the pain is where her appendix are. Should I go to another hospital to scan her to make sure? I do not want to leave this to get it worse. I would appreciate your advice. Thank you.


key: chroma:document
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Hi. I can understand your concerns. Revert back with the report to a child health specialist online -->


key: Patient
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Hi doctor, I am a 15 year old female and have been having RLQ pain for nearly five months. I am physically fit. I do exercise at least six days a week and eat quite healthy. I have a sharp stabbing pain at McBurney's point. I also feel immense pressure at my RLQ like someone is sitting on my stomach constantly. I had an ultrasound to find appendicitis. But, they found enlarged lymph nodes and said they would become normal soon. I did not have cold or anything in the past two to three months before this happened. It stopped hurting for about three days and then started hurting again, this time without the pressure. Within the last two weeks it has become worse than ever it hurts. I am always feeling nauseous, even when it is not hurting. It hurts daily and sometimes causes me to double over for 10-15 seconds. It has nothing to do with monthly cycle at all and does not seem to react with food. This Monday morning I had to stop my fitness training as it was so bad and could not complete the session, which is very unlike to me as I enjoy fitness. I have had two ultrasounds and could not find appendicitis or anything else wrong. Also, I have had two blood tests done for appendicitis and that showed slightly higher amounts of white blood cells, but that is not enough for doctors to diagnose as appendicitis. I went to ER at 3 AM; they did more bloods and sent me home about three months ago. Could this be chronic appendicitis? I do not know what to do and the doctors seem to think that I am making it up. Please help. Thanks.


key: chroma:document
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Hi. After reading your well presented history, I think the following are the possibilities. Urine for microscopy and routine pus cells and crystals. Use proton-pump inhibitors for some time and observe for any relationship between vigorous exercise and pain. Revert back with investigation reports to an internal medicine physician.--->


key: Patient
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Hello doctor, I am a 28 year old female. Whenever I have indigestion and gas formation in my stomach, I feel pain in the right side of my stomach. So, I did a whole abdomen USG. It shows appendicitis. I did blood ESR test also. Attached are the reports. As per my doctor's suggestion, I am having below mentioned medicines for one week. Folcovit (once a day), Tibrolin (thrice a day), Pan D (once a day), Zocef CV 500 (twice a day). So, I want to ask, whether these medicines are sufficient or not? Do I need to have surgery?


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Hi. I had seen your report (attachment removed to protect patient identity) and CBC (complete blood count) is not showing any shift to the left or high total count. You have mild appendicitis infection. For that, medical management will be beneficial. You have been prescribed antibiotic course and probiotic and antacid. Complete the course of prescribed medicines. Your prescription is correct as per mentioned history and report. For more information consult a family physician online -->


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Hi doctor, I am suffering from malabsorption. All my tests are normal. But, my radiology result reported appendicitis. Can appendicitis cause malabsorption?


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Hello doctor, I am a 55-year-old male. Routine CBC report shows hemoglobin 17.1, hematocrit 51.5, and platelets 255 (up from 201 last year). Should I be concerned about PV?


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Hello, Welcome to the icliniq.com. In polycythemia vera, hemoglobin level is usually more than 17.5, and hematocrit is more than 55. So you need not concern about polycythemia vera. The chance of secondary polycythemia also seems to be very less. So you need not worry about your CBC (complete blood count) result as per my opinion. If you have a history of persistently elevated hemoglobin for a long time, then only further investigation is needed or else do not worry. You can attach your reports to guide you further. I hope I have answered your question.


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Hello doctor, Three and a half months ago I started with numbness, burning and tingling on the left side of my face. I had been very sick with a chest cold. One week later I had blisters on my upper left palate, I went to the doctor and she said definitely shingles. Now l never had any pain or sensation really in my mouth or on my palate. The blisters did run liner towards the back it was not like a typical cold sore cluster. Now I do get cold sores once in a blue moon on my right side lingual gum and palate. I am still having numbness and tingling. So now my doctor thinks it may be trigeminal neuralgia and never was shingles. I am a healthy active 39-year-old woman. I am looking for a second opinion.


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Hello. You should know that trigeminal neuralgia is a common complication of shingles or herpes infection. As blisters appeared the first time, it means that the herpes infection was present (probably HSV1 (herpes simplex virus, which is typical in this region). It is quite common to have symptoms before the blisters appear. The fact that the numbness persists, it means that the trigeminal nerve remains irritated by this past infection, causing the trigeminal neuralgia, although less typical (trigeminal neuralgia is typically associated to short periods of shooting nerve pain, alternated with persistent numbness in the same region). Anyway, I would recommend performing IgG and IgM for HSV1 virus and also a brain MRI study. For more information consult a neurologist online -->


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Hello doctor,I am a patient, age 30, with Crohn’s disease. I take Humira and recently had a flare up, thus started a round of Prednisone to get through the flare-up. The combination of Humira and Prednisone has resulted in shingles. I saw a dermatologist who prescribed Acyclovir. I was six days into the shingles before realizing I needed to see a dermatologist. I have been on Acyclovir for two days and have not seen the shingles spread. Can I go for a trip?


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Hello. I went through your post. Shingles involve a single dermatome. So, it is unlikely going to spread and will heal completely in two weeks. Prednisolone is a steroid and can cause reactivation of Shingles. So you need to take Acyclovir at least for one week and continue Prednisolone and Humira (Adalimumab) until your IBD (inflammatory bowel disease) goes in remission. Then you can slowly decrease the dose of Prednisolone and finally take it off. You can go on a trip.


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Hi doctor, I am a 41 year old male. I am a non-vegetarian and intend to take paleo diet. For the last 20 years, I have been having IBS symptoms, sinus, ringing in ears, extreme anxiety, depression, respiratory allergy to dust and smell, muscle tension around nose and rectum, bad breath, stomach getting too full on eating, smelly outer ear, etc. Before 15 years, I had seizure once. 5 years before, I was diagnosed as having NASH, GERD, Lax LES and high cholesterol. I am ex-smoker, quitted 6 years ago. The treatment so far has been unsuccessful and I am currently on no medication. I had health check up a few days before and attached the report here. Please advise on the following. What should be my paleo diet? Does the report provide any clue to the symptoms I have experienced so far? I can see positivity for anti-CCP in my report. Do I have any serious medical condition?


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Hi. I have gone through your query with diligence (attachment removed to protect patient identity) and would like you to know that I am here to help you. Welcome to low carbohydrate high fat lifestyle. From your report, you have the following problems: I would suggest the following treatment for you. Consult your specialist doctor, discuss with him or her and take the treatment with consent. Your paleo diet should be as follows: For further information consult a paleo diet specialist online -->


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Hi doctor, Today I am in the 48th day of my cycle. I have PCOS. Still I did not get my periods. I took HPT on 45th day. It was negative. Tomorrow I am planning to take blood test. Currently I am taking Glycomet 500 mg. Is there any chance for positive blood test? Is HPT accurate? Suppose if I get my periods I am planning to follow paleo diet. Is paleo diet recommended for PCOD weight loss?


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Q. How long are knee and shoulder growth plates expected to be open following the closure of hip growth plates?


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Hello doctor, Is it possible for the knees and shoulder or spine growth plates to be open, once the hip and ankle growth plates have closed?


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Hello.  It depends upon the age. Because on an average if the hip and ankle growth plates have fused then the knees, shoulder, and spine follow it and close in the next six months of the onset of fusion of the hip and ankle growth plates.


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Hello, Welcome to icliniq.com. A few months ago, I went through a hard time, and since then, I have thoughts about death every day, all the time, which makes me depressed and anxious. I went to a psychiatrist and I was given Trintellix for depression treatment. I was on 10 mg for two weeks and have now been on 20 mg for a few days. It worked well for my depression, but I still suffer from anxiety and continued thoughts about death (though not suicidal). Depression is gone now, but I still have negative thoughts daily. Do you think my antidepressant is enough to treat anxiety, or do you recommend any medication specifically for anxiety?


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Hello. You should wait for about two more weeks to see the best effects of medicines. In most cases, typically antidepressant drugs show results in around four to six weeks. Since your bad thoughts about death are controlled, but you still have negative thoughts so in such case you should stick on this drug for a few more days and it will work. If symptoms persist, then the dose should be increased, or medication should be replaced. Consult your psychiatrist for this.


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Q. I did not follow drugs as suggested by the doctor for abortion. Will it lead to infection or infertility?


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Hello doctor, I had an abortion a week ago, and the doctor suggested me to take two pills at a time, but I have taken one tablet at each time. Will I be having any problem in future like infertility or infection? Will my uterus get cleaned due to this?


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Hello. The question is not entirely clear. Have you already aborted or yet to bleed, and what is the name of the pill? Any pill used for abortions are safe and have to be taken in full and advised doses to get the best results. They never affect the uterus adversely. They are usually hormones, so do not stay in your body beyond the particular cycle. They do not affect your health or your future fertility potential or future pregnancies. You will continue to have periods, as usual. You can have a normal sexual life, and healthy pregnancies in the future. If bleeding has stopped, have a pelvic scan to confirm if the uterine cavity is empty or any tissue is left over. I hope I have clarified your query, do write back if any more questions, and for your feedback.


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Hello doctor, He is 30 years old, and his height is 6ft. Gondotropin levels show moderate testicular failure, but no treatment was given. We had a micro TESE done for him, and no abnormalities were found. What does it mean? Should he have received medication to support this?


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Hello. I have gone through the reports (attachment removed to protect patient identity). The sperm analysis shows azoospermia (complete absence of sperm from the fluid ejaculated during orgasm) and testicular failure. If even after Micro TESE (testicular sperm extraction) testicular biopsy, there has been no sperm seen, and there is no blockage disorder either, then his chances of contributing to natural or assisted conception are grim which means that testis is not producing any sperms and have gone in failure. The next chance would be to opt for donor sperm, and IVF (in vitro fertilization) followed by embryo transfer to conceive.


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Hello doctor, I had forced gay sex before 17 days. I had an HIV rapid test after six days of having sex, and the result was negative. Am I prone to HIV and STD's? How long it takes to detect HIV and STD in urine test after exposure?


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Hello. Good, you have done a rapid HIV test, and it is negative. But normal results are negative. This means that no antibodies were found and that you may not be infected with HIV. Most people who become infected with HIV will develop antibodies to the virus within two months. During this time, you may have an HIV test, but this test cannot detect it. You will have to repeat the test more than three months after your possible exposure if your results are negative. Better do ELISA (enzyme-linked immunosorbent assay) for HIV, and VDRL (venereal disease research laboratory), TPHA (Treponema pallidum hemagglutination assay), and HBsAg (surface antigen of hepatitis B virus) for STD. If possible, investigate your sex partner also.


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Hello doctor, I am a 54-year-old woman. Around four to five months, I have been experiencing heavy hair fall in the frontal and lateral region. Since the past one year, I am also experiencing thyroid conditions (hypothyroid 6.40) along with stress and menopause (menopause onset was seven months before). I can notice new hair follicles but very less in number compared to hair fall (more than 100 at times). I have taken multivitamin tablets for a month. Now, I am taking menopause tablets. I have been applying onion, aloe vera, and ginger oil for the past two to three months. Also, I am consuming yogurt, milk, dry fruits. Kindly suggest some measures to arrest the hair fall and initiate hair growth. Also, suggest dietary restrictions and additions if any. I am a housewife and mainly do household chores, though nothing significant.


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Hello. I understand your concern. Thyroid issues and stress causes hair to fall. Please send me images of your scalp to assess your hair loss better and help you accordingly. Meanwhile, you can start using this. Kindly consult your doctor to discuss and take the treatment with consent. 1. Anaboom anti-hair fall serum on the scalp once a day. 2. Tablet Keraglo Eva once a day. 3. Keraglo-AD shampoo thrice a week apply on the hair for 10 mins and wash off. Also, get the following tests done 1. Hemoglobin. 2. Serum ferritin. 3. Vitamin D levels.


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Hello doctor,I am suffering from an epididymal cyst in my left testis. Large anechoic cystic lesion of size measuring 1.61*2.05*4.41 cm, vol 7.62 cc in the head of left epididymis. And my right epididymis is thickened and inflamed. Is it possible to cure both without surgery?


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Hello. I can understand your concern. There is a possibility to remove anechoic cyst naturally. You can take the following medicines. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Vridhivadhika Vati 1tablet, Kanchanara Guggulu 1tablet, Gokshuradi Guggulu 1 tablet, and Chandraprabha Vati 1 tablet twice a day after meals. 2. Varanadi Kashayam 15 ml twice a with an equal amount of water before meals. Avoid spicy and fried junk foods. Drink plenty of water. Take these medicines regularly for one month.


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Hello doctor, I have a positive UPT and my LMP is 31st March. I have an irregular period at 13th May and I found some blood spots. After that, I go for a TV ultrasound that shows no definite gestational sac, endometrial echo is central and normal in thickness and measures 0.6 cm. Before TV ultrasound, on 8th May, I checked my beta hCG and it is 178 and after 48 hours it is 247. Is this miscarriage or should I go for another ultrasound because after that I do not have bleeding or cramps or anything? Please guide.


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Hello.   I have gone through the description you mentioned and understand your concern totally. But the details are a little confusing, it would have been good if you could give details with dates when beta hCG (human chorionic gonadotropin) was checked. I understand that scans were performed and the beta hCG test on 8th May is 178 and on 10th May it was 247. On 13th May you got the scan as you had a spotting, right? See, as your previous cycles have been irregular, it is difficult to predict when you would have ovulated exactly. So we cannot go by your dates to calculate the duration of the pregnancy. May I know when did the urine pregnancy test turn positive for the first time? It would be advisable to recheck your urine pregnancy test now again, as you had spotting, if the levels are falling then it would be suggestive of a miscarriage, and mostly this could be like a biochemical pregnancy, where pregnancy is detected only in the blood tests, but on the scan I cannot find the gestational sac development, which has ultimately got aborted. (As levels you mentioned last were pretty low). Another possibility to be ruled out, more importantly, is ectopic pregnancy or pregnancy at some unknown location. To rule out all these, doing a serum beta hCG will clear your doubts. Serum beta hCG level. Repeat ultrasound after checking the beta hCG value. Report to your gynecologist if you have any sharp pain.


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Hello doctor, I have got my urine pregnancy test positive five days before. My last period was in the mid of last month. I have taken unwanted 72 after 11 days of my periods, but there may be some contraceptive failure. I consulted my medical friend, and she suggested me about medical abortion and prescribed Clear kit. So yesterday morning I have taken Mifepristone and today in the morning I have taken one tablet of Misoprostol as guided by her. But it is around four hours after taking medicine, but still, there is no bleeding. Now even three tablets are remaining. Please help me.


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Hello.  Let me start by giving the right schedule for MTP kit. Mifepristone 200 mg orally single dose, will dislodge an embryo from the uterine lining. This will have some gastric problems but no bleeding. After 48 hours of this oral pill, place all four tabs of Misoprostol 200 mcg each at a time vaginal, after wetting it properly in water. Or you can have all four tablets orally at a time. This will soften the cervix and also make uterus to contract. Now you will have pain and bleeding. Complete expulsion will occur within four to five days of Misoprostol. Now you can keep those remaining three tablets vaginal after two days in the morning time. Do not worry, and it will not fail. I hope I have clarified your query, do write back for your question and feedback.


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Hello doctor, I had unprotected sex with a girl, but a sperm has not come because I was inactive as I have drunk. This happened last month. After 23 days, I had RNA PCR, and ELISA both came negative. Then after 7th week, I had antigen, antibody test, which came back negative. In the 10th week, I went for Elisa test 0.4, and it was non-reactive. After completion of the 11th week, I went for Tri-Dot and that also came negative. Should I wait for one week, or is it sufficient for me? Please help me to come out of this situation.


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Hello. Guidelines says that you should repeat the test after 12 weeks of exposure, but because you have undergone test many times, you are almost sure that you do not have HIV. But it is better to repeat once after 12 weeks. You need not be anxious as most likely it turns to be negative as there is no hint of any symptoms and on previous test results.


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Hello. The size of the penis has no roles in sexual intercourse. Even a person with a small penis but good erection can satisfy any girl. Only a few centimeters of the vaginal wall has sensitivity. What is the size of your penis? If your erection is normal, then stop worrying for that. Jelqing is a home-based exercise that can be utilized to improve the size. The exercise is done in the semi-erected penis and some good lubricant can be used during this. Milking like action is done from base to tip in semi erected penis and this is repeated for around five minutes. This should be done 2 to 3 times a day and if done properly this provides good results. You can learn about this from the internet too.


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Hello doctor,One of my friends wants to use Dexona and Practin to gain weight. Can she use it for 10 days?


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Hello. Using Dexona (Dexamethasone) and Practin is not a correct drug for weight gain. Dexona is a corticosteroid hormone (glucocorticoid) used for arthritis, blood, hormone, immune system disorders, allergic reactions, specific skin and eye conditions, breathing problems, certain bowel disorders, and certain cancers. Practin (Cyproheptadine) is an antihistamine used to relieve allergy symptoms such as watery eyes, runny nose, itching eyes and nose, sneezing, hives, and itching. So these are not for weight gain.


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Hello doctor, I got an impacted wisdom tooth removed a week ago, I am still in a bit of pain and cannot open my mouth wide without a lot of pain and today I keep getting like pinching feelings in my temple, ear and neck on the same side as the extraction and I have bad breath and a yellow tongue and spitting out yellow stuff when I rinse my mouth. It worries me.


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Hi. This is a case of post-extraction trismus which occurs either due to traumatic extraction or wrong injection techniques. First of all, I do not know how much you open mouth, it would have been better if you can send photograph with open mouth at highest. Coming to your problem, you need to take muscle relaxants for one week like Zerodol MR (Aceclofenac with muscle relaxant) twice daily. You are required to do some exercise like placing ice-cream sticks between teeth till gap is closed. It must be repeated two to three times daily for same period. However, if there is a very small mouth opening and you are not able to eat, then you need to consult oral medicine specialist for mechanical opening of the mouth.


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Hello doctor, I had a 4.4 PSA and had an MRI that was negative. Six months later my PSA is 5.7 and even though the MRI was negative it is suggested that I should have a prostate biopsy. I am a 73-year-old male. I am certainly not that excited to have a biopsy. Any thoughts?


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Hi. I can understand your concern about undergoing an invasive investigation without any symptoms. Let me explain you what does PSA suggest. Basically, PSA is secreted by the prostate as well as some other body tissues. It does not reach circulation and hence remains low in blood as long as the barrier between prostatic tissue and blood vessel is kept intact. Rising PSA is a sign that there is some tissue alteration which has resulted in breach of this barrier. Hence, do not be under the impression that rising PSA always means malignancy. But it is better to confirm the absence of malignancy by biopsy as, at a PSA level as low as 5.7, even in a unlikely event of report being malignancy, the chances of organ confined lesion is very high, which is easy to treat and chances if cure are high. Hence, it is better to undergo biopsy and get your fears allayed. As such, the biopsy is a very small procedure and safe in experienced hands. Wish you a safe biopsy and I hope the results will be benign.


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Hello doctor, Recent health check (which I do it by myself routinely and I do not have any diabetes, BP or any other disorder), I found abnormal values of the following hematological parameters, Hb- just normal, RBC- low, MCHC- low, MCV- high (lab has marked all the last three items under bold). Liver , kidney and other blood parameters are normal. Cholesterol- normal, except TGL, which has slightly gone up. My age is 53, BMI- 23, active and fit. Kindly advice whether I need to worry. Even two years back also the parameters RBC/MCV/MCHC were marked as abnormal which now I have noticed.


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Hello. I have checked your attached reports (attachment removed to protect patient identity). Your hemoglobin level is within normal range. So you may need not to worry about that. You need not worry regarding slight low red blood cell count. For slight high MCV, you can investigate further with serum B12 estimation. Your triglyceride level is slight high. For that you can continue with prescribed medication that is Atorvastatin. So finally you need not worry regarding your all attached reports as per my opinion.


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Hello doctor, Is my throat swab wrong? Do I have MRSA? There is lymph node swelling and cobblestone appearance from 5 to 6 months. Tried different antibiotics but were not helpful.


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Hi. It is not MRSA at all. It is a staphylococcal infection (attachment removed to protect ptient identity).


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Hello doctor, I am suffering from chickenpox scars since childhood as it left so many marks and holes on my face. I need some suggestions to get rid of it. Please help.


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Hello. I understand that the chickenpox scars have been disconcerting to you. The treatment approach would depend on the depth of the wounds. Very deep scars would need a procedure like dermabrasion. For superficial scars, you can try Tretin 0.025 (Tretionin) cream daily night. Apply it in small amounts and very lightly over the scars, daily night for two months. It will not lead to a 100 % reduction in the scars, but it would gradually make the scars less visible by tightening the skin. If you are not satisfied with the results after two months, consult a local dermatologist for dermabrasion.


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Hello doctor, I have had heart palpitations for two weeks. 3 to 6 times a day. Feeling of one hard heatbeat. I bought a holter monitor and catched it today. Seeking advice.


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Hello. This is an atrial ectopic or extra beat in other words. These occurs intermittently, so, ECG may be normal in between. These are not worrisome usually and most of the times without much significance. However, we need to rule out the possibility of structural heart disease before calling them benign. So, echo should be obtained to rule out possibility of structural heart disease. Also, thyroid problems can cause these, so thyroid profile should be obtained. Also, too much coffee, sleep deprivation, stress, alcohol and other addictions may cause those, so should be minimized, if any. If too frequent and symptomatic, then one can have beta-blockers medicine like Metoprolol which suppress these. Otherwise these settles with time.


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Hello doctor, I have fever and leg pain since last night. I had preauricular sinus infection pus drainage three weeks back. I was on different antibiotics for the last 45 days. Taxim O, Centil, Augmentin, and Lizobact 600. I stopped taking them two days back.


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Hello. I have gone through your query. As per your query, you have taken multiple antibiotics for a long time which is not good. I need to know whether you have done a culture sensitivity test for the pus draining out of the sinus or not, because if you take antibiotics according to the culture then chances of recurrent sinus infection and fever are very less. Can you send me the photos of your infected area (preauricular sinus)? Mostly pus discharging sinuses are caused by tuberculosis infection in most of the cases. In my opinion, you should go for a detailed physical and systemic examination along with some blood tests and chest x-ray. Also, if discharging sinuses is still persisting then you need to do a pus culture sensitivity test both for bacterial culture and Acid fast bacilli (AFB) culture and other advanced tests for tuberculosis. Now you can take tablet Paracetamol 650 mg whenever you develop a fever. Please do not ignore your problem as it can lead to deterioration of your health. I suggest you to consult a physician and get a detailed physical and systemic examination done and detailed evaluation along with the above tests.


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Hello doctor, My younger daughter was diagnosed with pneumonia when she was 8 months old. She is better now (11.7 months now). Her birth weight was 3.5 kg. And by 7 months, she was 6.9 kg. But due to this pneumonia attack she lost her weight and is now weighing 6.9 kg. Is it okay? Or is she underweight? What can be done? I am worried that she is very tiny. Does pneumonia cause weight loss?


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Hi. The weight is quite less for an approximately 12 months old child. Please start the child on Multivitamins like Calcimax P 5 ml twice a day and syrup Visyneral Z 5 ml once a day each for three months. Also, start the child on complementary feeds if not yet started. Get the child physically evaluated and probably basic blood tests have to be done to find out if currently there is any infection because of which she is loosing weight.


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Hi doctor, I have been on my period for 15 days so far, and I just noticed today when I pee it stings first and then goes away. I am a virgin. I also missed my period for a month or two before this occurred due to stress with classes.


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Hello. There is nothing to get stressed. You might be having urinary tract infection, which is very common in girls. You take care of your hygiene, especially during periods and frequent change sanitary towels and wash the area with plain water as many times as possible. Secondly, increase the intake of water and also take cranberry juice three to four times a day. It will help relieve the pain. If this pain does not get relied on by these measures, then you might need antibiotics to cure the infection. But, hopefully, these simple measures would work out for you. Hope it has helped you.


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Hello doctor,I have done PRK eye surgery about a month ago in both eyes. A few days later, my left eye had some weird blurred vision which turned out to be corneal ulcer that is in the center and relatively big. I got treated immediately with heavy antibiotics Ceftin or Vigamox. After two to three weeks there was some improvement in vision, redness and the loss of epithelial cells is about 1.2 mm, after which I started taking eye steroids, and vitamin C three times a day. Unfortunately, I found out today that there is another small epithelial defect that opened under the first one (both are still very small). I have bad light sensitivity, and I would like to know if there is anything to be done now apart from waiting to get better. I have been told to be patient at least three months since the scarring is still prominent and central, although it is getting slightly better every time I see the doctor. I am currently on, antibiotic eight times a day with steroids three times and Sythnomyine twice a day. Most of the scar is in the front stroma. But central, and it has been slightly getting brighter every time.


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Hello. Indeed a corneal ulcer requires patience, time, and continuous monitoring until it is fully healed or scar forms. Sometimes it might take up to a year and more. It is however mandatory that you add to the list of eye drops that you are using a lubricant (artificial tears) because dryness is inevitable after any refractive surgery and once you are using eye drops that contain preservatives. You can use the lubricant every hour if you need but except the last hour before going to sleep. That is also very important if your job includes intense visual activities at the PC and or use of mobile devices. I wish you a fast recovery.


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Hello doctor, I am wondering if there is any specific thing to look for on an EKG to show bifascicular block? I am trying to learn EKG reading and was wondering if you can help me.


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Hi. Look for right bundle branch block and axis deviation. If left anterior or posterior hemi-block is also present, this makes it bifascicular block. If AV block also, this makes trifascicular block. If left anterior and posterior blocks combine, it is called left bundle branch block, if left and right both bundles block, this is called complete heart block and third degree AV block. If you are a medical personnel, it is easy to understand, if layman, then it may take some time to get used to EKG.


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Hello doctor, I am wondering how serious is bifascicular block? Is it common among younger people? I am only 30 years old and this came up on EKG. I was very surprised as I live a pretty healthy life. Any ideas what caused this and what steps I should take next?


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Hi. I can understand your worries. It is not common in general population. It occurs mostly in those who have heart attack, angina, have high blood pressure or some valvular disease, especially aortic valve. Other cause is fibrotic degeneration of conduction channels, but it occurs usually in old age as age-related degeneration. It may progress slowly and lead to trifascicular block or complete heart block. Treatment is not advised if heart rate is normal. If in future heart rate decreases or block progresses than cardiac pacemaker may be necessary to implant. Risk of this condition is that if it is due to fibrosis, then it may spontaneously progress which may take years. Other risk is that if anytime in future you have angina or heart attack, then there are more chances of further progression of block as compared to those who do not have this block. I advise you to repeat ECG, have an echocardiography done to see valvular disease, if present, monitor blood pressure.


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Q. My father passes stools whenever he gets an urge to pass urine and antibiotics did not help. Why?


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Hello doctor, My father is 86 years old. He is a hypertension patient and on Metosartan 25 mg, Ecospirin 75, and Nexpro. For prostrate, he is on Maxvoid 4 mg for the past 10 days. He is complaining that while passing urine there is an urge and sometimes he passes stool. On medical advice, he took Imodium four tablets for two days and Ofloxin 200 mg for five days but still the problem continues. Please advice.


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Hello, Welcome you to icliniq.com. I can understand you must be very concerned about your father's health. Well I have reviewed his medical history, which he has been taking for hypertension, prostate, and recent use of antibiotics and Imodium. So typical symptom you mention that whenever he urges to pass urine, stools passes by itself which is suggestive of stool incontinence-means loss of control stools. With his age, it is possible that he has weak anal sphincter. The anal sphincter is a muscle around the anus which contracts and control the stool output. In older age, it become weak and lack sustained contraction hence get loosened. With every attempt to pass urine, which increases abdominal pressure, would also lead to evacuation of stools. This stool incontinence because of loose sphincter at times perceived as diarrhea, however, it is not actual diarrhea. For diarrhea, once has to have stool volume more than 200 ml/24 hour, and significant change in consistency of stools like watery stools, or greenish unformed stools containing food particles. If none of these signs which are suggestive of diarrhea I suggest you to stop Ofloxacin if given for perceived diarrhea. The drug he has been taking for prostate also causes external anal sphincter and hence partly contribute to his stool incontinence. I want to know if he is feeling mucus (thick jelly like material) in stools, blood in stools or rectal pain, or repeated visits to toilet when nothing comes out? This information is important to rule out any inflammatory process beside loose anal sphincter. I suggest you few investigation for stool studies, which will tell if he has active infection of bowel and if present can be treated with antibiotics then. For treatment he can take Imodium, two tablets thrice daily for two more days. Excessive use of this medication would cause constipation and can worsen patient discomfort. I want you to help him learn pelvic muscle strengthening exercises. There are many youtube videos available to learn how to do pelvic floor strengthening exercises while sitting on a common chair. Lastly biofeedback therapy which is a computerized software which help him to control his anal sphincter while passing urine or otherwise. This treatment is offered at physiotherapy department of a hospital. Avoid excessive fibers and modify liquids (1 to 1.5 liter maximum) intake in a day. This would reduce the overall bulk of stools formation in the bowel and hence decreased stool output. Stop or reduce alcohol intake if taking. This also causes diarrhea and loose sphincter controls. I hope this helps. Stool incontinence secondary to age with loose sphincter, plus drug side effect. Digital rectal examination (performed by gastroenterologist in person). Norectal manometry (not usually required if digital rectal examination is suggestive of the diagnosis). Stool detail report. Stool fecal calprotecin and stool for occult blood. Stool for ova and parasites. Stool for fat globules and reducing substance. Complete blood count. Stool incontinence secondary to older age and drug-related. Follow up to disclose other parts of history as mentioned above. Otherwise follow above regimen and see me in one week time after investigation.


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Hello doctor, I have white patch on my face. It was very pale but when I apply Fluticasone, it appears as white even my cheeks are rough and slightly depigmented.


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Hello. How long it has been there? What are the symptoms of it? Any other area affected? Any other family members affected? Any history of hypertension? Diabetes mellitus? Thyroid disorder? Any known drug reaction? Looking forward to your response in order to help you.


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Hello doctor, I got dog bite before 17 days, and the wounds are categorized as a category -II. Within an hour, I got a Rabipure vaccine and TT at the hip area. However, the next day morning, one more dose of Rabivax has been given in the shoulder and continued the schedule from the second day. My doubts are, 1) Will there be any side effect due to the extra dose given within 24 hours? 2) Will, it make any difference in giving, first-day Rabipure and subsequently Rabivax? 3) Is there any food restriction after a dog bite? 4) Do I require booster vaccination every year?


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Hello. Yes, there is no problem in injecting two dosages within 24 hours. Usually, the first, two shots are given after one another. Apart from that Tetanus toxoid is must that you have taken. It is not the case that the vaccine is ineffective. This is the usual protocol that is followed for safety concerns. Overall, five shots are given within one month. You do not worry but follow your physician. There is no restriction on foods provided as you are fine with your stomach. However, you should avoid intoxicated drinks like alcohol and other things. Vaccination is recommended for high-risk cases. You can get vaccinated that is for safety after year, and it is recommended in case of risks. Rest do not worry as the majority of the times dogs are not rabid, and you might be aware of that.


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Q. My wife had a C-section done and her RBC is 3. 54, and hemoglobin is 11. 4. Are these values normal?


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Hello doctor,My wife gave birth before nine days, and we did a blood test yesterday, and her RBC count was 3.54, hematocrit 33.3, and hemoglobin was 11.4. Is this a normal result considering she just had a C-section?


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Hello, Welcome to the icliniq.com. Her hemoglobin level is borderline, and there is only mild anemia. There is no need to worry regarding these results. I suggest you give her a healthy diet like more green leafy vegetables, pumpkin seeds, dried beans, and more fruits. There is no need for any medication for anemia just now. I hope this will help you. Let me know if you have any questions.


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Hello doctor, I am getting married three weeks from tomorrow. I am taking the Progestin only birth control pill as I cannot take the combination pill due to my migraines with aura. I talked to my gynecologist a couple of weeks ago to see if there is a way to adjust my period date so that I do not get it during my honeymoon. She told me to go off of my pill this week so that I will get it this week (which I did) and my period would not come for my honeymoon. However, I am certain that she told me the wrong dates as now I am right on schedule to get it again for my honeymoon. I am just wondering if there is anything I can do now. Would it work to go back in the pill for the next week and then go off again and get my period again so that I can push it back and I do not get it in my honeymoon? Or will that probably mess with my system too much?


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Hi. How are you doing? As you have already stopped the pill, you should be getting the periods any day next week. In that case, it was a right advise. Once you get the periods start the same pills again, without any break, till the date you want to postpone the periods. This will be a good cycle controller and a contraception. But, if you feel the periods are going to be delayed to the end of this month, then better start the same pill till the date you want to postpone the periods. Do not forget any pill in between or you will have periods in between.  Just for an information, migraine can be cured by clearing the cause. Noone has found the etiology of migraine. Predisposing factors are lack of good sleep, sleeping too late, using the screens with bright blue light at close distance for long (tab, mobile, laptops, TV, etc.), missing timely meals, sweating a lot, taking too much of physical or mental strain, etc. So trying to make few changes will relieve you of this migraine. You can even start on combined pills, which are more effective than these Progestin pills.


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Hello doctor, I am 17 weeks pregnant. In my USG report a blood collection is found of 52 mm x 20 mm at internal os. I am very worried. What is to be done with the problem?


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Hi. How are you doing? After 12 weeks pregnancy, the risk of bleeding is low. Only a bleed from the margins of placenta is to be worried about. Cause of this collection could be: 1. Erosion and thereby minimal bleed from the raw surface of erosion. There may be mild discharge with or without some altered blood. You can have vaginal antifungal or antibiotics like Cansoft CL or Candid V or Clingen Forte once at night for 5 to 7 days. 2. If you have had sex recently. Above medications can be used. 3. I hope cervical length is greater than 2.5 cm and internal OS is closed. If not, you may need a cervical cerclage stitch.  To be on a safer side, you can have:  A. Injection Proluton depot 500 mg IM once in two weeks for 1 to 2 months. B. Capsule Susten or Dubagest or Naturogest or Vagestone 200 mg twice daily vaginally for 1 to 2 months.  These both can be used simultaneously. They both are Progestrone hormone. They relax the uterus and if the blood has any chance to irritate the uterus, these two will stop it. So can prevent preterm labor pains. It is not easy to prevent pain once it starts, so better to use it before any risk factors. I do not think there is anything to worry, avoid any strenuous work, journey and sex.


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Hello doctor, Can you please tell me the difference between left and right bundle branch block? And why is left considered far more dangerous?


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Hi. Heart needs current to beat. Current is generated in sino-atrial node. It is like electric generator. It travels via bundle branches, which are like wires. Current goes from SA node to AV node via atrial bundles. Then from AV node to a small bundle called HIS bundle. Then goes to right ventricle via right bundle branch and to left ventricle via left bundle branch. Then it further divides down.  When there is interruption in right bundle, it is called rbbb and same for left bundle branch. Right bundle branch may not always be dangerous because right ventricle is a low pressure chamber, pumps blood to lungs which is also low pressure. Left ventricle has to pump blood to whole body, it has to force more. When lbbb occurs, left ventricle is contracted via current coming from right bundle branch and it takes some time to reach left side although only milliseconds of difference but that is significant. Thus, there is dys-synchrony between ventricle which may lead to ineffective output from left ventricle, because whole vascular circuit is interconnected and should work in rhythmic synchronized way. Moreover, lbbb usually occurs due to heart attack. But all this is not as simple as mentioned. It is more complicated. It needs much time to make you properly understand the whole working of heart and its connections. Hope you got a little idea about lbbb and rbbb.


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Hello doctor, How accurate are early ultrasounds at determining gestational age and conception? Based on my 6th-week scan I am 23 weeks today means I conceived around December 25th. Is it possible that I actually conceived around December 5th and baby is measuring small? (I have had six ultrasounds and the baby has never measured more than 2 days off from the date given at my 6-week scan) even though my last period last came on November 28th she has never measured on track for that.


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Hello,  Welcome to icliniq.com. The first-trimester ultrasound scans done before 12 weeks are the most accurate ones in the assessment of gestational age with an error of only + /- 5 to 7 days in the assessment of gestational age. So they are used for obstetric dating and determination of expected date of delivery. Moreover, if you have done 6 ultrasounds and the date calculated from each of them corroborates and does not lag behind then probably your baby is growing well and it is not small as you apprehend. The date we calculate from the first day of last periods is accurate only if the periods were regular for the last 3 months and there was no history of miscarriage or ovulatory disorder like PCOS (polycystic ovary syndrome) or contraceptive pill intake. In case of any discrepancy the date from dating scan at 6 weeks are accurate and to be considered. It is a probability that you actually conceived in later part of the cycle which leads to this discrepancy between the date and USG.


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Hello doctor, I am an asthmatic for 15 years. Right now I am using Foracort 400 mg since three years. I am also hypertensive and using Telma-AM. Since past six days I am facing uneasiness in breathing and because of that maybe my BP has raised. Last week before all this happened I got a master health checkup done and my uric acid level was 9.1 and traces of albumin were there. Just to mention, that was my sixth day of keto diet when I got the checkup done. Later, I stopped Keto. Kindly guide me.


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Hello. As you know, asthma is the chronic inflammatory airway disease with waxing and waning episodes. If you have asthma, your airways are always inflamed. They become more swollen, and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for the air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and chest tightness.There is no permanent cure for asthma, and current guidelines suggest to keep it under control with the inhaler medicines. Foracort 400 mg is the best inhaler, and you should continue using it two puffs twice daily. As far as the diet is concerned, diet can increase or decrease inflammation in the airways, depending on what you eat. But the ketogenic diet per se is not responsible for worsening underlying asthma. Rather in some cases, it seems beneficial for the patients. So, the ketogenic diet is not at blame for asthma worsening. Might be there is another reason for the change in asthma pattern that is causing uneasiness or difficulty in breathing. So, it is advisable to see your treating physician and get the necessary investigations done to find out exact control of your asthma. Also as you said, the master check up uric acid value is high and needs evaluation by the doctor. Environmental changes as high pollution, colds, drop in temperature might cause asthma flare-up, and you may need to take inhaler like Levolin (Levosalbutamol) for the time being. So overall, only after proper physical evaluation, we can decide the exact cause of your discomfort. For more information consult an allergy specialist online -->


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Hello doctor,I started my paleo in the month of November wherein my HbA1c was almost 10, continued strictly for 100 days and in February HbA1c was 6.5 without taking medicines. Afterwards, cheating started and now it is 8.8. Also, there are some imbalances in the blood report. Now, I am assuring you that I shall stick to my paleo diet and follow your instructions. Kindly suggest me a plan. I can take eggs and chicken.


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Hello. Paleo or Keto diet is not sustainable, as it is elimination and crash diet, especially for morbidly obese people. It not only about bringing sugar levels down, also it should not cause any nutritional deficiency, which may happen with paleo. Having higher intake of animal foods means having higher and processed saturated fats. For diabetes, all carbs are not the culprit, only simple and processed form of carbs raise blood glucose levels. For sustainable lowering of blood glucose, one should have a large serving of fruits pre-breakfast (fruits do not increase blood glucose), a large serving of mixed salads before lunch and dinner. Reduce intake of rice and wheat based foods. Totally avoid market and packed foods, dairy in all forms, refined oils. With these changes, you can have sustained lower blood glucose. Please contact me for any further details. For more information consult a nutritionist online -->


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Hello. Keto diet is a crash diet, which means it can be done for a short period of two to three months or so. It can surely improve digestive issues such as IBS (irritable bowel syndrome) as it involves a very low intake of carbohydrates. But one must be careful in making the right food choices while consuming fats. Avoid eating fried stuff. Go for healthy fats and proteins like whole boiled eggs, steamed chicken, cottage cheese, raw olive oil, and avocados, etc. You can include vegetables like carrots, peas, broccoli, spinach, kale, and mushrooms, etc. Do it for one month, and if it shows good results, you can continue further.


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Hello doctor, For three years, I have been taking 12.5 mg of Atenolol and 80 mg of Diovan to control blood pressure. Readings over the years have been good and average. 120/60 was the blood pressure 55 to 60 was the pulse rate. I have a good blood pressure monitor, and I take readings three to four times a day. Last month while taking a regular reading, we noticed a reading of 136/60 blood pressure and pulse 32. A few minutes later, the bp was 141/68 and pulse 32. We went to the emergency room at the local hospital during a trip that took about 25 minutes. The readings had gone up to 60 bpm, and the blood pressure readings were satisfactory. I was in the emergency room for about 12 hours, where they did several blood tests an ECG and a chest X-ray. I was discharged the next day because they said my condition was fine and they recommended dropping the 12.5 mg of Atenolol completely. (I am attaching a 24 hour Holter monitor report that was done two or three days later). I took 0.4 mg of Flomax for 18 days for BPH. The readings were normal from the last month till the mid of this month. Then suddenly on a fine day, the readings of pulse rate and blood pressure were high, so the family doctor recommended resuming the Atenolol at 12.5 mg. After four days, we then found that the pulse rate was going down into the 30 bpm again, so the family doctor recommended cutting the Atenolol in half to 6.25 mg after which the readings of the pulse rate were high 30’s and blood pressure going up to 191/85. So the family doctor recommended taking 6.25 Atenolol in needed basis if the pulse rate and blood pressure started to spike. So we monitor blood pressure and pulse rate each morning before we go out to see if it is necessary to take the Atenolol and it is very stressful.


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Hello. So the problem you mentioned are two 1. High blood pressure and 2. Heart rate 1. For BP, continue Diovan (Valsartan) 80 mg. Regarding Atenolol, it does not has many effects on BP, but has an effect of lowering heart rate. If your BP remains elevated, you may increase the dose of Diovan to 120 mg. 2. Take Atenolol 6.25 mg, if heart rate without it remains more than 80 to 90. If the heart rate is below 90, no need to take Atenolol. Moreover, count heart rate manually by counting beats or pulse. Do not rely on what the BP measuring device tells. Remember one thing, sudden stopping of Atenolol increases heart rate beyond normal for a few days, but later it settles to normal. So, be patient.


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Hello doctor, I am 23, and I have too much problem. I have depression, anxiety, and many sexual problems. I watch extreme pornography daily. I think I damage my penis by rough and abnormal masturbation. I am too much worried about it because I face too many complications. How to diagnose whether my penis is damaged or not? Please help me.


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Hello. Why do you think you have damaged your penis. Is there anything abnormal in the penis? Too much of thinking about it may lead you in depressive mood state. Masturbations is normal thing, maximum persons in your age practice it. If I talk about prevalence you will be shocked, nearly 100 % of male and 70 % female practice masturbation (standard psychiatric book). There is no harm in masturbation, semen is an ordinary fluid like saliva, and in male sperm, it is produced daily. If we do not perform sex or do not masturbate, semen will come spontaneously in the form of nightfall, but that is not again a problematic thing. It is a harmless practice until if you become an obsession, and start hampering your daily life. Thinking about near one in fantasy is also not uncommon, it happens. If you want to quit it first set in your mind that you have not committed any crime, you are going to leave a habit that was trying to conquer you. You can do it. Do not remain in guilt, move ahead and involve yourself in other activities. Try to be with friends and family. You can take help of religious thoughts. Do moderate exercise, reschedule yourself, be active. You can contact some psychiatrist nearby you. Take proper sleep and a healthy diet. Practice yoga and meditation that will help you.


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Hi doctor, I am pregnant with my second child. According to my LMP, I am supposed to be about 10 weeks. However, I had a scan about 3 weeks ago which showed 6 weeks 5 days and another scan this week and it showed 6 weeks 3 days. Baby is also sitting on the uterus lining making the baby very easy to miss if the sonographer is not thorough. There is also a strong heartbeat. Is it possible that due to the baby's current position in the uterus we are not able to get the right measurements to see if the baby is growing well? I do not think it is possible for a baby to decrease in size with a strong heartbeat. Please help. I am emotionally stressed due to this. I have another follow-up scan in a week.


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Hi. Firstly, is your period regular or irregular? Were you breastfeeding or taking any pills? In these cases, LMP is not considered as accurate, and scan is the main thing to determine the gestational age. Secondly, the baby position does not play a role in hindering having measurements. The baby would sit on the lining because it gets nutrition from there, and that is what is called implantation. Thirdly, what concerning is that if measurements were the same three weeks ago why the baby has not progressed in these three weeks. Possibly one of these scans is not correct either this recent one or the last one. This thing is worrying for me, and it is good that you are having a follow-up scan, and if the baby's heartbeat is there, then you have nothing to fear. Hopefully, everything would be clear by next week. I am wishing you all the very best.


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Hi doctor, I have been having these eruptions on my forearms since past two months. They are not painful and cannot be popped. But they take a long time to disappear and look prominent. What are these and can they be stopped from re-occurring? I had them last year too during summers and they disappeared after 4 to 5 months. I have severe keratosis pilaris on my forearms and back, can they also be keratosis pilaris?


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Hi. From these two photos (attachment removed to protect patient identity), it is visible that lesions are little inflamed and red. It is indicating folliculitis. Non-bacterial folliculitis can be non painful. Specially pityrosporum folliculitis. Keratosis pilaris is a condition where you may have dry hard covering surrounding hair opening. Sometimes it may also get inflamed, so it can be related to this also. Arms are common site for such bumps. You need capsule Doxycycline 100 mg twice a day for 14 days, Clindamycin gel local application morning and evening, tablet Fluconazole 400 mg stat. For keratosis pilaris, you will need moisturizer. 14 days, it should subside.


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Hi doctor, My father is suffering from gas issue from the last 7 to 8 days. He does not feel like eating from 2 to 3 days. Have checked with local doctors, after a few tests they found nothing but his bloating has not gone down. He also feels pain in stomach. Please suggest.


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Hi, Welcome to iclinq.com. There are different conditions that can cause abdominal bloating that goes from non-urgent to serious conditions. If he is not passing bowel movements or gas and has remarkable abdominal pain, it can be a serious condition like bowel obstruction and needs to be taken to hospital emergency department. On the other hand, if he is passing gas and bowel movements, he needs to be checked for H. Pylori which is a stomach bacteria and has a specific treatment. If H.Pylori is negative then next step is to see a gastroenterologist for potential gastrointestinal endoscopy.


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Hi doctor, My dad is 78 years old and was diagosed with stage 4 transitional cell carcinoma of left kidney for which he underwent a neprourectomy. It is six months now and he took immunotherapy for the same. He had three doses of Ketruda but with third dose he developed pneumonitis and changes in lung. He had blood culture but no infection was present so they treated with steroids for 10 days, after stopping steroids he developed some tiredness and fever for which he was put on antibiotic Bactrim. But after he took that for a few days, he was better but just two days back he developed extreme drowsiness, slurring of speech and confusion. He was advised to rush to a nephrologist because his creatinine was 3.7 and his HB was 7. His potassium levels were high too and ESR was 120, lymphocytes were low. So, they took out all the drugs he is presently on to stabilise his creatinine and potassium levels and transfused blood. My question is he was on maintainance drugs for 40 years of which Sartel 40 for hypertension, Glyciphage for diabetes, Liofen and Gabantin for trigeminal neuralgia and Ativan for anxiety have been withheld. Do these drugs cause any interference with his kidneys? Please let me know because I want a second opinion and be double sure that this is the right thing to do.


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Hello. I have gone through the details about your history. Cause of deranged renal function is multifactorial. First of all, Ketruda that is Pembrulizumab can cause interstitial nephritis, that can cause damage to kidney and rise of creatinine. Sartel is for blood pressurebut it can cause rise in creatinine in acute setting such as after surgical stress, so stopping is a good decision. When there is a damage to kidney, drug such as Gabapentin get accumulated in body and can cause neurological symptoms as you told. It will subside gradually as kidney function improves. So, from current medicines, you stop Parozep until his kidney recover, for blood pressure take Amlodipine 5 mg (as the blood pressure is normal now) (attachment removed to protect patient identity). Get urine routine done and urine protein creatinine ratio and if creatinine continue to rise, a kidney biopsy may be needed. Otherwise, control of potassium and urine output as per regular protocol of treating nephrologist. Take care and would like to know further detail and progress, wishing him a speedy recovery.


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Hello doctor, I am a 36-year-old woman with family history of heart disease. For a couple of days, I have been feeling discomfort in my chest, like my heart gets squeezed and I have chest discomfort on the left top part of my chest, like six fingers down my clavicle. I also have a lot of fatigue, specially from 10 AM to 1 PM. The discomfort gets worse when I am laying on my back and I can feel my heart moving in my chest in an unusual way and the squeezing feeling coming and going. I have had anxiety disorder for almost 20 years but this does not feel like my usual anxiety. I am worried and not knowing exactly what to do.


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Hello. Classical cardiac chest pain is a sensation as if an elephant is sitting on your chest. It lasts from a few seconds to minutes and could be provoked by exertion. What you are feeling is classified as atypical chest pain but you also have palpitations. Do you have a way to check your blood pressure and heart rate? Please let me know.


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Hello doctor, I am a 36-year-old male. I previously had a chlamydia infection and was successfully treated. Will such previous infection interfere or affect my fertility? I recently had a scrotal examination and the results were normal.


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Hello. Chlamydia infection persistence or recurrence can definitely cause an apparent increase in the pus cell and WBC count in the seminal fluid which can easily decrease the total sperm count and its quality. If you have been treated it is good, but again it takes 90 days for new spermatids to form adults and become functionally mature for fertilization. It is always best to get a repeat semen analysis and culture done to be sure that there is no repeat or recurrence of chlamydia infection if you have been sexually active post your previous examination or if your partner was not treated along with you.


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Hello doctor, This is my CBC report and everything is normal except RBC. In it, RBC shows anisopoikilocytosis predominantly microcytic hypochromic cells along with normocytic hypochromic cells and few targets cells. WBC is within normal limits. Platelets: adequate. (MCV) mean corpuscular volume72.0 fL, normal range 80 to100 fL. (MCH) mean corpuscular Hb. 18.6 pg, normal range 30 to 36 pg. (MCHC) mean Corpuscular Hb. Concentration 30.0 g/dl, normal range 32 to 36 g/dl. I will attach the report. Please suggests cause and solution for this.


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Hello. Your report is suggestive of microcytic hypochromic anemia. Do not worry about that. It is a treatable condition. With the recovery of hemoglobin level by tablet, your PS (peripheral smear) will be reverted to normal. It is not an alarming condition. But I suggest the following work up for you. 1. Serum ferritin estimation. 2. Serum transferrin saturation. 3 Serum FEP. 4. Serum TIBC. These four investigations, help in rule out iron deficiency anemia. 5. HB electrophoresis. This fifth investigation will rule out any hemoglobinopathy if present. Kindly revert back with these reports so that I can guide you further. Hope I have answered your question.


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Hello doctor, I usually would get my period on placebo pills on the third day, and I skipped my period by not taking placebo pills for a couple of months. I started to take them again and had my period last month, and this month I am on the third day, but it has not come. Could my body just be changing? Is it normal to get my period farther into the placebo pills?


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Hello. Yes, what you are experiencing is very common, especially if you have been on the pills for a while. The birth control pill will actually thin the lining of the uterus over time, and many women barely have any bleeding during the placebo week, we sometimes call these pill periods as it is often just some very light spotting or brown discharge. It is ok if you do not have bleeding during the placebo week, as long as you have been taking your pills every day and you are sure you are not pregnant.


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Hello doctor, I have had a fishy odor down there since I was in elementary school. I was not sexually active at all either. Just a couple years ago I realized I might have something called bacterial vaginosis. I went to the doctor for it a couple years ago and got prescribed Metronidazole and it did nothing for me. Ever since then I have not really gone to the doctor about it again. I am worried because I have read that BV left untreated can make you infertile. How common is it that this could happen? And do you have any tips for me?


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Hello. Yes, you have heard right that if vaginal infections are left untreated they may lead to PID and infertility. It is a serious issue which must be dealt with promptly and appropriately. Bacterial vaginosis leads to change in vaginal flora and pH which results in fishy odor and discharge. Metronidazole is the recommended treatment for it but as you say it has not affected you then I would suggest that you must not neglect it and get yourself fully checked by having vaginal swabs tested and getting exact diagnosis and treatment. Secondly, hygiene is of very much importance with regards to vaginal discharge. Some tips are as below: Keep the vaginal area clean and wash with plain water as much as possible. Avoid any cosmetic products over the vaginal area and wear cotton rich undergarments.


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Hello doctor, I tore off a mole or a freckle some weeks ago and now the surface, it is like this. Is it good or should I worry? What are those red spots?


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Hi. I have gone through your case. Your lesion is active which means the area has not healed after removing your mole (attachment removed to protect patient identity). Keep applying Fucidin acid cream two times a day till red area disappears. It is not something to be worried for as such raw areas take some time to recover. But no opinion can be given for lesion or mole or freckle which you have removed yourself. It could be a simple mole or it could be a wart. Such raw areas are usually seen after wart scratching.


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Hi doctor, I have a kind of flap in my mouth since three weeks in the inner left cheek near the saliva hole. At the beginning, it was bright red with light pain when I put my tongue on it, and now, the flap is the same color than the rest of my mouth and painless. What should I do?


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Hi. In the absence of pain, it seems to be a case of fibroma, a non-benign lesion and you need not worry about that. This can be due to trauma, bite or sharp tooth or broken tooth in the area.  However, I need to rule out the possibility of stone in duct and tooth. Can you answer these questions: Do you feel any pain on chewing or during eating in any part of the mouth or gland? Is there any pain when you bite? Do you have any carious tooth in the region? Do you have any history of biting in that region? Any other problem for which you are taking medicines?


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I have a small pimple or swelling in anal area where stools are passing from last one week which is not painful and there is no problem with bowel movement. Its having an itching sometimes.. it is piles or any related disease. It just had a small itching sensation and had small pain while washing after bowel movement and no pain while passing stool.


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Hello Dear. I welcome you to icliniq. This seem to be a perianal boil. The boil is a pus containing hair follicle. Hair are the stalk and follicles are the trunk of the hair. The follicle can get infected and cause enlarged painful swelling called as boil. It is not communicating to your bowel thats why you dont have problem with your bowel. The best thing you can do is to keep this bottom are clean and hygienic. Wash it thoroughly with each bath and remove hairs timely.. You can apply fusidic cream three times daily over it. It shall heal in few days of application of this cream. I hope you will be fine. Good day. perianal boil/folliculitis none fusidin cream for local application follow up if symptom persist


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Hi doctor, I am having knee problems for a while. It feels like my knee needs to be popped but it will not. I cannot bend my knee without having pain. Could someone please tell me, why is it? And what should I do to make it feel better?


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Hello. Thanks for your query to this platform. You are actually quite young to be having persistent knee pains. Your knee pain could be due to certain reasons. But, common ones are chondromalacia, pain due to knee instability, inflammation, etc. If there is no history of any injury, and no signs and symptoms of inflammation or infection like swelling, skin redness or local warmth on touching, then I would like to advise you for conservative management initially in the form of.


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Hi doctor, My daughter has pleural infection in lungs. When she was 2 years, decortication was done by open surgery. Now she is four years old. 3 days back she got fever. Though after taking antibiotic her fever subsided, x-ray report showed mild cardiomegaly with bilateral perihilar congestion. Is there again a chance for fluid to get gathered inside her lungs? What should we do for the same? Please advice.


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Hi. I can understand your concerns. Pleural fluid collection occurs when infection persists for long time and is not responding to antibiotics. Pleural fluid collection in past does not increases the chances of collection at a later age. This time, x- ray (attachment removed to protect patient identity) shows mild cardiomegaly and perihilar congestion. This is not related in any way to lung infection and fluid collection. I suggest you to do an echocardiogram, to see what is the cause for cardiomegaly. Further treatment will depend on echocardiography report.


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Hi doctor, My father and my grandmother died within 3 months. After they expired, I started to face many issues like LIC claim and others. Due to too much stress, I am unable to sleep at night properly and feel sleepy in the morning. Because of this reason, I am unable to concentrate on my work. I am working in software industry. Due to the issue I am facing, I am not able to complete the tasks on time and going through a lot of problems. I am also suffering from body pain. Presently, I am on Zincovit multivitamin tablet. Thank you.


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Hello. I feel sorry for your loss. Your problems are stress, unable to sleep at night and body pain. So, basically it is your stress that is leading to other problems. Stress can be managed both by medication as well as by lifestyle modifications (behavior therapy). First, try lifestyle modifications which include: Also, proper sleep hygiene needs to be practiced daily, so as to help you to maintain good sleep in the long run. Sleep hygiene entails following important points. These lifestyle modifications will help in improvement of symptoms and you will feel better. If symptoms persist even after lifestyle changes, then visit a psychiatrist. Drugs like Modafinil or Armodafinil will help to maintain daytime alertness and will reduce fatigue. Visit a psychiatrist for proper prescription of this drug.


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Hi doctor, I am a 40 year old woman. I had hysterectomy 4 years back.  Now, I have no periods or blood loss of any measure. I am having balanced diet with plenty of meat and kale chips. Since 3 months, I have started taking raw food and prenatal vitamins because of cracks in mouth that would not heal and it seemed like hair was falling out. After over a year of severe insomnia, exhaustion, mouth sores, constant itchiness and RLS issues that made my husband wonder, I went to my doctor last week wondering if it could be hypothyroid. As I have not had periods since 4 years, I did not suspect any anemia. Doctor has done two CBC's. The second one had even lower hemoglobin and hemotocrit levels. My last CBC that was taken 4 years back showed a hb of 14.4 but vitamin B12 results were within normal range. I am attaching all my reports for your reference. Please guide.


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Hi. Based on your query and reports (attachments removed to protect patient identity), my opinion is as follows:The low hemoglobin at present is not due to blood loss, it is nutritional. If you look at the iron studies, the iron levels are very low, indicating inadequate iron in body. They can be possibly secondary to reduced intake and may be a cause of malabsorption. As the other vitamin levels are normal, it is more likely reduced iron intake or absorption. The reticulocyte count would increase in case of anemia, if the nutrition too improved. It is staying within the normal range. If you start iron supplements along with vitamin C (for better absorption of iron), you will find your reticulocyte count increasing within 2 weeks. There is no hemolysis or hemorrhage, as in both conditions, if nutrition was adequate, the reticulocyte count would have also increased. At present, all studies including red blood cell volume distribution (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) are iron studies that are pointing towards iron deficiency. Good to know your thyroid profile is good. Insomnia and exhaustion can be easily explained by anemia. Also improve the hydration (take at least 5-6 liters of water per day). Avoid coffee or tea along with food, as it inhibits iron absorption. Adding citrus fruits or vitamin C rich diet during food intake improves iron absorption. At present, nothing to worry except iron deficiency. Supplements of iron with iron fortified food and iron-rich diet should help. Also, take vitamin B-complex supplements, as early changes like ovalocytes are also seen in blood. Both iron and vitamin B-complex supplements to be taken, and within two months, you will return to your normal self. Repeat the reticulocyte count after 15 days to check if it is increasing. 1. Both iron and vitamin B-complex supplements to be taken. 2. Most importantly iron-rich foods to be taken along with vitamin C supplements. 1. Iron-rich diet, iron fortified foods. 2. Balanced diet and good hydration.


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Hi doctor, I got my dental checkup done recently. A small cavity was observed on the side of my tooth between 2 teeth. I am attaching a photo of x-ray. Please check second upper tooth from left in the x-ray. Also let me know, if this can be cured by filling?


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Hi. I checked the x-ray (attachment removed to protect patient identity) Yes, this can be cured by restoration.


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Hi doctor, My mother has been on Holter heart monitor for the last 24 hours. If any abnormalities found on this, then what treatment can be suggested by doctors?


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Hi. Thanks for the query. Holter monitoring is done to identify rhythm problems, to diagnose the type of arrhythmia, and its relation to daily activities, to detect heart blocks and to monitor treatment. Now depending upon sign and symptoms and rhythm identified, the treatment plan may be devised by a cardiologist. In general, for fast rhythms, medicines are given to slow down the heart rate and also reversion of rhythm to normal can be attempted via medicines or invasive intervention. For slower heart rates such as heart block and its symptoms such as loss of consciousness or dizziness, pacemaker (which is an electronic device than generates a pulse for the heart) may be implanted. Depending upon rhythm detected, further tests may be advised such as cardiac electrophysiology study. So, possibilities are many; if you provide some history of the patient, I can guide you properly. Just tell symptoms of the patient, any current illness and medicines she is taking, any previous ECG, echocardiography or other tests performed. If you can provide the above details, it will narrow down my answer and easy to understand for you. I am praying for your mother. Regards.


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Hello doctor,My baby has developed redness around the perianal area. We have been traveling for the last two days, and hence, the usage of the diaper was more. My husband has developed a fungal infection, and he is on antifungal. He avoids touching the baby. Please help.


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Hello. If possible, please avoid diapers. Apply easy nappy or rash free ointment around the anal area in thick layer three to four times a day. Apply candid cream twice a day around the anal and groin area. Diaper rash. Diaper rash.


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Hello doctor, Foot pain started 18 months ago after running. It has persisted, but the severity of pain depends on how active I am. Most recently, the pain has become more severe. Please review my X-ray.


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Hello. Please send me the full X-ray which you have sent (attachment removed to protect patient identity). I would like to see the whole joint, like of talocalcaneal joint.


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Hello doctor, My blood test shows platelets and monocytes above the normal range. Is this a sign of cancer?


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Hello. There are two types of thrombocytosis, primary and secondary. Primary thrombocytosis is a disease in which abnormal cells in the bone marrow cause an increase in platelets. Secondary thrombocytosis is due to another condition the patient may be suffering from, Increase of monocytes indicates there is a chronic infection, an autoimmune or blood disorder, cancer, or other medical conditions.


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Hello doctor,From the last six months, I am getting my periods either five days before my due date or two days later than the due date. I want to know, is it normal to experience this time interval in periods?


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Hello. Yes, this is normal. Seven days plus or minus is considered as a normal menses cycle. It means any cycle length between 21 to 35 days is normal.


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Hello doctor, I am 51 years old. I had a severe allergic reaction when I was 7 years old, after eating a crab meat sandwich. It was made with canned crab meat, and I cannot be sure if it was real or artificial. I found large round red hives all over my body, which turned to rings before healing. I never ate crab or lobster since then. I have always eaten shrimp, scallops, clams, and many other types of seafood without issue. I continue to wonder if my allergy all those years ago was a crab meat allergy. I have been avoiding crab and lobster for no reason. Does all seafood belong to the the same family?


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Hello. Allergy reaction is due to a specific particular protein or substance. Each group has a different type of protein. It varies from each. There are several types of shellfish, each containing different proteins like crustaceans include crabs, lobster, crayfish, shrimp, and prawn. Mollusks include squid, snails, clams, oysters, and scallops. Some people are allergic to only one type of shellfish but can eat others. Other people with shellfish allergy must avoid all seafood. So one may need not get an allergy to all group and family.


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Hi doctor, My son is 11 months old. He is suffering from cough and cold, and his BCG spot has also turned red. He received his vaccination long back. Then why did it turn red now? He is currently on Levolin. Please help.


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Hi. There is no issue with the BCG spot turning red at 11 months of age. It is alright. As long as it is not swelling up and ulcerating completely, it is fine. Sometimes, some children may scratch it making it red. In this regard, I would advise you to get the BCG scar evaluated physically by a pediatrician. As regarding cough and cold, you can give syrup Levolin 2 ml twice a day along with syrup Montair LC 2.5 ml once a day for 5 to 7 days. SOS, you can use nebulization with Duolin if the cough is very severe.


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Hi doctor, I am having red rashes on the glands of the penis. I used Candid Total and it disappeared completely. Again after seven days it again appeared and it seems red patches on right and left side of the penis. I continued using it and then got an advise form one of my friend for using Surfaz SN along with Doxt SL 100 which I am using it since last 15 days. It was improving slowly. I was using very hot water for cleaning the penis but suddenly day before yesterday, the color of the penis became red and the patches have also become red. I am having pain on the glands of the penis and seeing some white discharge. I do not know why it has happened suddenly, due to usage of hot water or for some other causes. I consulted local doctor and he advised to take LNZ 600 one tablet twice daily for five days and T-Bact ointment twice daily for 10 days. Please advise.


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Hi. You have erosions on the glans penis that is more consistent with candidal balanitis, other possibilities are chancroid, herpes. Please stop using Surfaz SN, it has steroid in it. Steroid helps to bring down the inflammation, itching will get better but it will not cure the fungal infection further makes the fungal infection worse. I believe that is what happened for you now. Can you please answer these questions so that I can rule out other possible conditions and suggest you appropriate medications. When did it start? Do you have similar red rash on foreskin as well? Any history of unprotected sexual intercourse? Any history of white discharge in the female partner? Did you have fluid filled blisters when it started? Is this the first time you are experiencing this kind of lesion? Do you have any allergies to medications? Do you have any other medical conditions? Diabetes? Do not use hot water for genitals. Always use lukewarm water.


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Hello doctor, My arms, neck and underarms are blackish compared to the rest of my body. Please look at my pictures and inform me the solution.


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Hello. I understand that you are concerned. Looking at your photographs, I can appreciate that you have two things (attachment removed to protect patient identity). 1. Acanthosis nigricans: The darkening of the neck and underarms is due to thickening of the skin, known as acanthosis nigricans. It is a manifestation of insulin resistance and is usually associated with diabetes mellitus, weight gain, obesity, thyroid disorders and certain drugs. Sometimes no cause can be identified. 2. The arms darkness seems simple tanning due to sunexposure as I can appreciate the sharp cut off at the arm, where sunexposure ends the skin is fairer. Use the following medications: 1. Kojic acid cream apply once at night for pigmentation. 2. Suncros sunscreen lotion apply three times every three hourly on sun exposed areas during day time. 3. Tablet Limcee (Vitamin C) one tablet once a day after breakfast. Get following investigations done 1. FBS. 2. T3,T4, TSH. 3. Fasting lipid profile. Please review with reports.


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Hello doctor, I am 31 years old, female. I had unprotected sex three days ago. What should I do now?


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Hi. No need to worry. There are two options.  1. You can go for Levonorgestrol, taken 72 hours after sex. 2. You can go for Ulipristal Acetate 30 mg taken 120 hours after sex.


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I have always had trouble with my tonsils. I get tonsil stones frequently and snore. For the past month I have had a mild sore/scratchy throat. I can tell my left tonsil is swollen, and it is causing some pain. Sometimes the pain reaches my ear, but not often. My doctor did a swab to check for infections but it came back clean. Could this be allergies? I have never had allergies before, except for asthma as a child. I have no other symptoms.


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Hi, I understand that you are worried about your long term tonsil problem.. Tonsil enlargement could be due to infection or as a part of some other disease If your swab is negative, we need to investigate for other possibilities also I would suggest you some investigations for the same Meanwhile also take the tablets as prescribed CBC, ESR, PERIPHERAL SMEAR CT NECK CHEST XRAY Tonsillar enlargement inder evaluation T. Cefuroxime 500mg 1tab twice daily for 1week after food T. Aceclofenac + Serratiopeptidase 1tab twice daily agter foof for 5day Betadine throat gargle thrice daily Review with investigations


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Hello doctor, My wife had a cervical tumor or some kind of growth in her teenage years. Whatever it was, medication took care of it for her. Now she is 31, has had three kids, and for the last few months has spotted and cramped for one day right after her period ends. She has a pap smear appointment for next week, but I am extremely worried in the meantime. What are the chances that the symptoms are because of cancer? Are there other benign conditions that are more likely causing this?


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Hello. Thanks for sharing this information here. First of all I would like to see her reports from the previous diagnosis and treatment and only then I would be convinced that it was a tumour. Secondly, from your point, it sounds that it was only a cervical polyp which is totally benign and after removal of it patient does not have any symptoms. And thirdly, pap smear does not detect cancer. It detects only early changes which Iead to cancer. So get relaxed now as nothing is wrong with your wife as she has given birth to three healthy kids. She must go for a pap smear without any hesitation and I hope it would be fine as well.


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Hello doctor, I have problem in one cord and it is for about a month now. I was given Defcort and antibiotic for a week. Persisting for little over a month now.


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Hi. Since how long you have been having this problem? As per the picture, it has been there on only one cord. If it is early stages, conservative management can be tried. Did your doctor tell you about it? One month duration is a bit less to decide on surgery I feel. You should go for conservative treatment. Conservative treatment means antireflux and antacid measures along with control of allergy. Dietary precautions are to be taken. Absolute voice rest should be maintained. What is your job? Do you speak a lot or sing?


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Hello doctor, Can I start Unwanted 21 after my periods? Four days back was my last day of period. My period cycle is usually for five to six days. Please suggest as I want to start my oral contraceptive.


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Hello. Oral contraceptive pills are normally taken cyclically from day-5 of menses to day-24. I suggest taking tablet Norethisterone 10 mg twice daily similarly in every cycle. Oral contraceptives are ideally started from the start of a cycle, but if you want to start, start now from today and then stick to it regularly. Take the 21 tablets and then the placebos or choose the pill-free period for withdrawal bleed. The body takes some time to get used to it. Side effects could be headache, breast tenderness, high BP, clot formation, on long-term use irregular bleeding, carcinoma of the breast and endometrial hyperplasia that can lead to endometrial cancer. Hormonal contraceptives are better not used for many years. Better to change the method to prevent long-term side effects like after taking it for a year, you can have injection Medroxyprogesterone (three monthly) for few months, etc. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, My wife is in the 14th week of her pregnancy. During a routine checkup, we came to know that she was infected from HEV. What will happen? Do we have to abort the child?


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Hello. There is no need for the abortion as HEV (hepatitis E virus) does not cross the placenta, but you need to have a close follow up for the pregnancy. Also, you have to get in touch with fetomaternal doctors (baby-mother doctors) and get a regular check-up of your liver function test. You would need to be delivered in a hospital setting as HEV may infect the baby at the time of birth. HEV is not harmful to the baby during pregnancy but needs close monitoring, and vigilant care of mother as mother's condition may deteriorate if not addressed properly. 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, My 1-year-old son has not started saying any word like mama or dada yet and I am worried. It could be sign of autism, though he turns when his name is mentioned, plays with his siblings, etc.


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Hi. Even though the child turns when his name is mentioned I would advise you to first get a hearing screening done to rule out hearing issues. Next, about the autism. Generally autism cannot be diagnosed in children below the age of 3 years. So it would be very harsh to label this child as autistic. Not just that, an autistic child generally does not play well with others. If the hearing is normal and other developmental milestones are normal, you need to wait for another 3 to 6 months. Some children are slow. Also, another thing that needs to be evaluated is a tongue tie. Kids with a tongue tie (depending on the extent) have difficulty in creating speech.


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Hello doctor, I have a pea sized lump between my right buttock and thigh (groin area) that I just noticed a few weeks ago after accidentally shaving over it. It is not painful, but a little sore like a scrape would be. It appears to be solid in the middle and darker, but has almost an inner tube look around it that is pinkish. It does not look like it has fluid in it.


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Hi. What your photo shows is a skin ulcer (attachment removed to protect patient identity). There are many reasons for skin ulceration in the groin area. We have to rule out sexually transmitted diseases first of all. I would like to know if you are sexually active, whether your partner has any such problems. How about your general health? Do you have any kind of problems in your other body systems?  For the ulcer, you can apply a topical antibiotic like T-Bact cream daily thrice. It will help it heal if it is a simple bacterial infection. I would suggest you apply it for two weeks, then approach a local dermatologist for a full checkup, in case it is not responding. Get well soon.


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Hello doctor, A week back, I wore a G-string that was a little snug and I accidentally fell asleep in it. The next day, I noticed that my perineum and anal area were sore so that night I got a mirror and looked and noticed that there was a straight swollen line from my anus to my vagina opening right where the string sits. So I did a sitz bath and applied Neosporin and Destin and the pain stopped. This morning I checked on it and it is still swollen but no more pain unless I poke it with ny nail. Is it herpes?


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Hi. I have seen your images (attachment removed to protect patient identity), looks like perianal area is swollen secondary to explained injury. It will take a little time to heal completely. Kindly follow the following instructions: 1. Lignocaine gel for local application over perianal area before and after defecation. 2. Continue sitz bath for 4 to 6 minutes a day. 3. Tablet Combiflam 400 mg BID for three days. 4. Drink plenty of water. 5. Keep hygiene over perianal area.


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Hello doctor, I recently had my thyroid test done. I am attaching the reports of the same. The note reads that a physiological rise in total T3 and T4 levels are seen in pregnancy and patients on steroids. Does it mean that I am pregnant? I am worried.


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Hi. Your thyroid level is upto normal level. The preference range given in the reports is for pregnant female (attachment removed to protect patient identity), not for non-pregnant female. And Thyroid levelnever determines pregnancy. If you had unprotected intercourse and delayed menses, then you can go for UPT test for confirmation of pregnancy.


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Hello doctor, I am 20 years old. My height is 6’4", and weight is 205 lbs. I noticed three decent sized painless blisters, looking like bumps on the shaft of my penis. I had sex before two and a half week. I do feel like I masturbate a lot which I am hoping it is, but I am freaking out with it.


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Hello. The bumps appear to be normal pimples (attachment removed to protect patient identity). Another possibility is an ingrown hair. Herpes vesicles could also be the possibility, but the chances are rare. Since the site is not common and I hope there is no discharge. If you have unprotected sex with any high-risk partner then you should go for test otherwise there is no need to get worried. Remain relaxed. I do not think this is due to an STD (sexually transmitted disease).


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Hello doctor, I had unprotected sex on the sixth day of my period in which bleeding has already stopped. What should I do to avoid pregnancy?


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Hello. Please send me some more details. If you have regular cycles with 28 days or more, then day six of periods is not the fertile period of your cycle. But having short irregular periods results in the risk of having the issue of conception. So check on your cycles. If regular and if 28 days or more in duration then no need of I-pill or emergency contraceptive. Otherwise, in case of the irregular or short period better to have emergency contraceptives pill. Have complete treatment of any health issue you have. Have a balanced diet, weight, and BMI. Practice daily walk and yoga. You can have regular contraceptives to avoid conception. Hormonal. Depends on cycles regularity. As per need.


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Hello doctor, I have been dealing with acne on my cheeks, chin, jawline, and neck for the past four years. I have recently graduated my bachelors and got accepted to medical school. I previously thought the acne was due to stress, but since graduating I have still been having breakouts and tried Benzoyl peroxide, Retin A products, and salicylic acid treatments. All of which clear up temporarily but then get worse. I am not on any medications (no birth control either) but currently started taking a few supplements to see if it would help. I take fish oil, probiotics, and turmeric for the past week and now it seems to be helping a little, but I also just got off my period and had some flare-ups on my cheeks. I am in the military, and out of all honesty I have tried getting appointments with my doctor, but she always recommends the same treatment with Benzoyl peroxide and Retin-A. She even had me on Spironolactone a few years ago, but I have a low natural BP, and that just made me dizzy from lowering my BP more. I wish to see a dermatologist, but the military makes that difficult to do unless I wanted to pay out of pocket to see one. My skincare routine consists of using Glowbiotic MD face wash, diluted apple cider vinegar toner, and plain Aloe vera for moisturizer. I try to keep it simple to not irritate my skin more than it is. Please advice.


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Hello. I understand acne is very frustrating. Many factors play a role in acne, they are, 1. The hormone is the main factor. Here acne is seen mainly on the chin and neck. A most common cause is the polycystic ovarian disease that presents with acne, increased hair on the face, hair loss from the scalp, irregular menstrual cycles. If you have any one of these symptoms along with acne, I strongly recommended evaluation by a gynecologist. 2. Stress. 3. Occlusion due to thick face creams, and foundation that block the pores on the face causing ductal block then inflammation. People from 13-30 years are more prone to acne. You have cystic acne, considering the distribution around chin and jawline, Spironolactone is the best medication in your case. Since you have a problem with blood pressure, I can suggest you other treatment options. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Aczone (Dapsone) 7.5 % topical gel, it is anti-inflammatory medicine but slow acting. 2. Oral Doxycycline or Minocycline for two to three months. These antibiotics are very useful for cystic acne. 3. Topical Fabior (Tazarotene) 0.01 % foam, this is the strongest topical retinoid. 4. Oral isotretinoin (Accutane) is the most effective treatment available for acne. It is weight based treatment, depending on your weight you will have to take Isotretinoin capsules for four to six months. It needs monthly blood work monitoring for serum lipids, liver enzymes, monthly urine, and a pregnancy test. Follow a monthly visit to the dermatologist.


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Hello doctor, I am a 30-year-old female with weight 95 kg. I have a sore in the right foot in which the skin is coming off and is irritating. Also I have a slim like substance that builds up. The smell is really bad.


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Hello. I understand your concern. This condition is known as pitted keratolysis (attachment removed to protect patient identity). It is a superficial skin infection, caused by Corynebacterium species. Take the following treatment. Kindly consult your doctor, to discuss the suggestions and take the treatment with consent. 1. Cream Mupirocin apply once at night. 2. Benzoyl peroxide 5 % gel apply once in the morning. Do this for three weeks, and try to keep the foot dry, avoid tight-fitting footwear, basically try to minimize the sweating on the occlusion part.


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Hello doctor, I had an ear infection in my left ear about a month ago, and my doctor prescribed Amoxicillin twice a day for a week. I went back shortly after and the ear infection moved to my right ear and my left ear was not any better so she prescribed Z-pack for five days. I finished my Z-pack last week and I am better overall, but I still feel a little dizzy when sitting down. When will that go away?


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Hi. Does the giddiness last for long? Is it only momentary? Is it spinning or weakness? Is there any hearing deficit?


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Hello doctor, I am passing the worst time of my life for more than 1.5 years. Because my husband is getting frustrated and depressed day by day. I love him more than anything in the world, so I am too much worried about him. He works at home since he is a freelancer. We got married four years back and his problem started a year back. He became almost detached from all of his friends and family. So can you imagine his regular life? He wakes up at 12 PM. After that, he starts working on laptop till midnight. This lifestyle continued for almost one year. In the meantime, my mother-in-law and father-in-law both passed away suddenly within two months. My husband could not take this shock and he was going absolutely abnormal. Now he cannot feel any happiness, any rhythm or any charm. He acts just like a robot. As a wife, I am trying my best to make him normal and happy. But nothing can change him. Here is another difficult problem in our life. I tried to do freelancing job so that we can synch our life together. But I failed badly. Now I have no income and I am totally unemployed. This thing also a big reason of his disturbance. I am trying my best to do something, but what can I do in this sector? Except this one thing, I think I fulfill every responsibility to my husband as a wife, as a best friend. In this situation, I am also becoming frustrated. I am really afraid of our current situation. We love each other for more than 11 years and struggled so much to get together. We were a very happy couple and want to live some more time happily. Will you please help us to recover this situation?


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Hello. From what you have described, your husband has not been his usual self for more than a year. Did his problems start after his parents passed away or was he feeling low and detached even before this? It looks like he has some features of depression which have been perpetuated by adverse life events. Do not worry, it will gradually get better with some support. It is highly positive that you are understanding his situation and taking steps to get better. It is quite natural to get frustrated but try to remember that this tough period will not last forever. Try following these self-help measures: 1. Encourage your husband to open up and talk about his difficult feelings. Do not get into arguments, just try to listen and look for constructive solutions. When someone is depressed, they can be more irritable and easily frustrated. So do not try not to take critical comments personally. 2. Encourage him to do some exercise daily. It will help to lift his mood. 3. Make sure he eats healthily and sleeps well. 4. Try to make him reconnect with his close friends and family. Avoid getting isolated. But do not force it too much, needs to be done gently. 5. Try to distract by going for cinemas once in a while. If the problems persist, it may be helpful to consult your doctor locally and have some counselling to manage the difficult life situation. Take care.


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Hello doctor, I am 18 and I have never had period but sometimes I feel like something wants to come but it does not come. I had puberty hair and underarms hair two years back.


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Hello. It is called primary amenorrhea and it is a complex problem for which you need full assessment with all blood tests and ultrasounds and even more to rule out the cause and find a diagnosis what actually is going on inside. And sometimes it usually runs in families like if your mother or sister also had delayed periods then that could be another cause. But I would suggest you to see a gynecologist for further evaluation.


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Hello doctor, I am 19 years old, male, recently I have discovered that my crown hair is slightly thinning, however I think it is a cowlick, because the middle part of the crown where the swirl is thick but away from the swirl it is thinner. You can actually see my scalp lines or hairlines. You can see my top back hairline and side of the crown hairline.


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Hi.  I can see thinning of hair in the picture you have attached, but I cannot see the hair line (attachment removed to protect patient identity). It could be telogen effluvium (stress induced) or early androgenetic alopecia or visibility of scalp could be because of your short hair. Androgenetic alopecia or male pattern baldness starts with receding hair line on the temporal and frontal area of scalp then there will be thinning in the crown of scalp. I will have to see pictures taken from the front to visualize hair line receding to confirm androgenetic alopecia. Are you actively losing hairs everyday? Do you see more hairs while taking shower? Do you have family history of baldness? Any history of illness in the recent past? Any surgeries? Hospitalization? Hair needs protein for growth, diet rich in protein say 40 to 60 g of protein per day is very helpful. It depends on the body weight. Avoid hot water, use lukewarm water to wash scalp.


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Hello doctor, I want to grow more hair and hair thickness and avoid losing hair and thinning hair. Please check my pictures and advise me a perfect solution.


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Hello.  I understand your concern. Your condition is known as androgenetic alopecia or male pattern baldness, which has genetic as well as hormonal factors as the causative factors. You need to use treatment for this condition regularly and it takes about 3 to 4 months to start showing the results as hair cycle itself takes this much time. Start the following medications: A. Tablet Finpecia/Propecia 1 mg, take one tablet once a day. B. Rogaine (Minoxidil) 5 % lotion apply 1 ml twice a day. C. Nizoral shampoo three days per week. Do this initially for two months and follow up after that.


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Hello. The report on your ECG (electrocardiography) states that (attachment removed to protect patient identity) there is a presence of nonspecific intraventricular conduction delay. Some of the causes of this disorder are amyloidosis, cardiomyopathy, and electrolyte imbalance, etc. Are you experiencing any symptoms? Why did you go for an ECG?


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Hi doctor, My mother is 51 years old. Over 9 years she is unable to sleep properly either in the day as well as night. She started to feel irritated and we consulted one of our family doctor and he suggested to start Stalopam plus. But now a days even after taking the same medicine she is not getting proper and sound sleep. Currently, she is on Stalopam plus one capsule a day. I have attached the prescription. Please suggest us what to do?


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Hello. I have gone through the prescription attached (attachment removed to protect patient identity). Diagnosis was anxiety with insomnia for which Stalopam plus (Escitalopram) was prescribed. It seems she has developed tolerance to this drug. So, either dose should be increased or new drug should be substituted. To manage her insomnia and anxiety you need drug therapy such as starting on a sleep aid drug which also lessens anxiety like Clonazepam at dose of 0.5 mg to be taken half an hour before bedtime and continue to take the same. This will ensure quick relief of your mother's anxiety and insomnia but it has to be taken after consultation with a psychiatrist. Proper sleep hygiene needs to be practiced daily, so as to help her maintain good sleep in the long run. Sleep hygiene entails following important points. Anxiety. Check blood pressure. Insomnia Selective serotonin reuptake inhibitor (SSRI) and Benzodiazepines along with sleep hygiene.


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Hi doctor, My son is 2 months old and he is suffering with dry cough over the last 3 days. We consulted local doctor and he advised TA-65 capsule which can be taken by mixing one capsule in 10 cc of distilled water. He advised to use 2 mL of this mixture for 3 days. My question is how exactly does TA-65 work for cough?


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Hello. Your kid is probably suffering from some throat infection or lung infection (respiratory infection). TA - 65 is a telomerase activator, it comes in capsule form. It is used to boost immune system, skin and given for sexual improvement. It has no role in cough and it is not given in children. I advice you to not to give this medicine to a child. You should probably consult a different pediatrician there as rest of medication like antibiotics or medicated nebulization or any investigation needed. It cannot be advised without examining the child. Viral infection of respiratory tract. 1. CBP (complete blood picture). 2. CRP (C-reactive protein). 3. Chest x-ray if required. 1. Upper respiratory infection. 2. Bronchiolitis. 1) Kufril LS drops (Ambroxol hydrochloride and Salbutamol), 4 drops, three times a day. 2) Nebulization with 3% NaCl (Sodium chloride), 3-4 times a day as required. Avoid cold weather and maintain hygiene.


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Hi doctor, I am very sad, and I am surrounded by negative thoughts and anxiety. I have taken Fluoxetine (Fludac 20) for 6 weeks. Now I am fine, but I wake up early in the morning around 3.30 AM. Hence having disturbed sleep in the morning. My doctor changed medicine to Flunil 40. I think this dose is not required. Kindly advice me to avoid sexual side effects from this medicine. Thank you.


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Hello. Fluoxetine is known to cause significant insomnia in many patients as it is an activating drug. Being an selective serotonin reuptake inhibitor (SSRI) Fluoxetine causes sexual dysfunction. Both these side effects can be treated by taking tablet Trazodone (brand name Trazaril) 25 mg at night time. It antagonizes the side effects of Fluoxetine. After two weeks, if needed, the dose can be increased to 50 mg. Fluoxetine induced sexual dysfunction or insomnia. SSRI induced sexual dysfunction. Tablet Trazodone 25 mg at night time.


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Hello doctor, My age is 31 years, had scan done at 27 weeks and it showed early dialostic notch in bilateral uterine arteries with mild increased mean uterine artery pi- 1.42. Suggestive of uteroplacental insufficiency. I have got BP now (150/90). This is not anomaly scan. Seek second opinion, please let me know what are complications arising from this. I have read that if BP increases, there might be case that baby would be prematurely born with intestinal issues as blood supply is restricted. Also, whether it can cause any issue to my child, if born early.


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Hello doctor, I am 30 years old and married for 2.4 years. Now we are planning for a child. On 14th of this month, I experienced periods with very little stomach pain and pain in legs. The next day on 15th there was no bleeding at all, 16th I had spotting of light red colored blood flow, 17th the same thing happened and then the flow stopped. Again on 23rd night I had bleeding light red coloured blood flow, on 24th no bleeding at all, 25th I had fresh pink colored spotting. Then 26th pinkish brownish spotting occurred, 27th morning I did pregnancy test by urine, it came negative, and at 8 AM had brownish spotting, 28th had brownish spotting too. Please help me to know whether it is implantation bleeding or anything else.


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Hello. This is not an implantation bleed at all as even urine pregnancy test is negative. Considering that you have been having regular spotting during this month since 14th of this month with hypomenorrhoea, there are possibilities that your serum Estradiol levels are low which is a possible cause of such irregular shedding of the endometrium. It is important that you get an ultrasound pelvis done to check for endometrial thickness which if less than 8 mm then likely that you would not conceive during this cycle. Please tell me what hormonal profile was done with thyroid levels, serum prolactin, serum progesterone, serum estradiol, FSH, LH and AMH levels to establish the cause of such irregular shedding.


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Hello doctor, My daughter is 9 years old and has a typical headache at right temple. The headache, she says, is more or less constant and not severe in the day but is intense at night. She sleeps at around 10:00 PM and wakes up around 12:15 AM to 12:30 AM. This is when she cries as she is not able to bear the pain. She gets up from the pain itself. We have already done head X-ray and sinuses is ruled out. Even though the medicine is for antibiotics and I am not sure that it is working, as there is no improvement for last four nights (saving the first night when there was no pain and she could sleep the entire night). During her night pains when we give her Crocin, she is better after 10 to 15 minutes and then typically sleeps the rest of the night. We are trying to get appointment for silent MRI and have our fingers crossed. However, as you are very experienced and could identify a pattern or known case or cause, please do share. Again, the pain is only at right temple and nowhere else


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Hello. I understand your concern and would explain that this type of headache could be related to hipnic headache. Anyway, a brain MRI or CT scan is necessary in order to exclude a possible brain lesion, as the headache is always located in the right temple. I would also recommend performing PCR and ESR for inflammation. Temporal arteritis is another possible disorder, which could lead to pain in this region. In such case steroids would be needed. A Doppler ultrasound of the temporal artery is needed too. In case the brain MRI, inflammation tests and transcranial doppler of the temporal artery is normal, I would recommend considering hipnic headache as a possible cause. In such case Flunarizine or Topiramate would help improve her situation.


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Hi doctor, I have had a red like spot on my nose for a few months and would like to get it looked at. It does not bleed or change shape. I think it has been there for a couple of months.


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Hi. I have gone through your case. Well in my opinion this red spot does not look ordinary to me (attachment removed to protect patient identity). It is highly suspicious lesion as its margins look rolled up and it is present on sun exposed site as well. I am not scaring you but in my opinion it should be biopsied as early as possible as unfortunately my differential diagnosis is basal cell carcinoma untill ruled out on biopsy. Do not scratch it or apply anything. Just regularly apply any sunblock during daytime. And get your appointment done with your GP or local dermatologist as early as possible. Take care. 1.Sun exposure. Skin biopsy Sunblock.


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Hello doctor, My nasal passage was cauterized four months back. Two days later I began having lots of yellow pus like discharge from my nose. It mostly was being expelled via my throat with sputum. The cauterized site was yellow and there was yellow pus like all over. I have been prescribed Amoxyclav 625 for seven days, Cefuroxime 500 for seven days. The cauterized site was still not healed and was still having yellow discharge. I then consulted an ENT doctor who took a look at it and gave me Linezolid 600 for 10 days. The infection of the cauterized site is still not healed and still oozing with yellow pus-like discharge although there is slight improvement. I have low grade fever on and off. I feel I may be having an infection in my nose that is resistant to antibiotics. Can you please help me and advice me on how to treat my nasal passage? And also what other investigations should I do? I am worried about the infection whether it could harm me as it continues.


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Hello. The cauterized site you have mentioned might be infected as you said. 1. The best treatement now in this situation is take a sterile swab and touch the swab with the pus and send it for culture and sensitivity, it will definitely give the medication sensitive for your bacteria. 2. Meanwhile start injectables preferably Ceftazidime 1 g and injection Amikacin 500 mg after test doses for five days. 3. Start application of Neosporin ointment on the site.


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Hello doctor, My 4 years old daughter has an inward turn in her right eye after concentrating for a while. We had an eye test recently. Can you tell me if her results mean she needs glasses as she keeps saying her eyes hurt watching television and readings of her results are: Right eye sph +1.50 cyl -0.50, left eye sph +1.50 cyl -0.50. They told me she is long sighted and we have a strong family history of squints and glasses. I do not know if I should get a second opinion.


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Hello. That is a very normal refractive condition of a 4-year-old child and I would not advise correction. However, you might want to consider reducing the time watching TV along with the brightness of the screen after sunset. Reduced blinking might lead to drying up of the eye and that will lead to headaches and pain also. Monitor every six months considering the family history.


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Hi doctor,About a week ago, I got a sinus infection which turned into two ear infections. I have now been on Z-pak as well as Flonase and steroids for four days. My left ear feels substantially better. My right ear, however, is still a little plugged, and now I am experiencing pressure in my temple and jaw area on the right side of my head. Should I be worried? I have one more day left of Z-pak and steroids.


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Hello. How do you feel now? Are you better? Did the pressure in the temple and area around the right jaw resolve? The reason for those two is the block of the eustachian tube on that particular side. This is the tube that equates pressure on either side of the eardrum by connecting back of the nose to the ear. When it gets blocked due to sinus or nasal problems we feel a sense of block and pressure classically in the area between jaw and ear. If the two have resolved and you are feeling better, then it is good. Otherwise, we have to check if the infection is persisting. Probably, the organism would be resistant to that particular antibiotic. In that case, I would suggest you take a course of Ciprofloxacin and Tinidazole and send a swab from the nasal cavity for pus culture sensitivity. Based on the report, we can change the antibiotic again. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Good supportive treatment is required - steroid sprays for the nose, systemic decongestants (Phenylephrine), and an antihistaminic (Allegra) to help keep the ear dry. A persistent sinus infection with ear problems requires a nasal endoscopy with documentation of ear findings also. Do revert with more details so that we can help you further. Hoping that you are just fine and that you do not require any further medical attention. For more information consult an ENT otolaryngologist online -->


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Hello doctor,I had a physical test, and blood works done about six weeks ago. I told my doctor, I had a lump, or mass, under my right armpit. He checked it out, and then sent me for an ultrascan, and a needle biopsy. A week later the doctor, called and said it was follicular lymphoma which is a type of non-Hodgkin's lymphoma and is treatable. I am going, to have a PET, and CT scan in two more days. The oncologist examined me and said there is no swelling, in the neck, and spleen. Please tell whether this kind of lymphoma is treatable because I am scared of death.


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Hello. Do you have lymph nodes only in axilla? If it is only in the axilla, it is treatable. This is stage one. In this stage, either chemotherapy or radiation therapy will be given. Need not worry too much. Did they say what type of Hodgkin's B-cell or T-cell? If possible send the needle biopsy report. They will do all blood test like a blood smear test, and CBC (complete blood count). Usually, a team of doctors like a medical oncologist, hematologist, a doctor who treats lymphoma with chemotherapy, immunotherapist, etc., handle this. Targeted therapy from this one of the treatment method they do. I gave full details reading this and so do not get panic.


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Hello doctor,I have a red area that is itching on the penis head for a week. It looks like balanitis according to the pictures I searched. I also have pain after urinating. I have tried with Nystatin cream, but I have more itching than before. I cannot go to the ER, but the quickest appointment with the specialist can be scheduled in a week. Please help.


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Hello.  I understand your concern. Please send a picture of the affected area to help you better. I need to see to suggest the appropriate diagnosis and treatment.


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Hello doctor, I think I have something along the lines of a bipolar hypertension situation. I wake up in the morning, my blood pressure is prehypertension to around hypertension stage 1. Not that bad. But In the evening, to later in the night my BP is through the roof. In the midnight, my BP is measured to be 176/126 on standing. When I lay down on my left side and it is down to 110/60 after a few minutes. I could use some help in figuring this out. I am 20 old.


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Hello. I understand your concern, do not be bothered you will be fine. I advise you to get a pen and paper, write down your blood pressure measurement for three days. Make sure to measure immediately you wake up from sleep in the morning before any activity. Get back to me with the readings, it will help understand what is happening.


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Hello doctor, Please review the attached panoramic X-ray and advise of any health concerns. I have been advised to remove all four third molars. Is there a possibility of sinus exposure?


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Hello. Yes, you have impacted molars (attachment removed to protect patient identity). One of the upper molars has proximity with sinus, but it will not cause any complication or sinus exposure. Sinus exposures are a complication to disimpaction, but it is not necessary to happen in your case. You need to go ahead and get them removed. The possibility is least as per the radiographic relation between the sinus and upper molars.


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Hello doctor, I have anxiety disorder from the age of 15 (will be 35 by the end of this month). I started having frequent panic attacks and debilitating anxiety after my grandmother's death. Before all this, I had been on Paxil. Six months before, my doctor switched me to Zoloft 50 mg and increased to 100mg and 150mg in the following consecutive months. I am very worried about the possible QTc prolongation and sudden cardiac death. I struggle daily to take Zoloft. I had three ECG. First one was taken before six months, the second one before a month and the third one in this month in which my QTc was 400 to 420. Is Zoloft safe? Will it cause me sudden cardiac death?


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Hello. Zoloft (Sertraline) is an effective and safe SSRI (selective serotonin reuptake inhibitor) for managing anxiety disorder. Zoloft is generally considered a low risk for QTc (is an electrocardiogram representation of ventricular depolarization and repolarization) prolongation in healthy people. I can see that you had three ECGs in the last few months with QTc between 400 to 420 which is within normal limits. Zoloft in traditional doses (up to 200 mg daily) usually does not cause any significant increase in QTc. You are only on 150 mg once daily. So highly unlikely to have an adverse reaction. Can I ask why you are particularly worried about QTc prolongation and sudden cardiac death? Do you have any relevant risk factor like a previous heart problem or family history of arrhythmias and heart problems? Were these repeat ECGs done for any specific reason or only because of your anxiety? If you are otherwise healthy, Zoloft is generally safe. If you need any other medication for other reasons, remind your doctor that you are on Zoloft so that they can avoid prescribing medication that can potentially interact together. Also, street drugs are not advisable. Regarding your other query about Ativan (Lorazepam), you can continue gradually weaning till you are off completely. When reduced gradually chances of withdrawal effects are much lesser. It is good that you are stopping Ativan as it is not recommended for long term use. I note that you are currently in therapy. It will help to address your longstanding anxiety and develop better psychological coping strategies. It is common to experience worsening of your symptoms when you lose a loved one. Hopefully, you will recover gradually from the loss. You can also try deep breathing techniques and progressive muscular relaxation for managing stress and anxiety. I will also advise you to discuss your worry about QTc prolongation with your prescribing doctor. He will be able to monitor and advise you accordingly.


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Hi doctor, Two months ago I started feeling tingling and itching sensation between my thighs and then up to my chest. I just took the most painful shower ever (warm water). It stung and I wanted to scratch my skin off. At first there was nothing visible, just itching, now you can see red dots here and there on stomach. In addition, I have a bump on each thigh that has recently surfaced, maybe from scratching. I also feel this intense itching on penis that gets inflamed with intercourse. A doctor looked at it and said it was probably an allergic reaction to something new. But, there has been nothing new, not soaps, not detergents and no new clothes.


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Hi doctor, I am 28 years old. My height is 5'11'' and I weigh 91 kg. I plan to get married this year. I am currently on no medication. I currently have the following problems for which I desire to seek some solution for premature ejaculation. I think so, there is some kind of problem on the forehead of the penis because of which my foreskin cannot get retracted. Some sort of skin attachment is present at one end of the foreskin and the head of the penis due to which the foreskin is getting hurt at times when I tried to push back. I apologize that I am not able to make myself clear enough at this point in words. I request you to provide some remedy to the problems that I am facing. Thank you.


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Hi. I completely empathize with you. The problem of premature ejaculation is quite common and is distressing to a young man but is seldom discussed. See most of the time the problem is secondary to the anxiety attached to your expectations in the bed. It has been wrongly projected by unscientific magazine articles and porn that a man can last for 30 minutes or more. Honestly, most of the male ejaculate before 5 minutes. When you are anxious about not lasting long in bed, you actually do not enjoy the act of intercourse and keep on thinking about prolonging the act without enjoying it. The preoccupation and anxiety about not lasting enough, in fact, cause hyperarousal and lead to premature ejaculation. Moreover, when the male start to thrust himself into the partner the moment he undresses leads to early termination of the coital act (the sexual union that takes place between male and female during insertion of the penis into the vagina). There are also lots of young men who are suffering from premature ejaculation without any associated anxiety or apprehension. Such men as well as you may benefit by taking oral medication like tablet Dapoxetine or Paroxetine before the sexual act. But in your case, I would like to suggest relaxation techniques like breathing exercises and progressive muscular relaxation. Regarding your problem pertaining to the non-retractable foreskin, my opinion is that you must consult a surgeon. It is always better to remove foreskin if it is causing inflammation or itchiness. Non-retractable foreskin is often associated with problems of genital hygiene that may subsequently lead to chronic infections. So make an appointment with a general surgeon.


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Hello doctor, I have left-sided pain in waist and groin region. I was already consulting a urologist and was told that I have an inguinal hernia. But, symptoms of groin pain are due to pancreatic irritation. I have noticed that pain sometimes occurs in different regions and there is bloating in my lower abdomen past few days. All other tests are normal and the urologist tells that there is no other problem but prostate irritation. I have a problem sitting properly and it pains in the groin. Also, bloating is very uncomfortable. Should I again consult a urologist? I feel there are gastric problems and there is also a pain in the groin during bowel movements. I am currently on Alfoo. Please help.


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Hello. Your symptoms of groin pain while sitting or during bowel movements is likely due to an inguinal hernia. The pancreatic irritation is unlikely to cause such a pain. It causes periumbilical pain and also there is no cause for it. Now, next is there a hernia or not is unsure. If it is present then you need to visit a general surgeon, confirm it and get operated as it can cause complications. In patients with hernia, they have groin swelling, sometimes only seen on standing and coughing. Just check if it is present for you or not. For your bloating problem, you should avoid fatty, oily and spicy diet. You need to have some walk after having food instead of taking rest. You need to have regular sleep habits and avoid stress. Have lots of green leafy vegetables, fruits and avoid smoking and alcohol if any. Try to achieve some weight loss through diet and regular exercise. I suggest you take tablet Pantodac DSR (Domperidone and Pantoprazole) 40 mg before breakfast once a day for two weeks. Also, you should get dewormed yourself with tablet Bandy-Plus (Albendazole and Ivermectin) at bedtime once and another dose should be repeated after two weeks. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. For more information consult an internal medicine physician online -->


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Hello doctor, I noticed a white cloudy area around the rim of my cornea a couple of days ago with no pain. After a couple of days, I used a rigid gas permeable contact wear. I have now woken up with pain in the same eye and it is now bloodshot around that one side. I decided not to wear the contacts today and I have worn the glasses only. I visited my optometrist and he has prescribed a steroid drop. I am looking for a second opinion. Of note, I have worn glasses for 25 years. I have used the RGP lenses for 12 years. Had a white patch on the edge of the cornea approximately five years back. This was attributed to contact irritation and healed after a few weeks of not wearing RGPs. Please advice.


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Hello. This is a corneal ulcer. The probable cause is trauma due to lenses or infected contact lens solution. Please do not use the steroid drop. You can have devastating consequences. The steroid drops will give you very mild relief but it will stop healing and promote the growth of the ulcer. Investigations to be done include cultures of lenses and its solution. You should refrain from wearing the contacts in future. I suggest you use spectacles only. I suggest you take the following. Consult your specialist doctor, discuss with him or her and with their consent take the following medicines. Have this treatment until the ulcer heals completely. Visit an ophthalmologist. Follow up every week. For more information consult an eye care ophthalmologist online -->


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Hello doctor, I have a very dark skin. One of my friends used skinlite cream and she has turned very fair. Can I also use that cream to get a fair and glowing skin?  I really want a fair skin. I am just tired of my skin. Please help me doctor.


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Hi. Natural complexion is the best. Melanin, the pigment responsible for the skin color has protective effects. Use cleanser like cetaphil to wash your face. You can use sunscreen lotions like shade lotion regularly 2-3 times a day. Skinlite is a combination cream with steroid too. It may do more harm than good. Once you stop using, it may worsen the situation or rashes may erupt. You can use peeling agents like glyaha lotion to begin with and later with glyaha-hq lotion in the night after consulting you doctor. Consult a dermatologist online for further follow up -->


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Hi doctor, Is female orgasm necessary to get conceive? Are both male and female orgasms required at the same time for conceiving? After sex some amount of semen leaks out, is it normal? Please give me some suggestion. Thank you.


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Hello doctor, It has been four months since I have been suffering this problem. I have been to the sexual clinic. They say that all my tests were negative. They keep saying it is a non-sexual rash. I have had this white spot near my urethral opening for three months which is what is worrying me. What is it? On the corona, I also have this rash which seems to be spreading around the penis head. What is it? I have attached the images. All the STD and HIV tests were negative.


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Hello. The spots near the tip are a normal variation perhaps due to the keratinized mucous membrane near the tip as it is exposed and therefore it has a slightly rough texture. They are not warts.  I am more concerned about the rash on the corona of the glans. It looks like eroded skin along the circumference of glans. I would like to rule out the possibilities of either candida or yeast infection or STDs (sexually transmitted diseases) like genital herpes. Do you have any associated symptoms of pain, burning, or itching? Are you sexually active? When was your last sexual contact? Was it protected or unprotected? For more information consult a dermatologist online -->


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Hello doctor, Please provide information about my query. I am a cable operator. Once I visited a foreign lady's house. While doing the work, the lady provided me a water bottle. I drank the water and after 10 minutes I had small sores. I think the lady has poured her blood in the water. I think she had HIV, and can I get infected in this way? What is the period of the virus in the water?


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Hello. HIV cannot be transmitted through water, and it is not infectious because HIV cannot live in water. Drinking water containing the virus cannot cause HIV infection. If it is possible, then no one can stop HIV infection and all the population will be infected. So, there is nothing to worry about.


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Hello doctor, Today I had an asthma attack at work and they treated me and did a chest x-ray. I am an x-ray technician and I just do not think my chest x-ray looks right. Please suggest. I am currently on Concerta, Omeprazole, Cetirizine, Montelukast, Symbicort, Pro-air emergency pump, and Albuterol.


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Hi. The chest x-rays (attachment removed to protect patient identity), PA and lateral views are showing mildly prominent bronchovascular markings in the bilateral perihilar and lower zones and might be of concern for hyperactive airways after the asthma attack. There are no focal lung lesions. There is no pleural effusion. The cardiac size is normal. The retrosternal space is normal. The domes of diaphragm are normal. Please discuss this in detail with your doctor.


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Hello doctor, My partner ejaculated hours before we had unprotected sex. According to my ovulation calendar, we had sex on the day of my ovulation. If it helps, I have a 30-day cycle, and my last menstruation started six days before. I want to ask whether I can get pregnant with the pre-cum because he withdrew on time before ejaculating in me. I am afraid of what the result would be. And, I took an emergency pill that contains Ethinylestradiol and Levonorgestrel, three days after intercourse. I know it would not affect much because it happened the day after ovulation. But I am hoping for a different approach.


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Hello. Yes, pregnancy can occur with just precum as well but as you had taken I-pill within 72 hours then hopefully it would be effective and would prevent pregnancy. It does not matter if it was your ovulation day or not that you had unprotected act, but i-pill works in every circumstances. And second option which you could avail to totally eliminate the chance of pregnancy (as if you have not had taken pill within 72 hours) is to opt for coil (intrauterine device) in this cycle. It can be inserted up to 10 days after unprotected episode and can be kept as a long term contraceptive method or be removed after period gets started. It all depends on your choice. 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 a large mole like discoloration, flat, that is larger than an eraser head, and getting bigger, from practically a year ago to its current size. I am wondering if it is not a mole and is just pigment.


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Hi. I have gone through your case. In my opinion it is a rapid growing mole. As you have decribed, it was not there almost a year ago but now it has grown to this much size. I am not making you tensed but any mole which grows rapidly is a matter of great concern. You need to get a biopsy report as early as possible. The great concern is to see if any melanoma is developing in it. Any mole which has any of the following sign must need an urgent biopsy. 1. A: asymmetry. 2. B: borders irregular. 3. C: color change. 4. D: diameter greater than 5 mm. 5. E: evolving. My advice to you is to see your local dermatogist as early as possible. Do not take it easy until unless melanoma is ruled out. Skin biopsy.


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Hello doctor, I met with a mountain biking accident about two years ago. What I believe is I have a hypertrophic scar from the base of my nostril to my upper lip, which is about 3/4 inches. It is flattened a lot and is no longer red. Can I make it even better?


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Hello. Yes, it is a hypertrophic scar (attachment removed to protect patient identity). It still looks bumpy and elevated in the picture, and it can be flattened with intralesional Kenalog (Triamcinolone Acetonide) injections. You may need two to three sessions to bring it to the skin level. There are scar gels like Serica (Pracaxi oil), you can use it along with intralesional Kenalog injections to improve the texture. Microneedling with radio frequency (MNRF) is an effective procedure for this type of scars, after getting it flattened using intralesional Kenalog.


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Hello doctor, I have found small bumps on the outer edge of my vagina. They are itchy and sometimes burning. Once in a while they leak a little blood but mostly yellow discharge. Also I am 34 weeks pregnant and currently on some medicines for UTI.


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Hello. I have not seen your problem and nature of the bumps, but from the symptoms you mentioned I suspect that this could be HSV (herpes simplex virus), but I am not sure about it. As you are pregnant, I would suggest you contact your local doctor and have it assessed urgently. Because if it is HSV, then it could be harmful to your baby as you need to plan safe delivery of the baby timely. And I must say that this is something which must not be ignored because especially you are approaching near term now. 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 got a swelling in the groin area. I clean the groin area daily. I suppose this is because of excess body heat. It appeared the day after I did a long drive of 12 hours from my home town. And the place was too hot.


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Hello. Do you have itching and a similar skin lesion on another side of the thigh? Is this the first time you are having this problem? In the picture (attachment removed to protect patient identity), it looks like tinea cruris which is a fungal infection of the groin. The picture is not very clear. I do not see any fluid-filled blisters. Is there oozing of fluid from the bumps?


key: Patient
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Hello doctor, I feel rather extremely angry than at the same time, very sad. I always have this very gory thoughts that I wanted to kidnap and torture the person I hate and again, at the same time, I want to hurt myself because I am so incompetent and I always feel like all the people think the same way to me, that I am incompetent and that if I die, everyone will be happy. I also started gripping things strongly and I always try to stop when I notice. Am I really unstable? Does this mean I cannot do my work properly?


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Hello. How long have you been experiencing these symptoms like extreme anger, sadness, and other difficult emotions? Has there been anything ongoing stressors in your life that affects you negatively? From the information you have provided, it appears that you are stressed, experiencing depressive thoughts, and need support to cope with the emotional difficulties. Speak to a trusted family member/friend about your difficulties so that they can understand and support you. Do not keep things to yourself as it will add to your stress. Having fantasy thoughts of wanting to hurt the person you hate and self-harming thoughts can happen if you are overwhelmed by your situation and not having positive coping strategies. You need to consult a psychiatrist near your place for a comprehensive assessment to clarify the nature and severity of symptoms based on which counseling or therapy can be provided. With the right treatment, you will feel more in control of yourself and will be able to function normally. I hope this helps.


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Hello doctor, My daughter is 2 years old and suffering from worm disease. After taking medicines, it repeatedly occurs every three months. She was already given Mebex before one month, but it does not work out. So please suggest how to completely clear worms disease. Please advise the treatment.


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Hello. In this case of recurrent worm infestation, I would advise you to do a course of Mebex (Mebendazole) for the entire family living with the child and for the child itself once a week for 10 weeks. This will be coupled with a thorough cleaning of the house, specifically doorknobs, water taps, handles, and bedsheets. The child should be given syrup Mebex 10 ml once a week for 10 weeks along with weight and age-appropriate dosing for other family members at the same time as the child is taking the medication.


key: Patient
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Hello doctor, I had abortion, D and C, two months ago. After that, I got my regular cycle on the next month, and it was normal. Last month starting there was a one-day spotting, which again started on the mid of the month and lasted for four days. And after some days I had periods with a dark brown colored discharge but not of that adequate amount, but it lasted for six days like a regular period. But I had contact last month after which only the next spotting kind of discharge came as I told. I had progesterone from this month for four days to regularize my cycles. But I have not got my cycle till today. It is more than six days now. I usually used to get my period on the 5th day after progesterone. But this time I did not get my period till now. I do not want to be pregnant now. What should I do?


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Hello. If there is a history of sexual intercourse after abortion, then I would suggest you do a blood test and serum beta hCG (human chorionic gonadotropin) after 10 days of intercourse. Also, I would advise you to do one pelvic ultrasound and serum beta hCG to rule out any retained product of conception. If everything is fine, then you can take OCP (oral contraceptive pills) for three cycles to regularize your periods. Please do a pelvic ultrasound and serum beta hCG and send me the report.


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Q. I have lost most of my foreskin in circumcision. Is there any medication to stimulate the growth?


key: Patient
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Hello doctor, 20 years ago, when I was an young adult, my foreskin was mostly removed in circumcision. Some loose skin remains, although not enough to cover the head at all. Is it possible to regrow the skin or parts of it? And is there any medication or cream that could be used to stimulate skin growth?


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Hello. I can understand your concern for your symptoms. There are medicines to grow cells, but using in penis region is not an option. If your excess skin is giving difficulty during masturbation or sex, the only option is to see a surgeon and remove the excess skin and lead a happy life. If there is any other reason you want to remove the skin, do explain. We can work it out. Kindly elaborate your complaints and all the doubts or question you have in one message so I will do my best to explain all in an understandable scientific way.


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Hello doctor, I am a 61 year old female and a diabetic for the last ten years. I had a cystocele repair surgery along with hysterectomy and cervix and ovaries removal five months ago. There is a slight discharge on and off. I did a urine culture now and found that there was a colony of Enterococcus faecalis. Please let me know if this is serious and whether I have to take a course of antibiotics for it. I do not have any symptoms of UTI or abscess etc. Also, the cystocele repair was not a success as the bladder is still at the mouth of the vagina. Please also let me know if anything can be done to put the bladder back in place. If this is not done, what are the repercussions?


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Hello. I have gone through your query and understand the concerns. Hope you found the answer helpful. Regards. For more information consult an obstetrician and gynaecologist online -->


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Hi doctor, I have acid reflux problem for the last 5 years. Pain in my throat also happens because of it. For the last eight months, I feel dizzy, vertigo after eating food and sometimes even after drinking water. I have started taking herbal medicines for psoriatic arthritis before six months. Whenever I stop them, I have a normal stool. But, for the last few days, I have black stools and a little pain in the upper stomach too. Is it due to gastritis? Should I consult gastroenterologist? Last time when I took vitamin D supplement with multivitamins this dizziness stopped. My TSH is 4.9, and other reports are normal.


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Hi. We are here to help you. For further information consult a medical gastroenterologist online -->


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Hello doctor, I would like to get a third opinion in regard to categorizing which uterine abnormality I possess. The initial doctor said it is arcuate. My current doctor thinks it is bicornuate but I am going to do a 3D ultrasound in the middle of my next cycle to get a better idea. I have MRI and hysteroscopy photos to provide. I have had two missed miscarriages, the last one hemorrhaged two days before going septic and sent me to the ER for five days. I have also been diagnosed with a placental site nodule on my right side where both pregnancies have been. Could my problem be surgically corrected? Currently, we are going through genetic, blood clotting disorder, and menstrual cycle/hormone monitoring. Genetic counselor said low risk for any genetic causes but is still waiting to complete the blood tests which should be done in four weeks, same for the blood clotting tests.


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Hello. Having gone through the MRI pelvis and hysteroscopy pictures (attachment removed to protect patient identity), it is evident that you have a bicornuate uterus with a single cervical opening and it is not a septate uterus or an arcuate uterus. Two different horns of uterus are evident on MRI (magnetic resonance imaging), indicating the bicornuate abnormality. The option which you have is called Straussman's operation where both the horns can be cut in the centre and joined to make a single uterine cavity. You may discuss the option with your gynecologist and make a decision.


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Hello doctor,I tested positive for an autoimmune disease. My titers were 1280. I then had more blood work done by a rheumatologist and just now received some back online. I noticed my alpha 2 globulin was high (1.12) and my gamma globulin was pretty high as well. The rest were normal on the protein electrophoresis. What does this mean?


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Hello. You have not mentioned which autoimmune disease test has come positive. High levels of alpha 2 globulin are seen when there is a loss of albumin via urine because alpha 2 is a large molecule. It does not pass kidney filtration. So, it is retained because it is a component of globulin. That is the reason for high levels of globulin in blood. You need to test your 24-hour urinary protein that will tell whether you are losing protein in urine or not. Regards. For more information consult a rheumatologist online -->


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Hi doctor,I have Fordyce spots on my private parts, could you please recommend some treatment for it? Tried Vitamin A but did not help.


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Hi. Kindly send good quality image and revert back so that first diagnosis can be made. Fordyce spots are basically prominent sebaceous glands. There is no treatment required for same because they are natural glands. Few people have prominent glands others do not. But if one does not like its appearance then it can be treated with the help of procedure like electrocauterization. No topical medications would help. For more information consult a cosmetologist online -->


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Hi doctor, I have throat pain. The pain aggravates during eating or drinking. I also feel the pain while even swallowing saliva. I have the pain for the past three days. I am currently taking lozenges (Strepsils).


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Hi. Thanks for posting the query. I have gone through the image (attachment removed to protect patient identity) thoroughly, and I believe that you are suffering from acute granular pharyngitis. You need to start with home remedies such as, 1. Drinking frequent sips of warm water. 2. OTC (over-the-counter) pain relievers such as Ibuprofen or Diclofenac. 3. Use Povidone iodine mouth gargles. 4. Avoid coffee, smoking, chilled food and beverages. If the symptoms do not subside within a couple of days, then you need to consult an ENT specialist for a thorough examination and management. Hope this answers your query; revert to me if you have any follow up questions.


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Hi doctor, I have some tiny red spots on my inner arms. I have had it for a few days. They are slightly raised, but not much at all, and they do not itch or hurt. I do have psoriasis on my ankle, which I have had for a few months now. I also had a UTI and took antibiotics to treat it a little more than a month ago. I am wondering if I should go in to see a doctor about it. I am currently on Zoloft and birth control pill.


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Hi. Is it one forearm or both? Is there any history of travel or stay in a new place like a hotel or camping? Is there any history of gardening, or playing outdoors? Considering the history and after seeing the clinical picture (attachment removed to protect patient identity), I can provide the most probable causes for this rash. 1. Papular pityriasis rosea, an inflammatory condition that follows any kind of illness like flu, UTI (urinary tract infection), etc. It usually presents with red scaly spots that do not itch or hurt, starts on the trunk then extends to limbs and resolves on his own in six to eight weeks. Check for similar spots on the body as well. 2. Drug rash from the antibiotics that you took for UTI. May I know which antibiotic did you take? 3. Allergic contact dermatitis either to new cloth, sweater or new hand lotion. Do you recall using any new skin products or clothes in recent past? 4. Keratosis pilaris (KP) is one of the differential diagnosis if it is in both forearms (as in picture) and arms. KP is usually associated with eczema. Do you have any history eczema? 5. Have you been using any creams or ointment? Please discuss the options with your GP or dermatologist and get the appropriate treatment. Take care.


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Hello doctor,I will be having prostate TURP surgery in five weeks. My Urologist has recommended daily Finasteride four weeks before to reduce bleeding during the surgery then stop. I am worried that Finasteride has been linked to prostate cancer. Is this true? Is there an alternative medication to reduce blood loss? I know the Finasteride is just for four weeks, but I am still concerned. Is there any research on short term use?


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Hello. Before I begin, let me assure you that there is no evidence that Finasteride causes malignancy when used for short term such as four weeks. As such, both Finasteride and Dutasteride can be used for reducing the vascularity of the prostate. Dutasteride is a good alternative. But Finasteride has better action in reducing vascularity in the short term. In short, let me assure you, there is hardly any chance of malignancy by using either Finasteride or Dutasteride. Do not worry, be positive and wish you a very uneventful and successful recovery, post-surgery.


key: Patient
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Hello doctor, I am 25 years old. I have fordyce spot type rashes on my penis for many years. Is there any treatment for it? I have oily skin.


key: Patient
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Hi doctor, About three years ago, I went seven days without sleeping. I was hospitalized, and they tried everything to get me to sleep, but nothing worked. Finally, after seven days, they put me on Seroquel, and it worked. Now, I must take 800 mg every night to sleep. I tried to wean myself down, but as soon as I went down to 600 mg, I could not sleep. Will I have to be on this medication all my life?


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Hello. I read your query and understand your concerns. First of all, I want to inform you that you are having insomnia, which means sleeplessness, Revert with more information to an internal medicine physician online -->


key: Patient
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Hello Doctor, I have a short and curved penis. The curvature is towards left side. How can I make it straight? I want to increase its length by around 2 inches. How to boost my libido, stamina and erection time without any side effects? Are there any tablets or should I just follow a particular diet?


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Hi,  Welcome to icliniq.com. Advice: After all these measures, if you really feel that your penis size is very small, then you can increase the size of penis by surgical means. Consult a sexologist online for further follow up -->


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Hi doctor, I need help. I had my molar extracted last week. The area where the tooth was removed is looking very weird. Green, white, blue, yellow, with a tint of blood? It looks like a mold. I am taking Mefenamic acid thrice a day, I put ice on it, and I am on a soft diet. It is sometimes painful, throbbing.


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Hi.  I have gone through your question. I can understand your concern. As per your history and sent photos (attachment removed to protect patient identity), it looks like the wound is healing and the color changes occur during the healing period. If you have bad breath and burning type of pain, it could have been dry socket which it does not look like.  If you feel continuous pain and throbbing, you may need a course of antibiotics like Augmentin 625 (Amoxicillin and Clavulanic acid) twice daily for five days. If the pain is an intermittent and only boring type, wait for three to four days.


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Hi doctor, How to stop ear crackling? I hear it everytime I yawn, swallow or do it intentionally. Why? What is the solution for it?


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Q. My schizophrenic mother turns violent on auditory and visual hallucinations. Please suggest medication.


key: Patient
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Hello doctor, My mother has paranoia schizophrenia for the past 16 years. The delusions have become very absurd and in her story, her immediate family is the culprit. She has very vivid auditory hallucinations and sometimes visual hallucinations. She has refused to see a doctor as she believes they are in on it. Her stage of psychosis is very violent in which she screams and shouts and also turns violent. This has been going on for 16 years, but now the episodes of psychosis are becoming more intense. Please advise on how to talk to her or at the very least medicate her because it is taking a toll on our mental health. My sister suffers from depression and I suffer from anger management. How our father holds it together I have no clue. Please advise.


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Hi. It is quite difficult to manage such issues when patient refuses to take the drug. However, nowadays Depot injections are available and their effect lasts up to four weeks. So talk to your psychiatrist regarding the injection. Once she is put on a monthly injection then it will be easier for you to give her a monthly dose. This will ensure drug compliance and a better outcome. I hope this helps.


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Hello doctor, I had a hip X-ray of 35 mAs. An average hip x-ray is supposed to be 20 mAs/.07 mSv. So if my hip x-ray was 35 mAs, how many more mSv have I received? Was I overexposed?


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Hello. The x-ray power output depends on mAs (milliampere-seconds) and kVp (kilovoltage peak) parameters. The average hip x-ray can be done at about 20 to 30 mAs and 70 to 80 KVp. The general rule is that the percentage increase in mAs causes a similar increase in radiation dose. In your case we can take the average tube current as 25 mAs and dose given to you is 35 mAs. Therefore you might have received 30 to 40 percent over the dose if given a 25 mAs exposure. As x-ray dose for hip x-ray is less when talking about the harmful effects of radiation, so you do not have any significant increase in radiation dose risks.


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Hi doctor,My 22 months old baby has a very high fever. It has been fluctuating from 38 to 40 degrees. I gave him Tylenol but it still did not come down after five hours. I put suppository. Last week he was diagnosed with an infection in the stomach and was prescribed Nortop antibiotic and then the infection moved to the chest. So he is on Amoxicillin but now even after I put the suppository the fever is still not going down. I am really worried about what to do?


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Hi. In view of such high-grade fever in such a small child, I would advise you to take the child to the nearest pediatrician in order to get the child physically evaluated and blood investigations like CBC, CRP (and others as per physical examination be done). Though the WBC count was 12000 last week they may have increased now since the fever is a little high (40 degrees). Also the antibiotics given previously may need to be changed) stepped up. As of now to bring down the fever you can do tepid sponging.


key: Patient
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Hello doctor, My son is having a fever for the last five days and has dipped slowly from 102.5 F to 100.4 F in five days. The fever is backed up by a cough also. For the last 36 hours, he is having a continuous dry cough for which our physician suggested Levolin syrup 2.5 mL thrice a day. Please opine. He is also on Crocin Suspension DS and RespiCare and Bresol. He has also taken these in the past. Please help.


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Hello. Your child is having viral upper respiratory tract infection. His fever will subside in another two days. Viral fevers last for five to seven days. A cough will remain for a few days. I suggest instead of giving syrup Levolin (Levosalbutamol/Levalbuterol), nebulize him with 1.2 mg of Levolin every six hours. This is a much lower dose than syrup and acts on lungs directly.  Apart from this, use syrup Benadryl (Syrup Diphenhydramine, Ammonium Chloride, Sodium Citrate) 5 mL thrice daily. Make him drink warm water, give him lozenges, and one teaspoon of honey in the morning and evening. This will take care of his problems. For more information consult a child health specialist online -->


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Hello doctor,I have a fever of 101 C. It has been almost 12 hours. I cannot breathe properly. My eyes are burning. I ate a Paracetamol 650 mg about one hour ago. Head feels heavy. Dizziness and confusion are the symptoms.


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Hello. After careful analysis of the history provided, I would like to assure you that having symptoms of eye burns, dizziness and confusion while having a viral fever is normal. You do not have to worry about that. Having said that, since you have mentioned that you have been having similar episodes in the past, I would like to suggest you to: As of now, Stay healthy and positive. For more information consult a general practitioner online -->


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Hi doctor, I was playing football and I had got bitten by a black and white mosquito. After some time, I got shaking and had a fever, head pain, and a back muscle pain.


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Hi. According to the history, you have to rule out dengue fever, chikungunya or malaria fever. So take Paracetamol 500 mg two tablets for six hours until the blood tests are done. Avoid mosquito breeding places like stagnant water near home, wear full sleeve clothes. Take an adequate amount of fluids. The probable cause could be due to Aedes mosquito. You can get a complete blood count, IgM test for dengue, IgG for malaria, microscopy, blood smear test done. For more information consult a general practitioner online -->


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Q. Due to my IT profession, I have lower back pain and shoulder pain. Please suggest treatment options.


key: Patient
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Hello doctor, I am running an IT firm for the past four years. Currently, I am having two health issues related to my work. 1. Lower back pain - it started two years back and now it has become worst. Now I cannot ride a motorbike, cannot sit in a normal chair, and cannot even sleep on my sides. I also cannot walk or stand continuously for more than half an hour. Currently, I am using a belt and it is helping a lot. 2. Pain in both the shoulders if they are not in action. Like if I am sitting in the chair for more than an hour without regularly using my hands. The shoulders start paining. This just started a few months back and getting worst. I have not consulted a doctor yet for both of these issues. I wish to book an appointment and it would be appreciated if the doctor knows Malayalam as my English is not up to mark.


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Hi. Well, you have a typical problem with people working in an IT firm. Tell me first how much physical activity you have in your daily routine.


key: Patient
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Hello doctor, Fever and chills in a child of age 3 years 6 months. A mild cough is also noticed. What can I do?


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Hi. Shivering may be because of a highfever, or because of urine infection or malaria. As of now use the below medication. Syrup Crocin DS (Paracetamol) 5 ml/240 mg, 4 ml if fever greater than 100 F every sixth hourly. Sponging with lukewarm water until the fever decreases to 99 F. Give Syrup. Meftal P 5 ml if fever not decreasing after giving Paracetamol or Crocin DS or when shivering present. For a cough, give syrup Ascoril expectorant (Bromhexine HCl, Guaiphenesin, Terbutaline HCl) 3 ml three times a day for five days.


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Hello doctor, My niece got a fever for the past eight days. Also, low WBC count. The doctors tried all the tests, antibiotics and medicines, but still, the fever is not controlled. She got fits 15 days back and the doctors prescribed Eptoin tablets. My question is whether Eptoin reduce the white blood cell counts?


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Hello. I understand your concern and would explain that Eptoin (Phenytoin) is a drug used to treat or prevent seizures. It does not usually affect WBC, but very rarely (like all the drugs) it can cause suppression of the blood cell formation in the bone marrow. The low WBC count can be related to different possible causes like viral disease, an autoimmune disorder, drug adverse effects, etc. A myelogram may be needed to exclude a possible hematological disorder. In the meantime, I recommend taking Eptoin, as it is well known that high fever can lead to seizures. I would also recommend taking steroids, because they can increase WBC and also help fight the fever.


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Hello doctor, I was exposed to a loud noise (gunshot). Since then, I have a static noise in my ears when it is really quiet, and I get a pressure at the back of my head that often turns into a headache. Sometimes, I also get a tone in my right ear. If I do some physical activity, I may have dizziness. This has been going on for six weeks now. I have been to an ENT and did various tests (attached). None are showing hearing loss, and since the tests are clean the ENT cannot determine what is wrong.


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Hello. Do revert with more information. I will be happy to help you. Revert with more information to an ENT otolaryngologist online -->


key: Patient
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Hi doctor, I am a 28-year-old male. My weight is 70 kg and 5'4". I diagnosed of LDL 188 for the first time. So what can I do?


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Hi. Well, not only the LDL (low-density lipoprotein) but the triglycerides, the HDL (high-density cholesterol) and their ratio are equally important. You need to do some dietary and lifestyle changes according to your current LDL score. Consult a physician for a thorough examination, ECG and discussion for changes in your lifestyle. As per the latest guidelines, you might not need any medication for your level of LDL unless any other problem does not exist. Take care.


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Hi doctor, I am always feeling depressed and lonely. I am now least interested in doing activities which I used to love doing. I cannot even concentrate on my studies. I am feeling dull every minute with stress, negative thinking, and overthinking. What to do?


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Hi. I can understand your problem. You are suffering from depressive episode. Your issues like being negative, sad, tensed, tiredness, decreased interest, weakness, decreased emotional control, sleepness, the eating problem are the core symptoms of a depressive episode. I have a few questions for you. Is there any family history of any such kind of illness? Is there any history of thyroid problem? Do you have any recent psychological trauma like breakup, examination results, or financial problem? Are you taking any medicine for any other issue? Do you have a history of self-harm? Can you reveal if there is any past medical history, the effect on you, and taken full treatment or not? I assure you that all your symptoms will disappear after treatment of depression with antidepressants and psychotherapy, CBT - cognitive behavioral therapy. The investigations to rule out a medical cause of depression are CBC (complete blood count), TSH (thyroid-stimulating hormone), blood sugar, serum calcium, and serum B12. Take a healthy diet, avoid junk food, do moderate exercise and relaxation technique (yoga, meditation, etc.,) which may help you. Thanks.


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Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.


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Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->


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Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.


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Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->


key: Patient
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Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?


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Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->


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Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?


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Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->


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Hello doctor, My wife has been having itching on her body for the past one year. Itching subsides with Allegra 120. She is taking this medicine for the last one year. Mostly, she gets itching on the area which is not covered by clothes. Skin becomes red when she scratches it. I am attaching the picture.


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Hello. She is allergic. The allergy can be due to food, sunlight, pollens, soap, moisturizer, or powder. So she can be allergic to anything. As you mentioned that only areas that are not covered by clothes are affected, which points to photosensitivity which is an allergy to sunlight. It can be an allergy to something else as well. It is very difficult to say only on the basis of history. I would suggest to look for any particular food if she develops itching after eating something. Change soap, moisturizer, and powder. Cover the whole body while going out which will protect if she is allergic to sunlight. You can also go for skin allergy testing which will confirm the diagnosis. Take tablet Montair LC (Montelukast and Levocetirizine) whenever she has itching. Stop Allegra. It is basically prevention from allergens she is allergic to. You can find it by yourself by closely watching or go for skin allergy testing.


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Hello doctor, I am a 23-year-old male. My height is 5.8. Some years ago I had an accident, and there are scars and black marks on my face. Please suggest me the ways to remove the scar and the black spot from my face. Also please provide me a solution for my dandruff.


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Hello. A black mark on the face can be quite worrisome. It can be treated, but I need to know how deep was the wound and is the mark accompanied by any scar? It will be helpful if you could provide a photo of the same. For the time being, apply Aloevera gel (natural) over the mark daily twice as it helps in healing. Regarding oily skin and dandruff, you can apply a Ketoconazole shampoo like Nizral weekly once and bath. Keep your scalp dust free. For oily skin, you can use good neem based facewash twice daily. Get back to me in 20 days, let us see how you have responded. Dandruff itself will lead to hair loss. So treat dandruff first and then treat hair loss if it persists.


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Hello doctor, I have psoriasis for a long time for which I have been taking Methotrexate. Last week I got my iron studies and blood test done. My transferrin saturation, and total iron levels are low but hemoglobin is fine. Kindly advice.


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Hello. Your transferrin saturation and iron level are mildly decreased, and your hemoglobin level is normal. So you do not have iron deficiency anemia, but it can be an early sign of iron deficiency. You need to investigate with serum ferritin level because that indicates iron storage level. You need to take iron-rich foods like red meat, beans, pumpkin seeds, and green leafy vegetables, etc. There is no need for taking an iron tablet as hemoglobin level is within the limit. I hope this will help you. Let me know if I can assist you further.


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Hi doctor, I had two psychotic episodes last year and was diagnosed with schizoaffective disorder. I have recently prescribed Risperidone (1 mg) in combination with Wellbutrin (150 mg). One is a dopamine blocker while the other is a dopamine reuptake inhibitor. Would not these cancel each other out?


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Hello. The short answer to your question is no. They do not cancel each other out. You may be aware that Risperidone (a dopamine antagonist) is prescribed as an antipsychotic and also helps to stabilize mood whereas Wellbutrin (Bupropion- norepinephrine-dopamine reuptake inhibitor) is used as an antidepressant. You need to be monitored for any potential side effects when you are taking a combination of these two medications. So kindly follow up with your prescribing doctor who will be able to review and titrate the dose accordingly. Also, inform your health care professionals if you are prescribed any other medication for other reasons. They will need to consider potential drug interactions. Take care.


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Hello. Hope this helps. Please feel free to ask more if you need further assistance. I would be happy to answer any queries. For further queries consult an internal medicine physician online -->


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Q. Why are faint T lines appearing on urine pregnancy tests, while ultrasounds say I am not pregnant?


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Hi doctor, I have been trying to conceive for a few months, but every time the test comes back negative. My last periods was on the 25th of last month, and I started ovulating on the third of this month, and it ended on the 12th. My husband and I had sex on the fifth. Despite my history of irregular periods, I was expecting them to come this time around the same date as I was put on Cabergoline to control my high prolactin (22 on the last report) for regularity of periods. I did not get periods on 25th, but I did not worry too much, as I could have been late in general. However, I checked pregnancy on 20th of this month, which was negative, but I kept the kit. I checked the pregnancy again on 28th and found it negative again, and kept the kit again. After a few hours, I went back to throw the kits, and I found a very faint line on the 28th one, and checked the other one also and found a very faint line on that also. The one on 20th was more fade than the one on 28th. I thought it is urine or evaporation line, and did not take it seriously. I went to the hospital, and the doctors did not find any gestational sac or ectopic pregnancy in ultrasounds also. Nothing at all. But as I had a faint line, they asked me to come back after 10 days. Yesterday morning, I again did a home pregnancy test. Within 2 to 3 minutes, I got another faint T line. This time it was a bit darker as compared to the previous one. I do not understand what is going on. The doctors said that there is nothing called as false positive if the test is checked within prescribed time frame, and a T line appears only when there is some hCG hormone, however, nothing on the ultrasounds. My all four I-can strips show faint lines, but the Prega news kit does not show anything at all. Complete negative. My ultrasound shows nothing. What could be happening with me? My medications since last month are Cabergoline, Metformin, and Folic acid. The doctors say that it could be too early to say something, or it could be ectopic, which could not be verified in the ultrasounds. Could you please give me some opinion on this, as to what could have been the reasons for faint T line appearing within 2 to 3 minutes, while ultrasounds say I am not pregnant?


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Hello doctor,My baby is three and a half months now. Since he completed three months, he is more on formula milk than breastfeeding due to supply issues. He poops every alternate day. I am concerned as his poop color is dark green and at the end of the process a slight yellow poop comes. I have learned that babies on formula milk poop green but it is dark green. That is the reason I am concerned. Please suggest. Also, I would like to add that the consistency is normal, not too hard or too watery.


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Hello. The color of the poop does not matter much unless it is dark black, which is a possible sign of occult blood. Usually poops in babies on formula feed is dark green. A breastfed baby will have golden yellow poop. So, do not be worried at all. I also suggest you take some medicines to increase your milk supply as every mother gets milk at least until the baby is six months old. You can try supplements like Lactare or Lactonic granules in milk. If this does not work, I suggest trying Domstal (Domperidone) tablet and it will surely increase milk supply. I hope you use a breast pump too at home. The more you pump and stimulate your breast, the more milk you will get. Hope this answers your queries. For more information consult a paediatrician online -->


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Hi doctor, I am having a white coating on my tongue. Also, since my childhood, I have had a problem with frequent urination. I have a slightly enlarged prostate of 21.9 whereas less than 20 is normal. My skin has always been very dry. For about 1 or 2 years, I am losing hair and suffering from dandruff. Now I am doing daily tongue scraping, oil pulling for 3 minutes, asanas and some pranayama. My diet is mainly vegetarian. I am on my 8th day of a kitchari mono-diet. I have taken 30 to 60 mL of ghee per day for one week. I am eating twice per day (breakfast and lunch). However, the coating on the tongue remains the same with no improvement. Should I continue the mono-diet? If so, then for how long? As for the urination problem and enlarged prostate, what is your opinion on Himplasia tablets? Would they be beneficial?


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Hi. I have gone through your details and found that you are following certain kind of diet, which is not really beneficial in this condition. Instead of sticking with a mono-diet (ayurveda diet for detoxification) you can make the following practices. Aama (toxins formed in the body) and diminished digestive fire. Revert back after two weeks to an ayurveda specialist online.--->


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Hi doctor,I think it is weird, but my xiphoid process has come out. It is paining a lot. I am 18 years old. Please help.


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Hello doctor, I am 29 years old. There are some reddish white hard spots on my scrotum. They are painless but itchy. How can I get rid of them? I have searched on the internet and it says that it is calcinosis cutis of the scrotum. Please suggest something to clear those.


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Hello. I understand your concern, but you should have sent me the pictures to confirm the diagnosis. If it is calcinosis, then no cream or powder will help. The only treatment is surgery for that. Take care.


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Hi doctor, I am getting pain in the middle of my chest when I put pressure on it such as while sleeping when I suddenly wake up or turn around. Why?


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Hi. Costochondritis is the most common cause of sternum pain. It occurs when the cartilage between the sternum and ribs becomes inflamed and irritated. Try the following methods. 1. Ice pack to your chest. 2. You can take non-steroidal anti-inflammatory drugs, like Ibuprofen to reduce pain and inflammation. Limit your movement and avoid any heavy lifting. If still pain persists, then go for investigation.


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Hello doctor, I am 24 years old. I have always been very anxious about health, especially my sexual health. But when I was about 9 or 10 a spot came up on my penis where the glans and shaft meet. It was flesh colored, painless, and round. There was no dimple in it. I was never sexually abused or sexually active at this age. I did not even masturbate the first time until I was 12 or 13. My mom took me to the doctor and they said like just come back if it gets bigger. She had likened it to a wart, but it was not very hard or dry. Anyway, it stayed for a couple of years after that it shrinks down. It no longer appears as if it is above the skin but appears as a small pin-sized bump underneath a skin bridge. I am curious if it cannot be an STD and I have never found anything similar online. So what could it be? I would not think a wart would stick around that long. And it really does not look like that at all. That was there over 12 years so I would not think it is anything fatal. To be even more specific, it is on the top side to the right. As I said, it looks like a skin bridge with a little bump underneath. But it really has no sort of texture. And the only problem it really causes is some skin rubbing when that extra skin rubs my underwear.


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Hello. This was likely a wart only. Warts can have very varied morphology and most plausible explanation is for wart only. Because, considering it was a single lesion, was not painful or itchy, flesh colored and it persisted for a long time and resolved on its own. So all these factors favor it. Morphology can be variable. The negative factor was not sexually active. Although most common causes are sexual contacts, but significant number of individuals may have it with non-sexual contacts as well, it can be transmitted vertically during childbirth and remain dormant for a long time activating later in life. It can be transmitted with usual contacts and can be transmitted through clothing like underwear (if came in direct or indirect contact with infected individual clothing), sharing toilets, etc., can also transmit it. So being not sexually active is not a strong factor against it. Rest all causes like skin tags which would persist without treatment or fall off suddenly, PPP (pearly penile papules) would be numerous papules, other infectious causes would be short-lived and multiple lesions and symptomatic like painful tender or red. Malignancies are unlikely at this age and would progress. So the probability is high for wart only. I hope this helps.


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Hi doctor,I have uncontrollable anger. I quickly get angry and throw things. When my anger reaches a point I start crying and I have an ache in my right head. Also, I feel weak. Please help me.


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Hello. It is good to know that you are insightful about having anger issues and seeking help to address the same. How long have you been having problems with anger? Have you always had an angry temperament or is it something you developed in recent years? What do your parents and friends say about it? Some people get angry in response to stressful situations; some get angry even with minor frustrations in their day-to-day life. People have different thresholds when they get angry. Uncontrolled anger outbursts happening regularly is not healthy as the body releases stress hormones which can make you emotional and also cause a headache. If you also have emotional problems, then they can be exacerbated during angry outbursts. I will recommend taking active steps to manage anger. These simple steps can help. 1. Exercise regularly. 2. Learn relaxation techniques. 3. Try yoga or meditation. 4. Have an open talk with your parents or trusted friends. If the problem is persistent, then you will benefit from counseling or anger management. You can contact again if any further advice is needed. Take care.


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Hi doctor, I have been suffering from itchy skin since early this year. My doctor does not know the reason for this itching. I had a blood test a few weeks ago, which came back fine. It is mostly itchy on my scalp, upper arms and back. I have been on Telfast to help with the itching and Daktacort to help with a red patch on my foreskin that my doctor said was thrush. Also, he thinks that the thrush may be the root cause of itchiness. The Daktacort has taken this patch down and almost goes away within a week but if I stop using the Daktacort the patch comes back. I have also developed a red spot on the tip of my foreskin, as well as two on the inside of my penis on the shaft. These are not itchy or sore but are just worrying to see as I am generally a healthy person. I also recently had an STI test which came back negative. My partner also had an STI test done and this came back negative as well. Any help would be great!


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Hi doctor, As I use glasses continuously whenever I put them off, my eyes start asking for them, and I feel discomfort. For some time it will be fine to put eye lens for 2-3 hours. If I do not wear specs for 3-4 hours, will it affect my power?


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Hello. From what you describe, you have become addicted to your glasses. Your age permits you to wear lenses, and that will provide you with even better correction and vision. But, to better evaluate your condition, I require to know your refraction and the power of your spectacles. It would be informative to know your visual acuity without and with spectacles.


