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### Human:\nwhy am i bleeding after taking contraceptive pill?\n\n### Assistant: the extra bleeding could be due to the pill. however it would depend on the pill you took. if you have taken an emergency contraceptive pill then yes that would be the reason of excessive bleeding. however if you have taken a normal contraceptive pill then it will not protect you against pregnancy. though your details are not complete i need further details to guide you better. so please give further details. revert back with further details to an obstetrician and gynaecologist online --> <link> |
### Human:\ncan a bad cold cause variation in lymphocyte count?\n\n### Assistant: low lymphocytes can result from a viral infection. as you are giving history of common cold and cough following which your lymphocytes are low there is nothing to worry at all as all this is due to viral infection only. this would recover soon. for further information consult a general medicine physician online --> <link> |
### Human:\nmy wife has peculiar headache near left ear. what is it?\n\n### Assistant: headache which you have described could be migraines. i would need to know answer of few questions which would help me in getting to the right diagnosis. any history of headache (ha) in your wife's family or your children? how does the headache feel - throbbing pulsating or pressure type? does she get any aura (symptoms) prior to start of her ha such as flashing of lights colors stars black dots etc? did she experience any numbness over face or fingers? describe her ha severity in grade 1-10 1 - minimum and 10 - maximum. what brings her ha and what relieves it? for example sleep food and dark room. is she sensitive to noise and sound during her ha? does she get nausea or vomiting with these ha? does she get any redness in eyes tearing in eyes (left eye) with these ha? does she have any motion sickness brain freeze with ice cream or wet hands? does she take any medicine for these ha? since your ha frequency are frequent (when they occur they occur as multiple episodes in a day). once i have answers to these questions i would discuss about management (drugs). in the interim it is good and reassuring that ct head is normal which tells you there is no mass occupying lesion or increase icp (intracranial pressure). also mild increase in tsh (thyroid stimulating hormone) should not be associated with her ha. things she should do in the interim are drink water 2 l per day and keep herself well hydrated. exercise daily and run 2 km at 4 km/hour speed at least. have a good sleep for eight hours a day. revert back with the answers for the above questions to a neurologist online --> <link> |
### Human:\nwhat are the treatment options for chronic sinusitis?\n\n### Assistant: an ent doctor would have advised you to undergo endoscopic sinus surgery and septoplasty. surgery is the treatment of choice because your problem seems to be chronic (from longer duration). if you do not want surgery then you can take nasal spray (a combination of steroid and antihistamines) for a month mucolytics for a week and antibiotics for 14 days. early morning jogging is really good for patients having sinusitis. please follow the advice for a month and check if you have any improvement in your symptoms. since the pollution levels are high in your locality i would advise you to do exercise and jogging at home itself. for further information consult an ent otolaryngologist online --> <link> |
### Human:\nwhat is the treatment for red sputum?\n\n### Assistant: acute sinusitis should be treated with 10 days of amoxicillin and what you are having is acute on chronic sinusitis. i would suggest completing the course for next five days. continue the steaming and use saline nasal spray. do not blow your nose so hard. if the antihistamine is making your nose dry then do not use it use paracetamol for pain relief. allegra (fexofenadine) is a good medication but sometimes can cause nasal dryness. once the nasal dryness is cured you can also use nasal steroid that has fluticasone or use nasonex (mometasone) or nasacort (triamcinolone). use one spray in each nostril throughout the spring season. for further information consult an internal medicine physician online --> <link> |
### Human:\nmy mom is a ckd patient and my bp is high. should i consult a doctor for hypertension?\n\n### Assistant: i understand what you are going through but there is no need to worry. hypertension is very common these days because of the prevalence of bad lifestyle genetic predispositions etc. in your case your mom's history of ckd (chronic kidney disease) increases your chance of hypertension. i suggest you get cbc (complete blood count) lipid profile urine analysis and ekg (electrocardiogram) to review your cardiovascular system. to help reduce your blood pressure changes have to be made as follows. lifestyle modification is the first step you have to eat healthily. eat more of vegetables nuts fruits whole grains fish and chicken. try to exercise at least 3 to 5 days in a week. reduce salt intake and always get adequate sleep. if after three weeks your blood pressure does not normalize you will have to start taking medications. for more information consult a cardiologist online --> <link> |
### Human:\ncan you suggest ayurveda medicine for sinusitis?\n\n### Assistant: anu thailam - ayurvedic nasal drop apply 2 drops in each nostril before bed and at morning. nirgundi thailam - apply 10 drops on scalp top of head and rub with fingers. this should be done at 6. 30 am. then take bath after 7. 30 am in normal water. take a dried turmeric stick. show it on the fire in a candle. once the turmeric stick gets burnt then blow it to stop fire. now you can see the smoke coming off from the turmeric. show this below your nose and take deep breath so that the turmeric smoke should enter into your nostrils. start pranayama (breathing exercise) and yoga practice. these will give a permanent solution for your nasal block and sinusitis. for further information consult an ayurveda specialist online --> <link> |
### Human:\ncan recurrent uti be caused by holding urine in for long?\n\n### Assistant: your history suggests that you have very frequent urination and poor flow with recurrent uti (urinary tract infection). i would like to know the following. do you have constipation or numbness of the sole? how frequently do you get up at night? has any catheter been put in your urethra for any reason? do you have to rush to pass urine? the urine analysis does not show significant pus cells why do feel that you have uti? probable cause: bladder irritability. sphincter dysfunction. investigation to be done: uroflowmetry. i suggest taking the following: tablet tolterodine 2 mg. tablet tamsulosin 0. 2 mg at bedtime. psyllium husk three teaspoons with two glasses of water. your post-void retention is 30 ml which is also fair. i think you have dysfunctional voiding. revert with more information to a urologist online --> <link> |
### Human:\ncan mucosal polyp in maxillary sinus cause headache?\n\n### Assistant: it is chronic maxillary sinusitis secondary to mucosal polyp and so go for a ct paranasal sinus. it will tell about the dimensions of mucosal polyp and its operability. till then i suggest you the following medicines. consult your specialist doctor discuss with him or her and take the medicines with consent. tablet cefpodoxime plus clavulanic acid combination for five days twice daily. tablet relent (cetirizine) one tablet twice daily for five days. capsule darolac (lactic acid) thrice daily for five days. tablet sumo (nimesulide) half tablet as and when necessary; maximum three times a day. for further doubts consult a general medicine physician online --> <link> |
### Human:\nwhy am i urinating more than 10 times a day?\n\n### Assistant: please measure your fasting and postprandial blood glucose level as you might have diabetes. it is usually accompanied with increased thirst and increased hunger. also please get a urine analysis as you might have a urinary tract infection. it is usually accompanied with burning sensation or pain during urination. for further information consult an internal medicine physician online --> <link> |
### Human:\ni develop sinusitis and severe cough in winter. i also have hair fall problem. kindly advise.\n\n### Assistant: it is important to get your sinuses and nose clinically examined for any conditions that might require treatment. some people also develop allergy and this happens more often in the winter season. to make a diagnosis of possible allergy a complete blood count (cbc) is suggested and high eosinophil count is an indication of allergy. if your severe cough is due to high eosinophil count then you should take particular medications to suppress the allergy. hair fall commonly occurs due to any stress and also if it runs in your family. for hair fall please consult a dermatologist and take a prescription for minoxidil 5 percent solution that can be applied in small amounts of 1 to 2 ml each day for hair growth. for further queries consult an internal medicine physician online --> <link> |
### Human:\ncan seizures be related to chronic sinusitis?\n\n### Assistant: we usually recommend antiepileptic if someone has two seizures within 24 hours. in approximately 70% cases we may not be able to identify any specific cause for seizures for example - infection stroke focal cortical dysplasia (fcd) and tumor as in your case. sinusitis is an incidental finding and at present it seems to be unrelated to epilepsy. you should complete antibiotic course as prescribed for its coverage. for epilepsy he will need antiepileptic drugs (aed). there are many aed to choose from but once you have been given keppra (levetiracetam) you can continue the same as it is a new generation drug with minimal side effects and drug interaction. with the limited information i have i would recommend starting it to prevent future seizures. your neurologist can provide you with its optimal dosing. high white blood cell (wbc) could be related to sinusitis or as a transient rise from seizure itself. it should come down by itself. it would be good to know how long his seizure was and what he did during his seizure. did he passed urine stool or bite his tongue during the episode? revert back with the asked details to a neurologist online --> <link> |
### Human:\ni feel constant throat irritation and acid reflux. please share your thoughts.\n\n### Assistant: the foreign body sensation in your throat is basically due to acid reflux. it is irritating the throat as acid raises high up to cause stickiness. along with all the medicines you are taking i would add few lifestyle measures. avoid a sedentary lifestyle and at least move around a bit after your meals may be just 5 to 10 minutes. drink plenty of water and avoid constipation. you can add roughage to diet avoid spicy and fried foods. i suggest pantoprazole 40 instead of zantac (ranitidine) and an antacid syrup two tablespoons thrice daily. consult your specialist doctor discuss with him or her and take treatment with consent. for further information consult an ent otolaryngologist online --> <link> |
### Human:\ncan burning sensation of throat occur from acid reflux?\n\n### Assistant: burning sensation behind throat is most commonly caused due to acid reflux. it can be also due to chronic smoking. as you smoke and drink you have much more chance of acid reflux. i suggest you to avoid spicy oily food for two weeks and tablet pantop (pantoprazole) 40 mg once daily for two weeks. consult your specialist doctor discuss with him or her get a thorough physical examination and take the tablet with consent. for further information consult an ent otolaryngologist online --><link> |
### Human:\nwhat is the permanent solution for testicular pain?\n\n### Assistant: a minimally thickened cord is of questionable importance. please get your urine analysis also. idiopathic orchialgia is very common in young people. i suggest you wear scrotal support. the testes carry a spiral muscle called cremaster with them while coming out of the abdomen to lie in the scrotum at the birth of a male child. the testes are in a dynamic position hanging in the scrotum. they adjust according to stimulus like temperature change touch and excitation. in some young people this causes pain due to strong muscles. with aging this decreases. if it bothers a lot then you may need treatment. keep them close to the body by using scrotal support. this is neuropathic pain so i suggest tablet pregabalin as and when required. consult your doctor discuss with him or her and take medicine with consent. treatment plan:continue antibiotics for 10 days. it takes time to resolve the pain of epididymitis may be four weeks. regarding follow up:for further information consult a urologist online. ---> <link> |
### Human:\nwhat is the treatment for sinusitis?\n\n### Assistant: we are here to help you. you are suffering from chronic sinusitis. and i feel this is all allergic and you do not need antibiotics. usually an acute attack takes five days to settle down. but if you have persisting sinusitis you would require ct paranasal sinuses. if the ct shows slight sinus infection then it can be treated with conservative treatment. but if the infection is severe you would require surgery for the same. the conservative management of sinusitis includes the following: steam inhalation four to six times a day. to take antiallergic like levocetirizine. in cases who do not respond to antiallergic drugs can opt for fluticasone nasal spray. short course of antibiotics like amoxicillin and clarithromycin will help. please share my opinion with your doctor before acting upon it. i hope it helps. for further information consult a general medicine physician online --> <link> |
### Human:\nsuffering from acid reflux and bloating for the third time in a year. why?\n\n### Assistant: you described two different entities here. if you have indigestion due to any reason then you may have bloating burping heaviness of abdomen and early satiety. this occurs due to less enzymes available from the stomach gall bladder and pancreas for digestion due to a variety of causes. if you have a weak junction of esophagus with the stomach then swallowed food with stomach acid move into esophagus and produce symptoms of gastroesophageal reflux. acid reflux will give you burning pain in the chest and upper center part of the abdomen nausea heaviness after meals and symptoms of acidity. you might need further evaluation to confirm the diagnosis. investigations to be done:ct scan of abdomen and upper gastrointestinal (gi) endoscopy. differential diagnosis:1. indigestion. 2. hiatus hernia. 3. esophagitis. probable diagnosis:gerd with gastritis. treatment plan:continue treatment for gastritis. regarding follow up:for further information consult a medical gastroenterologist online. ---> <link> |
### Human:\nhow to find out the reason for extreme sweating muscle stiffness and cramp?\n\n### Assistant: for better understanding i need more details from you. do you get high blood pressure with these episodes? is there any flushing? do you have diabetes? is there any medical problem that runs in the family? you can get kidney function hba1c urine analysis urine osmolality tsh (thyroid-stimulating hormone) liver function and plasma metanephrines during this episode. revert back with the answers to the above questions to an endocrinologist online --> <link> |
### Human:\ni am getting sharp headache and abrupt vision shift. what does it sound like?\n\n### Assistant: your symptoms could be due to ocular migraine brain lesion vasculitis hypertension and stress. i would suggest you to consult a neurologist and have yourself examined. you need to carry out mri brain to exclude any brain lesion as the cause for your symptoms. also have your blood pressure measured. in your case it seems to be due to migraine since you have a history of migraine. for further information consult an internal medicine physician online --> <link> |
### Human:\ni suffer from erectile dysfunction. can i take trazodone with fluoxetine and cialis?\n\n### Assistant: i have gone through your history. based on your history your erectile dysfunction is due to side effects of fluoxetine. erection problem can be psychological or organic (problem with blood supply of the penis) or drug-induced. cialis (tadalafil) will help if you have any problem with blood supply of the penis which is not the case with you. you should not take fluoxetine with trazodone and cialis. i suggest you try taking trazodone without fluoxetine. if possible consult your psychiatrist and ask him to modify the medicines for you. i think cialis will not help at this stage. for more information consult a urologist online --> <link> |
### Human:\ndo i need to check hormones for erectile dysfunction?\n\n### Assistant: did you check this hormone early morning? preferably sample should be given before 9 am to an endocrinology reputed laboratory. lot of errors can happen and always test for total testosterone. now you can control your diabetes and start some exercises. preferably morning or evening walking is enough for 30 to 45 minutes. control alcohol and stop smoking. repeat total testosterone after one month. if it is less than 250 ng/dl then you can consult an andrologist or urologist. for further doubts consult an andrologist online --> <link> |
### Human:\nmy wife has been suffering from migraine and gastric irritation. what to do?\n\n### Assistant: we are here to help you. her stomach irritation seems to be because of the migraine only. let me brief you about the migraine and its treatment. if you are suffering from migraine headaches then you should be started on medicines for the prophylaxis of the migraine. you have not mentioned the pattern of your wife's headache as you have to be sure that a headache is due to migraine. so i will brief you about the pattern of migraine headaches. migraine headaches are usually unilateral associated with throbbing vomiting sensations irritability and intolerance to lights and sounds. a person who has a migraine wants to sit in the dark and does not like anyone to speak. treatment given to her is fine but my experience and recommendations say that either sibelium (flunarizine) or topirol (topiramate) should be given along with amitriptyline (tryptomer) and see the effects. for further information consult a neurologist online --> <link> |
### Human:\ndo you recommend probiotics for acid reflux?\n\n### Assistant: your symptoms are suggestive of irritable bowel syndrome. yes probiotics play a wonderful role in this. in fact the famous probiotic for this purpose available in market are darolac-ibs and vsl-3 (lactic acid). you can take them twice a day. for further information consult a medical gastroenterologist online --> <link> |
### Human:\nare herbal medicines effective in curing erectile dysfunction?\n\n### Assistant: the drugs levosulpiride and flupentixol will cause side effects like reduced libido or erectile dysfunction. levosulpiride results in increased prolactin concentration and thus ultimately poor erection. as you have stopped the medicines just a week back it will take time to normalize the hormone levels. in most cases potency improves in about four to eight weeks. so do not remain stressed. be calm and relaxed. the problem will reduce in some time. the probable causes:drug induced hyperprolactinemia. investigations to be done:serum prolactin and testosterone if needed. treatment plan:wait and watch. if needed pde-5 (phosphodiesterase-5) inhibitors can help. regarding follow up:for further information consult a sexologist online. ---> <link> |
### Human:\nwhat is the solution for erectile dysfunction and premature ejaculation?\n\n### Assistant: erectile dysfunction and premature ejaculation can cause significant distress to a person. if your erectile dysfunction is persistent then i would advise you to get your serum testosterone and serum prolactin done to rule out any hormonal cause. if that comes back normal then most likely the cause of your problem is psychological. for erectile dysfunction medicines like sildenafil and tadalafil are used. these are pde-5 inhibitor drugs and have great efficacy in improving erection. the drug can be used even on sos basis (as and when required) about half to one hour before intercourse. for early discharge medicines like dapoxetine are used. the drug helps to delay the ejaculation time and thus help to solve your problem. dapoxetine is available in fixed combination form with sildenafil also and the drug combination will help in your complaints. please visit a psychiatrist for prescription of this drug and get your investigations done. do not remain distressed as these problems will get improved with medicines easily. the probable causes:anxiety and hyperexcitation. investigations to be done:serum testosterone and prolactin. treatment plan:sildenafil and dapoxetine combination. regarding follow up:for further information consult a sexologist online. ---> <link> |
### Human:\ni am getting erectile dysfunction as a side effect of dutasteride. please help.\n\n### Assistant: drugs like dutasteride acts by inhibition of conversion of testosterone to its more active and potent form of dihydrotestosterone. thus the side effects may include loss of libido erectile dysfunction low mood irritability and depression. although the frequency of such adverse effects is not very high but they are potentially frustrating. sometimes reduced libido may not be due to a direct side effect of dutasteride but is purely psychological. but still if you have noted significant reduction in sexual desire and erection i suggest you stop the medication. with prolonged use the condition may be irreversible and no doubt that would be more troublesome than loss of hair. let me give you two tips for both the problems. apply onion juice on scalp daily. it has got miraculous effect. consume three garlic cloves raw and crushed daily. you can swallow it with water. within a month you will see drastic improvement in libido and erection. onion juice contains sulfur which increases production of keratin. garlic on the other hand cleanses fat and cholesterol deposition from smaller blood vessels thus improving erections by supplying more blood to the penile tissues. for further information consult a sexologist online --> <link> |
### Human:\nkindly suggest ways to overcome migraine.\n\n### Assistant: i clearly understand your symptoms. the basic reason behind the whole issue is the autonomic imbalance which your nervous system shows to specific sensory inputs. let me simplify that thing for you. all the senses give input to our brain like smell vision taste hearing and touch. out of these five the first two can have relatively major influence on our autonomic nervous system. the autonomic nervous system is the part of nervous system which regulates blood circulation digestion respiration cardiac rhythm etc. the alteration of blood flow in the brain produces those flashes of light and sometimes a lost patch of vision in a field. now people with migraine have little problem with these autonomic regulations and that is what is happening to you. the new smell is excessively disturbing your autonomic nervous system and so you have all the symptoms which you described. the olfactory system gets adapted relatively quickly. so if you continue to go there eventually you will get adopted. if that does not happen then you can use mechanical barriers such as a small mask to avoid the smell up to a certain extent but it may not help much. for nausea i suggest emefilm (ondansetron) 8 mg a thin mouth dissolving film of medicine to be kept below the tongue when you feel nauseated and topiramate 50 mg twice a day for headache. consult your doctor discuss with him or her and take the medicine with consent. for further information consult a neurologist online --><link> |
### Human:\nwhy should we avoid oral contraceptive pills after 40 years?\n\n### Assistant: natural estrogen is cardioprotective as it increases the level of hdl (high-density lipoprotein) and decreases the level of ldl (low-density lipoprotein). oxidation of ldl cholesterol is believed to be the initiator of atherosclerosis. estradiol and other estrogens are believed to inhibit this process. hormone replacement therapy - hrt rapidly increases the level of c-reactive proteins in the body a marker of inflammation associated with increased risk of cardiovascular disease. recently two major studies found that hrt in postmenopausal women increases the risk of breast cancer. another study proved that hrt in postmenopausal women increases the risk of cardiac events and thrombosis. hence women should be advised to cease therapy postmenopause. however a detailed analysis showed that the time of initiating hrt postmenopause plays a crucial role. when initiated within five years of menopause in a healthy woman estrogen-based hrt has far more benefits than adverse outcomes. the pros of hrt includes: reduces symptoms of menopause. reduce osteoporosis dementia and colon cancer. improves cardiovascular system. the cons of hrt are: doubles the risk of thromboembolism. doubles the risk of breast cancer. so pros and cons are to be evaluated before initiating hrt in postmenopausal women. for more information consult a cardiologist online --><link> |
### Human:\ncould i have your opinion on my erectile dysfunction and low libido?\n\n### Assistant: i have a few questions as a follow up. when was your puberty? do you find any change in shaving frequency? are you getting morning erections? is there any history of testicular surgery? have you had mumps? when did you last take ecstasy (mdma - methylenedioxy-methamphetamine)? is there any double vision? revert back with the answers to the above questions to an endocrinologist online --> <link> |
### Human:\ni have pain in the eyes and severe headache. what could it be?\n\n### Assistant: these symptoms indicate migraine headache. these vision related symptoms are present in aura (temporary visual disturbances that precede the migraine headache). the treatment is by use of analgesic drugs in acute episodes and by use of prophylactic drugs like flunarizine to prevent recurrent attacks. consult a general medicine physician online for further investigations and treatment --> <link> |
### Human:\ni am 26 years old female who has ptsd bipolar and major depression. i also suffer from migraines anxiety and insomnia.\n\n### Assistant: i read your concerns. i feel that topamax 200mg which works well for migraine has a little role in bipolar disorders. studies show that monotherapy with topamax is not recommended but instead of taking topamax you can try sodium valproate (depakote xr 750mg at night) which will be helpful to you in both your migraine and bipolarity. divalpoex sodium (depakote) has sedative property as a side effect. so it will be helpful to you in your insomnia. if you take 750 mg of dep. at night then you can reduce the night dosage of clonapin and gradually increase the dosage of depakote to 1000 mg and reduce the clonapin. you can also take 500mg in morning and 1000mg at night. and i feel that if you are feeling depressed then only you should take paxil otherwise there is no role of it in bipolar disorder. if your migraine is severe then you should take propranolol 10mg twice a day. but you have to take care about your heart because you complained about side effects of seroquel. propranolol is beta blocker it is used in prophylaxis for migraine. and i feel that if you use it you finally will get relief from your migraine. i do not know whether you have ever tried non benzos like zolpidem zopiclone eszopiclone. you should try that also for your sleep. i feel that these will satisfy some of your concerns. you can book for an online therapy at icliniq for further consultation with me either via video session or on phone. |
### Human:\ni am suffering from migraine for the last 15 years. there is throbbing pain is on the one corner of the head\n\n### Assistant: both carbamazepine and flunarizine have side effect of memory loss. you should take tablet vasograin. it is most effective at the onset of migraine. once migraine starts though it reduces some symptoms but not so effectively. so along with it take tablet diclomol (combination of diclofenac and paracetamol) twice a day for three days. it is very effective to control migraine. if headache is very severe you can also take injection voveran intramuscularly. you also need to take tablet razo (rabeprazole) 20 mg twice a day to prevent acidity. for further information consult a neurologist online --> <link> |
### Human:\nhaving spotting after emergency contraceptive pill. is there anything to worry?\n\n### Assistant: first of all this is not acceptable if you take i-pill frequently. as these pills are of high hormonal content it can mess up your internal hormonal balance. so you may have these types of few abnormal bleeding for the following few weeks. now the intermenstrual bleeding or spotting might be due to ovulation itself and does not warrant any treatment. i suggest you to start regular contraceptive pills from the first day of your next cycle onwards. it will help you not only for protection but also for regularization of cycle. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ndoes a contraceptive pill affect periods?\n\n### Assistant: oral contraceptive pills are quite safe and do not affect periods in bad way. though does not protect 100% but chance of pregnancy is almost nil. if you have sex once a month then you can take emergency pill but it is known to be less effective. it should not be used more than once a month. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ndoes taking contraceptive pills before and after sex avoid pregnancy?\n\n### Assistant: theoretically abstinence is the only way to ensure that one does not get pregnant. however practically speaking there are many ways to avoid pregnancy. it ranges from using condoms to contraceptive pills to intrauterine devices to achieve longer contraception. if no method is used and pregnancy is feared then one can even use emergency contraceptive pills. it has to be used occasionally but definitely not more than once a month. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nis it safe to take oral contraceptive pill?\n\n### Assistant: combined oral contraceptive pill (cocp) is absolutely safe for her. it does not cause cancer (low dose cocp). just check the content of cocp which she is taking. if dose of estrogen (ethinyl estradiol) is 20 or 30 mcg she can safely continue the medicine. in fact cocp in such a case prevents endometrial cancer due to its progesterone content. regarding missed period it normally does not happen with cocp. normally period starts between 3 and 15 days of stopping the last tablet in the pack. if it has been more than 15 days since last tablet consult a gynecologist. if it has been less than 15 days she can wait till 15 days from last pill for periods to come. in any case she cannot start next pack without having periods unless instructed by doctor after examination. do not forget to tell her to use another form of contraception like condom if she is sexually active. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nhad an emergency contraceptive pill after sex. can i be pregnant?\n\n### Assistant: as you had taken one unwanted 72 within 24 hours after the intercourse you must have received a withdrawal bleed after 5-7 days. if yes then the date of the withdrawal bleed would form your fresh lmp (last menstrual period) and you should be starting your count for next menses from that date. as the pregnancy tests are negative you are not pregnant from that sexual encounter. hence considering the possible withdrawal bleed your next menses should start only by now. as you have started experiencing mild cramping and vaginal mucoid discharge which are part of pms (premenstrual syndrome) it is indicative that you will start your menses soon. hence please be patient for another one week and you will get your menses. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ncould you advise on my tiredness weakness and faint feeling following viral infection?\n\n### Assistant: two points are very important here. they are abnormal heart rhythm and tiredness. which type of abnormal heart rhythm are they trying to treat with propranolol? it seems like you have supraventricular tachycardia and the type depends upon the ekg and ep study. did you have any of these? the tiredness is very classical with propranolol. how much are you taking? the other possibility for tiredness could be viral myocarditis which could be seen on the echocardiogram. revert with the details to an internal medicine physician online --><link> |
### Human:\ni took emergency contraceptive pills few days back. i am bleeding today. am i pregnant?\n\n### Assistant: no. you are not pregnant. you had your emergency contraceptive pills on 26th november so this bleeding must be withdrawal bleeding due to that drug. but if bleeding does not settle get one ultrasound scan done and keep assured. revert back to a gynaecologist online --> <link> |
### Human:\nhave started my contraceptive pills on the third day. would they be effective?\n\n### Assistant: yes this oral contraceptive pill is more than enough for contraception. do not take any other medication as this will work as a contraceptive. you may or may not experience slight nausea abdominal cramping lightheadedness and headache but these will eventually settle down. it is because of the hormone present in the pill. most of the times it is very mild and goes unnoticeable. if you have symptoms and feel unbearable then do consult your gynecologist. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nthough i am on stalopam i am not getting sleep. what to do?\n\n### Assistant: i understand your concern. escitalopram may not help you to sleep since it does not have much sedative property. feliz plus has clonazepam in it which will aid in sleep but is not recommended long term. since you have not mentioned any other symptoms regarding the prescription of stalopam i am assuming that you do not have any other symptoms except sleep disturbance. for a beginning start practising sleep hygiene do a bit of exercise in the evening and avoid drinking coffee after 5 pm. if you are still unable to get sleep then i suggest you tablet ramelteon 8 mg known by brand name rametax which is very physiological and devoid of side effects. consult your specialist doctor discuss with him or her and take medicine with consent. but i will advise you to try the non-medical approach. if you have symptoms of anxiety or depression then it is better to continue stalopam. for further information consult a psychiatrist online --> <link> |
### Human:\nis herpes zoster dangerous?\n\n### Assistant: as you know it is a viral infection. it takes 7 to 10 days for the lesions to heal. but in patients who are diabetic old age secondarily infected and with an incomplete antiviral dose or seropositive it can take up to 15 days to get cured. in elderly age group even after the skin lesions heal the patient might experience intense pain in that particular area. it is called as postherpetic neuralgia. kapsi gel can be applied (capsaicin) once the skin is completely healed to relieve pain. consult your specialist doctor discuss with him or her and take the medicine with consent. how many days before she was diagnosed? what is her age? please send images of the area. revert back with the answers to the above questions to a dermatologist online --> <link> |
### Human:\nis there any medicine to control anger?\n\n### Assistant: the first step is to prevent yourself from acting out during anger episodes. while getting angry either do reverse counting from 20 to 0 or deep breathing. after calming down give logical suggestions to yourself against losing temper in that particular situation. log down the events resulting in stress and weekly review them. then think some alternative response from your side to resolve it. practice relaxation exercises like yoga (pranayama). follow steps of sleep hygiene such as avoiding caffeinated drinks. remember that every problem has a solution. you just need to try solving it. for further information consult a psychiatrist online --> <link> |
### Human:\ni have been suffering from throat pain headache and weakness sickness since last 2 days.\n\n### Assistant: hi from your query i understood that you have simple viral infection causing the upper respiratory tract infection (urti). so you have to take tablet febrex plus three times in a day for 3 days. use saline gargling for throat pain. use steam inhalation if there is any nasal block. better to take an antibiotic also tablet levofloxac 500mg once in a day for 3 days. if there is no relief with this you have to do blood test and urine test. for further evaluation revert back to a general practitioner online --><link> |
### Human:\nwhy do i feel lazy and sleepy the whole day?\n\n### Assistant: thank you for sharing your complain with us. most probably the cause behind your mentioned problem is sleep disorders like sleep apnea and rls (restless legs syndrome). sleep disorder such as sleep apnea affects the quality of sleep and makes a person more tired during all day. other medical problems which can cause similar manifestations are diabetes hypertension and weight gain. you are overweight to your height and should maintain a healthy bmi of 23. your weight should be around 55 according to your height. i would suggest you to exercise regularly. practice some form of relaxation exercise like deep breathing exercise and yoga. eat a healthy diet and avoid smoking or alcohol if you consume. take your prescribed medicines regularly if any. try to go to bed at same time every night and wake up also the same time every day. avoid watching tv before going to sleep. i would suggest you to get checked for mentioned causes first with your general practitioner and if your gp is concerned then will refer you to sleep therapist for further evaluation. for further information consult a general practitioner online --><link> |
### Human:\nwhile using contraceptive pill will i remain protected during pill free days?\n\n### Assistant: i guess you are taking combination pill that is hormonal contraceptives containing both estrogen and progestin (synthetic progesterone). these act by preventing your ovulation and making your cervical mucus thicker. you need to take combination pills within five days after the start of the period. then you need not follow other means of contraception. you may start combination pills at any time and only concern is that you will be protected from pregnancy 7 days from then. yes you need not take pills in the fourth week and this will initiate your withdrawal bleeding that is you will have a menstrual bleed in that week and you will be protected. some measures you need to follow. you need to ensure that you take these pills regularly at the same time each day. if you vomit immediately following pill consumption then take one more pill. you should not miss the pill. if you miss a period then do not panic as irregular periods are common. you need to confirm by urine pregnancy test. for further doubts consult an internal medicine physician online --> <link> |
### Human:\nare these medicines the apt ones for keratitis?\n\n### Assistant: let me share some facts about viral infection of eye. primary viral infection of the eye is usually followed by recurrent infection that may involve any or all layers of cornea. cornea has three layers: epithelium stroma and endothelium. it is when the stroma affected it causes stromal keratitis. this may be due to direct infection or your own body's immune response to viral antigens. most common viral keratitis is herpes simplex viral keratitis. stromal keratitis is usually recurrent. the treatment prescribed to you is according to the protocol. you need to ensure that you use them accordingly and apply topical medication five times daily. the response should be evident by two to four days. if not then you can change from acyclovir to ganciclovir ophthalmic gel 0. 15% five times daily or trifluridine 1% drops nine times daily. topical corticosteroid pred forte (prednisolone) is to bring down your immune response and is thus indicated in immune mediated non-necrotizing stromal keratitis. debridement can sometimes be tried according to the lesion. antiviral medications should not be taken for more than 10 to 14 days as they cause epithelial toxicity. patients with frequent recurrences of ocular hsv may be placed on a long-term regimen of oral antiviral medication at the prophylactic maintenance dose. valacyclovir has been shown to be as effective as acyclovir in reducing the recurrence of ocular hsv disease. have a word word with your treating physician if you are worried about recurrence. take care. for further information consult an internal medicine physician online --> <link> |
### Human:\nmy daughter finds it difficult to fall asleep. why?\n\n### Assistant: i understand that you along with your child are going through tough time. the weight of your child is a little bit more than expected for that age. encourage her to play outdoor games and do regular exercises. avoid watching television or movies that have an impact on her just before going to bed. snoring could be due to nose block or adenoids or overweight. if the problem is persistent please consult a sleep disorder specialist for further evaluation and treatment. take care of your child. for further information consult a paediatrician online --> <link> |
### Human:\ndoes my daughter's thyroid level warrant a follow up?\n\n### Assistant: the viral infection she might have caught from her school and there is no need to worry. usually that is self-limiting. we adapt the policy of wait and watch unless there are no complications and i think there are none. with respect to thyroid i suggest you do not panic. tsh (thyroid-stimulating hormone) of 5. 12 at this age in the morning is normal. her anti-tpo (thyroperoxidase antibody) is also negative. is there any family history of thyroid illness? she will not have joint pain for a tsh of 5. 12. the joint pain could be associated with viral infection. i would suggest repeating tsh and free t4 after six weeks. for further information consult an endocrinologist online --> <link> |
### Human:\nmy son complains of stomach pain and discomfort. what would be the likely reason?\n\n### Assistant: there could be some gas problem probably which is a minor issue. i suggest syrup colicaid (simethicone) 2. 5 ml thrice a day for three days. also i would advise against drinking raw milk. please sterilize and drink. please educate your son about raw milk that it can cause diseases and the need for sterilization. for further information consult a paediatrician online --> <link> |
### Human:\ni have been burping with stomach pain and discomfort. what can be the reason?\n\n### Assistant: after going through your concerns carefully i feel your symptoms may be due to any one of the following. gerd (acid reflux). small intestinal bacterial overgrowth. ibs (irritable bowel syndrome). i suggest you tablet pantoprazole 40 mg and zenflox-oz (combination of ofloxacin and ornidazole) for 14 days. consult your specialist doctor discuss with him or her and take treatment with consent. the fact that your symptoms disappear after taking zenflox-oz it means that your symptoms are due to large or small bowel infections. i would suggest you do hydrogen breath test to rule out or confirm small intestinal bacterial overgrowth. for further queries consult a medical gastroenterologist online --> <link> |
### Human:\nsuffering from floating stool and stomach pain. how can i help myself to get better?\n\n### Assistant: i can understand your concern for your symptoms. floating stool is suggestive of abnormal digestion and absorption of fat from the diet which leads to an excess amount of fat in the stool. stomach ache and gas are suggestive of indigestion due to lack of intestinal digestive enzyme supplementation. your history of type 1 diabetes along with these symptoms are suggestive of an inadequate amount of pancreatic juice (exogenous enzymes) for digestion. the probable causes:autoimmune pancreatitis. investigations to be done:ct scan abdomen with contrast lipase amylase and upper gi endoscopy (to rule out gastritis). differential diagnosis:severe gastritis. probable diagnosis:autoimmune pancreatitis. treatment plan:continue treatment for diabetes pancreatic digestive enzyme supplementation and treatment for acidity. preventive measures:avoid oily and spicy food. take fat-free and high protein diet. regarding follow up:for further information consult a medical gastroenterologist online. ---> <link> |
### Human:\nmy 4 year old has stomach pain. what is he suffering from?\n\n### Assistant: is he passing stools? this is a very important question because if he is not then it may point to obstruction. another possibility is that there may be some mild gastritis. you can manage the pain by giving syrup colicaid (simethicone) 5 ml only when there is the pain. for the vomiting you can give syrup ondem (ondansetron) 5 ml thrice a day for three days. wait for at least half an hour after giving ondem to give any food or water. i would also prefer if you get him evaluated physically since he is lethargic you said. he may be dehydrated. for further information consult a paediatrician online --> <link> |
### Human:\nshall i use drugs to get sleep?\n\n### Assistant: you try to exclude diet such as white flour products sugar tea coffee chocolates cola fatty foods fried foods excessive use of salt and strong condiments. breakfast should contain fresh fruits dried fruits and whole cereals. lunch should consist of large mixed salad. a cup of hot milk sweetened with honey at bedtime will be beneficial to get sound sleep. regular exercises like jogging joint exercises yogasanas are ideal exercises. do pranayama (breathing exercise) relaxation techniques and hearing soft music at bedtime may be helpful. hot foot bath at bedtime has significant effect on sleep. revert back after two weeks to consult a naturopathy specialist online --> <link> |
### Human:\ni feel sleepy during office hours even after 8 hours sleep at night. please advice.\n\n### Assistant: feeling sleepy during office timing is most commonly caused by absence of a sound sleep at night. sleeping for 8 hours during night not always means that you are having a healthy sleep. a healthy sleep is determined by the following factors: duration of the sleep. sleep-wake timings. number of awakenings during sleep at night. daytime sleepiness or drowsiness. any distress or dysfunction associated with sleep disturbances. as you told that you are sleeping for about 8 hours at night and your age is 24 years this is an adequate sleep at this age (6-8 hours). however if you still feel sleepy during your office hours this can be due to inadequate sleep in terms of quality of sleep. ensure that you are sleeping at an adequate time and getting up at adequate time in morning. no frequent awakening at night which reduces the quality of sleep. besides this few other things also hamper sleep quality such as: affective states anxiety states psychosis. endocrine disturbances such as hypothyroidism or hyperthyroidism. activating agents like tea coffee stimulant abuse. underlying physical illness. lack of interest in work boredom and burnout syndrome at work place also can cause sleepiness. i would recommend you a few changes that you can make at your work place such as make your work area more stimulating work in chunks take breaks in between your work do not work for long hours at a stretch drink water in between avoid too much tea/coffee in order to work continuously get involved in conversations in between for a while to refresh yourself. also try and maintain sleep hygiene at bed time. besides this if you continue to have this problem seek an opinion from a sleep medicine physician online get yourself evaluated for any of the above causes for sleep disturbances --> <link> |
### Human:\nmy daughter has stomach pain and foul smelling farts. please help with the treatment.\n\n### Assistant: the first striking point i have noted in your history is the weight of the child. 10 kg for a 5 year old is very less. this history coupled with the history of abdominal pain and indigestion may be indicative of a metabolic disorder or disorder associated with digestion of food. it needs to be evaluated with blood urine and stool tests after complete physical evaluation. as of now cyclopam (dicyclomine and simethicone) is the only treatment. but additional treatment may be required based on the results of the tests obtained and physical evaluation. for further information consult a paediatrician online --> <link> |
### Human:\ncan i take practin and decdan to gain weight?\n\n### Assistant: the tablets practin (cyproheptadine hydrochloride) and decdan (dexamethasone) would just add water retention in the body and not increase the muscle mass. so once you leave it your body shall return back to low weight itself. so practin and decdan are not recommended for instant weight gain. gradual weight gain is always advisable. an increase in 500 kilocalories per day can result in increasing the body weight by 0. 5 kg per week. eat plenty of healthy fats. have egg yolks meat with animal fat coconut oil and other healthy fats. increase calorie intake of healthy foods that include bananas. chew the food properly to improve digestion. keep a track of your weight gain as this is essential. it is healthy to increase approximately 5 to 6 kg per month. the right combination of healthy food exercise correct breathing rest and sleep go a long way in healthy and happy life. for further information consult a family physician online --> <link> |
### Human:\nwhy do i have persistently high hb and hct?\n\n### Assistant: you are having celiac disease in which because of malabsorption vitamin b12 deficiency and folate deficiency can occur. this deficiency also can be developed if polycythemia present in which proliferation more. here hemoglobin and hct is high as per history. hence if it is persistently elevated then polycythemia a form of blood cancer should be ruled out. for that one molecular investigation useful that is the detection of jak2 mutation. if polycythemia confirmed then phlebotomy is done regularly and other suitable medication prescribed like anagrelide that prevents thrombosis in such case if platelet count also high in cbc. rule out metastatic hodgkin's lymphoma also as you have a history by ct scan and bone marrow biopsy study. celiac disease is a form of autoimmune disease and gluten-free diet prescribed for that. take care. consult nearby oncologist for examination with keeping all this in mind. for further information consult a hematologist online --> <link> |
### Human:\ni got slight epidermal prick while tattooing. is the risk of infection high?\n\n### Assistant: there are lot of medical issues which can occur from tattooing like hiv infection tetanus hepatitis b and c and allergic reactions. nowadays tattooists reduced such risks by following universal precautions working with single use items and sterilizing their equipment after each use. as you mentioned your piercing was done only till the epidermis the infection is highly unlikely (very very less chance) that you will contact any infection. even if the needle was infected it requires contact with body fluids like blood. so you can relax. still i would like to make the following points:- in case of an hiv infection the test takes about 2-3 months to be positive. hence there is no way to find out if you got infected which is again highly unlikely. there is something called post-exposure prophylaxis (pep) given to individuals who have been exposed to the virus and includes three drugs given only under doctor's supervision. you can discuss this with your doctor. if you frequently get a tattoo done make sure your tetanus and hepatitis b vaccines are up-to-date. always have clear knowledge about the infections spread by tattooing like hiv and hepatitis and their mode of spread. take care and stay safe. for further doubts consult a hiv aids specialist online --> <link> |
### Human:\nwe are not sure about my friend's diagnosis. kindly help.\n\n### Assistant: one thing for sure is that he is having periodic hemolysis with adequate bone marrow response and he has a severe vitamin b12 deficiency. his corrected rpi (reticulocyte production index) is 2. 7% which means that his bone marrow is responding to the anemia appropriately. the broad differential here would be medication induced hypothyroidism vitamin b12 folate deficiency lead poisoning alcoholism and hemolysis due to ssd (sickle cell disease) or liver disease since he has transaminitis and elevated bilirubin. elevated ldh (lactate dehydrogenase) elevated reticulocyte count and low haptoglobin are indicators of hemolysis. he has splenomegaly as well which again favors either a chronic liver disease or most likely hemolysis. however the only tricky portion is his low wbc (white blood count). i do not think that it is a bone marrow process. it is more like peripheral destruction or nutritional deficiency. i do see that the vitamin b12 is very low at 209 and he has a normal g6pd level (glucose-6-phosphate dehydrogenase). i also reviewed that his bm was normal and his electrophoresis does not comment upon the sickle cell s or c disease. please mention whether he had any additional testing or work up for hemolytic anemia. i would like to know if he had a tsh done. why is he taking medications (all of them) including prednisolone azathioprine rituximab and mycophenolate? why is he not taking the vitamin b12 and vitamin d? these medications are toxic to bm and should not be used without a concrete diagnosis. revert back with the answers to the above questions to an internal medicine physician online --> <link> |
### Human:\ncan vitamin b12 deficiency cause depression and anxiety?\n\n### Assistant: yes vitamin b12 deficiency causes severe depression. also thoughts like not being able to fulfil duties can induce guilt and worse depression. please take your friend to a psychiatrist for treatment with a combination of antidepressants and cognitive behavior therapy for best results. please continue his vitamin b12 replacement as going on. eating green vegetables and white meat like chicken and fish will help. for further information consult a psychiatrist online --> <link> |
### Human:\nafter receiving tattoo should i be concerned about hiv infection?\n\n### Assistant: i have read your query in detail and do understand your concern. the conditions you have mentioned are not the risk factors for acquiring an hiv infection. the risk is there only if a drop of some hiv positive person's blood from the gun was transferred directly into your skin while tattooing. even then there is 3/1000 chances of you getting hiv from that drop of blood. so the probability of this happening is almost negligible. though hiv testing is not needed in your case but to relieve yourself from the associated anxiety you may get an elisa (enzyme-linked immunosorbent assay) for hiv test done after 12 weeks of possible exposure. the symptoms you have described are non-specific symptoms which can also be seen without any underlying cause and not indicative of hiv infection. for further doubts consult a hiv aids specialist online --> <link> |
### Human:\nwhy did my stomach pain end up in hospital admission?\n\n### Assistant: according to your complaints past history investigations and present condition you might have ibs-c that is irritable bowel syndrome constipation type with differential diagnosis of intestinal motility disorder. the latter condition produces symptoms of intestinal obstruction very similar for which you required hospitalization. both antroduodenal and rectal manometry can be done only during endoscopy and colonoscopy respectively. and if your doctor has a suspicion for motility disorder he can take biopsy tissue from a particular part of intestine during this. you needed hospitalization because your symptoms your intestine movement were so worse and caused significant dilatation of intestines which itself hampers motility. this requires aggressive treatment to decompress intestine to prevent blood supply movement and integrity of the intestinal wall the probable causes:intestine dysmotility. differential diagnosis:primary motility disorder of intestine. treatment plan:supportive medications need to be continued. preventive measures:avoid constipation adequate amount of fluid intake and can try semi-solid or crushed diet during active symptoms. regarding follow up:for further information consult a medical gastroenterologist online. ---> <link> |
### Human:\nwhat are the causes of vitamin b12 deficiency in a non-vegetarian?\n\n### Assistant: having vitamin b12 deficiency in a non-vegetarian is unlikely. why did you get your vitamin b12 levels checked? what is your hemoglobin level? do you drink alcohol? you can use nervijen capsule (combination of benfotiamine folic acid methylcobalamin nicotinamide and pyridoxine hydrochloride) safely. revert with more information to a general medicine physician --> <link> |
### Human:\nwill irregular period affect my fertility?\n\n### Assistant: all these problems of periods are due to overweight. your expected weight is around 55 kg to 60 kg. it is easy to say just to reduce. but it is quite impossible to reduce so much. please put some effort to do it for at least 2 to 5 kg per month. it is a start. reduce all high calories diet and junk bakery food. but you should not fast. have regular exercise especially for the middle segment of the body like aerobics or brisk walk. all the fat in the body gets converted to hormones. you would have seen big men having breast as their fat is producing the female hormone. this hormone will affect the normal cycle of ovulation and you will not get the periods regularly. your fat distribution will be mainly around mid-segment such as thighs breast back and hip but not below knees and elbows. also there will be black discoloration behind the neck side of breast and inner aspect of thighs. kindly get a scan to check polycystic ovaries. in the meantime also check your empty stomach early morning thyroid profile and serum prolactin. these hormones can also affect your periods and can be corrected. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ni touched a used needle. is there any chance of me getting hiv infection?\n\n### Assistant: the risk of infection from needlestick injuries depends on: the factors that influence exposure to a greater volume of blood (for example: visible blood on the device needle which has been placed directly into an artery or a vein of an hiv positive person). viral load of the source patient. deeper injuries and by hollow-bore needles (especially those needles with larger gauges). diabetics use fine gauge needle and that too for injecting insulin into the skin rather than into a blood vessel. moreover the needlestick injury you have mentioned here actually did not prick deep enough you just touched the needle and i think your chances are minimal if at all. are you unsure about the hiv status of the patient? if you are sure that the used needle belongs to him and no one else and if you know the person very well you may straight away go and tell him/her about the incident and your reason to be anxious and inquire about the person's hiv status. that would be the easiest way. you may get a hiv combo test (antigen and antibody based test) done after 1 month of exposure for your own peace of mind. consult a hiv aids specialist online for further help --> <link> |
### Human:\nhow to correct vitamin b12 deficiency?\n\n### Assistant: i had gone through all the data posted. the treatment duration for b12 deficiency depends upon the cause severity and symptoms. for example vitamin b12 deficiency is common in strict vegetarians. so we advise them to take injection daily once intramuscularly for one week and then weekly once for four weeks and then monthly once in six months. if pernicious anemia is the cause where there is a defect in the absorption of vitamin b12 then we will advise to take the same course for a longer duration. it also depends up on the signs and symptoms like low hemoglobin neuropathy etc. so if you are a strict vegetarian or the cause of b12 deficiency has not been evaluated then i suggest tablet containing b12 1000 mcg weekly two days. kindly review with further details so that i can help you better. revert back with further doubts to an internal medicine physician online --> <link> |
### Human:\nis it safe to take clenbuterol being overweight and asthmatic?\n\n### Assistant: the drug you have mentioned is a beta2-adrenergic agonist and it can cause bronchodilation in asthmatics and can also burn fat. it has other side effects also such as it can cause tremors increased heart rate high blood pressure muscle cramps and can also alter potassium level in your body. so it is better to avoid it. i would recommend you to go with natural ways of weight reduction. since you are already taking anti-asthma drugs there is no need of taking this drug. you can take other short acting beta2-adrenergic agonist as required. for further information consult an internal medicine physician online --> <link> |
### Human:\nwhat should people with pcos eat and should not eat?\n\n### Assistant: people with pcos usually are obese or overweight. however there are lean people with pcos also. people with pcos will usually have insulin resistance. so try to avoid sugary foods and keep a check on your weight and follow a regular exercise routine. this will help to cure the disease also. take good quality carbohydrates with whole grain meals. avoid fats and bakery products. you can take lean meat skinless chicken. avoid juices and take lots of fruits and salads. hope it helps. consult an obstetrician and gynaecologist online for further help --> <link> |
### Human:\nmy problem is regular hair fall. how to control hair loss? please help.\n\n### Assistant: before i can help you please tell me the average number of hairs that fall for you in a day? are you taking any sort of medications? have you fallen sick in the past one year? does your father or paternal uncles have baldness? do you have dandruff? you can start with biotin 10 mg orally and minoxidil 5 % topically. but to be sure it is male pattern baldness or androgenetic alopecia i will need the details i have mentioned above. get back to a dermatologist online --> <link> |
### Human:\ncan i reduce weight by going to gym?\n\n### Assistant: you are overweight. you have to reduce your weight to around 65 kg to live a healthy life. your lipid status and blood pressure may become normal once you shed those extra kilos. going to the gym is a good initiative and i suggest you not to lift weights until you become 90 kg. first reduce your weight by severe dieting eating very less. i suggest you to walk daily for 40 minutes quickly like 6 km per hour after one or two months convert it into jogging. within two months you must be doing two hours of this every day. after reducing 10 kg you do one hour jogging and one hour gym activity. and never stop your dieting and exercise ever in your life. it will lead to getting the same weight again. for further information consult a general medicine physician online --> <link> |
### Human:\ni have stretch marks all over my body. how to get rid of them?\n\n### Assistant: you have a body mass index - bmi of 28 which comes in overweight category. stretch marks result from excessive stretching of the skin. so i will highly recommend you to reduce weight by at least 7-8 kg. once stretch marks are formed they are hard to treat. number of treatments is available with varying success. co2 laser (carbon dioxide laser) : this will give you skin tightening over the affected area but again get treated for visible parts only and not the entire body as it will be quiet expensive. nonablative nd:yag (neodymium-doped yttrium aluminium garnet) laser and er (erbium-doped) glass lasers: these are skin tightening lasers. dermaroller and prp (platelet rich plasma): this is non-laser procedure with platelet rich plasma injected in the stretch mark to induce skin tightening. vitamin e capsules: used with variable success. vitamin c tablets: can be used as supplements. all of these treatments have varying success rate ranging from no improvement to 50% improvement. for the above treatments you will have to visit a dermatologist. for further information consult a dermatologist online --> <link> |
### Human:\nhaving dandruff and hairfall. suggest an ayurvedic procedure or medicine.\n\n### Assistant: there are many reasons for dandruff. close examination can help diagnose the exact reason for dandruff. i am sharing some steps which usually help cure dandruff. use mahabhringraj oil (any good brand) at night to massage scalp with finger tips. saturate the scalp. on the next morning use herbal shampoo with minimal preservatives and chemicals. rinse thoroughly afterwards. remains of shampoo on the scalp also lead to white flakes on scalp. avoid using conditioner in fact you will not need it if you once started using maha bhringraj oil as said above. avoid using hair dryer. brush your hair regularly to remove any dead tissues. in routine use a light refined oil. if dandruff still persist consult a dermatologist online --> <link> |
### Human:\ncan pregnancy occur outside uterus?\n\n### Assistant: whatever your doctor said is true. but there is no need to be afraid. even when it is an ectopic pregnancy it can be managed efficiently with medicines or laparoscopy in the modern era. an ectopic pregnancy will not cause pain bleeding etc. unless it is about to rupture. the second possibility is that of late ovulation with multiple pregnancies. pregnancy in that case will be seen late on ultrasound. you can just repeat beta hcg (human chorionic gonadotropin) after 48 hours to know about status and doctor will decide accordingly. the only caution is that if it turns out to be an ectopic pregnancy just follow your doctor's advice. for further doubts consult an obstetrician and gynaecologist online --> <link> |
### Human:\ncan stress cause hair fall?\n\n### Assistant: let me explain everything about hair fall. 100-150 hair fall every day is very normal. so it should be considered as hair loss only if the number of hair falls more than this. generalized hair fall in female is mostly due to stress poor sleep poor nutrition and excessive blood loss due to menstruation. stress alopecia is also common in which female keeps their hair very tight in certain manner which creates tension in root and cause hair fall. straightening and other procedure also cause weakness of root. other condition like fever typhoid malaria thyroid etc. can also cause hair fall but these are less common. regarding treatment have good sleep. eat proper food with green vegetables and fruits. take iron and multivitamin like follihair for at least three months. check your blood hemoglobin. if it is less then she should start iron and folic acid supplement. also check thyroid and diabetes to rule out other cause. for further information consult a dermatologist online --><link> |
### Human:\ndoes hair fall stop immediately with the use of proscar?\n\n### Assistant: both minoxidil and finasteride takes time to act and in some cases it will take two to three months. both are fda - food and drug administration approved for androgenic alopecia. you should always remember that if it is used once then you need to take it for a lifetime. otherwise you would come to a previous stage of baldness. for further doubts consult a dermatologist online --> <link> |
### Human:\npregnancy tests are negative but am still having pregnancy symptoms. why?\n\n### Assistant: i understand your concern. i see two problems in your history. let me tell you the reason and solution. birth control pills come in a pack of 21 or 21 active plus seven dummy pills or the single dose of an emergency contraceptive pill. whichever you take will suppress your body's natural hormones. if you forget to take the pill in between or take it haphazardly your natural cycle is out of the track but do not worry as it can be corrected. get a urine pregnancy test done if not done recently. then have the same oral combined birth control pill (21 pills) twice a day for ten days and throw away the last pill. within next 7 to 10 days you will surely have your periods. all these bleeding on and off will disappear and then from the first day of the bleeding have the next packet of 21 pills once at night for 21 days. your bmi (body mass index) is more which is the bigger problem. from your history i presume you to have pcod (polycystic ovarian disease) this is usually associated with obesity irregular menstrual cycles no periods for few months followed by heavy periods with clots and fleshy masses spotting on and off. you develop an extra pad of fat around the mid segment of the body especially waist thighs and breast. excessive body hair growth hair fall dark lower half of the face acne oily face dark skin in the back of the neck inner thighs and under surface of the breast. pcos will not allow ovulation to occur at times and so you cannot get pregnant till treated. it also increases your chances of early pregnancy abortions. but this has a solution. just delay pregnancy for a few months as your weight has to be reduced. once you reduce your weight you would not need any medicine to get periods or to get pregnant and the pregnancy will be healthy. i suggest you try the following to reduce weight. avoid fasting junk food and red meat. reduce snacks in between meals. have low calories and high-fiber diet. do regular exercise aerobics yoga and brisk walking. get your thyroid profile and serum prolactin test done in empty stomach. you can continue the same 21 pills packet to regularize periods till you shed some weight. try to reduce 2 to 4 kg per month. do not hurry on weight reduction as it will be difficult to maintain. as soon as you reduce at least 5 kg you will see changes. for further queries consult an obstetrician and gynaecologist online --> <link> |
### Human:\nis hair fall common after a surgery?\n\n### Assistant: you are suffering from acute telogen effluvium. telogen effluvium is a self-limiting disorder and is very common after any surgical procedure. keep taking the multivitamins and there is no need for minoxidil because it is mainly for androgenic alopecia. if you applied it once then you need to apply it for the whole life. do not worry; the hair will return to normal within four to six months. so no active intervention is needed. for further information consult a dermatologist online --><link> |
### Human:\npregnancy test shows negative shall i take medicine to induce periods?\n\n### Assistant: in your case if pregnancy test has been negative even till date then you are surely not pregnant. the delay and irregularity need to be evaluated and investigated to rule out pcos (polycystic ovarian disease) hypothyroidism or hyperprolactinemia which are the most common reasons for oligomenorrhea in young women. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nduring pregnancy when will the gender of the baby be more accurate?\n\n### Assistant: i understand your concern. i cannot say that 26 weeks of gestation is too early to declare the gender. but due to baby's position and as baby moves constantly it can be a bit difficult to make out the gender accurately. it will be more accurate after 32 weeks. for further information consult a fetal medicine specialist online --> <link> |
### Human:\npregnancy test positive. on the 9th day had slight bleeding why?\n\n### Assistant: this is a threatened miscarriage as it would be termed medically as the pregnancy test is positive. but ultrasound is not contraindicated as it is necessary to localize the pregnancy and rule out ectopic pregnancy as well which can have similar presentation with bleeding along with pain abdomen. so get an ultrasound done. if there is a gestational sac seen inside uterus then you can be placed on progesterone support hcg injections (human chorionic gonadotropin) to allow placental cytotrophoblastic invasion into endometrium thereby supporting pregnancy and also absolute bed rest should be followed. but there is absolutely no indication of termination at present when even fetal pole has not arrived. the decision can be taken if the pregnancy does not grow till nine weeks. revert back after the ultrasound abdomen to an obstetrician and gynaecologist online --> <link> |
### Human:\npregnancy tests were negative but i passed blood clots. what could it be?\n\n### Assistant: as the pregnancy tests were negative even after eight days post missed menses it ensures that you are not pregnant. the symptoms you had were common pms symptoms (premenstrual syndrome) which subsides slowly once the menses start. there is a possibility that a large endometrial chunk would have got passed out during the start of the flow due to delayed menses this time. so just allow the menses to continue and you should be fine. the chunk was definitely not a gestational sac or pregnancy as the pregnancy tests were negative. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nhow to overcome my depression symptoms?\n\n### Assistant: i can understand your concern. you are on 20 mg nexito (escitaprolam) modafinil 25 mg and 25 mg quetiapine even with these medicines your symptoms are persistent. so some minor changes in medicines will help you to come out of these symptoms. in suggest try taking amisulpride 25 to 50 mg in place of quetiapine it will help in reducing these negative symptoms. this will reduce the daytime sedation too. the dose of modafinil can be increased to 100 mg in the morning after breakfast. this will improve the daytime alertness and will surely improve your functioning. i advise you to get your thyroid function test and vitamin b12 levels done. hypothyroidism and low vitamin b12 levels are common reasons for persistent depressive symptoms. include vitamin b12 and omega-3 fatty acid supplements in your diet and you will surely see improvements. please follow these steps and consult your treating doctor about the dose adjustments. for more information consult a psychiatrist online --> <link> |
### Human:\nmy pregnancy tests are negative. can i be pregnant after taking i-pill?\n\n### Assistant: i have gone through your history and understand your concerns. in her case the chances of pregnancy are not present. symptoms associated with it can be due to impending period or a cause of infection. stay calm and wait for her periods. for further queries consult an obstetrician and gynaecologist online --> <link> |
### Human:\npregnancy tests are positive even after taking 2 mtps vaginally. why?\n\n### Assistant: you have already taken all the tablets but unfortunately you have taken it wrongly. the second dose of 2 tablets of misoprostol were to be taken after 36 hours and not before. the remaining two should have taken after 6 hours of the previous 2. now you must wait for the bleeding and abdominal cramps to initiate on its own in next 48 hours. if the bleeding does not ensue in next 48 hours then get an ultrasound pelvis done to reascertain an intrauterine pregnancy or whether it is an ectopic pregnancy. if intrauterine then safely a surgical abortion can be performed under ultrasound guidance by a gynecologist. there is no role of repeating the kit again. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nhow to tackle depression until i meet my psychiatrist?\n\n### Assistant: this is quite obviously appears to be the re-emergence of depression due to stoppage of medications. it should ideally be treated by reinstitution of the medicines. if that is not possible then certain temporary measures can be used. sleep deprivation is said to have depressant effects. sleep 6 hours per day but not less than that. eat chocolates. exercise for an hour five times a week. stay away from dim lit and depressing rooms. get exposed to bright light. give more time for your favorite hobbies and past times. make it a point to talk to your close friends and relatives once a day. follow the above until you meet your psychiatrist for a physical evaluation. for further information consult a psychiatrist online --> <link> |
### Human:\nmy friend is under depression due to work stress. please help.\n\n### Assistant: persistent work stress could lead to adjustment disorder and increases the risk of depressive and anxiety symptoms. she is suffering from polio and has work stress. these are probably the reasons that she behaves weird. if her symptoms persist then please consult a psychiatrist in person for physical evaluation and her treatment. with proper treatment she would come out of this bad phase. ssris (selective serotonin reuptake inhibitor) are the drugs of choice for these symptoms. for further doubts consult a psychiatrist online --> <link> |
### Human:\nhow to confirm depression?\n\n### Assistant: you should understand the difference between depression and disappointment. disappointment also manifest symptoms as in the case of the depression. were you deeply disappointed in the near past say within one year? you did not have any bad experiences and your family does not have any depression history. that is perfect. you feel numb sad and worthless. feeling irritable and spending more time alone. these are some of depression symptoms but your problem is never depression. from the given symptoms i see this as an attitude problem related to some sort of disappointment. you are just 19. i suggest you forcefully change your habit. do not be alone. be with family members or friends. if you do not have friends then make friends. go outside and socialize. engage in physical activities and outdoor or indoor games. you will have many things to study. do it. divert your attention to more productive creative and positive things rather than brooding yourself worthlessly. i do not see depression now. if you continue the present attitude and behavior further then it could lead to depressive disorder. please do compulsively as i advised. for further information consult a psychiatrist online --><link> |
### Human:\ni am a depression patient and taking medicines for long time. now i feel very sleepy and facing concentration problem.\n\n### Assistant: first of all i need to know what was the drug how long you took that medicine and have you felt tolerance to either effect or side effect of that drug? at this stage i like to inform you that with current available medication only two thirds of the patients improve the remaining and the other one third fail to improve even after trial of multiple drugs. the next course of action is decided on the basis of residual symptoms magnitude of improvement comorbid medical and psychiatric conditions tolerability and affordability to name a few. in your case your doctor may be right but if you are taking same medication for more than six weeks then it is time to intervene. if the concentration problem arose after the use of drug then it might be the side effect of drug itself and in that case it needs replacement. if the prescribed drug dose is in lower range side then increasing the drug dose might be the solution. at this stage i would like to tell you that drugs available currentlyt may be used for improving concentration after a detailed history of the patient and review of all previous drugs. i suggest you to approach a psychiatrist either online or in person for correction of your problem. you can also book a slot for an online video chat session i will be happy to help you out. |
### Human:\nto overcome my depression anxiety and stress i started masturbating. i feel weak.\n\n### Assistant: masturbation is actually a normal behavior. but it should not be excessive in frequency which may cause fatigue and back pain. you need not see a doctor right now. just divert your thoughts into much important things in life like studying enjoying outdoor sports finding good friends etc. try to reduce the frequency of the practice to about twice or thrice a week. this is the transient period in everyone's life when urge to explore and also trying to experience new things especially sexual pleasure occurs. as you are physically and mentally mature the problems that you are facing now will resolve spontaneously. apart from this as you said "proper diet and lifestyle changes" are to be followed: eat nutritious foods (encourage fruits vegetable salads nuts cereal sprouts). limit processed and deep fried foods. indulge in outdoor sports which you are interested like swimming etc. sleep adequately at least 7-8 hours as it is much needed for your normal growth too. avoid smoking and drinking alcoholic beverages. just follow these for a month and let me know how do you feel. get back to a sexologist online for further follow up --> <link> |
### Human:\ncan i take augmentin during pregnancy?\n\n### Assistant: yes augmentin (amoxicillin) is safe in pregnancy. please go ahead. for further doubts consult an obstetrician and gynaecologist online --> <link> |
### Human:\nhow do i come out of my failure?\n\n### Assistant: success and failure are the two sides of the same coin. you can never predict what will happen. life is never a smooth sailing boat. it is full of ups and downs. life does not end when you fail once. life is much more than your exams. you gain experience when you go through failures and hardships. you become tough and will learn to handle more difficult situations in the future. if you have fallen down get up and pursue your goal. be persistent till you achieve your goal. all great people gone through failures before they become successful in life. success will come when you are optimistic. be brave and face life. for further information consult a psychiatrist online --> <link> |
### Human:\nis mymox used to stop lactation?\n\n### Assistant: mymox (amoxicillin) is an antibiotic and has nothing to do with lactation or milk production. sudden weaning of baby may lead to both physical and emotional effects on both the mother and her baby. gradual weaning is good. medical suppression of lactation is not advised due to accompanying untoward effects. try doing the following. try using supportive padded bras. manual expression of the milk just enough to relieve pain or engorgement. do not empty the breasts at a time. frequency and time for emptying vary. for more information consult an internal medicine physician online --> <link> |
### Human:\ni could not bear the separation of my boyfriend. please help.\n\n### Assistant: from what you are describing it appears that he left you and it is irreversible. many things in life are irreversible such as death separation and so on. one must learn to let go and accept the loss. the more we try to hold on the more it hurts. it may seem difficult to let go but trust me as that is the most logical thing to do right now. discuss your pain with a trusted friend or a relative. go out and meet friends. strengthen your existing friendships and make new friends. spend more time on your hobbies. these alternative relationships will swell and fill the void left by him. after some time you will feel much better. remember that you lived happily before you met him also. you never know what life has in store for you. may be there is something more beautiful that is going to happen. try these techniques and if you are still having problems medicines can be started that will definitely improve how you are feeling. take care. for further information consult a psychiatrist online --> <link> |
### Human:\nhow to get rid of folliculitis?\n\n### Assistant: you need to take oral as well as topical antibiotics. start with tablet augmentin (combination of amoxicillin and clavulanate) 625 mg twice daily for a week and apply mupirocin ointment on the pimples twice daily till they resolve. this normally takes 7-10 days. if they are recurrent then go for blood sugar fasting to rule out diabetes and pus culture to find the exact bacteria responsible for your folliculitis. the probable causes:staphylococcus aureus bacteria. investigations to be done:blood sugar fasting and pus culture. probable diagnosis:folliculitis. preventive measures:frequent hand washing prevents spread of infection. regarding follow up:revert back after a week to a dermatologist online. ---> <link> |
### Human:\nwill accutane help in acne breakout?\n\n### Assistant: accutane (isotretinoin) alone can control your acne well. birth control pills are given to avoid pregnancy while on accutane treatment. if there is no sexual activity contraceptive pills can be safely withheld. however it is very important to understand that accutane can cause serious side effects on the fetus if at all pregnancy occurs while on treatment. for further information consult a dermatologist online --> <link> |
### Human:\nwhat causes acne when we were on our period?\n\n### Assistant: during menses body have spurts of androgen. these androgen causes stimulation of pilosebaceous duct and leads to acne during this period. these types of acne usually appear in chin area may be because of more concentrated pilosebaceous unit localized to this place. do maintain hormonal imbalance with the help of antiandrogen to reduce acne during these days. for further information consult a dermatologist online --> <link> |
### Human:\na patient with a fresh knee replacement has taken pre-medication amoxicillin 2g. what antibiotic can be given for her tooth abscess?\n\n### Assistant: i have read through your query in detail. please find my observations below. amoxicillin is still a better antibiotic for dental abscess as compared to other medicines. it is the first choice of medicine even for dental abscess. it is better to continue with amoxycillin as a treatment option for her. metronidazole or clindamycin is given only in case of severe infection. the order of preference of drugs for dental abscess in a patient is: amoxicillin erythromycin or clarithromycin or clindamycin metronidazole. ciprofloxacin is usually not given at first. she can be given amoxicillin on her next appointment as well. the above information is as per latest updates on pharmacological treatment of dental abscess. please keep in mind any allergy the patient might have to any of the medications and prescribe an alternative choice. hope this answers your question. please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. revert back to a pharmacologist online for further follow up --> <link> |
### Human:\nhow can i overcome the problem of assuming things?\n\n### Assistant: i read your query and understand your concerns. although we assume in one or the other way but it is not like that. the fact is first someone becomes topper successful and then his style are appreciated leading to wider recognition. we as a society focus more on successful people and try to imitate them in the way of writing or dressing but it is not the style which makes somebody a topper. it is the hard work and intelligence that make you topper. i mean to say that things are in different order. like successful person leads to the identification of his style. so you definitely need to get into how you can achieve something rather than trying to imitate others. do not have much spare time to engage in these thoughts and have some work which helps you in achieving something. whenever you are alone try to connect with friends and family. use stop technique. just say stop loudly when you feel there are excessive thoughts. for further information consult a psychologist counsellor online --> <link> |
### Human:\nwhy do i get attracted to both men and women?\n\n### Assistant: i have gone through your query and understood your concerns. firstly if you feel attracted towards men and women both it is just your sexual orientation. it is not a disorder. the more you will try to get rid of these feelings the more they will disturb you. secondly entering the vagina is a very different feeling as compared to just rubbing it over the clitoris. your wife can best tell whether you penetrated her or not. if you wife is very sensitive you can give sufficient time in foreplay. rubbing followed by fingering and penetration should be the plan. this will solve the problem of tight muscles also. the head of the penis is always sensitive. if your penile foreskin is tight your surgeon can help. otherwise its normal to have a sensitive penile head. 40% sperm motility is not too low in my opinion you do not need any medication for it. slowly as you would be able to do intercourse properly your wife can conceive. gradually she can guide your penis into her vagina. hope this helps. for more information consult a psychiatrist online --> <link> |