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Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, How to avoid pregnancy after sex without condom?

Q. How to prevent pregnancy without using a condom?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How to prevent pregnancy without using a condom? ### Input: Hello doctor, How to avoid pregnancy after sex without condom? ###Response: Hi. I am afraid the answer is not so simple. However you can avoid sex in the unsafe period. The unsafe period is the period roughly between 10th to 20th day in a woman having a 30 days menstrual cycle. This period roughly corresponds to the most fertile period in a woman's menstrual cycle. You can also try the withdrawal method where you need to withdraw just before ejaculation, but it needs lots of mental strength on your part. Your partner can also use certain female condom or spermicides also. Use emergency contraceptive methods to prevent pregnancy after having an unprotected sex. But please keep in mind that, all these are never 100% to prevent a pregnancy. Revert back to an obstetrician and gynaecologist online -->

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

Q. I have bad faeces smell coming from my nose when I breathe. What could be the possible causes?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have bad faeces smell coming from my nose when I breathe. What could be the possible causes? ### Input: Hello doctor, I have bad faeces smell coming from my nose when I breathe. What could be all possible causes? Nobody around me feels that smell and that is how I got to know that it is from my nose itself. Please advice. ###Response: Hello. Bad smell during breathing could be due to various reasons. Let us see those one by one. Malignancy: an intranasal (inside the nose) or intraoral (inside the mouth) malignancy can produce foul smell, that can be perceived as faeces smell by the nose. Malignancy can be painless and without any symptoms. Malignancies of paranasal air sinuses also produce foul odor. Dental infection: a tooth decay can produce bad smell. Dental infection usually produces significant pain. Food particles get collected inside the decayed tooth and hence cause the bad smell. Sinusitis: Chronic sinusitis can cause constant post nasal drip and purulent discharge (pus discharge). This results in foul odor. Maxillary sinusitis commonly produces foul odor. Sinusitis will have other symptoms like headache, facial pain, nasal blockage, post nasal drip, etc. Foreign body inside nose: A foreign body which has got stuck inside nose without being removed for many days will produce purulent discharge and smell. The discharge will be from one side of the nose. It is common among kids. Foreign body produces nasal block. Atrophic rhinitis: It is a disease where the normal space inside the nose gets increased due to destruction of the anatomy. Also the condition causes merciless anosmia (loss of sensation of smell). The sufferer cannot perceive any smell but the people around him can get the extreme foul odor emanating from the patients nose. Atrophic rhinitis also presents with crusting inside nose and nose block. Maggots in nose: Maggots are larval stage of fly (chrysomia). Maggots usually occur in association with atrophic rhinitis. Fly lays its eggs inside nose leading to maggots inside nose. They are attracted to the foul odor and they themselves aggravate the odor. Tonsillitis: Pus accumulated over the tonsil can cause bad smell. Tonsillar enlargement with infection and consequent foul breath is common in many children. Other symptoms of tonsillitis include fever, throat pain, enlarged lymph nodes of neck, difficulty and pain while swallowing. Nasal diphtheria can produce foul odor. Diphtheria produces a membrane over the affected mucosa. Rhinitis caseosa: it is a destructive disease producing foul odor. It was thought to be a fungal disease, exact etiology is still not clear. Tuberculosis: TB of nasal mucosa produces granulomatous inflammation and caseating necrosis, consequent death of tissues and foul smell. Hope I have cleared your query. Further evaluation and clinical examination is required. For further follow up, consult an ENT otolaryngologist online.--->

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

Q. I have a burning sensation on the tip of my penis when I pee. Is it due to an infection?

Hello. For more information consult a urologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have a burning sensation on the tip of my penis when I pee. Is it due to an infection? ### Input: Hello doctor, Recently I have been experiencing a slight burning sensation on the tip of my penis. When I pee, it stings a bit. The stinging sensation is subtle, but there is always a slight urge to pee. It feels like something is streaming down, but I can only feel it when it reaches close to the head of my penis. I am uncircumcised and I notice a white substance that seems to be, what I feel is, dripping down. I have not had sex in a while and if I did, it was always protected. I thought it might be due to lack of hydration. So, I have started to drink more water. I was told that cranberry juice works, which I started drinking today. My pee stream is slightly weaker, but the color is normal. Any advice? I thought it might be an infection but I do not want to jump to conclusions yet. ###Response: Hello. For more information consult a urologist online -->

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

Q. How many times can I masturbate a day?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How many times can I masturbate a day? ### Input: Hello doctor, How many times can I masturbate a day? I am a 14 year old boy going through puberty and hence such doubts. ###Response: Hello. It is one of its kind and the most interesting question that I have come across. It is good to see that how an adolescent can be so inquisitive about his sexual development. For any other sexual health related queries, feel free to consult a sexologist online -->

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

Q. If I stop taking Keppra suddenly, will it cause withdrawal seizure?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. If I stop taking Keppra suddenly, will it cause withdrawal seizure? ### Input: Hello doctor, I had a seizure for the first time in my life when I was about 19 years old. The emergency room physician did not do any tests before he put me on Keppra. After I had been put on Keppra, I went to a neurologist who did an MRI and a sleep study. Nothing showed up on either test, but he wants to keep me on the medication. The issue that I have is I think the medication is causing more problems than helping. Why would he keep me on the medication when I was not diagnosed with anything? But I was told that even if I do not need the medication and I still stopped it cold turkey, it could cause seizures. Is it true? ###Response: Hi. I read your query and understand your concern. I hope this answers you. If you have more questions feel free to write back to me. For more information consult a neurologist online -->

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. How do I get rid of enlarged circumvallate papillae?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How do I get rid of enlarged circumvallate papillae? ### Input: Hello doctor, I have enlarged circumvallate papillae from the last 45 days. How do I get rid of it? What medicines are suggested? ###Response: Hello. Normally, circumvallate papillae are enlarged structures at the base of the tongue. So it is normal to have enlarged papillae and it does not need any treatment especially if you do not have any symptoms like pain, swallowing difficulty, etc. Also, there is unlikely to be any abnormalities in them as it is unchanged since last 45 days. You upload the picture of those papillae so that I can confirm. However, with a sore throat, it may appear bulky and slightly enlarged but it settles down after it is treated, and you already took Amoxicillin for that. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->

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

Q. Why do I have bad smell coming from my nose?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why do I have bad smell coming from my nose? ### Input: Hello doctor,Why do I have this bad smell coming from my nose? It is embarrassing. People around me smell it all the time. I do not have my mouth open and people smell it soon as I walk in the room. What is it? ###Response: Hi. The first thing that comes to my mind is a disease called atrophic rhinitis. Here, the mucous membrane and structures inside the nose shrink and the nasal cavity is filled with crusts, which get infected and smell. In this condition, the patient has decreased sense of smell, but others can feel bad smell coming out from the patient's nose. A diagnostic nasal endoscopy is sufficient to diagnose the condition. It can specify whether it is atrophic rhinitis or something else. If it is at all atrophic rhinitis, the treatment is frequent saline nasal washes and mechanical removal of the crusts by an ENT specialist. Rarely surgery is needed. For more information consult an ENT otolaryngologist online -->

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

Q. I had two menstrual cycles in one month. Is it something serious?

Hello. For more information consult an obstetrician and gynaecologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I had two menstrual cycles in one month. Is it something serious? ### Input: Hello doctor, I had two menstrual cycles in one month, two weeks apart. I have not had an intercourse for two months. Should I be concerned? ###Response: Hello. For more information consult an obstetrician and gynaecologist online -->

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

Q. I have a BB sized lump where my preauricular node is. What are the possibilities?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have a BB sized lump where my preauricular node is. What are the possibilities? ### Input: Hello doctor, I have a BB sized lump where my preauricular lymph node is, right outside my right ear. My dermatologist, who is treating me for melanoma in situ, is sending me to an ENT this week to check it out, but said melanoma in situ cannot spread. I have no other symptoms. It is not tender and he described it as rubbery and movable. I discovered it a few weeks ago incidentally because my jaw hurt a little one day, so who knows how long it has been there. It has not changed in the two to three weeks I have known about it. What are the possible things it could be (your differential)? Should I have it biopsied, and does it sound like cancer? ###Response: Hello. For swelling in the pre-auricular area, my differentials are: Since it is rubbery and movable, I feel it is more like a node only. Nevertheless, we need to investigate it. A fine needle aspiration cytological (FNAC) study will be required, but since the area is close to the branching of the facial nerve, we need to very careful with this investigation. An ultrasonogram of the swelling will be very useful for this. It demonstrates the likely contents of the swelling and indicates a diagnosis.The likelihood of cancer is there but not more than other possible differentials. Parotid tumors can occur in young individuals like you. They are not uncommon. Please revert back with details and we shall help you. Revert with more information to an ENT otolaryngologist online -->

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

Q. How long will it take to heal frenulum tear?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How long will it take to heal frenulum tear? ### Input: Hi doctor, I got married before seven years and living happily with my wife. A week ago, I had a very enthusiastic sex session in the shower. During which I slipped out and missed going back in and had a substantial impact. At that time I believe I had a frenulum tear and the skin was split. After initial redness and swelling, now it has a small scab. How long will it take to heal? And is going to a doctor worth my time? ###Response: Hi. It is quite common to get a frenulum tear while having coitus. It will heal within four to five days and pain will subside in a day or two. However, if you still continue to have pain, you can seek an opinion. Avoid coitus for few days for a quick recovery. For further information consult a sexologist online -->

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

Q. Suddenly my nipples are swollen and boobs are tender. Why?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Suddenly my nipples are swollen and boobs are tender. Why? ### Input: Hello doctor, Just as of today my nipples have got swollen and my boobs are tender to touch. It started less than an hour ago. I had headache all day. As far as I am aware, I am not sure what is going on? I never had this issue before. Please help. ###Response: Hello. A swollen nipple as well as tender breasts can occur if you are just before your cycle. If so, it is quite normal. It is due to the temporary hormonal fluctuation inside you. Otherwise, taking hormonal contraceptive pills could be a reason. Hard sex with rough handling of your breasts is another issue. Just apply some hot compress over your breasts and put them in tight undergarments all the time. If the pain is more, you can avail Paracetamol 500 mg tablets as and when necessary basis. For further doubts consult an obstetrician and gynaecologist online -->

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

Q. Is there any treatment for frequent urination in ayurveda?

Hello. Urodynamics if needed. Revert back after a month to an ayurveda specialist online.--->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Is there any treatment for frequent urination in ayurveda? ### Input: Hi doctor, My sister is 20 years old. She does not feel bladder emptying and she was diagnosed to have a weak bladder. She has frequent urination problem and undergoing allopathy treatment for the past one year. Still, there is no significant improvement. Is there any treatment for frequent urination in ayurveda? ###Response: Hello. Urodynamics if needed. Revert back after a month to an ayurveda specialist online.--->

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

Q. Why is my foreskin not covering my penis properly?

Hello. For further information consult a urologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why is my foreskin not covering my penis properly? ### Input: Hi doctor, I am a 21 year old virgin. My foreskin is tight which has not gone down. I had sexual intercourse with my girlfriend yesterday, were my foreskin came far down the penis head that was really paining and hurting me. Now, my foreskin is still back and not going up. My exposed penis is very much sensitive, like even my pants touch them also it is very much incredible for me to bear. The foreskin which has come beyond the penis head is not going back and I do have some scar wounds reddish on my foreskin. The other problem is, if I get erection it is paining for me, I do not really feel comfortable like before. I am also getting some smell around my penis, can it be smegma? What should I do? Is this a serious issue? Why is my foreskin not getting above my penis head and covering my penis like before? Is this normal? Should I go consult a doctor? I am so much confused. Please help. ###Response: Hello. For further information consult a urologist online -->

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

Q. I am a 25 year old male. My body looks feminine. Please help.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am a 25 year old male. My body looks feminine. Please help. ### Input: Hello doctor, I am a 25 year old male. I am 181 cm tall and I weigh 70 kg. All the members in my family are tall, but I am not that big when compared to my father and brother. I am mentally depressed since my childhood. It is all about my body. I was a female looking boy with very soft body, less energy and not interested in sports. Since that time my arms and legs are very long. But arms are very lean as girls. My puberty was too late at around 18 years of age. But after puberty, I have hair on face, but till now it is not much as my brother had in that age. Facial hair is also thin and not uniform everywhere. I feel my bones are like females and not very strong, arms and fingers are not as big as males. My muscles are less too. I went for gym and built up a little muscle, but forearm and fingers are still feminine. I feel my waist is a little wide. Did I have any genetic problem or hormonal imbalance at puberty stage? I am totally exhausted. I am always worried about that. Please help me. ###Response: Hi. I totally understand your anxiety. Based on the description which you have given, there could be a possibility of Klinefelter syndrome. This condition can be seen in about one in 600 boys. A normal male will have a chromosomal pattern of XY. However, in case of Klinefelter syndrome, there would be an extra X chromosome which would have happened randomly during the formation of the egg or sperm, or after the baby boy had conceived. The extra chromosome is not inherited. So, this condition does not run in families. The adult male body may not be able to produce enough testosterone, the hormone responsible for the development of male characteristics. There may be low energy and sex drive, lack of muscle and too much body fat around the waist. Most men with this condition lead normal lives and also have normal relationships. A few boys with condition may feel shy and may have low levels of self confidence. They may grow quickly than usual and may become taller than other family members. The testicles may be smaller than normal and may not produce enough of the sex hormone testosterone. This may lead to features such as: This condition can be diagnosed by: It is advisable to get treat early in order to avoid further fertility issues. Treatment options available are: A definitive diagnosis can be made only after a complete physical examination and after performing laboratory tests. Visiting an endocrinologist at the earliest would be advisable. Consult an endocrinologist online for further follow up -->

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

Q. Is Arjunarishta beneficial for heart patients?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Is Arjunarishta beneficial for heart patients? ### Input: Hi doctor, I am a 33 year old male. My height is 5'10" and I weigh 81 kg. I am suffering from anxiety and somatization (as described by my medical report) more than a year. I was under allopathy medical treatment without any remarkable benefit with many doctors as general physician and cardiologist. I was also suffering from some side effects of these medicines. One day suddenly I came to know about the Arjunarishta, then I left all allopathy medicines and started this ayurveda medicine and felt relax within a week. I have been taking Arjunarishta since two months approximately but I still have some problems on and off as 1-3 times in a day. They are congestive pain in chest and neck, irregular heartbeat, hard and pounding heartbeat, pain in left arm, pain in jaw, hot and cold flashes, rarely feeling suffocation or dizziness or vertigo (not together) for 2-5 seconds, feeling relax at morning or when I sleep if feeling any problem. I am feeling one or two symptoms together; I have many normal ECG and blood test when I was under allopathy medical treatment. Am I suffering these current problems because of Arjunarishta? Even I do not want to leave Arjunarishta. Even my parents have also started Arjunarishta. My mother who is 55 years has left anterior fascicular block as in ECG. Is it fine to continue Arjunarishta for whole life? ###Response: Hi. Arjuna tree bark has many benefits in the cardiac patients. I suggest you to continue arjuna bark medicines. In your case, the Arjunarishta contains minimal alcohol. So, continuous consumption may cause some gastritis. If the symptoms appear within 2 hours of the consumption of Arjunarishta, then it might be due to the medicine. If the symptoms appear after 3 hours of consumption of Arjunarishta, then it means; it is due the disease itself. Only first 3 hours, the Arjunarishta will control the disease. So, you can consume the arjuna tree bark in different method, such as tablets or powder. This will avoid the bad effect of alcohol in Arjunarishta. For further information consult an ayurveda specialist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. What can cause waxy buildup on the roots of hair?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What can cause waxy buildup on the roots of hair? ### Input: Hello doctor, I am an 18 year old female. For the past two years, I have had this waxy buildup only on the roots of my hair. It feels sticky, oily and stiff. None of the shampoo I have tried has fixed it. The problem goes away a couple of days after I dye my roots. I am wondering if there may be a problem with my scalp. Please help. ###Response: Hi. I have seen your query and concern. Oily skin and excess sebum secretion. 1. Seborrheic capitis. 2. Tinea capitis. Seborrheic capitis. I would suggest you Sebowash (Fluocinolone) shampoo twice weekly. It has to be applied on scalp and left for 15 minutes before you wash. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You should not apply hair oil. You can use conditioner and shampooing regularly rest of the day. Revert back after a month to a dermatologist online.--->

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

Q. Why do I have dark spots on my fingers and knuckles?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why do I have dark spots on my fingers and knuckles? ### Input: Hi doctor, I am 44 years old. For the past one year, I have noticed dark spots on the fingers and near knuckles on the left hand. They do not hurt, but look like a burn. I also noticed numbness in the tip of my left middle finger. I have allergies, asthma and sleep apnea. I am also suffering from herpes 1 and 2. My current medications are Adipex, Zyrtec, Oxybutynin multivitamin, Valtrex (only when I have a flare-up) and Ventolin inhaler. Please suggest some advice. ###Response: Hello. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. You are most probably suffering from hand eczema or lichen simplex. Numbness in your finger does not seem to be related to this, however, it may be seen in case of certain orthopedic such as nerve compression or medical conditions like diabetes. For the dark patches, I suggest steroid ointment containing Clobetasol twice a day for two weeks. Consult your doctor, discuss with him or her and take the medicine with consent. 1. Avoid excessive use of soap. 2. I suggest apply an emollient or a moisturizing cream to your hand frequently during the daytime. Revert back after two weeks to a dermatologist online.--->

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

Q. My left nose makes a weird sound following a hit. Why?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My left nose makes a weird sound following a hit. Why? ### Input: Hello doctor,One week ago and five days, I hit a school clock off the wall and on the left side of my nose. I went to the E.R., and they said it was not broken, and it was only swollen and bruised. The swelling went down, but it is still hurting, and it has been stuff since then. I used a flashlight to look into my nose, and in the left nostril, I saw to things like deep into that was red and kind of swollen, and when I looked into the right nostril, I saw the same thing, but they were pink and not swollen. But when I breathe in hard, my left nostril makes a weird nose like a motor that was not before the injury. Please help. ###Response: Hello. Nasal trauma and consequent inflammation can cause symptoms like you are complaining. Epistaxis and stuffiness can be present. Since you have been examined at ER and they did not find any signs of fracture, there is nothing much to worry. The swelling you saw deep into your nose is turbinate, and they need not be necessarily identical on two sides. Since there was trauma, it is likely to be congested. There is no reason to be worried too much. Use decongestant drops for a while, and it will be fine.

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

Q. Does ill fitting dentures lead to peeling of skin inside the mouth?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Does ill fitting dentures lead to peeling of skin inside the mouth? ### Input: Hello doctor, The last week two weeks I have been getting peeling in my mouth like on my cheeks. And I wanted to know if that is from loose fitting dentures or if I have not been cleaning them properly. ###Response: Hello. Usually, vitamin B complex deficiency causes such peeling of the oral mucosa. If you are using dentures for a long time, then it may be the reason for this.Take a multivitamin once a day and eat a good healthy wholesome diet.

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

Q. Kindly see my results and advice whether I can father a child?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Kindly see my results and advice whether I can father a child? ### Input: Hello doctor, Please, can you help me to analyze this result. I need a specialist who can help me to investigate this result and can a person with such a result father a child? If no, what is the remedy or treatment for it? ###Response: Hello. The two semen analyses reports show entirely different semen characteristics (attachment removed to protect patient identity). The first report is entirely normal, and the person can father a child as long as his female partner is normal. The second report shows no sperms, hence the person cannot father a child. But there are few clarifications needed, 1. Whether both reports are from one person only? 2. What were the collection methods? 3. What was the time gap between two reports if both are from one person? 4. What is the fructose value in the second report? 5. What is the serum FSH (follicle stimulating hormone) value in person with the second report? 6 . what does transrectal and scrotal ultrasound show in both? If you can clarify these points, I shall be able to give still a detailed answer.

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

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

Q. What type of cap should I opt for RC treated tooth, single or joined?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What type of cap should I opt for RC treated tooth, single or joined? ### Input: Hello doctor, I went for five root canals on front teeth. Which type of caps are advisable single or joined? ###Response: Hello. Yes, caps are advisable but single is best. Joined or bridge has a drawback. If any side of the joined cap is loose or any damage comes, then the whole bridge is removed. In single if one particular tooth or cap has any problem or any damage, then the single cap will be repaired and removed.

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

Q. Why could be the reason for breathing difficulty in breathing after mitral valve replacement?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why could be the reason for breathing difficulty in breathing after mitral valve replacement? ### Input: Hello doctor,My mother is 59 years old and had undergone mitral valve replacement operation 15 days back. Now she is having breathing difficulty sometimes. SpO2 after exertion is 87 to 89 (without 02), the respiratory rate is around 28 to 30. I have attached the CT contrast thorax. There is no fever and wheezing. The echo shows only mild MR, and TR. No pulmonary hypertension and pleural effusion. She cannot take Duolin nebulization because she is a patient of atrial fibrillation, it increases her heart rate. But atrial fibrillation is under control by medicine. Please suggest the treatment. ###Response: Hello. I have gone through all the history you provided here. Your mother is currently suffering from two different problems. Mitral valve replacement followed by mild MR and TR as well as atrial fibrillation, are distinct cardiac problems. And according to you, she is taking prescribed medicines regularly.After going through the CT scans images (attachment removed to protect patient identity), it looks like she is suffering from some infective lesions in the lungs, most probably pulmonary tuberculosis (PTB). She is having breathing difficulty with low oxygen saturation, probably due to underlying lung infection. To confirm the diagnosis, further sputum tests are advised for sputum AFB (acid-fast bacilli) and culture tests. If no sputum sample is available, then induce sputum by nebulization with saline solution or perform a bronchoscopy. You are advised to consult pulmonologist doctor who will evaluate history and will advise recommended tests and medicines if required. Currently, symptomatic management includes oxygen supplementation with a high protein diet. Continue all cardiac medicines as advised. Depending upon the sputum AFB report, further treatment can be planned. I hope I have cleared all your doubts. In case you have any questions please do not hesitate to contact me again. Infection with PTB. Sputum AFB and Bactec AFB Culture. Depending upon sputum AFB report may require antitubercular treatment. Strictly use a mask while coughing and talking.

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

Q. I have bipolar 2 and panic disorder. Is it normal for me to think that I have psychosis?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have bipolar 2 and panic disorder. Is it normal for me to think that I have psychosis? ### Input: Hello doctor,I was diagnosed with bipolar 2 and panic disorder. I currently take Zoloft and Klonopin. My psychologist believes I am functioning normally, but sometimes I worry that I may be in psychosis, or displaying symptoms. My only concern is that recently, I have been having paranoid thoughts. Nothing extremely delusional, but sometimes I feel like my parents think I am crazy or that they are lying to me. I also had a paranoid thought that my boyfriend was lying to me. The thoughts do not happen very often, but is this normal for bipolar type 2? ###Response: Hello. It is common to have some paranoid thoughts, especially when you are feeling stressed, anxious, and feeling low in confidence. From the way you have described your symptoms, psychosis appears very unlikely. You can recognize the paranoid nature of your thinking, and your thoughts do not seem to have delusional thinking. Your report says that you are functioning normally and so I think your psychologist is right. Continue with your psychological therapy to manage your mood and anxiety symptoms and challenge your distorted thinking pattern. I will recommend having regular follow-up with your prescribing doctor to monitor your mental state and seek review if you experience any new symptoms.

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

Q. Please advice on my blood reports.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Please advice on my blood reports. ### Input: Hello doctor,I did the blood test a few days ago, and the reports state that,1) Monocytes 0.19.2) Red cell distribution width 46.7.3) Platelet distribution width 21.4) Mean platelet volume 13.4.5) Platelet to large cell ratio 50.5.Kindly advice. ###Response: Hello. The test is not specific. You need to specify why it was done and what your symptoms are. The test indicates macrocytosis larger platelet than usual, red cell distribution width is higher than normal (11.5 to 14.5). This indicates that your bone marrow which produces all the blood cells such as red blood cells, platelets and granulocyte white blood cells (neutrophils, eosinophils, basophils) and monocyte is not getting enough vitamin B 12 (cyanocobalamin) and folic acid. I do not know are you anemic since there is no indication of red blood cell count there. The cause can be from not getting enough folic acid and vitamin B 12 in your diet, or your intestine does not absorb enough B 12 vitamin, a condition called pernicious anemia from lack of intrinsic factor needed for their absorption. You may be a vegetarian because if you eat enough meat, you would not be having folate and B 12 deficiency.You may have vitamin B12 and folic acid tablets.

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

Q. Kindly suggest treatment for urticaria.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Kindly suggest treatment for urticaria. ### Input: Hello doctor, I am a 25-year-old male. I am suffering from urticaria for a long time. I did not remember exactly how long but it has been approximately four months since I am suffering from this issue. My father and brother also had suffered from this, but only once or twice, but for me, this is a normal thing. My skin has become so much sensitive that even soft rubbing can cause redness, itching, and swelling. I had not taken any treatment yet because I was told that this would be cured automatically within a short span of time. But in my case, it is getting worse day by day. ###Response: Hello. You have new-onset urticaria. Since it has gone on for longer than six weeks, it is now considered chronic urticaria. It is a common condition. Most people will experience at least one episode of urticaria during their lifetimes. There are many causes of urticaria such as 1. Infections-viruses, bacteria, and parasites 2. Drug allergies. 3. Food allergies. 4. Insect bites or stings. 5. Physical causes like exposure to cold. The exact cause cannot be identified in about 50 % of the cases. Please try to see if you have changed any cosmetics (hair dye, creams, powders, soaps, shampoos, deodorants, etc.). Have you started any new medicine or supplements (including herbal, over-the-counter, etc.)? Any recent change in your occupation, use of latex, etc. Any urine infection-burning urine etc. Any use of food colors?If no answer can be obtained, I suggest checking a complete urine examination. Also, I would try a course of de-worming treatment. Albendazole chewable tablets (brand name Zentel) 400 mg. Take it in two doses. The first and second dose should be separated by a week. Take after food, only two doses are required. For symptom relief, try antihistamines. I suggest a non-sedating anti-histamine taken once a day in the morning.If this alone helps, fine, if not, take a different antihistamine at night. Take them daily for a few weeks and then start cutting back slowly and observe. If your itching and urticaria do not respond to anti-histamines, you may need to take corticosteroids.

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

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

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I get throbbing headache in the morning after long working hours and late night sleep. Please help. ### Input: Hello doctor, I woke up with a throbbing headache. Previously I was alright before going to sleep which was around 2 AM. Lately, I have been sleeping very late due to working at home for long hours. Please help. ###Response: Hello. I can understand your concern. According to your statement, you have been suffering from throbbing headaches during waking up. Headache which is throbbing in nature may result from the dilation of blood vessels from increased blood flow. Headache is very common in everyone life. Strenuous work, stressful life, dehydration, anxieties, tension, common cold, allergies, low glucose sugar level, etc., can cause headaches. Throbbing headaches may result from some health conditions such as migraines. Throbbing headache occurs at the top of head, Cluster headache occurs as throbbing headache behind the eyes, Occipital neuralgia presents as throbbing headache at the back of headache, Temporal arteritis occurs as throbbing headache in temples, Hemicrania continua occurs as throbbing headache on one side. Treatment depends on the causes. You should undergo some investigations like CBC (complete blood count), x-ray PNS (paranasal sinus) can detect the cause which is responsible for your sufferings and then treat them accordingly. You can take for your headache as follows. Tablet Inderal (Propronolol) (40mg) 0+0+1 for 15 days, Naprosyn (Naproxen) (500 mg) 1+0+1 for 10 days, Prevacid (Lansoprazole) (30 mg) 1+0+0 for 15 days. In case of allergy or cold take tablet Allegra (Fexofenadine) (120 mg) 0+0+1 for 10 days. In case of any other query knock me.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. Can LSD, DMT, and Ecstasy trigger the borderline personality in seperation anxiety disorder?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Can LSD, DMT, and Ecstasy trigger the borderline personality in seperation anxiety disorder? ### Input: Hello doctor, I am 23 years old. I have been diagnosed in the past with (SAD) separation anxiety disorder, autism spectrum as well as ADHD. Lately, I have been harming myself and having trouble controlling my emotions. I sometimes feel as if the whole world hates my guts. Then I feel good again a little while later, sometimes soon, sometimes not even until the next day. As well as some delusions towards those closest to me. Now that I have told you a little about my self. The question is, can separation anxiety develop into borderline personality? Can the fact that I have smoked weed almost daily for the past two to three years and occasionally from age 16 cause borderline. Or can substances like LSD, dmt, and ecstasy trigger the borderline as well? I am having a hard time believing how extreme my emotions are. Kindly advice. ###Response: Hello. Yes, separation anxiety disorder might develop in borderline personality disorder (BPD). But based upon the information you provided I am not sure if you have SAD. Smoking weed might increase anxiety, which could worsen the symptoms in BPD. Smoking weed can lead to precipitation of acute psychosis, which can prove dangerous. LSD (lysergic acid diethylamide) or any hallucinogen can increase psychotic symptoms.

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

Q. Will IgG antibodies take care of the secondary infection in a HSV 1 postive patient?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will IgG antibodies take care of the secondary infection in a HSV 1 postive patient? ### Input: Hello doctor, I recently have had tests done after I was with someone that I do not trust after the fact. The only thing I have come up positive for is the common HSV 1. I remember having one outbreak when I was young and no outbreaks after. I have IgG antibodies present in my blood. I fear that the person I was with carried HSV 1 and reinfected me. I hope that my antibodies reacted and destroyed the second infection. I had a blister present on my skin after being with this friend. But it healed up immediately, more than a regular blister. Is there a chance that my IgG antibodies took care of the second infection? I told this person that I had perfect sexual health, and it was essential to me and the love of my life, which I am hoping to find. So it has hurt me at a phenomenal rate. I think of it daily. I need to know if I had IgG antibodies built up before reinfection, can it destroy the reinfection if symptoms are present? My symptom was present one day before it started healing. On the upside, a doctor that looked at it said it was nothing. Other doctors said it was probably nothing. It has cost thousands of dollars to find an answer. I am looking for a true love to live life out with and this is very important to me. Please let me know if IgG antibodies could kill reinfection if a symptom were only present for a day. It has been about nine months, and I have not had any symptoms. If you can help me, it would mean the universe to me. ###Response: Hello. I understand your concern. Please follow the following facts. 1. Once you get infected with HSV-1 (herpes simplex virus), as you had been in childhood, IgG antibodies remain there in the blood indefinitely or life long. 2. They help in containing further episodes, so subsequent episodes of herpes are always less in severity than the primary one. 3. Usually, herpes secondary episodes last for a few days, can heal in a couple of days also if it is minimal. 4. You are getting worried too much, and please relax, it has been nine months, there is no need to panic now. 5. You did not mention the site of blisters or any photographs you have taken, and it might not even be herpes. 6. There is no sign of HSV IgG in blood, and it just indicates you had an infection anywhere in the past.

Hello doctor, I am suffering from sinusitis and dust allergy. I cannot eat or drink cold items.

Q. I have allergy and sinusitis so I cannot eat or drink cold items. Please help.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have allergy and sinusitis so I cannot eat or drink cold items. Please help. ### Input: Hello doctor, I am suffering from sinusitis and dust allergy. I cannot eat or drink cold items. ###Response: Hello. Have you done the X-ray of the sinusitis? Sinusitis is inflammation of the paranasal sinuses which are like air pockets found within the cheeks, frontal part of the skull and inside the anterior skull bases. Obstruction to the draining channels of those sinuses lead to blockage and accumulation of secretions which becomes infected and the problem begins. Or there can also be a congenital deficiency in the ciliary cells that beats to drain the secretions into the meatus. You will have to use antibiotics such as Augmentin, use Actifed tablet one tds. Also, you can use nasal drop to help open the ostium so that the mucus clogging it can go out. There is also a surgical procedure, e.g., antrostomy to drain out the maxillary antrum sinuses.

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

Q. My genital redness exists still after medication. Please help.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My genital redness exists still after medication. Please help. ### Input: Hello doctor, I am 25 years old male. My problem is redness of the genitals. It has been two months now. It first started from my penis head with four or five red bumps like spots. Then I consulted a dermatologist. He gave me Candid-B cream to apply and some anti-fungal tablets. But I mistakenly use liquid Dettol in water to wash my penis, and it spread badly to my scrotum area. Whole red no itching and no pain just a little red nerves beneath. I have used creams like Onabet, Dermiford k5 prescribed by doctors. And have done 25 days course of Itraconazole 200 mg two times per day. And that with Onabet cream and glycerin lotion. The last cream I used was Betnovate gm, which damaged my penis and gave me a burning sensation on scrotum and foreskin. Now I am applying no cream, only keeping ice pack, and I consulted another doctor. He said after seeing pictures that there is no fungus just irritant contact dermatitis. Please help. ###Response: Hello. According to the history given by you, it could be irritant contact dermatitis followed by application of dettol. Since you have used most of the creams and few of it containing steroids, your skin has got thinned, and that is why you could see red colored vessels. It is advisable that you should not apply any cream which contains steroids it could worsen your lesions. Apply coconut oil before taking a bath, no soap on the affected area during bath. Please share pictures of it so that we could start with the treatment. You might need to take oral steroids to improve your condition, but no topical cream. You can take tablet Levocetirizine 5 mg at night time for five days. This is to reduce the itching or burning part but not going to cure it. It is advisable to consult a dermatologist.

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

Q. My sister has pain in the legs from thigh to knee. Please help.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My sister has pain in the legs from thigh to knee. Please help. ### Input: Hello doctor, The problem is with my second elder sister who is unmarried and aged 62 years. She was a school teacher and has retired from service. She is 160 cms in height and weighs 60 kg. She falls under the category lean to good health except for a bulging tummy. Main problems are, 1. Pain in both the legs with more pain in the right leg from thigh to the knee. 2. Sometimes a feeling of being pushed from behind when standing. a. Apart from these, she is also suffering from, When lying down to sleep or sitting for some time, 1. Feeling as if the veins inside the legs are getting loose with pricking pain on both feet. 2. Biting pain on both feet even when one foot is pressed with another foot 3. Sometimes a feeling of scratching with a sharp instrument. 4. Pain in toes and nails. 5. Pain in the bottom of the feet 6. Burning sensation in feet, especially when the saree edge touches the feet. 7. Feeling of standing on a carpet while standing on the ground without slippers. 8. Tips of the toes are getting rough even though creams are applied. 9. The sudden jerk of hand enough to break sleep. 10. Pain in the legs are spreading from the feet upwards towards the knee. b. While standing 1. Need for placing hands on nearby objects like a wall, chair, table to get better support. 2. Pain just on the right side of the right knee (the place where the knees fold) and a feeling as if the bone will break c. When walking 1. A feeling of getting pushed from the back 2. Unable to walk at a stretch for even half a kilometer 3. The feeling of forceful dragging of legs 4. Feeling of breathlessness d. Hands are unable to work with both sides together (e.g., holding utensils with both hands for placing them on a gas oven, holding the utensil with one hand while stirring the contents with the other) even though there is no problem when working with one hand alone. She has some relief when washing legs with cold water I am attaching herewith copies of all the doctor's prescriptions, the test reports including latest scan and MRI report of the spine, the medicines she has taken for your kind perusal, please. Please go through the details and kindly advise us what to do and what medications to take to make the pain bearable, if not eradicate the same. ###Response: Hello. Went through your queries and the files attached (attachment removed to protect patient identity). This clinical scenario is possible in two cases. 1) Compression of the spinal cord at the cervical level or lumbar level or both. 2) Peripheral neuropathy is affecting all four limbs. She has been extensively investigated. Treatment for peripheral neuropathy has been tried in the form of pregabalin, gabapentin, nor tryptiline, etc. which do not seem to have afforded any improvement to her. So I suggest we may try a course of the following medications for a week. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1) Tablet Medrol 4 mg 1-0-1 after food (Methylprednisolone). 2) Tablet Pan 40 1-0-1 before food (Pantoprazole). 3). Tablet Phlogam 1-1-1 before food (Trypsin, Bromelain, Rutoside). 4). Tablet Nurokind LC 1-0-1 after food (Vitamin B12, Levocarnitine). 5). Tablet Nervijen-NP 1-0-1 after food (Nortryptiline, Pregabalin). 6). Tablet Alsody 1-0-1 after food (Alpha lipoic acid, Superoxide dismutase). Cervical stenosis, lumbar stenosis or peripheral neuropathy.

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

Q. Why does bruise reappears after stopping the vitamin supplements?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why does bruise reappears after stopping the vitamin supplements? ### Input: Hello doctor,I get bruising easily. My blood reports are fine, and the bruise gets clear with vitamin C and K tablets but occurs again when I stop the medicine. Why? ###Response: Hello. Kindly mention since how long you have such problem? And mention the duration of the treatment. In such easy bruising case, the causes like liver disease, low platelet count, and coagulation abnormality have to be ruled out. You have investigated for that, and all the parameters are within the range. So if your problem is since a few days, then you can continue oral vitamin C that is Limcee and topical vitamin K. If the problem continues, then consult nearby hematologist for detailed evaluation. Hematologist might evaluate further in the form of fibrinogen estimation and full coagulation profile testing. I hope I have answered your question. Let me know if I can assist you further.

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

Q. Can Homeopathy help in masturbation problem?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Can Homeopathy help in masturbation problem? ### Input: Hello doctor,I have some health issues that I would like to address. I have depression, fatigue, low energy, tiredness, and red eyes when I wake up, and I feel exhausted after masturbation. I have a history of masturbating for eight to nine years since I was 12 years old. The first few years, I was continually masturbating with lots of pornography. I am now masturbating one to two times a week yet still feel exhausted and fatigued daily and even watch porn one to two times a week. I have trouble with morning wood maybe once a week. What can Homeopathy offer me to heal from masturbation and get back to being healthy? ###Response: Hello. I understand that you are concerned about various health issues, and it seems most of the symptoms are related to over masturbation. Masturbation at the teenage is prevalent. Homeopathy has a vast number of remedies to heal this issue. However remember that masturbation was is not bad, but overuse is something that causes health issues, twice or thrice a week is not bad.Homeopathic remedies will help you to deal with this habit, and you would be able to concentrate more on other things in life like a career or job, etc. Homeopathic remedies are prescribed after taking your mental, emotional and physical health in to the consideration. Based on the little information you provided here you can start Lycopodium 30c four pills once a day for five days. Then begin with Kali Phos 6x two tablets twice a day for 15 days.These pills and tablets usually dissolve as soon as you keep them over the tongue. Hence there is no need to swallow these with water or anything liquid. Kindly report back on15 days. I hope you start feeling better. Let me know if you have any questions. I would be happy to answer.

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

Q. Will emergency contraceptive pills work when taken during withdrawal bleeding?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will emergency contraceptive pills work when taken during withdrawal bleeding? ### Input: Hello doctor, 1. I took ECP during withdrawal bleeding (as I stopped contraceptives). Will it work? 2. Will this affect my menstrual cycle as I have not got my periods in my due date. I am freaking out. 3. When should I go for pregnancy test to clear my doubt? ###Response: Hello. 1. Usually the possibility of ovulation is less during withdrawal bleeding, so the need for emergency contraception is less. But as you took the pill already, if at all there is any possibility of pregnancy, it can help. 2. Because of high dose of hormone in it, it can affect your periods. Sometimes after taking emergency contraceptive pill, you may see withdrawal bleeding after 7 to 10 days. 3. For accurate result better to test three weeks after having unprotected intercourse.

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

Q. Why does the stomach blossoms without food in the morning?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why does the stomach blossoms without food in the morning? ### Input: Hello doctor,The stomach blossoms without food, even in the morning. It is felt more in the upper part of the stomach. ###Response: Hello, Welcome to the icliniq.com. You can have a gas problem due to functional indigestion. I suggest you take gelusil MPS like syrup before bedtime for one week. It is advisable to take Rabeprazole like antacid for the week also. If there is no improvement than USG abdomen scan should be done for further workup, meanwhile avoid gas forming foods like cabbage, cauliflower, etc. Carbonated drinks should be restricted. I hope I have answered your question. Let me know if I can assist you further.

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

Q. My tongue is bleeding while brushing and having white sopts in the uvula. Kindly explain.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My tongue is bleeding while brushing and having white sopts in the uvula. Kindly explain. ### Input: Hello doctor,My tongue hurts and bleeds when brushed. White spot on uvula area and white and small red dots on the roof of my mouth. Also, a yellowish color is seen on the roof of my mouth. ###Response: Hello. The condition is called aphthous stomatitis. It usually follows a brief period of stress to be emotional or physical, as a febrile sickness. You need to take a short course of antibiotics, topical analgesics, anesthetics. Multivitamin supplements and antacids can be taken. It is usually self-limiting, and the treatment is aimed at symptom relief.

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

Q. Does alcohol hinder the work of Abilify?

Hi. For further information consult a psychiatrist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Does alcohol hinder the work of Abilify? ### Input: Hi doctor, A person used Abilify and drank alcohol heavily on Abilify. Then switched medications and quit drinking for years. Can that person go back to Abilify again? Will it work? Or does drinking alcohol make the medication never work again? Please explain. ###Response: Hi. For further information consult a psychiatrist online -->

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. Can Seroquel withdrawal cause loss of sensation in penis?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Can Seroquel withdrawal cause loss of sensation in penis? ### Input: Hello doctor,I finally withdrew from the drug called Seroquel. But now my penis has no sensation at all. I have much more arousal meaning my sex drive is back. But it is as though 90 % of the sensation is gone. While on Seroquel, I had more, but I stopped the medicine due to many bad side effects. It has been two weeks since my last dose. ###Response: Hello. Seroquel is Quetiapine, and the drug is an antipsychotic and mood stabilizer drug. In high doses in some individuals the drug is known to result in side effects like reduced libido, sometimes delayed ejaculation, difficulty in orgasm, etc. But Quetiapine is one of the safer antipsychotics if we compare this drug with other antipsychotic drugs. The possible explanation of reduced sensation on the penis could be mild withdrawal, which might result in numbness like symptoms, and this may present with symptoms like reduced sensation around the penis. But the dose you were taking that is 50 mg is not a very high dose. Stopping this would not result in much withdrawal except mild insomnia. If we link this with sexual side effects of Quetiapine or Seroquel, then this will reverse by own in coming days. In most cases, sexual side effects go by own in less than four weeks of stopping the offending drug. You were not on a very high dose so that the recovery would be earlier. Prolactin levels increase seen with antipsychotic use (in high doses for a long duration, but some individuals even in low dosage). The standards will normalize in some days, and this will result in an improvement of sensation on the penis. No need to worry, and at this point nothing should be done because your erection is relatively better now, this means libido is improving.

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

Q. What should I need to do to get rid of my skin infection on my arm?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What should I need to do to get rid of my skin infection on my arm? ### Input: Hello doctor, I have a skin infection on my right arm and would like to know what I need to get better. ###Response: Hello. How long has it been there? What are the symptoms in it? And any other family member affected?

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

Q. A gurgling occurs while breathing in and out. Why?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. A gurgling occurs while breathing in and out. Why? ### Input: Hello doctor,I am gurgling when breathing in and out, especially when laying down. In the beginning, I had a fever with strong cough and wheezing sound when breathing in and out, after a few days, I am back to normal, but this wheezing turned into gurgle till now. ###Response: Hello. Take syrup Bromhexine two tablespoon thrice daily for a week. It will produce a cough. Please excrete it out. Also, do steam inhalation thrice a day for a week.

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

Q. How long should I take Soltus for delusion?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How long should I take Soltus for delusion? ### Input: Hello doctor, I am a 33-year-old male, and my height is 5 ft and 8 inches. I am currently on medication of Soltus 75 mg, which was earlier Soltus 100 mg. I am on medication for one year and a half. I was having delusions. I want to know till how long do I need to continue this medication as I am gaining wait and my mental alertness has also reduced. What could it be? ###Response: Hello. Soltus (Amisulpride) is an antipsychotic medication given to manage symptoms like delusions, hallucinations, thought disturbances, etc. These symptoms can occur in different situations like extreme stress, psychosis, etc. Discuss with your prescribing psychiatrist regarding the diagnosis as he will have a complete history. This medication needs to be continued for at least a year, possibly longer depending on the nature of your symptoms, previous history, etc. So again, kindly discuss with your prescribing doctor. If you are stable, your doctor may consider decreasing the dose to soltus 50 mg daily. But any dose reduction needs to be done under medical supervision. Weight gain can be an issue with this medication. It can be managed by eating healthily (avoid fast foods, high-calorie snacks, etc.) and having regular exercise.

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

Q. I have eczema only in my legs. What to do?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I have eczema only in my legs. What to do? ### Input: Hi doctor, I am aware that I have eczema. But, everything I try does not work. I have been having severe eczema since I was 8. I am about to be 19 now. I have tried using unscented lotions, dermatology approved lotions, organic oils and even all of the ointments doctors prescribe me with. The only thing that the lotions and ointments do is calm the irritation. Over the years, I have learnt to resist the urge to scratch unless it becomes unbearable. But, I always find myself sleep scratching. Yeah, I said it sleep scratching. I wake up with tingling legs and can see how hard I have scratched in the middle of the night. I moisturize all the time. Yet nothing works. I am getting to the point where it is starting to interfere with my life. I am young. I want to wear shorts and sundresses whenever I want. But I cannot because of the ugly scarring I have on my legs. I forgot to mention that my eczema is only active on my legs. Occasionally it occurs in my hands and rarely on my arms. Sometimes I even get it on my face. I have tried keeping my nails short so I do not have gross scratch scars but it does not work. I get my nails done because it does not leave scratch scars but it leaves bruises. And do not get me wrong the ointment is the best thing that works but I do not want to have to be wearing that ointment as a lotion. I have to leave to the ladies room about every hour so I can moisturize my legs to prevent the itching from happening but honestly who wants to live a life like that? It has begun to affect my life emotionally and I do not know how much more I can take of it. ###Response: Hi. I can understand your concern. Being a dermatologist observes in day-to-day activity few diseases have bad impact on lifestyle, out of which eczema is one of them. But, with your descriptions it seems to be atopic dermatitis, which becomes better as age progress. In adults, it involves the flexural surface eventually localizing to the front of elbows and behind the knees. You need not have to worry that much. Besides medicine, you should do some yoga exercises, which will help you much. Few general measures you have to follow are: In case of oozing, avoid ointment or cream, corticosteroids in lotion form may be used. When there is no oozing or in dry eczemas, corticosteroid cream is to be applied locally twice a day. Local antibiotic cream with or without corticosteroid is helpful where bacterial infection is present. Skin biopsy needs to be done to confirm the diagnosis. Atopic dermatitis. Revert back for regular follow up to a dermatologist online.--->

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

Q. Can missed period mean pregnancy?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Can missed period mean pregnancy? ### Input: Hello doctor, I am 18 (unmarried) and I have missed my periods on first two days and I suppose I might be pregnant (unplanned) as I am not having any symptoms of my monthly periods. Me and my fiance had a pullout in 6-10 seconds after he inserted the penis in vagina but there was just a pre-cum which he had already wipped away and there was no ejaculation taken place (sure). Is it a sign of pregnancy? Can I consult a Gynecologist alone without parents or guardian? Can I terminate the pregnancy by medication as it has been only 6 days? What should I expect? Please help, I am stressed. ###Response: Hello. Please do not get worried or panicked. Get a beta hCG test done. It is a blood test to confirm pregnancy. A value less than 5 means you are not pregnant. Even if it is positive, you do not need to worry. You can get it terminated by medicines (You will need to get an USG done first). You can visit a gynecologist without parents and your privacy will be respected. Please make sure you visit a qualified gynecologist and do not visit quack out of social fear. Gynecologists are professional and will not meddle in your private life and will help you get rid of pregnancy without risk to your life.

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

Q. Why do white spots appear on teeth?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Why do white spots appear on teeth? ### Input: Hi doctor, I have two small white spots on the lower portion of my front tooth. Can it be removed by microabrasion? Is the procedure worth? Please guide. ###Response: Hi. There are several reasons for the white spots on your teeth. Usually, white spots appear when the mineral content in the outer part of the teeth (enamel) is less. White spots could also occur due to high fluoride level in the drinking water or nutritional deficiency during teeth development and infections to name a few. Are the white spots only on the front teeth? Or do you have them on other teeth as well? Microabrasion certainly does not help whatever the cause of the white spots may be. It just makes the surface of the teeth rough and gives rise to other problems. You could consult your dentist and ask whether bleaching can be done. There are other options like placing a veneer on the surface of the teeth. However, a small part of the tooth surface needs to be abraded to place the veneer.

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

Q. I am finding it difficult to have intercourse. Why?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am finding it difficult to have intercourse. Why? ### Input: Hello doctor, I recently got married and I knew my partner for long before marriage. My query is I am finding it hard to have intercourse. I am very active while doing foreplay, but when I am about to insert somehow I end up ejaculating outside. We as a couple are planning for pregnancy at the earliest. Please guide us. Thank you. ###Response: Hello. As per your history, you seem to be suffering from erectile dysfunction (difficulty in sustaining erection) after marriage. The commonest cause of erectile dysfunction after marriage is performance anxiety. If you are worried about erection and your performance during sexual intercourse, it could cause problems with erection. To overcome this, you can try the following techniques. You can take these tablets on alternate days if needed as the effect of these medicines will last for 2 days. If you are taking any other medicine for blood pressure or cardiac condition, ask your doctor if it is fine to take these medicines along with the other medicines. You will not need these medicines for more than 15 to 20 days because you will develop confidence when you have sex successfully for a few times. As you are recently married, do not worry about pregnancy so soon. You will have plenty of time and opportunity for planning a baby. This added pressure of getting pregnant could also adversely affect your erection. Performance anxiety. Erectile dysfunction. 1. Relaxation techniques. 2. Tablet Forzest and Rivotril.

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

Q. Will sleep deprivation cause any permanent changes in brain?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will sleep deprivation cause any permanent changes in brain? ### Input: Hi doctor, I do not used to sleep a lot from early age. Daily to the maximum I will sleep for 6-7 hours. Now, these days I find scary researches about how sleep deprivation can damage brain permanently. I want to know whether my condition too is also related to sleep deprivation. Will it cause any permanent subtle changes to my brain? Please help me. ###Response: Hi. Yes, the research has gained a lot of attention and we do consider the facts. But, what has been done cannot be reversed. However, if we go with clinical experience, usually people who modify back there lifestyle do not get any ill effects in life. In fact, I would advice in such case that you should stop thinking that what is reversible and what is not. Start living your life normally and take help with a psychiatrist if there is great difficulty in sleeping. One can be treated easily with hypnotic drugs which help in controlling these issues.

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

Q. My child developed phobia for terrorist. How to eliminate this?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My child developed phobia for terrorist. How to eliminate this? ### Input: Hi doctor, Recently my child seems to have developed phobia for terrorist. She is just 4 years old. I did not know how really she even came to know about the word terrorist. Now, she remains afraid for most of the day and night. She thinks that they are going to come to her. She does not like to go outside the flat and visit public area. I think it may be that one of the movies seen recently has left a deep impact on her. We tried our level best to convince her that movies show false things, but somehow the word terrorist has got deep inside her. She keeps talking about them throughout the day. We do not really know how to get this out of her. These things have started very recently and becoming more intense. Kindly help. ###Response: Hello. Child's mind is very delicate and easily moldable. Subtle things can cause drastic and unexpected effect on them, which we cannot even predict at times. In your case, it is quite easily observable to you. It is good that you could recognize this change in her behavior so early and decided to take an opinion for the same without wasting further time. Violence and rage have very severe effect on a child's mind. This is what happened with your daughter. The violence depicted in the movie and the reactions caused by that violence in the movie characters have made a deep impact on her mind. The fear caused by that violence had got imprinted on her mind. This can be the beginning of development of an underlying anxiety illness in her. So, it is very important for you as a parent to help her overcome this. You have to gradually make her aware that though the terrorist are the ones who spread violence and chaos, but on the other hand there are good people also who stop them. To begin with storytelling is a good way to inculcate things. Then play therapy can help. You can get her into play activities where you can strengthen her faith that there is no need to be afraid of bad guys and there are always good guys to help with. Gradually start taking her out and expose her to the people in neighborhood. Tell her about different kind of people living nearby. Familiarize her with the surroundings. Besides this, you should avoid watching content depicting violence and rage in front of your daughter. Child's age is a tender part of their life, they learn very quickly. So, use this as a therapy to manage her fear.

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

Q. How can I divert my mind when I become sad due to the rude behavior of my loved one?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. How can I divert my mind when I become sad due to the rude behavior of my loved one? ### Input: Hello doctor,I am a 32-year-old woman. The one with whom I am in love sometimes behave rudely to me. He remains silent whenever he dislikes anything that I say. I am a bit outspoken, and I am unable to control this. His silence kills me. I find it difficult to do routine work. I feel so sad and shattered. He will not answer my messages and will not pick up my call even if I had called 50 times a day. I feel like hurting myself. I suffer from depression since childhood, and I am taking Amitriptyline since the last 13-14 years. How can I divert my mind and focus on my work during those times? It happens almost twice a month. We are together for five years now. ###Response: Hello. It looks like you and your partner have different personality styles and deal with conflicts differently. For example, if you are an extrovert, you would like to talk your way through issues. But if your partner is an introvert, he may have an aversion to conflict and arguments and may withdraw during stressful periods. This is a natural way of responding to some people and not to be taken personally. If your partner is otherwise fine and treats you well, it may be helpful to have an open and honest discussion with him when both of you are calm. Write down your thoughts if direct talking can be difficult and ask your partner to reply. Both of you have to respect each other and learn to form your ways of dealing with conflict as a couple. It is natural for all couples to have disagreements, try not to overthink in such situations. Try relaxation techniques and carry on with your usual routines. If needed, you can try counseling or couples therapy. Also, look after your emotional health. Consult your doctor to review your mental health and the need for continuing anti-depressants. I hope this helps.

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. Will delaying vaccines for an infant cause any problem?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will delaying vaccines for an infant cause any problem? ### Input: Hi doctor, I am blessed with a baby boy (3 months 10 days). I am sharing with you his vaccination card. All vaccines are almost due because of the Corona Pandemic. Most of the clinics are almost closed. Will you please suggest, whether these vaccines can be delayed a bit till the suspension of lockdown, or do I need to arrange it ASAP. Really tensed about this unexpected and unfortunate situation. ###Response: Hello. I understand your concern for your child. I would say you can wait for some more time till the end of this month as probably after this month lockdown restrictions will be over. I believe you should go according to your pediatrician as he would understand the situation best at your place. Till then, best hygiene measures should be taken for your child. Use hand rub or wash hands properly before touching your child. Avoid giving bottle feeds. If you maintain this, there should be no problem. All vaccines can be given at a later date.

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

Q. I need some medications to relax as I am nervous most of the time. Please help.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I need some medications to relax as I am nervous most of the time. Please help. ### Input: Hello doctor, I am a 26-year-old female. I am nervous most of the time and cry a lot because my dad passed away a month ago. I feel like there is no reason for life now, have no goals and moments without happiness. I thought about suicide several times, so I need some pills to relax me during the day time without sleeping effect. What should I do? I will never see my father again, which drives me crazy. ###Response: Hello. It is always painful to lose a loved one. Your symptoms are suggestive of an acute grief reaction to the loss of your dad. Grief causes significant emotional distress for some weeks, but usually, you will heal gradually with support from family and friends. To clarify, did you experience any emotional problems or mental health issues before your dad passed away? In that case, the grief can be more intense, prolonged, and you may need professional support like bereavement counseling. Usually, pills are not recommended for normal grief. But if you have any other underlying emotional problems, kindly consult your doctor who can assess and prescribe according to the need. I will advise not to isolate yourself during this period. Try to go out regularly even if you do not feel like it. Open up and talk to trusted family and friends, tell them how you feel. Try to eat daily and sleep well. Go for short walks and try to do your regular activities.

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

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

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am suffering from burning sensation and inflammation in anus after intercourse. Will this be HPV? ### Input: Hello doctor, I am a 24-year-old bisexual male. 10 months ago a friend stroked his penis between my thighs, and suddenly his penis slipped and entered my anus for merely an inches, and he pulled out then we stopped performing it. And after four months I got constipation and hard stools, and then day by day I started to feel inflammation and burning sensation throughout my anus sometimes this burning pain moves to my perianal area and maybe in the rectum. As I read about the HPV infection, I got very scared, and I am in a deep depression. I do not know what this HPV or piles are? Kindly tell me what to do as I am in deep agony, pain, and depression. Please help. ###Response: Hello. HPV (Human papillomavirus), usually HPV infection does not cause any noticeable symptoms or health problems. Some time produce genital warts.For your complaints, constipation and burning sensation may be due to piles or anal fissure. So better go for the rectal exam and proctoscopy examination to rule it out. For piles and fissure try these medicines. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Tablet Pilex 1 t.i.d (three times a day) for 20 days. 2. Tablet Dulcolax (Bisacodyl) one or two for constipation. 3. Proctosedyl ointment use, as per instructions are given in box for 20 days.

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

Q. 18 weeks pregnant woman used spray pesticide. Is it harmful for the baby?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. 18 weeks pregnant woman used spray pesticide. Is it harmful for the baby? ### Input: Hello doctor, My wife is around 18 weeks pregnant and, she started to spray pesticides inside our home. I am concerned that this might harm our developing baby. Please advise. ###Response: Hello. I understand your concern. Definitely pesticides of any category are harmful. If it can damage the pests, then that will be harmful to the baby. But we humans are bigger in size and damage is not significant, unless sprayed daily for many days, for a long time and directly onto the face. By 18 weeks, the baby is fully formed, so there cannot be any significant damage or long term effects on the baby. To be on a safer side better to avoid your exposure to pesticides. Do not worry, and your baby will be ok now. I hope I have clarified your query, do write back if any more questions and for your feedback.

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

Q. Does side effect of the anxiety drug diminishes the memory?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Does side effect of the anxiety drug diminishes the memory? ### Input: Hello doctor, I am a 42-year-old male. When I was 15 years old, I started to suffer from depression and had to undergo psychiatric treatment. I was prescribed Trazonil for a sleep disorder and Flunil for depression and anxiety. I was under this medication for nearly seven years. In the meanwhile, I got hooked to alcohol and smoking before 20 years. I took an overdose and consumed almost 90 tablets of Trazonil in an attempt to end my life. However I survived, but I have felt that it really damaged my brain especially my memory and till today I remember most of the things which took place prior to this incident as well as things I learned, but in my daily life after that I became very forgetful and had trouble remembering things, events or new things which I try to learn. So my question is that is there any way which I can reverse this ill effect or lessen to a high degree so that I can remember things better or have a better memory. I have been drinking for the past 20 years, and since last three years after moving to another place my frequency and dosage of alcohol has increased, and I know it also plays a significant role in diminishing memory. I quit taking medicines almost 14 years back. ###Response: Hello. It is good to know that you are insightful about the problems caused by excessive alcohol intake. Have you contemplated cutting down on alcohol? Alcohol may be playing a significant part affecting your memory and also have a negative impact on your emotional health. Your memory difficulties may be more related to a history of depression and concurrent alcohol abuse. It is less likely to be a long term effect of Trazonil (Trazodone) overdose. You may know that alcohol has a depressant effect on the brain (despite the initial euphoric effect). With your history of depression, it is essential and can be tackled at the earliest. You appear to have experienced significant depression, including a risky overdose. You seem to be resilient in your way but are you still depressed? Are you using alcohol as a coping mechanism to manage everyday stressors? I will recommend consulting a doctor to review your mental state and proceed accordingly. You can consider counseling or talking therapy to address issues related to excessive alcohol use. Try reading books. Also make sure you take care of the basics like eat healthily, sleep enough, and exercise regularly. Try yoga or meditation if available locally.

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

Q. My girlfriend takes Microgynon for PMS. Is it normal for her to experinece spotting?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My girlfriend takes Microgynon for PMS. Is it normal for her to experinece spotting? ### Input: Hello doctor, My girlfriend has been taking Microgynon 30 for two months, with two packages back to back. She took Microgynon for suppressing severe PMS. The medicine successfully suppressed the PMS, but there seem to be some side effects. She experienced some spotting for a week, and the other doctor told me that it is normal for a microgynon-taker. Her actual period started the very next day after stoppage of spotting (which is late for two weeks), and it has been lasting for 18 days. In the beginning, the volume is lower than average, but red blood is visible. In recent days, the volume keeps increasing, and it gets me worried about whether some issues are occurring. Should I take her to a gynecologist for a check-up or it is entirely reasonable for a microgynon-taker? We did not have any sexual intercourse before and in the case for an extremely rare accident, she took a pregnancy test, the result was negative. Therefore, pregnancy could be eliminated. She finished her second package of Microgynon around 6/4, and the next day, the blood volume started to increase. One more question, she has a third package of Microgynon and the gynecologist we saw said that she should begin the third package when the second period stops. Is this correct? ###Response: Hello. Your doctor is right in saying that this is normal with the medicine you are taking. Microgynon is progesterone. It is a hormone which builds up and helps in the growth of the inner layer or lining of the uterus called endometrium. Due to overgrowth sometimes the endometrium sheds off and appears as vaginal bleeding or periods. The drug is otherwise safe just that continuous bleeding is a nuisance and may lead to anemia. She must take some iron supplements and wear a panty liner. For PMS (premenstrual syndrome), she can try a few things after the course of medicine is finished. She must stop taking tea and coffee. Minimize her salt intake and less water for a week before her expected periods. Also, PMS is a broad term, and treatment depends on what symptoms bother her more.

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

Q. My husband behaves rudely all the time. Kindly advice.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. My husband behaves rudely all the time. Kindly advice. ### Input: Hello doctor,My husband is mostly sad and depressed. He cannot listen a word against him or his family(mom, dad & sister). He gets mad and behaves very rudely with everyone if they do not agree to what he says. He fought with his boss in his company for silly reasons. He abuses me emotionally and mentally. He hides from colleagues and friends about his marital status, to some he says he is not married and to some, he says he is married, and his wife stays with his family and works in a bank (but I live with him and work in MNC). He always uses to tell a lie to me in small things also, he is never ready to accept his fault. Even if it is evident that it is his fault, he will never agree. He was flirting with some girl and went to meet her, and I got to know this when I checked his phone when I confronted him, he got mad at me. He is not ready to accept that he is at fault. He never answers my questions, always diverts the discussion. He does not have any plan. He hates my family for no reason and always say abusive things against them. He says he loves me but never let me live happily. In short, he is still right. Is he mentally ill? ###Response: Hello. I can understand your concern. Considering the history of the symptoms you have mentioned, there are few possibilities. One is some underlying mood disturbance which could part of bipolar disorder. This should be appropriately evaluated to make a diagnosis. Repetitive mood swings, keeping grudges, anger outbursts, repetitive lying, etc., are seen commonly. Such symptoms can occur as part of some personality disturbance. Anger, irritation, etc., could be related to personality issues. Please talk to him and if possible, consult a psychiatrist. Mood stabilizers can be used to control his anger and mood swings.

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

Q. I am scared to sleep whenever I hear about some accident. Why?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am scared to sleep whenever I hear about some accident. Why? ### Input: Hello doctor, It has been around four years that I am always scared to sleep. It usually happens if there is an accident I am scared that it will happen to me too, and I would not sleep for about a week. I am so scared of earthquakes, and many nights, I will not sleep thinking that our building will fall. If there is any news like killing people, I will lock all the doors and windows thinking that I will be killed too. And another thing is supposed I eat at 1 pm for the next two hours I will be full and suddenly I feel so hungry, and in a minute I started feeling so weak and start to shiver. This happens whenever I am feeling hungry. ###Response: Hello. Your symptoms are suggestive of an anxiety disorder, which is making you excessively worried about things happening around you. It can be tiring and emotionally exhausting to experience high levels of anxiety all the time. Try relaxation exercises to help manage stress and related anxiety levels. Deep breathing techniques and progressive muscle relaxation exercises will be beneficial. If possible, try yoga as well, and counseling or talking therapy will be helpful. If symptoms are severe and persistent, you will benefit by consulting a psychiatrist for a full assessment and consider medication options as well.

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

Q. I am worried about my reports. Kindly advice.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am worried about my reports. Kindly advice. ### Input: Hello doctor,I had a seven-day monitor, and I have attached my reports. Nothing has been added about whether I need medication, etc. This sounds dangerous. should I be worried? ###Response: Hello. Can you upload the report again? I did not get the part narrow complex 5 qrs hr etc. Do you have any chest pain or discomfort heaviness on exertion, or shortness on exertion? These are ectopics or extra beats. These are usually benign and not life-threatening. These are frequently associated with MVP (mitral valve prolapse), caffeine, alcohol, thyroid problems may aggravate these. But, considering your age, we should rule out ischemia in you. You should also get a thyroid test done. So should get a stress test like stress thallium or TMT (treadmill test) done. You will need beta blockers like Metoprolol to keep these under control. If there is any evidence of ischemia, then you can opt for antiplatelets and Statin. I hope this helps you and get back if you have any questions.

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

Q. What can be done for treating chest acne?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What can be done for treating chest acne? ### Input: Hello doctor,I am an 18-year-old male, and for over two years, I have been dealing with a lot of chest acne. I have been told it is folliculitis. I have gone to three different derms who have just prescribed me Benzoyl peroxide washes, sodium washes, Doxycycline, and a bunch of different creams but nothing helped.It has impacted the quality of my life, and I am not sure what else to do anymore. I have been doing a lot of research on fungal acne, and I feel like this is the problem I have. Even though I mentioned this to my dermatologist, she said she thinks it is more bacterial and said to see if it would improve by prescribing me new creams, and that I would maybe have a culture test done later on to see if it is fungal acne. Do you have any tips or recommendations on what I can do to solve my problem? Or does this look like fungal acne? ###Response: Hello. I understand your concern. It looks to me like Pityrosporum folliculitis. Some people call that fungal acne too. Does it itch? Please take the following medications for three weeks. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Capsule Itraconazole 100 mg after dinner once a day. 2. Ketoconazole, 2 % Cream, apply twice a day. 1. Capsule Itraconazole 100 mg once a day after dinner 2. Ketoconazole 2% Cream apply twice a day For 3 weeks

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

Q. I am getting some rashes after taking Aripiprazole. Should I worry about this?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am getting some rashes after taking Aripiprazole. Should I worry about this? ### Input: Hello doctor,I have started taking Aripiprazole 5 mg tablets, after which I started getting spontaneous rashes. My question is, is this effect worrisome (should I go to urgent care)? ###Response: Hello. Aripiprazole can induce skin rashes though it is not commonly reported. It will be safer to get yourself checked to rule out any systemic involvement, especially if you have any fever, pain, signs of the exfoliating rash. Are you on any other medication that can increase the chances of drug-induced rashes? Most rashes are simple and transient, but a few rashes need more urgent attention. So you need to be examined. Depending on the nature and severity of the rashes, you will be advised either to stop or discontinue Aripiprazole. So consult your primary doctor at the earliest.

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

Q. What has to be done for accidental swallowing of tooth crown?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What has to be done for accidental swallowing of tooth crown? ### Input: Hello doctor, My friend had accidentally swallowed tooth crown an hour ago, she is not facing any problem till now, what should she do, kindly advise. ###Response: Hello. I understand your concern but I think as so much time has already passed and by God's grace everything is fine then I think it has not gone into the airway, problem erupts only when it gets stuck in the airway, it might have gone down through the digestive tract and shall pass out normally through faeces. The biggest question is whether it went inside along with breath or food? That will surely subside the confusion and the one who swallowed most probably can feel this. I would surely want to know which number tooth it belonged to in order to know whether it was bigger or smaller in size. Anyway, an X-ray is always advisable for safety if your area is now open for the same. Be careful and look for the engulfed crown in your passed out fecal matter that will also relax you if you find it sooner. It mostly passes out in 24-48 hours. You can have banana so as to help it pass digestive tract smoothly.

Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?

Q. What does abutment of the nerve root mean?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What does abutment of the nerve root mean? ### Input: Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? ###Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->

Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide.

Q. Will Nano-Leo give permanent solution for erection problem?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Nano-Leo give permanent solution for erection problem? ### Input: Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. ###Response: Hi. For further doubts consult a sexologist online -->

Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.

Q. Every time I eat spicy food, I poop blood. Why?

Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Every time I eat spicy food, I poop blood. Why? ### Input: Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. ###Response: Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->

Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.

Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?

Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? ### Input: Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. ###Response: Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.

Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.

Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way?

Hi. For further doubts consult a sexologist online -->

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? ### Input: Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. ###Response: Hi. For further doubts consult a sexologist online -->

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

Q. I am having small black spots on my toenail. Does it indicate melanoma?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. I am having small black spots on my toenail. Does it indicate melanoma? ### Input: Hello doctor,I am 21 years old. Today I noticed a small black spot on my toenail, I did a little research and found out that it might be a melanoma cancer, but also it could be a fungus infection. After a bit more research, I noticed that an unusual cystic pimple between my chest that I have had for two months now might also sign of melanoma. I spend little to no time in the sun. Do I have melanoma? The black spot on my toenail might be because of the tight shoes I have been wearing lately, my toe also hurts a little bit from those shoes. The red pimple between my chest appeared five to six month ago, then disappeared and reappeared multiple times, I squeezed it, and blood and fluid came out of it. ###Response: Hello. I understand your concern. The thing on the chest looks more of a sebaceous cyst, (attachment removed to protect patient identity) which comes and goes even if you pop out the contents as it needs to be excised completely to prevent the recurrence. For the toenail spot, I am not sure that it is melanoma, it can be other things like a subungual traumatic hematoma, or pseudomonas nail infection. Nonetheless, you need to keep observing it for any color or size changes. The two conditions you mentioned do not seem to be related, though. Use the following medication for two weeks, and if it is because of infection it will improve 1. Tablet Ciprofloxacin 500 mg twice a day for two weeks. And avoid tight footwear.

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

Q. Is it safe to use Montair LC kid in a 4-year-old for reactive airway disease?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Is it safe to use Montair LC kid in a 4-year-old for reactive airway disease? ### Input: Hello doctor,My son is four and a half years old, and he is suffering from reactive airway disease (enclosing the reports and prescription). Kindly suggest based on the above medication that till how long we can safely go ahead with Montair LC Kid. Is there any upper limit of giving this. I am very skeptical about continuing it in the long run. He is completely fine with this medicine, but if I skip a single dose, he starts coughing just anyways and ends up vomiting everything he had. So I keep on giving him a daily dose of MLC kid. Also, he is a bit aggressive and impatient. I do not know whether these are the emotional changes associated with this medicine. Please tell me that is he losing his natural immunity due to this. ###Response: Hello. Please note that the medications prescribed are to the best of my knowledge. Montelukast has been prescribed for patients for prolonged periods extending up to even two years without any problems. It uses has shown reduced requirements of admission and improving the quality of life in patients suffering from hyperreactive airway disease. However, it would be good if we can omit the LC (Levocetirizine) content by just giving Montelukast alone in the form of tablet Montair 4 mg daily at 8 pm instead of Montair LC syrup (Levocetirizine, Montelukast). The Levocetirizine component may cause dry mouth, sleepiness consequent irritable behavior in very few children if given for prolonged periods. The tablet (Montair) can be crushed in a small cup of water, and the child can consume the paste or solution. Most of such cases usually get alright as age advances with complete remission by the age of six to eight years. Very rarely this may persist till 10 years. If it continues until the age of 10 to 12 years, it may progress into asthma in adulthood.

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

Q. Kindly advice about the diagnosis of paranoid schizophrenia.

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Kindly advice about the diagnosis of paranoid schizophrenia. ### Input: Hello doctor, I am concerned about my friends medical diagnosis about paranoid schizophrenia is fabricated by him and resulting in unnecessary medication. Kindly advice. ###Response: Hello. The diagnosis of paranoid schizophrenia is not easy. Proper evaluation by a psychiatrist is needed to make the final diagnosis. The individuals with schizophrenia show symptoms like hearing voices talking or voices are giving commentary, suspiciousness against anyone or even family members, ideas of prosecution, ideas of reference, etc. These should be present persistently, and in usual cases, there is no insight about the symptoms. It is the family and friends who take the patient for evaluation and not the patient he or herself visits the doctor for a diagnosis. Yes, depression or anxiety can be the possibilities, but these too should be evaluated. Symptoms of depression like low mood, anhedonia, reduced energy, fatigue, negative thoughts, bad thoughts, lack of surety about future, feelings of helplessness, worthlessness or hopelessness, etc. are seen.If he has doubts about his symptoms, he should be evaluated by a psychiatrist.

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

Q. Do my symptoms indicate bipolar disorder or schizophrenia?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. Do my symptoms indicate bipolar disorder or schizophrenia? ### Input: Hello doctor, Since I was around 8 years old, I have experienced mood fluctuations but not in the normal bipolar way (which I am being tested for). I do not feel like my mood sways between depression and mania. It is always some level of mania but without depression. I also experience tactile hallucinations such as something grabbing my leg, ants or bugs crawling up my legs as well as something breathing on and grabbing my arm. Tension headaches are also common, and intrusive thoughts pretty much ruin my life. Another common occurrence is I notice I have trouble talking, not in a word salad kind of way, but a slurred sometimes mumbled speech. My Psychiatrist says it is likely bipolar, but I do not think that that is the only possible diagnosis. To me, it seems more closely related to schizophrenia or schizoaffective disorder. All I want to know is that is there a possibility that I am correct? Could it be a schizophrenic related disorder? In the past, they gave me Citalopram for anxiety. ###Response: Hello. Yes, your psychiatrist is correct. Bipolar is a more likely diagnosis. Bipolar disorder need not be present with depression and mania both. Recurrent mania also comes under the category of bipolar disorder. In mania, our sensitivity to stimulation increases like colors appear more bright, music appears more appealing and smoothing, also hallucinations are common in mania too. Schizophrenia and schizoaffective disorder diagnosis are made only when there are criterias of disease which get full filled. You can refer ICD 10 bluebook for detailed criteria. To me also, the diagnosis of schizoaffective disorder and schizophrenia is less likely.

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

Q. What are the ways to control schizophrenia?

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

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request ### Instruction: Q. What are the ways to control schizophrenia? ### Input: Hello doctor, My son aged 32 years is suffering from schizophrenia for the last six months and not accepting any treatment and since the last 10 days his symptoms got worsened and became violent and today he tried to get injured and he is suspicious on everybody thinking everyone is talking about him and plotting to harm him and asking us to kill him by giving poison and today he became very violent and after consulting a psychiatrist doctor today we gave him Risdone liquid 2 ml by mixing with fruit juice. Now he is sleeping calmly tonight. Please help us for further treatment. ###Response: Hello. I can understand your concern. A lot of patients of schizophrenia or other psychotic disorder refuse to take medicines and this becomes difficult in treatment. Risperidone liquid is tasteless and odorless and can be given without knowledge to the patient. But keep one thing in mind that he should not become suspicious that he is being given medicine by mixing with food. Most of the patients come to know about this. You will have to remain alert for this. This should be followed strictly. In coming days he will become ready to take medicines by own. Till then you can give him Risperidone liquid. He is on 2 mg per day and if needed, the dose can be increased to 3 mg per day. The second option in his case if he refuses to take even food or juices from you is long-acting injectables. Long-acting injections of Haloperidol or Fluphenazine or Risperidone or Paliperidone are available. These have actions for around 15 days and can be given to him if he refuses to take medicines. This can make treatment easy for him. You can discuss with his doctor for this treatment option.