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Hello doctor,My urologists have recommended circumcision to improve my symptoms and to be able to look inside the urethra, etc., and wants to perform the procedure under general anesthesia. Can this also be done under local or epidural instead, as I am having anxiety about the general method? Am I overreacting, maybe to a common method? Currently, I am taking Flomax once a day.

Q. Is it possible to get circumcision done under local anesthesia?

Hi. Regarding the type of anesthesia for circumcision and cystoscopy, it can be done under local anesthesia or spinal or epidural anesthesia or general anesthesia. Local has the following benefits of no risk related to anesthesia. The drawback is some discomfort but usually tolerable in a cooperative patient. Spinal or epidural has the benefit of good analgesia, post-operative pain control for a few hours, reasonable safety. The drawback is may need to stay in the hospital longer to avoid a post-spinal headache. For cardiac patients not so safe. General anesthesia, the benefit is it can be tailored to a short procedure. Relatively safe in cardiac patients. The drawback is higher cost, inherent risk for short neck or asthmatic patients. So anesthesia has to be tailored or individualized after discussion with your doctor.

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 possible to get circumcision done under local anesthesia? ### Input: Hello doctor,My urologists have recommended circumcision to improve my symptoms and to be able to look inside the urethra, etc., and wants to perform the procedure under general anesthesia. Can this also be done under local or epidural instead, as I am having anxiety about the general method? Am I overreacting, maybe to a common method? Currently, I am taking Flomax once a day. ###Response: Hi. Regarding the type of anesthesia for circumcision and cystoscopy, it can be done under local anesthesia or spinal or epidural anesthesia or general anesthesia. Local has the following benefits of no risk related to anesthesia. The drawback is some discomfort but usually tolerable in a cooperative patient. Spinal or epidural has the benefit of good analgesia, post-operative pain control for a few hours, reasonable safety. The drawback is may need to stay in the hospital longer to avoid a post-spinal headache. For cardiac patients not so safe. General anesthesia, the benefit is it can be tailored to a short procedure. Relatively safe in cardiac patients. The drawback is higher cost, inherent risk for short neck or asthmatic patients. So anesthesia has to be tailored or individualized after discussion with your doctor.

Hi doctor, What are the ramifications if you lose 20 pounds with new dental implants? I have lost seven pounds since this month. Also, having immediate dentures over implants, my dentist gave me a water pik and said it is fine to leave the immediate dentures in for a month while my extraction area is healing. I am worried that it is too long and infection could set in. Lastly, she also said having a few drinks was fine. Is it so? They are mini implants I had put in (six of them) with new immediate upper dentures.

Q. Is it fine to have immediate denture over implant for a month to promote healing?

Hello. I have been through your query and I can understand your concern. Regarding weight loss with respect to the dental Implants, I do not see any reason from your query that could lead to the weight loss. Dental implants do not lead to weight loss. However, what I could comprehend from your query is that you have been too much thinking about the weight loss due to implants which has set in the anxiety complex in you. Anxiety might be a cause of weight loss. And in response for the immediate dentures, yes they can be kept for weeks and if kept clean for even some months. Immediate dentures are fabricated in such a way that they enable the healing of the extraction site and will not lead to any discrepancies during the fabrication of the implants. They protect and preserve the bone where the implants are to be inserted. Regarding infection to the extraction site, there should not be any infection as long as you keep the mouth hygiene good and clean regularly as advised by your dentist. If you feel any pain or discomfort, then you can approach your dentist for the same. However, that is unlikely if you maintain good oral hygiene. Also, the alcohol or drinks as you call, if you have done your extraction within a week, I would advise you not having an alcoholic drink but if the extraction is done past a week, then I can allow you for a drink or two but not too much as the extraction site would not have healed properly and could lead to the insult of the injury causing pain and discomfort. However, I guess your dentist has done a good job as I can understand from your query. I would just say that you follow your dentist’s advice and visit her on the scheduled 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. Is it fine to have immediate denture over implant for a month to promote healing? ### Input: Hi doctor, What are the ramifications if you lose 20 pounds with new dental implants? I have lost seven pounds since this month. Also, having immediate dentures over implants, my dentist gave me a water pik and said it is fine to leave the immediate dentures in for a month while my extraction area is healing. I am worried that it is too long and infection could set in. Lastly, she also said having a few drinks was fine. Is it so? They are mini implants I had put in (six of them) with new immediate upper dentures. ###Response: Hello. I have been through your query and I can understand your concern. Regarding weight loss with respect to the dental Implants, I do not see any reason from your query that could lead to the weight loss. Dental implants do not lead to weight loss. However, what I could comprehend from your query is that you have been too much thinking about the weight loss due to implants which has set in the anxiety complex in you. Anxiety might be a cause of weight loss. And in response for the immediate dentures, yes they can be kept for weeks and if kept clean for even some months. Immediate dentures are fabricated in such a way that they enable the healing of the extraction site and will not lead to any discrepancies during the fabrication of the implants. They protect and preserve the bone where the implants are to be inserted. Regarding infection to the extraction site, there should not be any infection as long as you keep the mouth hygiene good and clean regularly as advised by your dentist. If you feel any pain or discomfort, then you can approach your dentist for the same. However, that is unlikely if you maintain good oral hygiene. Also, the alcohol or drinks as you call, if you have done your extraction within a week, I would advise you not having an alcoholic drink but if the extraction is done past a week, then I can allow you for a drink or two but not too much as the extraction site would not have healed properly and could lead to the insult of the injury causing pain and discomfort. However, I guess your dentist has done a good job as I can understand from your query. I would just say that you follow your dentist’s advice and visit her on the scheduled date.

Hello doctor, I have been a high BP and sinus bradycardia (heart rate of 52) patient for the last four years. I used to take Metpure-XL 25 mg after breakfast based on my cardiologist's advice. For the last six months, I was having headache and confusion plus slightly increased urination. Last week, I visited another cardiologist who checked my BP. My BP was very high i.e. 175/105. He asked me to start with Telma 40 mg and Metpure-XL 50 mg after breakfast. I did all types of blood tests. My uric acid is slightly elevated at 7.8. Vitamin D is deficient at 10. All the other tests like the lipid profile, renal tests, LFTs, sodium, potassium, and blood sugar are alright. My headache is gone after taking new medicines. However, I am feeling bloated most of the time. My questions are 1. Is bloating a side effect of Telma 40 mg? Can you advise another medicine? 2. Is Metpure-XL 50 mg advisable in sinus bradycardia (a heart rate of 52)? Please assist me with next course of action.

Q. Can Metpure-XL be taken by a sinus bradycardia patient?

Hello. Hope this helps you and you can get back if you have any doubts. For more information consult a cardiologist 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. Can Metpure-XL be taken by a sinus bradycardia patient? ### Input: Hello doctor, I have been a high BP and sinus bradycardia (heart rate of 52) patient for the last four years. I used to take Metpure-XL 25 mg after breakfast based on my cardiologist's advice. For the last six months, I was having headache and confusion plus slightly increased urination. Last week, I visited another cardiologist who checked my BP. My BP was very high i.e. 175/105. He asked me to start with Telma 40 mg and Metpure-XL 50 mg after breakfast. I did all types of blood tests. My uric acid is slightly elevated at 7.8. Vitamin D is deficient at 10. All the other tests like the lipid profile, renal tests, LFTs, sodium, potassium, and blood sugar are alright. My headache is gone after taking new medicines. However, I am feeling bloated most of the time. My questions are 1. Is bloating a side effect of Telma 40 mg? Can you advise another medicine? 2. Is Metpure-XL 50 mg advisable in sinus bradycardia (a heart rate of 52)? Please assist me with next course of action. ###Response: Hello. Hope this helps you and you can get back if you have any doubts. For more information consult a cardiologist online -->

Hello doctor, I grind my teeth at night even though it has not been confirmed. I have the white lines on my cheeks. Yesterday and today I have this pain from my left molar to my TMJ and ear ache. And I do not know if it is from where the grinding is getting worse, a tooth infection, or ear infection. I have an ulcer at the back of my mouth where the white line is where I grind my teeth. A bit sore and tender at one spot under my mandible.

Q. What can be done for pain in and around left molar, TMJ and ear caused by teeth grinding?

Hi. The grinding teeth at night usually come from stress or psychological problems so you should visit a dentist near to you in order to get a night guard to protect grinding teeth at night. At the same time, you should consult with your psychiatric physician to know the cause and the origin of the grinding that why it comes at night. The night guard is a plastic impression that covers the crown of your all teeth. You should wear at night when you are sleeping and you will remove when you wake up in the morning. It would be good to attach the photo of your teeth.

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 pain in and around left molar, TMJ and ear caused by teeth grinding? ### Input: Hello doctor, I grind my teeth at night even though it has not been confirmed. I have the white lines on my cheeks. Yesterday and today I have this pain from my left molar to my TMJ and ear ache. And I do not know if it is from where the grinding is getting worse, a tooth infection, or ear infection. I have an ulcer at the back of my mouth where the white line is where I grind my teeth. A bit sore and tender at one spot under my mandible. ###Response: Hi. The grinding teeth at night usually come from stress or psychological problems so you should visit a dentist near to you in order to get a night guard to protect grinding teeth at night. At the same time, you should consult with your psychiatric physician to know the cause and the origin of the grinding that why it comes at night. The night guard is a plastic impression that covers the crown of your all teeth. You should wear at night when you are sleeping and you will remove when you wake up in the morning. It would be good to attach the photo of your teeth.

Hello doctor, I have a light pain in my upper abdomen with a bloated feeling after eating, and occasional pain in my gut. I did experience some violent pain about a year back, while I was training with an exercise program to strengthen my abs. It felt like a tear in my gut while training. I do not know if this has something to do with what I am experiencing now. I also train with heavy weights. Can you please give me an idea as to what is going on, and what I should do about this situation?

Q. I have pain in my abdomen and a bloated feeling. What do I do?

Hello. If you can answer following questions, then it will help to reach a definitive diagnosis: In the meantime, I would suggest you try the following things for improvement: It would be advisable to have a proper examination by your family doctor, to determine whether or not this is a gastrointestinal problem related to digestion, or possibly a hernia from overexertion while exercising. A hernia occurs when the intestine protrudes or bulges out from the abdominal wall, which can cause abdominal pain.

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 pain in my abdomen and a bloated feeling. What do I do? ### Input: Hello doctor, I have a light pain in my upper abdomen with a bloated feeling after eating, and occasional pain in my gut. I did experience some violent pain about a year back, while I was training with an exercise program to strengthen my abs. It felt like a tear in my gut while training. I do not know if this has something to do with what I am experiencing now. I also train with heavy weights. Can you please give me an idea as to what is going on, and what I should do about this situation? ###Response: Hello. If you can answer following questions, then it will help to reach a definitive diagnosis: In the meantime, I would suggest you try the following things for improvement: It would be advisable to have a proper examination by your family doctor, to determine whether or not this is a gastrointestinal problem related to digestion, or possibly a hernia from overexertion while exercising. A hernia occurs when the intestine protrudes or bulges out from the abdominal wall, which can cause abdominal pain.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

Hi doctor, I had a biochemical pregnancy before seven months. One month later, when I took a scan it showed a simple right ovarian cyst measuring 33 x 27 mm. I took Meprate tablet and got my period. Then, my cycle was regular for a month. Then, when I tried again for pregnancy, I did not get my period and PT also came back negative. Again, I took Meprate tablet and got by period. I had LH and FSH test on the second day of my period. LH is 11.93 and FSH is 5.96. RBC and thyroid test are normal. Is this LH value an issue? What should I do to overcome this? When can I try for pregnancy again?

Q. What is the normal LH and FSH value on day 2 of periods?

Hi. Regarding the simple cyst and its size, there is no matter of worry. The normal value of LH on day 2 is 2-18 and the normal value of FSH on day 2 is 1-18. Both of which fall in the normal range and so you need not worry. You please start on Folic acid supplements and also meet your gynecologist. The growth of the follicles can be studied in detail and then we can know the day of ovulation and plan for pregnancy accordingly. Usually, if you try from day 12 to day 22 of your fertile period, the chances of you getting pregnant are more. So, please take those supplements and plan on these days for better results. For further 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. What is the normal LH and FSH value on day 2 of periods? ### Input: Hi doctor, I had a biochemical pregnancy before seven months. One month later, when I took a scan it showed a simple right ovarian cyst measuring 33 x 27 mm. I took Meprate tablet and got my period. Then, my cycle was regular for a month. Then, when I tried again for pregnancy, I did not get my period and PT also came back negative. Again, I took Meprate tablet and got by period. I had LH and FSH test on the second day of my period. LH is 11.93 and FSH is 5.96. RBC and thyroid test are normal. Is this LH value an issue? What should I do to overcome this? When can I try for pregnancy again? ###Response: Hi. Regarding the simple cyst and its size, there is no matter of worry. The normal value of LH on day 2 is 2-18 and the normal value of FSH on day 2 is 1-18. Both of which fall in the normal range and so you need not worry. You please start on Folic acid supplements and also meet your gynecologist. The growth of the follicles can be studied in detail and then we can know the day of ovulation and plan for pregnancy accordingly. Usually, if you try from day 12 to day 22 of your fertile period, the chances of you getting pregnant are more. So, please take those supplements and plan on these days for better results. For further information consult an obstetrician and gynaecologist online -->

Hello doctor, My 24-year-old wife is having a fever of 103.4 F. She is puking every time when she is about to eat something. Her joints are aching. She is feeling dizziness and she has vomited also. It has been about 30 hours. She has taken Paracetamol but nothing happened. She is not getting better. Please help.

Q. What medicines can help prevent vomiting?

Hello. I went through your post. The predominant complaints are fever and vomiting. However, you have not mentioned whether she has any cause for fever like a sore throat, cough, dysuria, abdominal pain or urine problems. Anyway, the first thing is to stop vomiting so that she can take some medicines and food. I suggest you give her tablet Ondem (Ondansetron) 8 mg mouth dissolving three times a day for a few days. Once vomiting is controlled, you can start antibiotics preferably Zifi O (Ofloxacin and Cefixime) 200 mg twice daily and Dolo 650 (Paracetamol) if there is fever or a headache. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Ask her to take enough fluids. 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. What medicines can help prevent vomiting? ### Input: Hello doctor, My 24-year-old wife is having a fever of 103.4 F. She is puking every time when she is about to eat something. Her joints are aching. She is feeling dizziness and she has vomited also. It has been about 30 hours. She has taken Paracetamol but nothing happened. She is not getting better. Please help. ###Response: Hello. I went through your post. The predominant complaints are fever and vomiting. However, you have not mentioned whether she has any cause for fever like a sore throat, cough, dysuria, abdominal pain or urine problems. Anyway, the first thing is to stop vomiting so that she can take some medicines and food. I suggest you give her tablet Ondem (Ondansetron) 8 mg mouth dissolving three times a day for a few days. Once vomiting is controlled, you can start antibiotics preferably Zifi O (Ofloxacin and Cefixime) 200 mg twice daily and Dolo 650 (Paracetamol) if there is fever or a headache. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Ask her to take enough fluids. For more information consult an internal medicine physician online -->

Hello doctor, I had two C-sections and within a gap of 2.8 months post delivery, I had heavy hair fall. So I took Lycopodium 15 drops twice a day for 15 days and simultaneously used a mixture of Jaborandi, Amla, and Arnica with coconut oil. For few months hair fall was less but suddenly again I started having heavy hair fall. Please help.

Q. What causes heavy hair fall post C-section delivery?

Hello. You can start Sepia 30 five pills in the morning, noon, and then Wiesbaden 200 five pills at bedtime. Arnica mother tincture 10 drops in coconut oil (amount for one use) mix it and apply in hair roots thrice in a week. Apart from these, Fenugreek seeds are good for hair. Have it in ladoo form or raw form. Black sesame seeds are also good for hair, have it. Have simple food which has all nutrients for hairs. Do not change shampoo and oil often. You can also mix coconut oil, castor oil, sesame oil. Massage with this. You can add Arnica, Mother tincture in this mixture also. Give follow up to decide further medication and duration of treatment.

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 causes heavy hair fall post C-section delivery? ### Input: Hello doctor, I had two C-sections and within a gap of 2.8 months post delivery, I had heavy hair fall. So I took Lycopodium 15 drops twice a day for 15 days and simultaneously used a mixture of Jaborandi, Amla, and Arnica with coconut oil. For few months hair fall was less but suddenly again I started having heavy hair fall. Please help. ###Response: Hello. You can start Sepia 30 five pills in the morning, noon, and then Wiesbaden 200 five pills at bedtime. Arnica mother tincture 10 drops in coconut oil (amount for one use) mix it and apply in hair roots thrice in a week. Apart from these, Fenugreek seeds are good for hair. Have it in ladoo form or raw form. Black sesame seeds are also good for hair, have it. Have simple food which has all nutrients for hairs. Do not change shampoo and oil often. You can also mix coconut oil, castor oil, sesame oil. Massage with this. You can add Arnica, Mother tincture in this mixture also. Give follow up to decide further medication and duration of treatment.

Hello doctor, My daughter is 6.5 years old complaining of stomach pain. She vomited once. What medicine should I give for the quick relief?

Q. Kindly suggest a medicine for quick relief of stomach pain and vomiting in a child.

Hi. I understand your concern. Most common abdominal pain in children at this age is due to worm infestation and indigestion. If deworming is not done, do it with Bandy plus syrup (5 ml is equal to 400 mg Albendazole and Ivermectin 2.5 mg). Give 5 ml once in the night. If indigestion is there, symptomatic treatment is required. Syrus Emset (Ondansetron) 5 ml twice a day to be given. Any history of fever? If the pain is persistent, you need to do USG to rule out other causes and can give Cyclopam 2.5 ml once.

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 a medicine for quick relief of stomach pain and vomiting in a child. ### Input: Hello doctor, My daughter is 6.5 years old complaining of stomach pain. She vomited once. What medicine should I give for the quick relief? ###Response: Hi. I understand your concern. Most common abdominal pain in children at this age is due to worm infestation and indigestion. If deworming is not done, do it with Bandy plus syrup (5 ml is equal to 400 mg Albendazole and Ivermectin 2.5 mg). Give 5 ml once in the night. If indigestion is there, symptomatic treatment is required. Syrus Emset (Ondansetron) 5 ml twice a day to be given. Any history of fever? If the pain is persistent, you need to do USG to rule out other causes and can give Cyclopam 2.5 ml once.

Hello doctor, My child is 18 years old and has been preparing for the entrance exam for the past one year. He did well in some of the topics he covered but four months back, he got some negative thoughts and started complaining about less concentration. He became excited, irritated and got disturbed. With my affection and care, most of the things have gone away in three months but I still feel something wrong in comparison to his earlier nature. His sleep and food are fine. I consulted two psychiatrists and they advised the problem will go away on its own. The child was not able to give board exams and he has started studying a little. He has a fair hold on the studied topics. Now he studies very less and is afraid of giving entrance exams in which he mostly solves the questions verbally.

Q. There is lack of concentration with negative thoughts. Why?

Hello. It is quite common for 18-year-olds to become stressed when preparing for school final and college entrance examinations. With appropriate care and encouragement, you can support your child to handle to stress appropriately. Kindly do not put too much pressure on him to study and excel. It can be counterproductive. If he is putting too much pressure on himself, it can lead to significant stress and affect his ability to do well in exams. Remind him that though exams are important, it is not a life or death situation. Continue to encourage and support him to do well but also tactfully advise him that there are multiple career options available. This can help him to relax and eventually help him to do better. It is good to know that he is eating and sleeping well. Encourage him to do atleast 30 minutes exercise or physical play daily. It is time well spent, it will sharpen his memory and reduce his stress levels. If stress continues to increase, it can lead on to depression, anxiety and related emotional and behavioural problems. Do not let exams to take over the family all the time. Have fun whenever possible. Remember a relaxed mind performs better.

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. There is lack of concentration with negative thoughts. Why? ### Input: Hello doctor, My child is 18 years old and has been preparing for the entrance exam for the past one year. He did well in some of the topics he covered but four months back, he got some negative thoughts and started complaining about less concentration. He became excited, irritated and got disturbed. With my affection and care, most of the things have gone away in three months but I still feel something wrong in comparison to his earlier nature. His sleep and food are fine. I consulted two psychiatrists and they advised the problem will go away on its own. The child was not able to give board exams and he has started studying a little. He has a fair hold on the studied topics. Now he studies very less and is afraid of giving entrance exams in which he mostly solves the questions verbally. ###Response: Hello. It is quite common for 18-year-olds to become stressed when preparing for school final and college entrance examinations. With appropriate care and encouragement, you can support your child to handle to stress appropriately. Kindly do not put too much pressure on him to study and excel. It can be counterproductive. If he is putting too much pressure on himself, it can lead to significant stress and affect his ability to do well in exams. Remind him that though exams are important, it is not a life or death situation. Continue to encourage and support him to do well but also tactfully advise him that there are multiple career options available. This can help him to relax and eventually help him to do better. It is good to know that he is eating and sleeping well. Encourage him to do atleast 30 minutes exercise or physical play daily. It is time well spent, it will sharpen his memory and reduce his stress levels. If stress continues to increase, it can lead on to depression, anxiety and related emotional and behavioural problems. Do not let exams to take over the family all the time. Have fun whenever possible. Remember a relaxed mind performs better.

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 have minor beta thalassemia which I got from my mother, but unlike her (asymptomatic), I have anemia symptoms like paleness, shortness of breath after the least effort, feeling tired all the time, broken nails and I want to know if it could be due to lack of iron? Could people with minor beta thalassemia also get iron deficiency anemia? Knowing that I get heavy cycles and my diet is very poor.

Q. Can lack of iron cause anemia symptoms in a beta thalessemia minor patient?

Hi. I have reviewed your query and here is my advise. Yes, your symptoms point towards iron deficiency anemia. In beta thalassemia minor patient usually feels more fatigue on exertion as compared to normal people without thalassemia. However do not worry regarding thalassemia minor, they can live a normal life. Thalassemia people can develop iron deficiency anemia secondarily. So rule it out by CBC profile with blood indices as well. You can revert back with reports so that I can guide 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. Can lack of iron cause anemia symptoms in a beta thalessemia minor patient? ### Input: Hello doctor, I have minor beta thalassemia which I got from my mother, but unlike her (asymptomatic), I have anemia symptoms like paleness, shortness of breath after the least effort, feeling tired all the time, broken nails and I want to know if it could be due to lack of iron? Could people with minor beta thalassemia also get iron deficiency anemia? Knowing that I get heavy cycles and my diet is very poor. ###Response: Hi. I have reviewed your query and here is my advise. Yes, your symptoms point towards iron deficiency anemia. In beta thalassemia minor patient usually feels more fatigue on exertion as compared to normal people without thalassemia. However do not worry regarding thalassemia minor, they can live a normal life. Thalassemia people can develop iron deficiency anemia secondarily. So rule it out by CBC profile with blood indices as well. You can revert back with reports so that I can guide you further.

Hi doctor, I am suffering from headache for the last 20 years. Initially, I used to take Saridon tablets to get relief from headache and it has given results for some time. After a few years, one of the doctors advised me to do pranayama (breathing exercise) and it has given good results. My frequency of headache has come down drastically once in three months or so. Whenever this headache occurs, some red rashes will appear on my forehead, especially in the center of my forehead and will disappear after two or three days. I could not understand the reason for the rashes. When I touch the rash, I do feel some pain. Recently, I consulted a neurologist and he said that it is migraine headache and the tablet Dolo 650 has to be used whenever headache starts. If headache appears twice in a month, then I should use Sibelium 10 mg (Flunarizine). He also said that this headache will be there till the age of 55 years and I am 43 now. My mother also gets headache for the last 40 years. Please clarify the reason my rashes during headache. Also, can I Dolo 650 for headache?

Q. Will you clarify the reason for my forehead rashes during headache?

Hi. I read your query and understand your concerns. First of all, I like to inform you that the rash over the forehead is a part of migraine headache and disappears within 72 hours. In other words, a typical migraine track never goes beyond 72 hours and the same is applicable for rashes associated with it. Although the exact pathology is not known, it has been speculated that the rashes appear due to immune system dysregulation. Yes, Dolo 650 mg (Acetaminophen) is able to treat the migraine. This is indicated that the frequency of migraine is very low for around one or two times in a month. In case there is more frequency, then you may need regular treatment. 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. Will you clarify the reason for my forehead rashes during headache? ### Input: Hi doctor, I am suffering from headache for the last 20 years. Initially, I used to take Saridon tablets to get relief from headache and it has given results for some time. After a few years, one of the doctors advised me to do pranayama (breathing exercise) and it has given good results. My frequency of headache has come down drastically once in three months or so. Whenever this headache occurs, some red rashes will appear on my forehead, especially in the center of my forehead and will disappear after two or three days. I could not understand the reason for the rashes. When I touch the rash, I do feel some pain. Recently, I consulted a neurologist and he said that it is migraine headache and the tablet Dolo 650 has to be used whenever headache starts. If headache appears twice in a month, then I should use Sibelium 10 mg (Flunarizine). He also said that this headache will be there till the age of 55 years and I am 43 now. My mother also gets headache for the last 40 years. Please clarify the reason my rashes during headache. Also, can I Dolo 650 for headache? ###Response: Hi. I read your query and understand your concerns. First of all, I like to inform you that the rash over the forehead is a part of migraine headache and disappears within 72 hours. In other words, a typical migraine track never goes beyond 72 hours and the same is applicable for rashes associated with it. Although the exact pathology is not known, it has been speculated that the rashes appear due to immune system dysregulation. Yes, Dolo 650 mg (Acetaminophen) is able to treat the migraine. This is indicated that the frequency of migraine is very low for around one or two times in a month. In case there is more frequency, then you may need regular treatment. For further information consult a neurologist online -->

Hello doctor, I have just finished six rounds of chemotherapy for breast cancer treatment. Before starting, I was diagnosed with folate deficiency and prescribed six months of folic acid tablets. However, my oncologist was not happy with me taking it during chemotherapy so I had to stop after one month. I have now finished chemotherapy and I still have a very sore red tongue and no texture to my tongue or roof of the mouth. I cannot use any toothpaste or eat anything with any strong flavor without an extremely sore tongue. I also have fatigue, shortness of breath, resting heart rate of 90 to 100 and also have angular cheilitis. I asked my general physician to re-test my hematinics. Now I have finished chemotherapy three weeks ago as I am keen to start taking supplements to help my body recover and because I am symptomatic of a deficiency of folate and/or B12? Bizarrely, my results say my folate is now 6, hemoglobin is pretty good at 11 but my B12 is 2000. How can this be? It was 500 when they tested me some months ago and told me I had low folate level. I was symptomatic with sore red tongue and loss of texture with tongue sensation. My GP does not understand and is going to ask my oncologist. I am not sure it is his area and I do not want to be fobbed off without it being properly investigated. Do you have any idea what might cause this? I have started FEC chemo four months back and had four rounds of Docetaxel. I was on Fragmin, Rivaroxaban until for PE prevention of recurrence but had to go on to Fragmin during chemo.

Q. Can folic acid supplements be started after completing chemotherapy?

Hello. The folic acid tablets that you had taken for a month helped to raise your folate levels from 4 to 6. The high level of vitamin B12 can only be explained if you were given a single megadose of vitamin as an intramuscular injection during your chemotherapy. Folate levels of 6 are still low and are responsible for angular stomatitis and sore tongue. For more information consult a hematologist 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. Can folic acid supplements be started after completing chemotherapy? ### Input: Hello doctor, I have just finished six rounds of chemotherapy for breast cancer treatment. Before starting, I was diagnosed with folate deficiency and prescribed six months of folic acid tablets. However, my oncologist was not happy with me taking it during chemotherapy so I had to stop after one month. I have now finished chemotherapy and I still have a very sore red tongue and no texture to my tongue or roof of the mouth. I cannot use any toothpaste or eat anything with any strong flavor without an extremely sore tongue. I also have fatigue, shortness of breath, resting heart rate of 90 to 100 and also have angular cheilitis. I asked my general physician to re-test my hematinics. Now I have finished chemotherapy three weeks ago as I am keen to start taking supplements to help my body recover and because I am symptomatic of a deficiency of folate and/or B12? Bizarrely, my results say my folate is now 6, hemoglobin is pretty good at 11 but my B12 is 2000. How can this be? It was 500 when they tested me some months ago and told me I had low folate level. I was symptomatic with sore red tongue and loss of texture with tongue sensation. My GP does not understand and is going to ask my oncologist. I am not sure it is his area and I do not want to be fobbed off without it being properly investigated. Do you have any idea what might cause this? I have started FEC chemo four months back and had four rounds of Docetaxel. I was on Fragmin, Rivaroxaban until for PE prevention of recurrence but had to go on to Fragmin during chemo. ###Response: Hello. The folic acid tablets that you had taken for a month helped to raise your folate levels from 4 to 6. The high level of vitamin B12 can only be explained if you were given a single megadose of vitamin as an intramuscular injection during your chemotherapy. Folate levels of 6 are still low and are responsible for angular stomatitis and sore tongue. For more information consult a hematologist online -->

Hi doctor, My last 2 periods were very light. The latest one came after 50 days and started with 5 days spotting followed by light flow which is going on for 6th day now and has not stopped. My periods have been regular so far, 30 days cycle and lasts for 3 days with 2nd day heaviest. But, since the last 2 cycles there has not been a heavy day. I have a history of systemic lupus erythematosus since age 14 and now am 31. Recently for acidity I was on Rabeprazole for close to 3 months.

Q. What can be the reason for spotting and delayed periods?

Hello. I understood that your menses have been regular so far and it is just since last 2 months that you have been experiencing delayed menses and metrorrhagia (abnormal bleeding). It seems unlikely that there is a sudden hormonal deficiency. But, likely stress induced hormonal imbalance and late estrogenization has probably occurred. Date should not be a concern here in the delay as the pattern had been regular till last 2 cycles. The delay can also possibly be due to hyperprolactinemia or recent onset hypothyroidism as well. Hence, I would advise you to get a thyroid profile and serum prolactin levels done as well. However, if the bleeding does not stop in next few days then you can consider opting for Progesterone pills like Meprate (Medroxyprogesterone) 10 mg once a day for next 15 days. This shall not just help control bleeding but also regulate it for this cycle. Observe the pattern for next 2 cycles and try to keep the stress levels low in next cycles. Follow up with the reports 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. What can be the reason for spotting and delayed periods? ### Input: Hi doctor, My last 2 periods were very light. The latest one came after 50 days and started with 5 days spotting followed by light flow which is going on for 6th day now and has not stopped. My periods have been regular so far, 30 days cycle and lasts for 3 days with 2nd day heaviest. But, since the last 2 cycles there has not been a heavy day. I have a history of systemic lupus erythematosus since age 14 and now am 31. Recently for acidity I was on Rabeprazole for close to 3 months. ###Response: Hello. I understood that your menses have been regular so far and it is just since last 2 months that you have been experiencing delayed menses and metrorrhagia (abnormal bleeding). It seems unlikely that there is a sudden hormonal deficiency. But, likely stress induced hormonal imbalance and late estrogenization has probably occurred. Date should not be a concern here in the delay as the pattern had been regular till last 2 cycles. The delay can also possibly be due to hyperprolactinemia or recent onset hypothyroidism as well. Hence, I would advise you to get a thyroid profile and serum prolactin levels done as well. However, if the bleeding does not stop in next few days then you can consider opting for Progesterone pills like Meprate (Medroxyprogesterone) 10 mg once a day for next 15 days. This shall not just help control bleeding but also regulate it for this cycle. Observe the pattern for next 2 cycles and try to keep the stress levels low in next cycles. Follow up with the reports to an obstetrician and gynaecologist online -->

Hello doctor, My tooth started hurting about a month and a half ago, just one night of hurting badly. Then went away. About weeks later started hurting again but nothing too bad. I just dealt with it. Now, again I have severe pain. I went to ER, said it was abscessed tooth and gave me Amoxicillin. The pain was still very bad so went back to the doctor. Three days later they prescribed me Clindamycin. Started taking them this morning. The pain is very bad and now my face is starting to get swollen. My whole face hurts, hurts to talk or really do anything. Should I go back to the ER or wait and see if this new antibiotic works? Please help me.

Q. Why is there severe toothache with swollen face even after taking antibiotic?

Hi. I have gone through your question and I can understand your concern. I think you are having an acute periapical infection with involvement of buccal and mandibular space infection. If the swelling is increasing and there is burning pain you may need another antibiotic with Clindamycin. For that upload a picture so that I can provide you with the best possible treatment plan. Make sure you do not have any airway obstruction, that can be dangerous. Periapical infection due to the cavity. IOPAR X-ray. Acute apical periodontitis. Buccal space infection.

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 there severe toothache with swollen face even after taking antibiotic? ### Input: Hello doctor, My tooth started hurting about a month and a half ago, just one night of hurting badly. Then went away. About weeks later started hurting again but nothing too bad. I just dealt with it. Now, again I have severe pain. I went to ER, said it was abscessed tooth and gave me Amoxicillin. The pain was still very bad so went back to the doctor. Three days later they prescribed me Clindamycin. Started taking them this morning. The pain is very bad and now my face is starting to get swollen. My whole face hurts, hurts to talk or really do anything. Should I go back to the ER or wait and see if this new antibiotic works? Please help me. ###Response: Hi. I have gone through your question and I can understand your concern. I think you are having an acute periapical infection with involvement of buccal and mandibular space infection. If the swelling is increasing and there is burning pain you may need another antibiotic with Clindamycin. For that upload a picture so that I can provide you with the best possible treatment plan. Make sure you do not have any airway obstruction, that can be dangerous. Periapical infection due to the cavity. IOPAR X-ray. Acute apical periodontitis. Buccal space infection.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

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 and for about nine months I have had severe jaw pain and it hurts when I chew and sometimes it pops and locks into place. My parents brought it up to my dentist about two months after it started but without looking at my jaw or even asking me about it they said it is growing pain and they will not worry about it unless I still have it when I am little older but I am also getting way more headaches than I used to and sometimes the pain is so severe it makes me cry. Sometimes, it is getting way worse to the point where I suddenly have to stop talking sometimes because my jaw locks in place. Please help.

Q. Can jaw pain with popping and locking indicate TMJ problem?

Hi. I have read through your complaint and the relevant details. Lock jaw, clicking sound are one of the classic symptoms of TMJ disorders. TMJ stands for temperomandibular joint which is the joint that moves the mandible up, down and sideways. If there is a lack of cushion effect, the mandible head slides through the other bone surface giving this kind of sounds and pain. It cannot be a growing thing. If this continues, it might lead to loss of bone in the joint or even fracture at some point. Addressing at an early stage can be of massive help. You should be given a custom fabricated mouth guard to be worn daily specially during night times. This mouth guard is a flexible one which can be used easily by yourself and maintained clean. This is the initial treatment approach in such a scenario. You will definitely see a huge difference in 3 to 6 months. I request you to visit the dentist again and stress in your complaint so that the right treatment approach is given to you. TMJ X-ray. Mouth guard fabrication. 1.Avoid chewing in one side. 2.Also, avoid biting hard food.

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 jaw pain with popping and locking indicate TMJ problem? ### Input: Hello doctor, I am an 18-year-old female and for about nine months I have had severe jaw pain and it hurts when I chew and sometimes it pops and locks into place. My parents brought it up to my dentist about two months after it started but without looking at my jaw or even asking me about it they said it is growing pain and they will not worry about it unless I still have it when I am little older but I am also getting way more headaches than I used to and sometimes the pain is so severe it makes me cry. Sometimes, it is getting way worse to the point where I suddenly have to stop talking sometimes because my jaw locks in place. Please help. ###Response: Hi. I have read through your complaint and the relevant details. Lock jaw, clicking sound are one of the classic symptoms of TMJ disorders. TMJ stands for temperomandibular joint which is the joint that moves the mandible up, down and sideways. If there is a lack of cushion effect, the mandible head slides through the other bone surface giving this kind of sounds and pain. It cannot be a growing thing. If this continues, it might lead to loss of bone in the joint or even fracture at some point. Addressing at an early stage can be of massive help. You should be given a custom fabricated mouth guard to be worn daily specially during night times. This mouth guard is a flexible one which can be used easily by yourself and maintained clean. This is the initial treatment approach in such a scenario. You will definitely see a huge difference in 3 to 6 months. I request you to visit the dentist again and stress in your complaint so that the right treatment approach is given to you. TMJ X-ray. Mouth guard fabrication. 1.Avoid chewing in one side. 2.Also, avoid biting hard food.

Hi doctor, I had taken Meprate one month back and still have not got my periods. I have done home pregnancy test five times and beta hCG, all were negative. What can be the reason for my delay in periods? Plus my weight is 96 kg and I have PCOD and am obese. What can be the reason for delayed menstruation?

Q. I have PCOD. Why have I missed my periods after taking Meprate?

Hi. PCOD is a condition where ovary causes multiple cysts which makes menses irregular and obesity itself increases the condition. So, only Meprate will not solve the problem, you should get an LH and FSH test done and please send me your sonography report. Meanwhile, I would suggest you reduce your weight by physical exercise. In this condition, the patient may have acne and abnormal hair over their body like over jaw area, etc., and the delaying menses which will cause amenorrhea is due to your PCOD. Please send me your blood sugar fasting and hemoglobin also. Brisk walking is the best ideal physical 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. I have PCOD. Why have I missed my periods after taking Meprate? ### Input: Hi doctor, I had taken Meprate one month back and still have not got my periods. I have done home pregnancy test five times and beta hCG, all were negative. What can be the reason for my delay in periods? Plus my weight is 96 kg and I have PCOD and am obese. What can be the reason for delayed menstruation? ###Response: Hi. PCOD is a condition where ovary causes multiple cysts which makes menses irregular and obesity itself increases the condition. So, only Meprate will not solve the problem, you should get an LH and FSH test done and please send me your sonography report. Meanwhile, I would suggest you reduce your weight by physical exercise. In this condition, the patient may have acne and abnormal hair over their body like over jaw area, etc., and the delaying menses which will cause amenorrhea is due to your PCOD. Please send me your blood sugar fasting and hemoglobin also. Brisk walking is the best ideal physical exercise.

Hello doctor, I believe I have some form of social disorder. I do not have feelings like others. I do not feel empathy but can be empathetic on cue as I know the social cues. And I prefer to keep to myself. Can you please advise where I can be diagnosed? I have always thought it was anxiety as this has been a problem in the past. I realize I have never been in love and probably do not know what it really is. I have five kids and saw them all taking birth but I never felt joy or real happiness when they were born even though I knew I should be happy. I am taking Lexam 20 for anxiety.

Q. Can anxiety or social disorder make someone apathetic?

Hi. With the limited information you have provided, it is difficult to give an accurate opinion. It is possible you are describing some features of autism spectrum traits or Asperger syndrome which can manifest as social communication difficulties and anxiety. It is not uncommon and the majority do not even know they have autism spectrum traits. But whether you actually have enough features to reach the diagnostic threshold can only be confirmed after a detailed assessment. Usually, people with autism spectrum traits would have displayed symptoms from their childhood and would have faced peer relationship difficulties at school. Check with your parents and siblings. Also, these traits can run in families. If your social difficulties and anxiety developed later on in life, it is unlikely to be due to an underlying neuro-developmental condition like autism spectrum condition. If you actually want to know whether you have the condition, speak to your local GP or family doctor about a referral to appropriate local specialist services.

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 anxiety or social disorder make someone apathetic? ### Input: Hello doctor, I believe I have some form of social disorder. I do not have feelings like others. I do not feel empathy but can be empathetic on cue as I know the social cues. And I prefer to keep to myself. Can you please advise where I can be diagnosed? I have always thought it was anxiety as this has been a problem in the past. I realize I have never been in love and probably do not know what it really is. I have five kids and saw them all taking birth but I never felt joy or real happiness when they were born even though I knew I should be happy. I am taking Lexam 20 for anxiety. ###Response: Hi. With the limited information you have provided, it is difficult to give an accurate opinion. It is possible you are describing some features of autism spectrum traits or Asperger syndrome which can manifest as social communication difficulties and anxiety. It is not uncommon and the majority do not even know they have autism spectrum traits. But whether you actually have enough features to reach the diagnostic threshold can only be confirmed after a detailed assessment. Usually, people with autism spectrum traits would have displayed symptoms from their childhood and would have faced peer relationship difficulties at school. Check with your parents and siblings. Also, these traits can run in families. If your social difficulties and anxiety developed later on in life, it is unlikely to be due to an underlying neuro-developmental condition like autism spectrum condition. If you actually want to know whether you have the condition, speak to your local GP or family doctor about a referral to appropriate local specialist services.

Hello doctor, For the past three days, I have had severe tooth pain and swelling. My filling fell out and it has started to decay to the point that I only have half a tooth and a giant hole where food is constantly getting stuck. The swelling is so bad I can only describe it as it looks as if I am hoarding a golf ball in my cheek. The pain has subsided due to warm salt water rinses, Peroxide or warm water rinses, Tylenol for every four hours, warm compress, and brushing my teeth every three hours. But the swelling has not gone down at all. How can I get it to go down?

Q. I have swelling and tooth pain. Can this be due to dislodged filling?

Hello. There is a swelling. It means that it still has an infection. Please do not use a warm application in infection side. You need a dental check up as soon as possible. Your dentist will take an X-ray and see the infected area after he or she decides treatment (either root canal treatment or extraction of the tooth) followed by antibiotics. So I suggest you please see your dentist as soon as possible because our smile matters. Periapical abscess due to deep dental caries. Clinical examination and dental X-ray. Periapical abscess, dental caries, perioendo lesion. Periapical abscess. Root canal or extraction (decided after clinical examination). Avoid hot food, pressure on the affected side.

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 swelling and tooth pain. Can this be due to dislodged filling? ### Input: Hello doctor, For the past three days, I have had severe tooth pain and swelling. My filling fell out and it has started to decay to the point that I only have half a tooth and a giant hole where food is constantly getting stuck. The swelling is so bad I can only describe it as it looks as if I am hoarding a golf ball in my cheek. The pain has subsided due to warm salt water rinses, Peroxide or warm water rinses, Tylenol for every four hours, warm compress, and brushing my teeth every three hours. But the swelling has not gone down at all. How can I get it to go down? ###Response: Hello. There is a swelling. It means that it still has an infection. Please do not use a warm application in infection side. You need a dental check up as soon as possible. Your dentist will take an X-ray and see the infected area after he or she decides treatment (either root canal treatment or extraction of the tooth) followed by antibiotics. So I suggest you please see your dentist as soon as possible because our smile matters. Periapical abscess due to deep dental caries. Clinical examination and dental X-ray. Periapical abscess, dental caries, perioendo lesion. Periapical abscess. Root canal or extraction (decided after clinical examination). Avoid hot food, pressure on the affected side.

Hello doctor, Can we take Kalarchika during periods as I have PCOD? I started to take it two weeks before but yesterday I suddenly had mild pain in the lower left abdomen. Kindly advice.

Q. Is it advisable to take Kalarchika for PCOD?

Hi. Kalarchika or Kalchikai is a well known Siddha medicine to manage PCOD. In Ayurveda, it is identified as Kuberaksh or Lata karanja. It helps to reduce the size of an ovarian cyst and regulates hormonal imbalance. You should continue this even in periods too. Pain or cramps may be due to irritation or constipation. It can be managed by symptomatic treatment. Hormonal imbalance, pelvic inflammation, constipation, etc. USG abdomen, thyroid profile, FSH, LH. You can take Kalarchika powder 3 gm twice a day with warm water after meals. If bleeding is there then you can take Styplon two tablets twice a day after meals. You should take proper line of treatment of PCOD. Avoid spicy and fried junk foods, eat fibrous foods and fruit as well as green leafy vegetables. Do regular Kapalbhati and Mandukasana.

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 advisable to take Kalarchika for PCOD? ### Input: Hello doctor, Can we take Kalarchika during periods as I have PCOD? I started to take it two weeks before but yesterday I suddenly had mild pain in the lower left abdomen. Kindly advice. ###Response: Hi. Kalarchika or Kalchikai is a well known Siddha medicine to manage PCOD. In Ayurveda, it is identified as Kuberaksh or Lata karanja. It helps to reduce the size of an ovarian cyst and regulates hormonal imbalance. You should continue this even in periods too. Pain or cramps may be due to irritation or constipation. It can be managed by symptomatic treatment. Hormonal imbalance, pelvic inflammation, constipation, etc. USG abdomen, thyroid profile, FSH, LH. You can take Kalarchika powder 3 gm twice a day with warm water after meals. If bleeding is there then you can take Styplon two tablets twice a day after meals. You should take proper line of treatment of PCOD. Avoid spicy and fried junk foods, eat fibrous foods and fruit as well as green leafy vegetables. Do regular Kapalbhati and Mandukasana.

Hello doctor, I have some red papules on my fingers to arms for the past one day. I am so worried. What is the cause of it?

Q. I am having red papules from fingers to arms. What can be the cause?

Hi. I can understand your concern. I have gone through the images you have attached (attachment removed to protect patient identity). The possibility of allergic etiology is more likely. So apply Mometasone cream thrice daily. Drink plenty of fluids orally and keep yourself hydrated. Also, take Fexofenadine (120 mg) and Montelukast (10 mg) combination once a day at night before going to sleep. Do not itch. You can apply moisturizer lotion or Calamine lotion. Do not worry, you will be alright with all these in 1 to 2 days. Do let me know if you have any allergies. Skin allergy. Mometasone cream and Fexofenadine plus Montelukast combination.

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 red papules from fingers to arms. What can be the cause? ### Input: Hello doctor, I have some red papules on my fingers to arms for the past one day. I am so worried. What is the cause of it? ###Response: Hi. I can understand your concern. I have gone through the images you have attached (attachment removed to protect patient identity). The possibility of allergic etiology is more likely. So apply Mometasone cream thrice daily. Drink plenty of fluids orally and keep yourself hydrated. Also, take Fexofenadine (120 mg) and Montelukast (10 mg) combination once a day at night before going to sleep. Do not itch. You can apply moisturizer lotion or Calamine lotion. Do not worry, you will be alright with all these in 1 to 2 days. Do let me know if you have any allergies. Skin allergy. Mometasone cream and Fexofenadine plus Montelukast combination.

Hello doctor, I have this strange feeling behind my jaw on the left side just under my earlobe. When I fill my mouth with air to increase the pressure, the area that is irritated fills with air and makes a strange separation noise. It sounds like pulling apart wax and hair and I can feel the air in the area. Then it just makes a squishy noise. I have no idea why this happened but it started approximately 1 to 2 days ago. What could this be?

Q. I am hearing a separation noise under earlobe while filling mouth with air. Can this be due to wax?

Hi. The problem you are stating can be wax filled in the ear which is in a liquid state due to the entry of water and can cause this squishy noise in the ear. I suggest you prevent entry of water while taking bath for a few days by applying cotton to your ear during the bath time. If this wax sustains in the ear use wax melting ear drops and can get it cleaned or can consult your nearby ENT surgeon and get it confirmed and cleaned.

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 hearing a separation noise under earlobe while filling mouth with air. Can this be due to wax? ### Input: Hello doctor, I have this strange feeling behind my jaw on the left side just under my earlobe. When I fill my mouth with air to increase the pressure, the area that is irritated fills with air and makes a strange separation noise. It sounds like pulling apart wax and hair and I can feel the air in the area. Then it just makes a squishy noise. I have no idea why this happened but it started approximately 1 to 2 days ago. What could this be? ###Response: Hi. The problem you are stating can be wax filled in the ear which is in a liquid state due to the entry of water and can cause this squishy noise in the ear. I suggest you prevent entry of water while taking bath for a few days by applying cotton to your ear during the bath time. If this wax sustains in the ear use wax melting ear drops and can get it cleaned or can consult your nearby ENT surgeon and get it confirmed and cleaned.

Hello doctor, I have been suffering from anxiety for the last 10 years. I was able to live a normal life and working happily. I was on Nexitoplus (do not know if I had depression). Two months back because of family problems (father health issue), financial stress, work pressure, and continuous thoughts. The panic attack was on Nexito 20 and Etizola but with no greater relief. After that, our family doctor changed to Nexito forte. Now I am feeling physically well. Looking for motivation to get on with life and go to the job. Prior to use of Nexito forte, I was not able to concentrate. I was feeling less interested. Can you suggest how long should these medications be used? Also, how can I be mentally strong?

Q. I have anxiety and panic attack. How long should I use Nexito Forte?

Hi. It is quite common for anxiety to get elevated when faced with stressful situations in life. The good thing is with appropriate support your anxiety will come down eventually and you can function normally. Nexito (Escitalopram) is a good medication for your condition. It is positive that you are feeling better now. I see that you are prescribed Nexito Forte (which contains Clonazepam in addition to Escitalopram). I will recommend discussing with your family doctor and switch from Nexito Forte to Nexito (Clonazepam is not recommended for long-term use). Nexito 10 mg once daily can be continued at least for a year after your anxiety comes down and you are feeling better. Then it can be gradually cut down. I will recommend having some psychological therapy or counseling to deal with factors contributing to your anxiety and help manage family problems and stress at work. Exercise regularly, try yoga or meditation whichever you find comfortable. Cut down on drinking excessive coffee or tea or caffeinated drinks. It can worsen your anxiety.

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 anxiety and panic attack. How long should I use Nexito Forte? ### Input: Hello doctor, I have been suffering from anxiety for the last 10 years. I was able to live a normal life and working happily. I was on Nexitoplus (do not know if I had depression). Two months back because of family problems (father health issue), financial stress, work pressure, and continuous thoughts. The panic attack was on Nexito 20 and Etizola but with no greater relief. After that, our family doctor changed to Nexito forte. Now I am feeling physically well. Looking for motivation to get on with life and go to the job. Prior to use of Nexito forte, I was not able to concentrate. I was feeling less interested. Can you suggest how long should these medications be used? Also, how can I be mentally strong? ###Response: Hi. It is quite common for anxiety to get elevated when faced with stressful situations in life. The good thing is with appropriate support your anxiety will come down eventually and you can function normally. Nexito (Escitalopram) is a good medication for your condition. It is positive that you are feeling better now. I see that you are prescribed Nexito Forte (which contains Clonazepam in addition to Escitalopram). I will recommend discussing with your family doctor and switch from Nexito Forte to Nexito (Clonazepam is not recommended for long-term use). Nexito 10 mg once daily can be continued at least for a year after your anxiety comes down and you are feeling better. Then it can be gradually cut down. I will recommend having some psychological therapy or counseling to deal with factors contributing to your anxiety and help manage family problems and stress at work. Exercise regularly, try yoga or meditation whichever you find comfortable. Cut down on drinking excessive coffee or tea or caffeinated drinks. It can worsen your anxiety.

Hello doctor,I am a 34-year-old male. I am suffering from jaundice. Last week my eyes have turned slightly yellowish and after that, I had my blood test and hepatitis test. Tests show positive, bilirubin levels are 10 mg/dl. Can you suggest me medicine and diet plan?

Q. Please suggest medicine and diet plan for high bilirubin levels.

Hello. I went through your post. You have possibly hepatitis which needs to be checked for the type of hepatitis. So viral serology needs to be done. Regarding diet, you have to take vegetables, fresh fruits, and avoid oily and fatty stuff. Most of the hepatitis is self-remitting and resolve of its own so only supportive treatment is given. The medicines are given only if hepatitis persists after six months. For time being you take Dolo 650 (Paracetamol) if there are fever or body aches otherwise no treatment is needed just have to watch for altered consciousness. 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. Please suggest medicine and diet plan for high bilirubin levels. ### Input: Hello doctor,I am a 34-year-old male. I am suffering from jaundice. Last week my eyes have turned slightly yellowish and after that, I had my blood test and hepatitis test. Tests show positive, bilirubin levels are 10 mg/dl. Can you suggest me medicine and diet plan? ###Response: Hello. I went through your post. You have possibly hepatitis which needs to be checked for the type of hepatitis. So viral serology needs to be done. Regarding diet, you have to take vegetables, fresh fruits, and avoid oily and fatty stuff. Most of the hepatitis is self-remitting and resolve of its own so only supportive treatment is given. The medicines are given only if hepatitis persists after six months. For time being you take Dolo 650 (Paracetamol) if there are fever or body aches otherwise no treatment is needed just have to watch for altered consciousness. For more information consult an internal medicine physician online -->

Hi doctor, I have been a vegetarian for over two years, and a vegan for about three months. I had my bloodwork done this past week, and the numbers were confusing. I have had anemia in the past, and it was thought to be due to my ulcer, which I take over the counter medicine (which I was told now to make absorption difficult). I stopped being anemic about four years ago, but these numbers look like I am there again. But my B12, which is what I was actually most concerned about has been having symptoms of deficiencies, but my number was 1353, way above the highest end of the spectrum. So I am all over the place, and my regular doctor is out on medical leave. Thought I should have some information before I talk to a stranger. He has already recommended stopping being vegan. I reminded him I also had gastric bypass surgery 15 years ago, so that combined with an ulcer, anti-ulcer medicines, vegan and surgery seem to be culprits, but I need direction. Oh, since becoming vegetarian, then vegan, I have gained almost 50 lbs, not good. I do not see an upload option, so I will just write some of the numbers. B12 1253, folate 33.1. iron and TIBC 36 and 453, transferrin saturation 8 %, hematocrit 34, hemoglobin 10.3, ferritin 5 ng.

Q. Can being a vegan cause anemia with high vitamin B12 level?

Hello. I have reviewed your query and below is my advice. The peptic ulcer can lead to minor bleeding in the intestinal tract and so anemia can develop due to it. For ulcer healing, Rabeprazole like antacid can be prescribed for 2 to 4 weeks. Stool routine micro examination and occult blood test are done to rule out parasitic infestation and minor bleeding from the gastrointestinal tract. Your CBC and iron profile are suggestive towards iron deficiency for which Orofer XT like Ferrous ascorbate containing medication can be prescribed for two to three months. For high B12 level, you can investigate further with SGOT, SGPT, urea, creatinine estimation to rule out liver and kidney disease. In these diseases, excretion of B12 is affected and so level can be high. The other cause for high B12 is a myeloproliferative neoplasm. For that, you can investigate with full CBC and peripheral smear examination report to check if any abnormal cells are present or not. In this portal, you can always upload report while asking the question. Hope this will help you while you consult the doctor. I would be happy to help you further whenever needed. Best regards.

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 being a vegan cause anemia with high vitamin B12 level? ### Input: Hi doctor, I have been a vegetarian for over two years, and a vegan for about three months. I had my bloodwork done this past week, and the numbers were confusing. I have had anemia in the past, and it was thought to be due to my ulcer, which I take over the counter medicine (which I was told now to make absorption difficult). I stopped being anemic about four years ago, but these numbers look like I am there again. But my B12, which is what I was actually most concerned about has been having symptoms of deficiencies, but my number was 1353, way above the highest end of the spectrum. So I am all over the place, and my regular doctor is out on medical leave. Thought I should have some information before I talk to a stranger. He has already recommended stopping being vegan. I reminded him I also had gastric bypass surgery 15 years ago, so that combined with an ulcer, anti-ulcer medicines, vegan and surgery seem to be culprits, but I need direction. Oh, since becoming vegetarian, then vegan, I have gained almost 50 lbs, not good. I do not see an upload option, so I will just write some of the numbers. B12 1253, folate 33.1. iron and TIBC 36 and 453, transferrin saturation 8 %, hematocrit 34, hemoglobin 10.3, ferritin 5 ng. ###Response: Hello. I have reviewed your query and below is my advice. The peptic ulcer can lead to minor bleeding in the intestinal tract and so anemia can develop due to it. For ulcer healing, Rabeprazole like antacid can be prescribed for 2 to 4 weeks. Stool routine micro examination and occult blood test are done to rule out parasitic infestation and minor bleeding from the gastrointestinal tract. Your CBC and iron profile are suggestive towards iron deficiency for which Orofer XT like Ferrous ascorbate containing medication can be prescribed for two to three months. For high B12 level, you can investigate further with SGOT, SGPT, urea, creatinine estimation to rule out liver and kidney disease. In these diseases, excretion of B12 is affected and so level can be high. The other cause for high B12 is a myeloproliferative neoplasm. For that, you can investigate with full CBC and peripheral smear examination report to check if any abnormal cells are present or not. In this portal, you can always upload report while asking the question. Hope this will help you while you consult the doctor. I would be happy to help you further whenever needed. Best regards.

Hello doctor, We got married for the past three years. We planned to have a child after one year. We tried to conceive for about a year but were unable to do so. Then we consulted a doctor who conducted many tests such as endometrial lining, hormonal levels, etc. All tests including hormonal levels were normal but the ultrasound as per doctor showed PCO (not PCOS). She prescribed medicines for three months, Duphaston 10 mg from 16th day of period, Feril XT, and M-Fol. At the end of the third month, my wife felt pain similar to menses but nothing happened. We tested with hCG strip which resulted in positive and her last period date is 2nd April. Now the problem is I am now unable to contact the present doctor due to lockdown. I want suggestions regarding, whether to continue the medicines or not? If not will there be a change in medicine? Any specific diet plan? Any exercise, yoga, etc? Will complete bed rest help or can she do some house chores in the initial pregnancy period?

Q. My wife's hCG test is positive. Should she continue the same medicines prescribed for conceiving?

Hello. If the hCG (human chorionic gonadotropin) strip results positive, it means that your wife is pregnant. Based on her last menstrual date she is 5 weeks and 2 days pregnant. She can take Duphaston for two weeks every day two tablets a day and Folic acid 400 mcg one tablet a day until 12 weeks of pregnancy. She should not take any other medication. Ultrasound.

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 wife's hCG test is positive. Should she continue the same medicines prescribed for conceiving? ### Input: Hello doctor, We got married for the past three years. We planned to have a child after one year. We tried to conceive for about a year but were unable to do so. Then we consulted a doctor who conducted many tests such as endometrial lining, hormonal levels, etc. All tests including hormonal levels were normal but the ultrasound as per doctor showed PCO (not PCOS). She prescribed medicines for three months, Duphaston 10 mg from 16th day of period, Feril XT, and M-Fol. At the end of the third month, my wife felt pain similar to menses but nothing happened. We tested with hCG strip which resulted in positive and her last period date is 2nd April. Now the problem is I am now unable to contact the present doctor due to lockdown. I want suggestions regarding, whether to continue the medicines or not? If not will there be a change in medicine? Any specific diet plan? Any exercise, yoga, etc? Will complete bed rest help or can she do some house chores in the initial pregnancy period? ###Response: Hello. If the hCG (human chorionic gonadotropin) strip results positive, it means that your wife is pregnant. Based on her last menstrual date she is 5 weeks and 2 days pregnant. She can take Duphaston for two weeks every day two tablets a day and Folic acid 400 mcg one tablet a day until 12 weeks of pregnancy. She should not take any other medication. Ultrasound.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

Hi doctor, I have itching problem in the whole body since last six months. When I take the Cetirizine tablet for this then it is fine for 4 to 5 days after that it again occurs.

Q. Why am I having recurrent generalized itching that relieves on taking Cetirizine?

Hello. It seems you have chronic urticaria. In more than 50 % of cases, the cause is unknown. The rest of the patients it can be due to any infection anywhere in body or thyroid problems or diabetes, etc. I suggest you get the following tests done. CBC with ESR, S.TSH, S.T3, S.T4. Also, please note if it gets precipitated due to some stimuli such as sweat, exercise, cold, etc. Follow up with the above reports.

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 am I having recurrent generalized itching that relieves on taking Cetirizine? ### Input: Hi doctor, I have itching problem in the whole body since last six months. When I take the Cetirizine tablet for this then it is fine for 4 to 5 days after that it again occurs. ###Response: Hello. It seems you have chronic urticaria. In more than 50 % of cases, the cause is unknown. The rest of the patients it can be due to any infection anywhere in body or thyroid problems or diabetes, etc. I suggest you get the following tests done. CBC with ESR, S.TSH, S.T3, S.T4. Also, please note if it gets precipitated due to some stimuli such as sweat, exercise, cold, etc. Follow up with the above reports.

Hello doctor, My mother has been having throat pain while swallowing and fever since last evening. She has been advised Clavam 625 twice for five days. Her fever has not gone below 100 and after about four hours of taking Dolo 650, it goes up to 102.5. So far, she has taken three doses of Clavam. Is it normal to have such a high fever in throat infection? Could it be dengue?

Q. My mom has throat pain while swallowing and fever since yesterday. Is it dengue?

Hello. Yes, it is certainly possible to have such a fever and it is likely she has an upper respiratory tract infection. I think whatever she is receiving is fine. Antibiotics will take at least 48 hours to act and initially, the infection is viral. So, antibiotics may not work for the initial two to three days. I think she should continue the same treatment. Hope this helps you. Get back if you have any doubts. For more information consult a general 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. My mom has throat pain while swallowing and fever since yesterday. Is it dengue? ### Input: Hello doctor, My mother has been having throat pain while swallowing and fever since last evening. She has been advised Clavam 625 twice for five days. Her fever has not gone below 100 and after about four hours of taking Dolo 650, it goes up to 102.5. So far, she has taken three doses of Clavam. Is it normal to have such a high fever in throat infection? Could it be dengue? ###Response: Hello. Yes, it is certainly possible to have such a fever and it is likely she has an upper respiratory tract infection. I think whatever she is receiving is fine. Antibiotics will take at least 48 hours to act and initially, the infection is viral. So, antibiotics may not work for the initial two to three days. I think she should continue the same treatment. Hope this helps you. Get back if you have any doubts. For more information consult a general medicine physician online -->

Hello doctor, Is it possible to prepone my periods by a few days?

Q. Is it possible to prepone periods?

Hi. I do understand that when we want our periods to be earlier rather than later. But unfortunately delaying cycles is usually better. If you have 28 days cycles then this month your cycles will start on the expected date. But, if you have 30 or more days cycles I will suggest starting tablet Meprate (Progestin) 10 mg twice daily from two days before the expected date till the day you do not want your periods. After stopping tablet, the cycles will start in 2 or 3 days. They might be heavier than usual but no worries.

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 possible to prepone periods? ### Input: Hello doctor, Is it possible to prepone my periods by a few days? ###Response: Hi. I do understand that when we want our periods to be earlier rather than later. But unfortunately delaying cycles is usually better. If you have 28 days cycles then this month your cycles will start on the expected date. But, if you have 30 or more days cycles I will suggest starting tablet Meprate (Progestin) 10 mg twice daily from two days before the expected date till the day you do not want your periods. After stopping tablet, the cycles will start in 2 or 3 days. They might be heavier than usual but no worries.

Hello doctor,Third time on Lexapro started again two months back. Taking 10 mg, after about 20 days, I felt good again. Then it stopped working after about two weeks. My GP raised the dose to 20 mg. Today is a full week without much improvement. How long should I wait to see if 20 mg will kick in for me? I am also taking Metoprolol.

Q. I have increased the dose of Lexapro from 10 to 20 mg. When can I expect the effect?

Hi. First of all, try to stay calm because it is your third episode and medications take time to act. If you have come out of your illness twice before then this time too you will come out of your illness. Do not lose patience. As you have mentioned you are taking third time this medication. So this is your third episode. Lexapro is an antidepressant SSRI (Escitalopram). It generally takes 14 days to start the action. As you have mentioned you are taking it for the past two months and you started feeling good so you should wait for another one week for this medication to act before switching to another medication or adding a medication with it. Since it is working for you because you did feel good after taking the medication, so I would suggest you take the medication for one more week minimum to experience the effect. I would like to know more about your past episodes and which drugs were prescribed to you for it? Were you prescribed the same drug in all the episodes you had? Did you improve on the same drug? What symptoms are you experiencing right now? What is bothering you the most? Have you ever gone for psychotherapy in the past? I think along with drugs you should also go for psychotherapy- Cognitive behavioral therapy will be the best for you along with medication. It will hasten your recovery. Briefing about your previous episodes will let me know better about your past illness and medication and can give you a better outlook on your query.

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 increased the dose of Lexapro from 10 to 20 mg. When can I expect the effect? ### Input: Hello doctor,Third time on Lexapro started again two months back. Taking 10 mg, after about 20 days, I felt good again. Then it stopped working after about two weeks. My GP raised the dose to 20 mg. Today is a full week without much improvement. How long should I wait to see if 20 mg will kick in for me? I am also taking Metoprolol. ###Response: Hi. First of all, try to stay calm because it is your third episode and medications take time to act. If you have come out of your illness twice before then this time too you will come out of your illness. Do not lose patience. As you have mentioned you are taking third time this medication. So this is your third episode. Lexapro is an antidepressant SSRI (Escitalopram). It generally takes 14 days to start the action. As you have mentioned you are taking it for the past two months and you started feeling good so you should wait for another one week for this medication to act before switching to another medication or adding a medication with it. Since it is working for you because you did feel good after taking the medication, so I would suggest you take the medication for one more week minimum to experience the effect. I would like to know more about your past episodes and which drugs were prescribed to you for it? Were you prescribed the same drug in all the episodes you had? Did you improve on the same drug? What symptoms are you experiencing right now? What is bothering you the most? Have you ever gone for psychotherapy in the past? I think along with drugs you should also go for psychotherapy- Cognitive behavioral therapy will be the best for you along with medication. It will hasten your recovery. Briefing about your previous episodes will let me know better about your past illness and medication and can give you a better outlook on your query.

Hello doctor, A pregnant woman aged 24 years with running the 36th week of the gestation period, undergone ultrasound given a report of looped nuchal cord around the neck twice. Is there any complication? Fetus movements are good with a normal heartbeat and raised liquor. Are there any complications?

Q. What are the expected complications in case of cord around fetus neck?

Hi. The complication could be at labor, at contractions or during Braxton Hicks contractions. Have a strict check on fetal movements and do have recurrent fetal electronic monitoring. In case of reduced fetal monitoring, you need to evaluate electronic fetal monitoring. During labor also this could be stressed labor as cord around the neck that can press neck and can cause compression and reduced fetal hearts. During labor, you need strict and continuous monitoring. In case of abnormal graph during labor, you need to be evaluated by a senior gynecologist and to decide for delivery. Have a strict check on fetal movements and report if feel reduced.

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 expected complications in case of cord around fetus neck? ### Input: Hello doctor, A pregnant woman aged 24 years with running the 36th week of the gestation period, undergone ultrasound given a report of looped nuchal cord around the neck twice. Is there any complication? Fetus movements are good with a normal heartbeat and raised liquor. Are there any complications? ###Response: Hi. The complication could be at labor, at contractions or during Braxton Hicks contractions. Have a strict check on fetal movements and do have recurrent fetal electronic monitoring. In case of reduced fetal monitoring, you need to evaluate electronic fetal monitoring. During labor also this could be stressed labor as cord around the neck that can press neck and can cause compression and reduced fetal hearts. During labor, you need strict and continuous monitoring. In case of abnormal graph during labor, you need to be evaluated by a senior gynecologist and to decide for delivery. Have a strict check on fetal movements and report if feel reduced.

Hello doctor, I have been suffering from gas for the past three years. I have bloating after meals for about 15 minutes after which it passes away. I can eat normally, but some times I feel bloated and cannot eat. I keep burping like once in 20 minutes. Is that normal? And also bloating increases when I have anxiety. I am taking Sompraz L (Esomeprazole 40 mg and Levosulpiride 75 mg) once in an empty stomach daily. Whenever I try to leave the medicine I have gas and acidity on the second day. I also take alcohol like 90 ml regularly for three years. There is no pain or anything but only burping and bloating. I wonder is it just anxiety or something serious? I am also very much afraid to visit a doctor least they prescribe endoscopy. I am 5 feet 8 inches tall and weighs 78 kg. I had an ultrasound about one and a half years ago and it was normal. Please suggest.

Q. I feel bloated with frequent burping after meals. Is this due to anxiety?

Hello. Well, the burping while having meals, or just after the meals is a normal phenomenon. And I assure you it is not alarming in your case. However, it may cause trouble if gas trapped excessively and result in belly swelling. The reason behind this excessive bloating in your case may be aerophagia (engulfing air while taking meals that commonly occur in one who keeps speaking while having bolus) can be due to supragastric belching and may be due to excessive gas production after meals. The last group of people in medical science are termed as bloater, some are early bloaters where bloating occurs within 15 minutes of meal and some are late bloaters where bloating occurs after two hours of meal. This whole explanation is just to make you understand your own condition well. You seem to be late bloater and cause seems to be excessive gas production plus aerophagia. I want you to take a three-week course of antibiotics to reduce the excessive gas production within your bowel. The antibiotic is safe without any side effects except in some may cause diarrhea of mild intensity. SIBO (small intestinal bacterial overgrowth). Tablet Rifxamin 200 mg thrice daily for three weeks and then stop, tablet Digestine (Metaclopramide) 40 mg half an hour before meals for one week and then as per need. You can stop Sompraz L, as Tab Digestine will work in more effective way than this.

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 feel bloated with frequent burping after meals. Is this due to anxiety? ### Input: Hello doctor, I have been suffering from gas for the past three years. I have bloating after meals for about 15 minutes after which it passes away. I can eat normally, but some times I feel bloated and cannot eat. I keep burping like once in 20 minutes. Is that normal? And also bloating increases when I have anxiety. I am taking Sompraz L (Esomeprazole 40 mg and Levosulpiride 75 mg) once in an empty stomach daily. Whenever I try to leave the medicine I have gas and acidity on the second day. I also take alcohol like 90 ml regularly for three years. There is no pain or anything but only burping and bloating. I wonder is it just anxiety or something serious? I am also very much afraid to visit a doctor least they prescribe endoscopy. I am 5 feet 8 inches tall and weighs 78 kg. I had an ultrasound about one and a half years ago and it was normal. Please suggest. ###Response: Hello. Well, the burping while having meals, or just after the meals is a normal phenomenon. And I assure you it is not alarming in your case. However, it may cause trouble if gas trapped excessively and result in belly swelling. The reason behind this excessive bloating in your case may be aerophagia (engulfing air while taking meals that commonly occur in one who keeps speaking while having bolus) can be due to supragastric belching and may be due to excessive gas production after meals. The last group of people in medical science are termed as bloater, some are early bloaters where bloating occurs within 15 minutes of meal and some are late bloaters where bloating occurs after two hours of meal. This whole explanation is just to make you understand your own condition well. You seem to be late bloater and cause seems to be excessive gas production plus aerophagia. I want you to take a three-week course of antibiotics to reduce the excessive gas production within your bowel. The antibiotic is safe without any side effects except in some may cause diarrhea of mild intensity. SIBO (small intestinal bacterial overgrowth). Tablet Rifxamin 200 mg thrice daily for three weeks and then stop, tablet Digestine (Metaclopramide) 40 mg half an hour before meals for one week and then as per need. You can stop Sompraz L, as Tab Digestine will work in more effective way than this.

Hello doctor, I got one of my wisdom teeth taken out a week back. My stitches came out and now there is a big hole where the tooth was extracted. My dentist gave me nothing, not cleaning tools at all. I am just freaking out because their office is closed. What should I do about the giant hole? It hurts a lot. My breathe stinks and taste is bad as well.

Q. What should I do for severe pain with bad breath and taste after wisdom tooth extraction?

Hello. If it hurts a lot, it means that you have a dry socket condition, where the blood clot gets dislodged from the wound causing infection. You need to start taking antibiotics like Augmentin 625 mg and a painkiller. Also, use warm salt water gargling three times a day. Do not touch the area. And wait it out till you can see a dentist nearby. In such condition it takes time for full healing of the area, thus you have to be patient, get the wound cleaned and debrided by your dentist as soon as possible.

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 do for severe pain with bad breath and taste after wisdom tooth extraction? ### Input: Hello doctor, I got one of my wisdom teeth taken out a week back. My stitches came out and now there is a big hole where the tooth was extracted. My dentist gave me nothing, not cleaning tools at all. I am just freaking out because their office is closed. What should I do about the giant hole? It hurts a lot. My breathe stinks and taste is bad as well. ###Response: Hello. If it hurts a lot, it means that you have a dry socket condition, where the blood clot gets dislodged from the wound causing infection. You need to start taking antibiotics like Augmentin 625 mg and a painkiller. Also, use warm salt water gargling three times a day. Do not touch the area. And wait it out till you can see a dentist nearby. In such condition it takes time for full healing of the area, thus you have to be patient, get the wound cleaned and debrided by your dentist as soon as possible.

Hello doctor, Masturbation is stoppable or not? And if a man has the habit of hand practice once in a month and doctor says it is not a big deal, but he wants to stop this nonsense. Then what should he do? I feel so bad and embarrassing. I feel too much hurt for many weeks whenever I do masturbation.

Q. I feel embarrassed and painful with masturbation. How can I stop it?

Hello. First, please stop worrying or feeling guilty. Masturbation is a completely normal physiological phenomenon (like eating and sleeping). Almost everyone does it, even married people continue to do it. There has been some misconception about the practice. As long as it is not excessive and affecting your other normal activities, there is nothing to worry about. Concentrate on your studies and/or work. Be physically active. Get married in a few years time and live happily.

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 feel embarrassed and painful with masturbation. How can I stop it? ### Input: Hello doctor, Masturbation is stoppable or not? And if a man has the habit of hand practice once in a month and doctor says it is not a big deal, but he wants to stop this nonsense. Then what should he do? I feel so bad and embarrassing. I feel too much hurt for many weeks whenever I do masturbation. ###Response: Hello. First, please stop worrying or feeling guilty. Masturbation is a completely normal physiological phenomenon (like eating and sleeping). Almost everyone does it, even married people continue to do it. There has been some misconception about the practice. As long as it is not excessive and affecting your other normal activities, there is nothing to worry about. Concentrate on your studies and/or work. Be physically active. Get married in a few years time and live happily.

Hello doctor, My 3 month old baby cries every night for about half an hour before she sleeps. Is this normal? What might be the reason?

Q. My 3 month old baby cries every night for about half an hour before she sleeps. Is this normal?

Hello. This is a common complaint in newborn babies and infants. The common causes of frequent crying in infants could be the following:

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 3 month old baby cries every night for about half an hour before she sleeps. Is this normal? ### Input: Hello doctor, My 3 month old baby cries every night for about half an hour before she sleeps. Is this normal? What might be the reason? ###Response: Hello. This is a common complaint in newborn babies and infants. The common causes of frequent crying in infants could be the following:

Hello doctor, I am going to be really specific so that you can best help me. Six months back, I went to the doctor, and I was prescribed Ciprofloxacin HCl (Hydrochloride) for a UTI (Urinary Tract Infection). I took the antibiotic for 7 days. I am taking an oral contraceptive, and I am sexually active. During the week I was taking the antibiotic, I had unprotected sex once. The following week, I started my period as usual. I started a new pack of my birth control pills on after my periods. I forgot to take the pill on the eight-day, so I took two on the next day. I have not missed a pill or taken it late since then. There has been an increase in vaginal discharge for about 3 days. At first, there was no color to it, but yesterday, I noticed that there was a pink tint to it, and it is still present today. Everything that I have looked at online says it could be a sign of early pregnancy. What is your opinion?

Q. I missed a pill. I have spotting. Could I be pregnant?

Hello. In my opinion, if you have had your period this month on time, and you have been on oral contraceptive (birth control) pills, then you are not pregnant at all. Sometimes, spotting continues longer with discharge in the initial days of the cycle because, during the previous proliferative phase, there can be left over endometrium, which is shed after that when you have your period. By "proliferative" I am referring to growth. During the second part of your menstrual cycle, hormones which your body produce naturally cause growth to occur in the lining of the uterus also called the endometrium. Oral contraceptive pills usually cause a reduction in bleeding and some cases, may cause spotting. So, please do not worry; it is not pregnancy. This spotting should stop. Continue the pills you are taking, as prescribed. One missed pill is not the cause, as you correctly took two the next day.

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 missed a pill. I have spotting. Could I be pregnant? ### Input: Hello doctor, I am going to be really specific so that you can best help me. Six months back, I went to the doctor, and I was prescribed Ciprofloxacin HCl (Hydrochloride) for a UTI (Urinary Tract Infection). I took the antibiotic for 7 days. I am taking an oral contraceptive, and I am sexually active. During the week I was taking the antibiotic, I had unprotected sex once. The following week, I started my period as usual. I started a new pack of my birth control pills on after my periods. I forgot to take the pill on the eight-day, so I took two on the next day. I have not missed a pill or taken it late since then. There has been an increase in vaginal discharge for about 3 days. At first, there was no color to it, but yesterday, I noticed that there was a pink tint to it, and it is still present today. Everything that I have looked at online says it could be a sign of early pregnancy. What is your opinion? ###Response: Hello. In my opinion, if you have had your period this month on time, and you have been on oral contraceptive (birth control) pills, then you are not pregnant at all. Sometimes, spotting continues longer with discharge in the initial days of the cycle because, during the previous proliferative phase, there can be left over endometrium, which is shed after that when you have your period. By "proliferative" I am referring to growth. During the second part of your menstrual cycle, hormones which your body produce naturally cause growth to occur in the lining of the uterus also called the endometrium. Oral contraceptive pills usually cause a reduction in bleeding and some cases, may cause spotting. So, please do not worry; it is not pregnancy. This spotting should stop. Continue the pills you are taking, as prescribed. One missed pill is not the cause, as you correctly took two the next day.

Hello doctor, Two years back, I had a left PICA Aneurysm (Posterior Inferior Cerebellar Artery), for which it was coiled. Since then, I am taking tablet Levipil. Right now, I am taking tablet Levera XR 750 mg once daily. Sometimes, when I sit for a long time that too only when I use the Indian style toilet and sit for a long time like 15 minutes, I feel dizziness as if I was going to fall. This feeling will be there only for about 5 seconds, and after that, I will be normal. When I go out in the sun and come back, I feel the same. Is it due to the tablet or any other reason? I am very much worried about that.

Q. I am taking tablet Levera. I am getting dizziness. Is it due to the tablet?

Hi. Dizziness that you are having is a very normal phenomenon, which occurs in a large number of normal individuals. It may happen while standing from sitting position, because of a relatively low cerebral perfusion (blood supply to the brain) for a few seconds. It is during these few seconds when autonomic nervous system adapts itself to bring the cerebral perfusion pressure to normal. It is in those few seconds that such a feeling of dizziness occurs. Coming from sunlight to indoor may cause a similar physiological phenomenon and hence the dizziness. So, keep yourself hydrated well. Drink at least 3 to 4 liters of fluids per day, and these symptoms should improve. Clinically, tablet Levera (Levetiracetam) does not cause such effects. It is just a theoretically listed side effect, but not observed clinically. This tablet is not causing it. This is the safest antiepileptic drug. Please do not worry and continue the same treatment. It is a normal phenomenon.

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 taking tablet Levera. I am getting dizziness. Is it due to the tablet? ### Input: Hello doctor, Two years back, I had a left PICA Aneurysm (Posterior Inferior Cerebellar Artery), for which it was coiled. Since then, I am taking tablet Levipil. Right now, I am taking tablet Levera XR 750 mg once daily. Sometimes, when I sit for a long time that too only when I use the Indian style toilet and sit for a long time like 15 minutes, I feel dizziness as if I was going to fall. This feeling will be there only for about 5 seconds, and after that, I will be normal. When I go out in the sun and come back, I feel the same. Is it due to the tablet or any other reason? I am very much worried about that. ###Response: Hi. Dizziness that you are having is a very normal phenomenon, which occurs in a large number of normal individuals. It may happen while standing from sitting position, because of a relatively low cerebral perfusion (blood supply to the brain) for a few seconds. It is during these few seconds when autonomic nervous system adapts itself to bring the cerebral perfusion pressure to normal. It is in those few seconds that such a feeling of dizziness occurs. Coming from sunlight to indoor may cause a similar physiological phenomenon and hence the dizziness. So, keep yourself hydrated well. Drink at least 3 to 4 liters of fluids per day, and these symptoms should improve. Clinically, tablet Levera (Levetiracetam) does not cause such effects. It is just a theoretically listed side effect, but not observed clinically. This tablet is not causing it. This is the safest antiepileptic drug. Please do not worry and continue the same treatment. It is a normal phenomenon.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

Hi doctor, I am 26 years old and trying to conceive. I ovulated on 16th April and noticed spotting on 17th and 18th April. My period was due on 30th April and I am currently 8 days late. My pregnancy test is negative and I was prescribed Deviry. I am on my first day of Deviry, when can I expect my period and will I ovulate in this cycle?

Q. I started Deviry after negative pregnancy test. When can I expect my period?

Hi. I understand your concern. You are absolutely correct that stoppage of pill causes mid-cycle spotting. Why are you taking birth control if you are trying to conceive? Now coming to your question. The dose of Deviry (Medroxyprogesterone) is 10 mg, twice a day for five days. You only need to take 10 tablets and your period will start about two to seven days after taking the last tablet. It varies from person to person. Deviry will not interfere with ovulation and since you get regular cycles you can expect to ovulate any time between 12 to 16th day. I am sharing a little extra detail that will help you. Ovulation symptoms that can help you plan intercourse during those fertile days are cervical mucus changes, heightened sense of smell, breast soreness or tenderness, mild pelvic, or lower abdominal pain, light spotting or discharge, libido changes, and changes in the cervix. You should have intercourse on every alternate day from 10 th to 20 th day of your cycle to increase your chances of conception. 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. I started Deviry after negative pregnancy test. When can I expect my period? ### Input: Hi doctor, I am 26 years old and trying to conceive. I ovulated on 16th April and noticed spotting on 17th and 18th April. My period was due on 30th April and I am currently 8 days late. My pregnancy test is negative and I was prescribed Deviry. I am on my first day of Deviry, when can I expect my period and will I ovulate in this cycle? ###Response: Hi. I understand your concern. You are absolutely correct that stoppage of pill causes mid-cycle spotting. Why are you taking birth control if you are trying to conceive? Now coming to your question. The dose of Deviry (Medroxyprogesterone) is 10 mg, twice a day for five days. You only need to take 10 tablets and your period will start about two to seven days after taking the last tablet. It varies from person to person. Deviry will not interfere with ovulation and since you get regular cycles you can expect to ovulate any time between 12 to 16th day. I am sharing a little extra detail that will help you. Ovulation symptoms that can help you plan intercourse during those fertile days are cervical mucus changes, heightened sense of smell, breast soreness or tenderness, mild pelvic, or lower abdominal pain, light spotting or discharge, libido changes, and changes in the cervix. You should have intercourse on every alternate day from 10 th to 20 th day of your cycle to increase your chances of conception. I hope this helps.

Hello doctor, I have attached all my reports. Please let me know how Embeta-AM will help me improve my health. Will there be any side effects? The recent medications which I have used are, Maxoza from last four months, one sachet daily and Fluconazole 200 mg, two tablets in the last two weeks. Influvac vaccine, two doses for the prevention of swine flu. Since last month, tablet Atorva 20 mg in the night. Please help.

Q. I have palpitations and high BP. There is problem in my complete lipid profile. Please help.

Hi. I have gone through all your reports (attachment removed to protect patient identity). There is a problem in the complete lipid profile, which is due to increased weight. So, I will advise you to go for a regular brisk walking for 1 hour every day, at least 6 days a week. Avoid diet with high sugar, carbohydrate, and high-fat diet and consult a dietician online for a well-balanced diet so that your diet contains mostly high fiber, fruits, vegetables, less fat, high proteins. Please let me know why have you been using Fluconazole 200 mg. Attach the latest serum calcium, phosphorous, alkaline phosphatase, and BP charting (BP for three times a day). Have a good sleep, do yoga, meditation regularly. Avoid stress. Last but not least, you will be completely relieved from your ill health if you follow the above accordingly.

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 palpitations and high BP. There is problem in my complete lipid profile. Please help. ### Input: Hello doctor, I have attached all my reports. Please let me know how Embeta-AM will help me improve my health. Will there be any side effects? The recent medications which I have used are, Maxoza from last four months, one sachet daily and Fluconazole 200 mg, two tablets in the last two weeks. Influvac vaccine, two doses for the prevention of swine flu. Since last month, tablet Atorva 20 mg in the night. Please help. ###Response: Hi. I have gone through all your reports (attachment removed to protect patient identity). There is a problem in the complete lipid profile, which is due to increased weight. So, I will advise you to go for a regular brisk walking for 1 hour every day, at least 6 days a week. Avoid diet with high sugar, carbohydrate, and high-fat diet and consult a dietician online for a well-balanced diet so that your diet contains mostly high fiber, fruits, vegetables, less fat, high proteins. Please let me know why have you been using Fluconazole 200 mg. Attach the latest serum calcium, phosphorous, alkaline phosphatase, and BP charting (BP for three times a day). Have a good sleep, do yoga, meditation regularly. Avoid stress. Last but not least, you will be completely relieved from your ill health if you follow the above accordingly.

Hello doctor, I am 8 weeks pregnant, and I found some blood spot with blood clots coming out while urinating. I consulted the doctor and underwent an ultrasound scan with the following observation. Number of fetuses - 1, Viability - Live, Fetal Cardiac Pulsation - Seen, Fetal Heart rate - 160 bpm. Peridecidual fluid - a chunk of fluid covering one-sixth of sac dia is seen at the fundal end of the sac. Yolk sac - seen. Fetal Biometry CRL 9.2 mm, 6W6D. Maternal Cervix length - Adequate, Internal OS - Closed. Maternal Ovaries - Normal. Impression - Single live fetus of 6 weeks of gestation. Mild Peridecidual Bleed. Post which, I was advised by the doctor to consume Duphaston thrice a day. There is no blood spot post that, but there is still blood clot coming continuously. About four days back, the doctor recommended consuming Duphaston with Sustain 200. I need to know the following. Am I or my child in danger? What percentage is the success rate of such pregnancy? Is there any issue in consuming so much medicines? Is there any other way forward?

Q. I am pregnant by 8 weeks and found some blood clots coming out while urinating. Am I or my child in danger?

Hello. I have gone through your reports and understand your concerns (attachment removed to protect patient identity). You should take all the drugs as your doctor has advised along with tablet Folvite 5 mg (Folic acid) once daily for better prognosis. There is some kind of a problem, but if you take all these drugs and take rest, then you can overcome these problems. Yes, all these drugs are needed at this time. Do not be worried. Take fresh fruits and vegetables and take rest adequately.

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 pregnant by 8 weeks and found some blood clots coming out while urinating. Am I or my child in danger? ### Input: Hello doctor, I am 8 weeks pregnant, and I found some blood spot with blood clots coming out while urinating. I consulted the doctor and underwent an ultrasound scan with the following observation. Number of fetuses - 1, Viability - Live, Fetal Cardiac Pulsation - Seen, Fetal Heart rate - 160 bpm. Peridecidual fluid - a chunk of fluid covering one-sixth of sac dia is seen at the fundal end of the sac. Yolk sac - seen. Fetal Biometry CRL 9.2 mm, 6W6D. Maternal Cervix length - Adequate, Internal OS - Closed. Maternal Ovaries - Normal. Impression - Single live fetus of 6 weeks of gestation. Mild Peridecidual Bleed. Post which, I was advised by the doctor to consume Duphaston thrice a day. There is no blood spot post that, but there is still blood clot coming continuously. About four days back, the doctor recommended consuming Duphaston with Sustain 200. I need to know the following. Am I or my child in danger? What percentage is the success rate of such pregnancy? Is there any issue in consuming so much medicines? Is there any other way forward? ###Response: Hello. I have gone through your reports and understand your concerns (attachment removed to protect patient identity). You should take all the drugs as your doctor has advised along with tablet Folvite 5 mg (Folic acid) once daily for better prognosis. There is some kind of a problem, but if you take all these drugs and take rest, then you can overcome these problems. Yes, all these drugs are needed at this time. Do not be worried. Take fresh fruits and vegetables and take rest adequately.

Hello doctor, I have a back pain which has made me stay in bed for two weeks. Now the pain has reduced but I have very limited movement, just to go to the bathroom but still, there is a pain when I want to stand up. I did the MRI test, the result was showing lumbar lordosis is decreased with scoliosis, disc dehydration and small central disc protrusion are seen at L3 to L4 level, disc dehydration and left paracentral disc extrusion are seen at L4 to L5 level with moderate central canal stenosis, disc dehydration and central disc protrusion are seen at L5 to S1 level with lateral recess stenosis and S1 nerve root impression. Please advice the best treatment option according to my situation, preferably non-surgery option.

Q. I have lumbar lordosis and disc dehydration. Which is the best the non-surgical treatment?

Hello. Your MRI report shows evidence of wear and tear of the lumbar disc with some pressure on the nerves (attachment removed to protect patient identity). It is difficult to suggest the treatment without examining you in person. However, generally speaking, it is possible to treat lumbar disc disease without surgery with medication and physiotherapy. Wishing you a speedy recovery.

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 lumbar lordosis and disc dehydration. Which is the best the non-surgical treatment? ### Input: Hello doctor, I have a back pain which has made me stay in bed for two weeks. Now the pain has reduced but I have very limited movement, just to go to the bathroom but still, there is a pain when I want to stand up. I did the MRI test, the result was showing lumbar lordosis is decreased with scoliosis, disc dehydration and small central disc protrusion are seen at L3 to L4 level, disc dehydration and left paracentral disc extrusion are seen at L4 to L5 level with moderate central canal stenosis, disc dehydration and central disc protrusion are seen at L5 to S1 level with lateral recess stenosis and S1 nerve root impression. Please advice the best treatment option according to my situation, preferably non-surgery option. ###Response: Hello. Your MRI report shows evidence of wear and tear of the lumbar disc with some pressure on the nerves (attachment removed to protect patient identity). It is difficult to suggest the treatment without examining you in person. However, generally speaking, it is possible to treat lumbar disc disease without surgery with medication and physiotherapy. Wishing you a speedy recovery.

Hello doctor, I have a cold and have lost my voice. But my gum has swollen up significantly behind my last tooth in my lower right side.

Q. Why am I having swollen gum behind last tooth with cold?

Hello. I have been through your query and I can understand your concern. The swollen gum behind your tooth is a condition called pericoronitis. It generally occurs with the partially erupted last molar or teeth. The food gets entraped between the tooth and gum and it gets infected leading to pain and swelling of the gums. It is also characterized by the pain while opening the mouth. After checking your drug history I would advise you to take antibiotics Metronidazole 400 mg three times daily for three days and also analgesic Aceclofenac 100 mg (Zerodol MR) when you have any pain (if you are not allergic to any of these). Also use Hydrogen Peroxide 0.1 % mouthwash diluted in water (1:1) three times daily for five days. If the problem still persists, I suggest you go to the dentist and get the procedure called operculectomy done. Also, I would advise you to have good oral hygiene from now on and brush your teeth twice daily and floss regularly. Use mouth rinses after every meal.

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 am I having swollen gum behind last tooth with cold? ### Input: Hello doctor, I have a cold and have lost my voice. But my gum has swollen up significantly behind my last tooth in my lower right side. ###Response: Hello. I have been through your query and I can understand your concern. The swollen gum behind your tooth is a condition called pericoronitis. It generally occurs with the partially erupted last molar or teeth. The food gets entraped between the tooth and gum and it gets infected leading to pain and swelling of the gums. It is also characterized by the pain while opening the mouth. After checking your drug history I would advise you to take antibiotics Metronidazole 400 mg three times daily for three days and also analgesic Aceclofenac 100 mg (Zerodol MR) when you have any pain (if you are not allergic to any of these). Also use Hydrogen Peroxide 0.1 % mouthwash diluted in water (1:1) three times daily for five days. If the problem still persists, I suggest you go to the dentist and get the procedure called operculectomy done. Also, I would advise you to have good oral hygiene from now on and brush your teeth twice daily and floss regularly. Use mouth rinses after every meal.

Hello doctor, I (66 years, 145 lbs) am using a can of enamel paint in my basement. Total of 1 to 2 minutes. Had a mask on then took it off while I cleaned up 5 to 10 inhaling residual fumes. However, the mask was old. I know I should not have done it inside. Can this cause any health issues? Ran an air cleaner that helped take care of the smell. Now, most importantly my 15 months old granddaughter came to stay four days later. She never went to the basement. We try to keep the basement door closed. Could she have any health issues near or long term? It is really worrying me.

Q. I inhaled enamel paint residual fumes. How will the health be affected?

Hi. The paints usually have toxic chemicals, which on long-term continuous inhalation (more than one month) definitely can accumulate sufficiently in lung and body, to produce the toxic effect. This can happen for the painting professionals without proper precautions. In your case, it is the single time (few hours) exposure. This can produce local irritation on eyes, nose, lungs, and skin. The symptoms are skin itching, burning sensation of eyes, headache, increased secretions from eyes and nose, cough, sometimes wheezing in susceptible cases. There are no possibilities for any other bad effects. That too these effects usually start within 30 minutes to one hour of exposure and last only for one day. Once we breath normal air, there is proper ventilation in the lungs, these paint chemicals from lungs would be washed out. After one day, you will be safe and can forget about this. My suggestion is to open windows and run exhauster fans to expel the smell (indicates the chemicals) of paint from the room. More ventilation, more washout. Three days it may take to completely remove the smell from the room. After that, you can allow the kid in the room. If the paint smell is there, do not allow the child to smell it. It will produce the above mentioned bad effects for her also. In case, if the kid is exposed into the room before complete washing out, no issues. Bring the child out, wash the face, eyes and nose with water. Keep baby in an open air space for 30 minutes. In a few new fresh breathing, the toxic chemicals from the lung get washed away. Usually, after painting, we need to pass new air to wash out the chemicals in the air. For a few days. If not, some other when we enter the room, we will be the victim.

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 inhaled enamel paint residual fumes. How will the health be affected? ### Input: Hello doctor, I (66 years, 145 lbs) am using a can of enamel paint in my basement. Total of 1 to 2 minutes. Had a mask on then took it off while I cleaned up 5 to 10 inhaling residual fumes. However, the mask was old. I know I should not have done it inside. Can this cause any health issues? Ran an air cleaner that helped take care of the smell. Now, most importantly my 15 months old granddaughter came to stay four days later. She never went to the basement. We try to keep the basement door closed. Could she have any health issues near or long term? It is really worrying me. ###Response: Hi. The paints usually have toxic chemicals, which on long-term continuous inhalation (more than one month) definitely can accumulate sufficiently in lung and body, to produce the toxic effect. This can happen for the painting professionals without proper precautions. In your case, it is the single time (few hours) exposure. This can produce local irritation on eyes, nose, lungs, and skin. The symptoms are skin itching, burning sensation of eyes, headache, increased secretions from eyes and nose, cough, sometimes wheezing in susceptible cases. There are no possibilities for any other bad effects. That too these effects usually start within 30 minutes to one hour of exposure and last only for one day. Once we breath normal air, there is proper ventilation in the lungs, these paint chemicals from lungs would be washed out. After one day, you will be safe and can forget about this. My suggestion is to open windows and run exhauster fans to expel the smell (indicates the chemicals) of paint from the room. More ventilation, more washout. Three days it may take to completely remove the smell from the room. After that, you can allow the kid in the room. If the paint smell is there, do not allow the child to smell it. It will produce the above mentioned bad effects for her also. In case, if the kid is exposed into the room before complete washing out, no issues. Bring the child out, wash the face, eyes and nose with water. Keep baby in an open air space for 30 minutes. In a few new fresh breathing, the toxic chemicals from the lung get washed away. Usually, after painting, we need to pass new air to wash out the chemicals in the air. For a few days. If not, some other when we enter the room, we will be the victim.

Hello doctor,Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies report shows CSF hyperdynamic flow of absolute stroke volume of 110 microliters per second against the normal of 50 microliters per sec per cardiac cycle. Also, my treating neurologist wanted an opinion on the following. Are there signs of NPH? But do the findings of brain atrophy, ventriculomegaly, hyperdynamic CSF flows suggest of idiopathic hydrocephalus and are some intervention required?

Q. Kindly explain whether MRI brain and CSF studies show any relation to NPH.

Hi, Welcome back to icliniq.com. The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if incontinence is there. Confirming NPH without typical features is difficult in your case. There are controversies regarding NPH and CSF hyperdynamic values and different researchers have come to variable conclusions. Since gait problems are most common in NPH, therefore, most researches have mentioned the importance of gait problems when confirming NPH or incontinence if gait problem is not there. Treatment with shunting might help only when NPH is confirmed. If there is no NPH then the diagnosis is likely due to neurodegenerative disorders and the symptoms can be treated by medicines. There are many different and complicated types of neurodegenerative disorders and a clinical emphasis is more important than only MRI findings when confirming a condition.

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 explain whether MRI brain and CSF studies show any relation to NPH. ### Input: Hello doctor,Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies report shows CSF hyperdynamic flow of absolute stroke volume of 110 microliters per second against the normal of 50 microliters per sec per cardiac cycle. Also, my treating neurologist wanted an opinion on the following. Are there signs of NPH? But do the findings of brain atrophy, ventriculomegaly, hyperdynamic CSF flows suggest of idiopathic hydrocephalus and are some intervention required? ###Response: Hi, Welcome back to icliniq.com. The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if incontinence is there. Confirming NPH without typical features is difficult in your case. There are controversies regarding NPH and CSF hyperdynamic values and different researchers have come to variable conclusions. Since gait problems are most common in NPH, therefore, most researches have mentioned the importance of gait problems when confirming NPH or incontinence if gait problem is not there. Treatment with shunting might help only when NPH is confirmed. If there is no NPH then the diagnosis is likely due to neurodegenerative disorders and the symptoms can be treated by medicines. There are many different and complicated types of neurodegenerative disorders and a clinical emphasis is more important than only MRI findings when confirming a condition.

Hello doctor, I had braces years ago due to my bite being the wrong way round. I then have had retainers to wear at night for a few years. I think the retainers are giving me ulcers. I want to stop wearing them. Will my bite go back the wrong way if I do not wear them?

Q. I want to stop wearing retainers. Can this change my corrected bite?

Hi. Yes, your bite may go back to a previous alignment if you will not wear retainers properly. This will cause your whole treatment to relapse and it would be bad. Things you can do is you can put some oral gel at ulcer in the daytime and at least wear for 2 to 3 hours for a week so that ulcer may heal up and then come back to 14 hours of wearing from the next week. If some wire is hurting you and creating ulcer, get it fixed from your dentist and then start wearing. If you cannot go to dentist urgently chew some chewing gum and put it on the point where it is causing the ulcer and wear it. Or you may put a tiny piece of moldable wax too at that point. It will not hurt that bad then and you can wear it. But do wear it somehow. Take care. Stay happy and blessed.

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 want to stop wearing retainers. Can this change my corrected bite? ### Input: Hello doctor, I had braces years ago due to my bite being the wrong way round. I then have had retainers to wear at night for a few years. I think the retainers are giving me ulcers. I want to stop wearing them. Will my bite go back the wrong way if I do not wear them? ###Response: Hi. Yes, your bite may go back to a previous alignment if you will not wear retainers properly. This will cause your whole treatment to relapse and it would be bad. Things you can do is you can put some oral gel at ulcer in the daytime and at least wear for 2 to 3 hours for a week so that ulcer may heal up and then come back to 14 hours of wearing from the next week. If some wire is hurting you and creating ulcer, get it fixed from your dentist and then start wearing. If you cannot go to dentist urgently chew some chewing gum and put it on the point where it is causing the ulcer and wear it. Or you may put a tiny piece of moldable wax too at that point. It will not hurt that bad then and you can wear it. But do wear it somehow. Take care. Stay happy and blessed.

Hello doctor, I am a female, 28 years old. I do not smoke or play sports or have alcohol. I have BP borderline (130/85) at rest, I suffer from tachycardia at rest. I often have ventricular extrasystoles, frequent bigeminy, and couples of VT. My heart is mad and begins to beat very fast and loud at rest without exercise with chest pain. When I was a child I got echocardiography done that diagnosed a mild mitral regurgitation but I never have done other exams. I got EKG done some days ago, the heartbeat is very very fast at rest. I would like to have an opinion on my EKG, what is it showing?

Q. What does my EKG report taken for fast heart beat during rest show?

Hi. Your EKG shows sinus tachycardia and probably left ventricular hypertrophy (attachment removed to protect patient identity). As you said you had mild valvular leakage, there might be some other problem as well. Therefore I advise you to have echocardiography done. If your heart rate is high at almost all the times then also have ambulatory EKG (Holter monitoring) done for 24 hours. Sometimes this tachycardia is due to anxiety, pain, anemia, infection, and hyperthyroidism. So, ruling out these entities is a must. Followup after having done the advised tests within 10 days, so you can be guided better and proper. Anxiety, anemia, hyperthyroidism, pain, infection. CBC, TSH, echo, 24 hours Holter monitoring, ESR. Tablet Atenolol 50 mg daily (only after having Holter monitoring done and ruling out other causes of fast heart rate).

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 my EKG report taken for fast heart beat during rest show? ### Input: Hello doctor, I am a female, 28 years old. I do not smoke or play sports or have alcohol. I have BP borderline (130/85) at rest, I suffer from tachycardia at rest. I often have ventricular extrasystoles, frequent bigeminy, and couples of VT. My heart is mad and begins to beat very fast and loud at rest without exercise with chest pain. When I was a child I got echocardiography done that diagnosed a mild mitral regurgitation but I never have done other exams. I got EKG done some days ago, the heartbeat is very very fast at rest. I would like to have an opinion on my EKG, what is it showing? ###Response: Hi. Your EKG shows sinus tachycardia and probably left ventricular hypertrophy (attachment removed to protect patient identity). As you said you had mild valvular leakage, there might be some other problem as well. Therefore I advise you to have echocardiography done. If your heart rate is high at almost all the times then also have ambulatory EKG (Holter monitoring) done for 24 hours. Sometimes this tachycardia is due to anxiety, pain, anemia, infection, and hyperthyroidism. So, ruling out these entities is a must. Followup after having done the advised tests within 10 days, so you can be guided better and proper. Anxiety, anemia, hyperthyroidism, pain, infection. CBC, TSH, echo, 24 hours Holter monitoring, ESR. Tablet Atenolol 50 mg daily (only after having Holter monitoring done and ruling out other causes of fast heart rate).

Hello doctor, My husband and I have been trying to conceive for five months now. The past few months I have been noticing severe breast pain throughout my entire breast and fullness of both breasts from ovulation until the time I get my period. I read that this could be indicative of a hormone imbalance? My periods are regular and I typically have 30 days cycles.

Q. I have severe breast pain with fullness from ovulation to periods. Is it hormonal imbalance?

Hi. Symptoms you have described are effects given by hormones produced before menses and after ovulation. As you are trying to conceive as well and active sexually, the body tries to respond to that too. Attempts for trying to conceive stimulates and activates hormones more efficiently. So those hormonal presence gives effects as well, like breast tenderness. If the pain or tenderness is there all over the cycle and on a specific side only then you need to worry and consult breast specialist. Hot fomentation, warm baths and then oil massage could be helpful. Have folic acid daily. Try to have a complete treatment of any health issue you have. A daily walk and exercise to have normal BMI. Have recreational activities and quit recreational drugs. Hormonal changes of the cycle. Massage, hot fomentation, warm bath. Can have tablet Postan 500 mg for severe pain. Folic acid, sex in the fertile period.

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 severe breast pain with fullness from ovulation to periods. Is it hormonal imbalance? ### Input: Hello doctor, My husband and I have been trying to conceive for five months now. The past few months I have been noticing severe breast pain throughout my entire breast and fullness of both breasts from ovulation until the time I get my period. I read that this could be indicative of a hormone imbalance? My periods are regular and I typically have 30 days cycles. ###Response: Hi. Symptoms you have described are effects given by hormones produced before menses and after ovulation. As you are trying to conceive as well and active sexually, the body tries to respond to that too. Attempts for trying to conceive stimulates and activates hormones more efficiently. So those hormonal presence gives effects as well, like breast tenderness. If the pain or tenderness is there all over the cycle and on a specific side only then you need to worry and consult breast specialist. Hot fomentation, warm baths and then oil massage could be helpful. Have folic acid daily. Try to have a complete treatment of any health issue you have. A daily walk and exercise to have normal BMI. Have recreational activities and quit recreational drugs. Hormonal changes of the cycle. Massage, hot fomentation, warm bath. Can have tablet Postan 500 mg for severe pain. Folic acid, sex in the fertile period.

Hello doctor, I am suffering from severe pain in my cervicothoracic spine and upper right back and scapula and right shoulder and right arm accompanied by numbness in the right forearm since last 40 days. The pain is acute during bending, sitting and walking but I get some relief while lying down on bed on my back. I got my MRI done in which it has been revealed that there is a diffuse annular bulge with posterior right lateral disc extrusion at D1-D2 level which is causing severe compression over right lateral recess with entrapment of the exiting nerve root. I have tried McKenzie neck exercises but my right upper back and cervicothoracic pain has only increased. Please advise how can I get relief ftom acute pain. Please suggest me treatment to get relief from acute pain in cervicothoracic spine region, upper right side back, scapula area and right shoulder and arm. I tried McKenzie neck exercises but my pain has only increased.

Q. How can I mange acute pain in cervicothoracic spine region?

Hello. I read your concern. I would like to know the exercises McKenzie correction you had done for reduction. You need a proper manual therapy assessment and mechanical restoration with mobilization. I would like to advise you to get your D1 properly mobilized with a physiotherapist. The mobilization of the facer joint will also help you a lot. In your case, McKenzie should work better as I do not know what have you done. And what kind of mechanical restoration was done and manipulation performed? Kindly give me details so that we can suggest your correction. Manipulative correction of deranged spinal alignment will help you to recover faster. Keep icing your upper back and lower part of the neck. Avoid prolong bending forward movement. Try massaging over upper neck and scapula gently to reduce spasm. And thereby reducing the pain. Try lying down in that position that gives you maximum comfort. Kindly revert back so that I can help you to choose better techniques and speedy recovery. Postural. Rest ice mobilization of soft tissue and manipulative correction of deranged segments. Segmental stability exercises. Avoid provocative postures.

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 mange acute pain in cervicothoracic spine region? ### Input: Hello doctor, I am suffering from severe pain in my cervicothoracic spine and upper right back and scapula and right shoulder and right arm accompanied by numbness in the right forearm since last 40 days. The pain is acute during bending, sitting and walking but I get some relief while lying down on bed on my back. I got my MRI done in which it has been revealed that there is a diffuse annular bulge with posterior right lateral disc extrusion at D1-D2 level which is causing severe compression over right lateral recess with entrapment of the exiting nerve root. I have tried McKenzie neck exercises but my right upper back and cervicothoracic pain has only increased. Please advise how can I get relief ftom acute pain. Please suggest me treatment to get relief from acute pain in cervicothoracic spine region, upper right side back, scapula area and right shoulder and arm. I tried McKenzie neck exercises but my pain has only increased. ###Response: Hello. I read your concern. I would like to know the exercises McKenzie correction you had done for reduction. You need a proper manual therapy assessment and mechanical restoration with mobilization. I would like to advise you to get your D1 properly mobilized with a physiotherapist. The mobilization of the facer joint will also help you a lot. In your case, McKenzie should work better as I do not know what have you done. And what kind of mechanical restoration was done and manipulation performed? Kindly give me details so that we can suggest your correction. Manipulative correction of deranged spinal alignment will help you to recover faster. Keep icing your upper back and lower part of the neck. Avoid prolong bending forward movement. Try massaging over upper neck and scapula gently to reduce spasm. And thereby reducing the pain. Try lying down in that position that gives you maximum comfort. Kindly revert back so that I can help you to choose better techniques and speedy recovery. Postural. Rest ice mobilization of soft tissue and manipulative correction of deranged segments. Segmental stability exercises. Avoid provocative postures.

Hello doctor, I am 21 years old. I have been worried because my penis head has turned blackish and I have horizontal wrinkles on it. I masturbate once a day for the past three years and often forget to clean the sperm after masturbating. Please suggest.

Q. My penile head turned blackish with horizontal wrinkles in it. Do regular maturbation be the cause?

Hello. I read your query and understand your concerns. I have gone through the attached images (attachment removed to protect patient identity), and it is true that there is some black discoloration at the glans penis (penis head) but it does not look like symptom of any illness or disease. In other words, it can be stated that poor personal hygiene can be the cause and exercising proper care during bath and otherwise can be of much use. I must acknowledge that images attached to the query are of low resolution but can be considered of average quality for the initial assessment. In case there is no improvement after improving personal hygiene I recommend you to post high-resolution images on the follow-up query. I must also inform you that slight black pigmentation of the penis can be due to the overproduction of melanin which is responsible for the color of our skin. This generally represents injury to the penis because of some injury due to aggressive masturbation which may be applicable in your case. So it is important to remain gentle with yourself when you hold your penis next time. I recommend you to wash with a mild cleanser and rinsing thoroughly so that dead skin can be removed which will change the color to the original. It is also recommended to use antioxidants and mineral rich diet in your daily schedule to rejuvenate the skin of the body. 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. My penile head turned blackish with horizontal wrinkles in it. Do regular maturbation be the cause? ### Input: Hello doctor, I am 21 years old. I have been worried because my penis head has turned blackish and I have horizontal wrinkles on it. I masturbate once a day for the past three years and often forget to clean the sperm after masturbating. Please suggest. ###Response: Hello. I read your query and understand your concerns. I have gone through the attached images (attachment removed to protect patient identity), and it is true that there is some black discoloration at the glans penis (penis head) but it does not look like symptom of any illness or disease. In other words, it can be stated that poor personal hygiene can be the cause and exercising proper care during bath and otherwise can be of much use. I must acknowledge that images attached to the query are of low resolution but can be considered of average quality for the initial assessment. In case there is no improvement after improving personal hygiene I recommend you to post high-resolution images on the follow-up query. I must also inform you that slight black pigmentation of the penis can be due to the overproduction of melanin which is responsible for the color of our skin. This generally represents injury to the penis because of some injury due to aggressive masturbation which may be applicable in your case. So it is important to remain gentle with yourself when you hold your penis next time. I recommend you to wash with a mild cleanser and rinsing thoroughly so that dead skin can be removed which will change the color to the original. It is also recommended to use antioxidants and mineral rich diet in your daily schedule to rejuvenate the skin of the body. I hope this helps.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

Hi doctor, I know a patient who is having hypertension. The doctor has prescribed Losalife H in the morning and Losalex 50 in the night. Is this an excess dose or is it normal?

Q. Taking Losalex twice a day. Is it an excess dose for hypertension?

Hi. It depends entirely on the extent of BP (blood pressure) elevation. Usually, most of the patients become well on once-daily dosing. But in some patients, we need twice daily dosing. So often, once daily is enough. But if the BP is not getting controlled or there is too high elevation say more than 190 mmHg, then we can give twice daily dosing. So the best option, in this case, is monitoring the BP at home using electronic BP apparatus and have the dosing accordingly. Let me know the BP readings if available so that I can suggest the treatment. So overall, if it is a need, a twice-daily dose can be taken.

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. Taking Losalex twice a day. Is it an excess dose for hypertension? ### Input: Hi doctor, I know a patient who is having hypertension. The doctor has prescribed Losalife H in the morning and Losalex 50 in the night. Is this an excess dose or is it normal? ###Response: Hi. It depends entirely on the extent of BP (blood pressure) elevation. Usually, most of the patients become well on once-daily dosing. But in some patients, we need twice daily dosing. So often, once daily is enough. But if the BP is not getting controlled or there is too high elevation say more than 190 mmHg, then we can give twice daily dosing. So the best option, in this case, is monitoring the BP at home using electronic BP apparatus and have the dosing accordingly. Let me know the BP readings if available so that I can suggest the treatment. So overall, if it is a need, a twice-daily dose can be taken.

Hello doctor, My age is 18 years. I had a root canal last year. I have many cavities in my teeth. I brush three times a day nicely then also cavities grow up and come on other teeth. Please tell me any of your solutions.

Q. How can i prevent getting dental cavities?

Hello. I have been through your query and I can understand your concern. The cavities (caries) have many causes to occur in the mouth. And overall cleaning with proper technique of brushing and flossing is essential to maintain good oral hygiene. Good oral hygiene with regular dental check-ups will ensure no cavities in the future. I would advise you to have a visit to your nearest dentist and get the remaining cavities filled (restored). And have a proper cleaning and scaling done for the teeth. In order for proper brushing technique, ask the dentist you visit to show you the suitable and proper brushing technique. As for now, you can search the modified bass technique for brushing your teeth. Be gentle while brushing. Always brush after breakfast in the morning and after the dinner (before sleeping) in the night. Do regular oral rinses after having meals and floss regularly in order to ward off the cavities. Also, come for the regular dental checkups after six months to your nearest dentist (dental check ups will cost merely some bucks which is better than one time huge amount to spend and that too for drilling and filling your teeth). Maintain good oral hygiene and follow above said things and I can assure you that your teeth will never get any cavities.

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 prevent getting dental cavities? ### Input: Hello doctor, My age is 18 years. I had a root canal last year. I have many cavities in my teeth. I brush three times a day nicely then also cavities grow up and come on other teeth. Please tell me any of your solutions. ###Response: Hello. I have been through your query and I can understand your concern. The cavities (caries) have many causes to occur in the mouth. And overall cleaning with proper technique of brushing and flossing is essential to maintain good oral hygiene. Good oral hygiene with regular dental check-ups will ensure no cavities in the future. I would advise you to have a visit to your nearest dentist and get the remaining cavities filled (restored). And have a proper cleaning and scaling done for the teeth. In order for proper brushing technique, ask the dentist you visit to show you the suitable and proper brushing technique. As for now, you can search the modified bass technique for brushing your teeth. Be gentle while brushing. Always brush after breakfast in the morning and after the dinner (before sleeping) in the night. Do regular oral rinses after having meals and floss regularly in order to ward off the cavities. Also, come for the regular dental checkups after six months to your nearest dentist (dental check ups will cost merely some bucks which is better than one time huge amount to spend and that too for drilling and filling your teeth). Maintain good oral hygiene and follow above said things and I can assure you that your teeth will never get any cavities.

Hello doctor, I have endometriosis, diagnostic or excision lap was done three years back. Recently I have had GI symptoms including extreme pain on defecation, rectal bleeding with a period, and tenesmus. Last exam showed a nodule in my vaginal wall and ultrasound showed left ovarian endometrioma. About a week ago I noticed my vaginal walls seemed to have collapsed so that they are both bulging and pressed together. I felt inside and noted that my cervix was about 1 to 2 inches past the vaginal opening and it is sideways, with the cervix opening to the right side. Does this sound like a rectocele or is it possible that my uterus has tipped over or something? I am not sure what to do as it is very difficult to get in to see my gynecologist. Please help. Currently, I am taking Dienogest 2 mg OD, Taro-Tramadol ER 200 mg OD, Apo-Tramadol 50 mg Q6H PRN, Paroxetine 20 mg OD, Lorazepam 0.5 mg SL PRN.

Q. Why are my vaginal walls collapsed and cervix shifted to right side?

Hi. How are you doing? You seem to be suffering a lot at this young age of 25 years. From your history and examination findings, I feel there is deep infiltrating endometriosis. Usually, bowel symptoms, distended bowels into the vagina, nodules in ligament could mean that. But the uterus will be stuck and will never descend, especially after a surgery. But when you say cervix is outside the vagina, it means cervical descent or elongation. It could mean a nulliparous prolapse. The best method would be to have an examination done, scan taken, to know if any large cyst is pushing uterus out. If everything is normal, you can have 3 to 4 doses of monthly Lupreolide 3.75 mg i.m. Followed by tablet Ormeloxifene 60 mg weekly twice for any number of years. I have found it more effective than Dienogest. If prolapse is significant, it may resolve if any cyst of pressure from inside is relieved. You have bowel symptoms and you said cervix is pushed to the right, so there must be something on the left side, the location of the colon, sigmoid colon, and rectum. Have a scan anyway.

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 are my vaginal walls collapsed and cervix shifted to right side? ### Input: Hello doctor, I have endometriosis, diagnostic or excision lap was done three years back. Recently I have had GI symptoms including extreme pain on defecation, rectal bleeding with a period, and tenesmus. Last exam showed a nodule in my vaginal wall and ultrasound showed left ovarian endometrioma. About a week ago I noticed my vaginal walls seemed to have collapsed so that they are both bulging and pressed together. I felt inside and noted that my cervix was about 1 to 2 inches past the vaginal opening and it is sideways, with the cervix opening to the right side. Does this sound like a rectocele or is it possible that my uterus has tipped over or something? I am not sure what to do as it is very difficult to get in to see my gynecologist. Please help. Currently, I am taking Dienogest 2 mg OD, Taro-Tramadol ER 200 mg OD, Apo-Tramadol 50 mg Q6H PRN, Paroxetine 20 mg OD, Lorazepam 0.5 mg SL PRN. ###Response: Hi. How are you doing? You seem to be suffering a lot at this young age of 25 years. From your history and examination findings, I feel there is deep infiltrating endometriosis. Usually, bowel symptoms, distended bowels into the vagina, nodules in ligament could mean that. But the uterus will be stuck and will never descend, especially after a surgery. But when you say cervix is outside the vagina, it means cervical descent or elongation. It could mean a nulliparous prolapse. The best method would be to have an examination done, scan taken, to know if any large cyst is pushing uterus out. If everything is normal, you can have 3 to 4 doses of monthly Lupreolide 3.75 mg i.m. Followed by tablet Ormeloxifene 60 mg weekly twice for any number of years. I have found it more effective than Dienogest. If prolapse is significant, it may resolve if any cyst of pressure from inside is relieved. You have bowel symptoms and you said cervix is pushed to the right, so there must be something on the left side, the location of the colon, sigmoid colon, and rectum. Have a scan anyway.

Hello doctor, I have keratitis and after the treatment, I still have a tiny grey spot on my cornea. Here is the treatment which I had followed: Visit 1 - (October 2014) Fucithalmic eye drops 1 % - three times daily for two weeks. Visit 2 - (October 2014) Exocine 0.3 % - four times daily for a month. Visit 2 - Artelac eye drops - four times daily for a month. Visit 3 - (December 2014) Artelac eye drops - two times daily for a month. Visit 4 - (24th February 2015) - Zylet Etabonate and Prednol, Tobramycine 0.3 % for two weeks. Visit 4 - Artelac eye drops - two times daily. I have been using till now. I am really worried about my eye. Please help me.

Q. I have keratitis and after the treatment I still have a tiny grey spot on my cornea. I am really worried about my eye.

Hello.I reviewed your history. It seems from the history that you had keratitis and following the treatment, you have a small corneal opacity. Artelac is an artificial tear eye drops and it can be used for a long time without causing side effects. Hence no need to be worried about the use of Artelac eye drops. The next treatment depends on the site and size of the opacity. If the opacity is superficial and peripheral, then no need to be worried becauseit will be replaced by clear corneal layers slowly as the epithelium of the cornea sheds and regrows. However, if the opacity is deeper and bigger then you may need further surgical intervention like keratoplasty. Since you have mentioned that the opacity is tiny, this may resolve and you need not be worried about it. Hope this information is helpful to you. Revert back to an eye care ophthalmologist 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 have keratitis and after the treatment I still have a tiny grey spot on my cornea. I am really worried about my eye. ### Input: Hello doctor, I have keratitis and after the treatment, I still have a tiny grey spot on my cornea. Here is the treatment which I had followed: Visit 1 - (October 2014) Fucithalmic eye drops 1 % - three times daily for two weeks. Visit 2 - (October 2014) Exocine 0.3 % - four times daily for a month. Visit 2 - Artelac eye drops - four times daily for a month. Visit 3 - (December 2014) Artelac eye drops - two times daily for a month. Visit 4 - (24th February 2015) - Zylet Etabonate and Prednol, Tobramycine 0.3 % for two weeks. Visit 4 - Artelac eye drops - two times daily. I have been using till now. I am really worried about my eye. Please help me. ###Response: Hello.I reviewed your history. It seems from the history that you had keratitis and following the treatment, you have a small corneal opacity. Artelac is an artificial tear eye drops and it can be used for a long time without causing side effects. Hence no need to be worried about the use of Artelac eye drops. The next treatment depends on the site and size of the opacity. If the opacity is superficial and peripheral, then no need to be worried becauseit will be replaced by clear corneal layers slowly as the epithelium of the cornea sheds and regrows. However, if the opacity is deeper and bigger then you may need further surgical intervention like keratoplasty. Since you have mentioned that the opacity is tiny, this may resolve and you need not be worried about it. Hope this information is helpful to you. Revert back to an eye care ophthalmologist online for further follow up -->

Hi doctor, I saw a blood streak while coughing into a tissue in the morning for the past three days, occurring only in the morning. I had a cold, but now I have just been coughing for the past 10 days. Please tell me if the blood I see is something to worry about or not. Also, I would like to know what to do about my cough.

Q. I noticed a blood streak while coughing. Is this something to worry about?

Hello. You have mentioned that you have a blood streak while coughing and only in the morning. You have also mentioned that you have a cold. There are many possibilities as to what caused the blood streak with your cough. As you have been suffering from a cough, it is highly probable that you might be coughing hard to expel the phlegm in the morning due to more accumulation during the night. During the day, you might be coughing periodically, and a light cough would expel the phlegm. Coughing too hard causes minor tears in the pharyngeal lining and a small bleed may occur. This is most likely the case with you. And I assure you that it is a simple issue that will resolve spontaneously. This kind of bleeding does not require any treatment. For the cough I would prescribe:Ambrodil-S Syrup: two teaspoonfuls three times daily after food, for a week. Ambrodil-S is a mucolytic agent, which means that it helps to loosen and clear the mucus from your bronchial tract. Tablet Limcee 500: One tablet twice daily for 15 days. Limcee is a Vitamin C supplement. It will boost your immunity and help with early recovery. Gargle twice daily with warm salt water (a half teaspoon of salt in a glass of warm water). This is a very important step and it should be practiced whenever you have a cold. I thought I would mention that another common cause for blood in the sputum is tuberculosis, but it is highly unlikely in your case. If you want to be tested, you can visit any hospital and have a sputum test done (Ziehl-Neelsen sputum test). You will need to submit two sputum samples to the laboratory. But I would fully expect this situation to clear up soon after following my suggestions, which I would advise you to try first. If this situation persists, then you may want to look into further testing, including possibly a chest x-ray to rule out pneumonia. I wish you an early and speedy recovery. Revert back to a general practitioner 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 noticed a blood streak while coughing. Is this something to worry about? ### Input: Hi doctor, I saw a blood streak while coughing into a tissue in the morning for the past three days, occurring only in the morning. I had a cold, but now I have just been coughing for the past 10 days. Please tell me if the blood I see is something to worry about or not. Also, I would like to know what to do about my cough. ###Response: Hello. You have mentioned that you have a blood streak while coughing and only in the morning. You have also mentioned that you have a cold. There are many possibilities as to what caused the blood streak with your cough. As you have been suffering from a cough, it is highly probable that you might be coughing hard to expel the phlegm in the morning due to more accumulation during the night. During the day, you might be coughing periodically, and a light cough would expel the phlegm. Coughing too hard causes minor tears in the pharyngeal lining and a small bleed may occur. This is most likely the case with you. And I assure you that it is a simple issue that will resolve spontaneously. This kind of bleeding does not require any treatment. For the cough I would prescribe:Ambrodil-S Syrup: two teaspoonfuls three times daily after food, for a week. Ambrodil-S is a mucolytic agent, which means that it helps to loosen and clear the mucus from your bronchial tract. Tablet Limcee 500: One tablet twice daily for 15 days. Limcee is a Vitamin C supplement. It will boost your immunity and help with early recovery. Gargle twice daily with warm salt water (a half teaspoon of salt in a glass of warm water). This is a very important step and it should be practiced whenever you have a cold. I thought I would mention that another common cause for blood in the sputum is tuberculosis, but it is highly unlikely in your case. If you want to be tested, you can visit any hospital and have a sputum test done (Ziehl-Neelsen sputum test). You will need to submit two sputum samples to the laboratory. But I would fully expect this situation to clear up soon after following my suggestions, which I would advise you to try first. If this situation persists, then you may want to look into further testing, including possibly a chest x-ray to rule out pneumonia. I wish you an early and speedy recovery. Revert back to a general practitioner online for further follow up -->

Hello doctor, We noticed our 6-year-old daughter has a visible blood vessel on one of her tonsils. She feels fine and says her throat feels fine. Is this a cause of concern? We have never noticed it before? It has been three months since she was at the dentist and I know they check her tonsils. This is very weird, please advise if this is very serious.

Q. My 6-year-old daughter has visible blood vessels on tonsils with no symptoms. Is it a matter of concern?

Hi. I have had a look at the pictures you have sent (attachment removed to protect patient identity). The tonsils are definitely enlarged in this case, there is no doubt about it. The tonsils have a very rich blood supply and are relatively avascular structure. It is normal to encounter leash of blood vessels over the tonsil or its adjacent areas like the anterior and posterior pillars (these are two walls in between which the tonsils reside). Unless and until the tonsils are inflamed and the child is symptomatic, we do not need to give any sort of antibiotics as it is not indicated. At the same point of time, enlarged tonsil indicates possible previous episodes of recurrent tonsillitis as a result of which the tonsillar tissues get hypertrophied and attains a larger size. It is always better to maintain strict oral hygiene, do saltwater gargles five to six times a day at regular intervals. Avoid anything cold, spicy, and oily food/beverages. Maintaining precautionary measures definitely goes a long way in preventing recurrent sore throats or streptococcal infections. However, in a situation where the child is having recurrent sore throats with associated fever, significant leaves from school, it is always better to get the tonsils removed. There are criteria given by aao-hns (American association of otorhinolaryngologists and head and neck surgeons) who have laid down criteria for a patient to undergo tonsillectomy. In nutshell, visible blood vessels over the tonsils or related adjacent structures is not a worry as it is very common and seen in health and have not pathology related to it. Sticking of the uvula to the right tonsil is due to surface tension of the saliva and enlarged size of the tonsil. This again has no clinical significance. There is absolutely nothing that you need to worry or get stressed about. Make sure you advise the child to follow the instructions that I have given above to prevent recurrent sore throats. In addition, she can also use crushed ginger with manuka honey (you can add crushed ginger and honey in a cup and give it together one tablespoon three times a day). Honey has excellent antioxidant, antiviral, antibacterial properties and so does ginger. 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. My 6-year-old daughter has visible blood vessels on tonsils with no symptoms. Is it a matter of concern? ### Input: Hello doctor, We noticed our 6-year-old daughter has a visible blood vessel on one of her tonsils. She feels fine and says her throat feels fine. Is this a cause of concern? We have never noticed it before? It has been three months since she was at the dentist and I know they check her tonsils. This is very weird, please advise if this is very serious. ###Response: Hi. I have had a look at the pictures you have sent (attachment removed to protect patient identity). The tonsils are definitely enlarged in this case, there is no doubt about it. The tonsils have a very rich blood supply and are relatively avascular structure. It is normal to encounter leash of blood vessels over the tonsil or its adjacent areas like the anterior and posterior pillars (these are two walls in between which the tonsils reside). Unless and until the tonsils are inflamed and the child is symptomatic, we do not need to give any sort of antibiotics as it is not indicated. At the same point of time, enlarged tonsil indicates possible previous episodes of recurrent tonsillitis as a result of which the tonsillar tissues get hypertrophied and attains a larger size. It is always better to maintain strict oral hygiene, do saltwater gargles five to six times a day at regular intervals. Avoid anything cold, spicy, and oily food/beverages. Maintaining precautionary measures definitely goes a long way in preventing recurrent sore throats or streptococcal infections. However, in a situation where the child is having recurrent sore throats with associated fever, significant leaves from school, it is always better to get the tonsils removed. There are criteria given by aao-hns (American association of otorhinolaryngologists and head and neck surgeons) who have laid down criteria for a patient to undergo tonsillectomy. In nutshell, visible blood vessels over the tonsils or related adjacent structures is not a worry as it is very common and seen in health and have not pathology related to it. Sticking of the uvula to the right tonsil is due to surface tension of the saliva and enlarged size of the tonsil. This again has no clinical significance. There is absolutely nothing that you need to worry or get stressed about. Make sure you advise the child to follow the instructions that I have given above to prevent recurrent sore throats. In addition, she can also use crushed ginger with manuka honey (you can add crushed ginger and honey in a cup and give it together one tablespoon three times a day). Honey has excellent antioxidant, antiviral, antibacterial properties and so does ginger. I hope this helps.

Hello doctor, This query is for my daughter who is 6 years and 7 months old. She lost her top primary incisor teeth (universal numbering -9) before four months. She still has not got the permanent teeth until now. She however, has lost the other three incisors and got the permanent teeth. Kindly do let me know if the above delay in the growth of these teeth is normal. She is taking Eltroxin 25 mg since birth.

Q. How long will it take for permanent incisors to erupt after shedding of milk teeth in a 6-year-old kid?

Hello. As you mentioned your daughter is 6 years and 7 months old. Please confirm if she has lost all her upper primary teeth or lowers where the permanent teeth have come? Other thing is if all the upper four primary incisors are gone and three have come. Generally, we need to see which tooth incisor has not come out of four permanent incisors. If missing tooth is lateral incisor means next to two central incisors then we can wait and watch for another two to three months. Other scenario is if only one upper incisor is lost three to four months ago and the rest of the milk (primary incisors are intact) then we can still wait two to three more months. But if out of four upper permanent incisors, only one that too central permanent incisor has not come out, then it is better to take radiograph IOPA (intraoral periapical radiograph) x-ray first to rule out any hindrance in the eruption of the tooth or any permanent missing tooth. If possible click and share the picture of mouth (oral cavity) with teeth and send it across. Generally, a delay of one year in an eruption of permanent teeth is quite normal. But we need to confirm which tooth is missing and need to see the chronology of other teeth simultaneously to rule out any abnormal changes. Eruption delay if only one primary tooth was lost and counterpart permanent tooth is missing for the past four months. IOPA x-ray of upper front teeth. First need to examine clinically and then if needed IOPA x-ray. And depending on IOPA findings treatments to be planned.

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 for permanent incisors to erupt after shedding of milk teeth in a 6-year-old kid? ### Input: Hello doctor, This query is for my daughter who is 6 years and 7 months old. She lost her top primary incisor teeth (universal numbering -9) before four months. She still has not got the permanent teeth until now. She however, has lost the other three incisors and got the permanent teeth. Kindly do let me know if the above delay in the growth of these teeth is normal. She is taking Eltroxin 25 mg since birth. ###Response: Hello. As you mentioned your daughter is 6 years and 7 months old. Please confirm if she has lost all her upper primary teeth or lowers where the permanent teeth have come? Other thing is if all the upper four primary incisors are gone and three have come. Generally, we need to see which tooth incisor has not come out of four permanent incisors. If missing tooth is lateral incisor means next to two central incisors then we can wait and watch for another two to three months. Other scenario is if only one upper incisor is lost three to four months ago and the rest of the milk (primary incisors are intact) then we can still wait two to three more months. But if out of four upper permanent incisors, only one that too central permanent incisor has not come out, then it is better to take radiograph IOPA (intraoral periapical radiograph) x-ray first to rule out any hindrance in the eruption of the tooth or any permanent missing tooth. If possible click and share the picture of mouth (oral cavity) with teeth and send it across. Generally, a delay of one year in an eruption of permanent teeth is quite normal. But we need to confirm which tooth is missing and need to see the chronology of other teeth simultaneously to rule out any abnormal changes. Eruption delay if only one primary tooth was lost and counterpart permanent tooth is missing for the past four months. IOPA x-ray of upper front teeth. First need to examine clinically and then if needed IOPA x-ray. And depending on IOPA findings treatments to be planned.

Hi doctor, The dermatologist has said that I have urticaria (hives) and prescribed Deflazacort 6 mg and Hydroxyzine HCl, but I am 28 weeks pregnant. Can I take those medicines? Suspecting it is chickenpox. The itching started 10 days ago, rashes started five days ago. Appears to be small red bumps on thighs and hands. Then appearing as water blisters and healing now.

Q. Is it advisable to take Deflazacort and Hydroxyzine HCl for hives during pregnancy?

Hi. Deflazacort is corticosteroids and can be used as per need but can interact with diabetic medications and will act as an anti-inflammatory and can give side effects like weight gain, mood variations, vomitings, etc. Hydroxyzine is antihistamine and can be used but better only in need, do not make it as a habit. Suspecting chicken pox at 28 weeks, you need to report urgently to treating obstetrician. If you tell within 24 hours of the appearance of the lesion, you can have medications like Acyclovir. If severe symptoms, it can be given orally as well. Chicken pox first needs to check as urgent before treatment for IgG and IgM as well ( IgM recent infection and IgG already immunized petient). In pregnancy, the vaccine could not be given as it is a live attenuated vaccine but after 20 weeks if patient reports within 24 hours of having confirmed leisions of chicken pox could have medical treatment. Take it seriously and just report to your treating obstetrician to have proper examination and treatment accordingly. But it seems you have spent most of the infectious and symptomatic period already but better to have a check up immediately and do have electronic fetal monitoring to check fetal well-being. Continue Iron and Calcium supplements. A healthy balanced diet with less salt, sugar, oil and spice. Have isolation, try to avoid children, adults at home and exchange of your things like utencils wth others. Pregnancy with chicken pox and urticaria. Report reduced fetal movements.

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 advisable to take Deflazacort and Hydroxyzine HCl for hives during pregnancy? ### Input: Hi doctor, The dermatologist has said that I have urticaria (hives) and prescribed Deflazacort 6 mg and Hydroxyzine HCl, but I am 28 weeks pregnant. Can I take those medicines? Suspecting it is chickenpox. The itching started 10 days ago, rashes started five days ago. Appears to be small red bumps on thighs and hands. Then appearing as water blisters and healing now. ###Response: Hi. Deflazacort is corticosteroids and can be used as per need but can interact with diabetic medications and will act as an anti-inflammatory and can give side effects like weight gain, mood variations, vomitings, etc. Hydroxyzine is antihistamine and can be used but better only in need, do not make it as a habit. Suspecting chicken pox at 28 weeks, you need to report urgently to treating obstetrician. If you tell within 24 hours of the appearance of the lesion, you can have medications like Acyclovir. If severe symptoms, it can be given orally as well. Chicken pox first needs to check as urgent before treatment for IgG and IgM as well ( IgM recent infection and IgG already immunized petient). In pregnancy, the vaccine could not be given as it is a live attenuated vaccine but after 20 weeks if patient reports within 24 hours of having confirmed leisions of chicken pox could have medical treatment. Take it seriously and just report to your treating obstetrician to have proper examination and treatment accordingly. But it seems you have spent most of the infectious and symptomatic period already but better to have a check up immediately and do have electronic fetal monitoring to check fetal well-being. Continue Iron and Calcium supplements. A healthy balanced diet with less salt, sugar, oil and spice. Have isolation, try to avoid children, adults at home and exchange of your things like utencils wth others. Pregnancy with chicken pox and urticaria. Report reduced fetal movements.

Hello doctor, I cannot get to sleep due to a racking cough and have stuffy nose and headache as I take Apixaban blood thinner. I do not know what medication to take to treat this. Currently taking Apixaban, Bisoprolol, and Amlodipine.

Q. Is it normal to have cough, stuffed nose and headache after taking Apixaban?

Hello. This is likely a result of upper respiratory infection or allergic manifestations. Firstly, it is better to get examined by a local practitioner for throat and nose examination for signs of infection. You will need and should get prescribed antibiotic like capsule Augmentin 625 mg thrice a day along with some antacid like tablet Pantoprazole 40 mg once a day before breakfast for five days. For symptomatic relief, antiallergic medicine like tablet Allegra 120 mg once a day preferably bedtime till this resolves. Also, for cough syrup like Alex 2 teaspoon SOS will be helpful. For a stuffy nose, you may use Xylometazoline nasal drops, a drop in each nostril SOS. Also, avoid using over-the-counter other than Paracetamol like Ibuprofen, Diclofenac. Paracetamol may be used 650 mg three times a day accordingly.

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 normal to have cough, stuffed nose and headache after taking Apixaban? ### Input: Hello doctor, I cannot get to sleep due to a racking cough and have stuffy nose and headache as I take Apixaban blood thinner. I do not know what medication to take to treat this. Currently taking Apixaban, Bisoprolol, and Amlodipine. ###Response: Hello. This is likely a result of upper respiratory infection or allergic manifestations. Firstly, it is better to get examined by a local practitioner for throat and nose examination for signs of infection. You will need and should get prescribed antibiotic like capsule Augmentin 625 mg thrice a day along with some antacid like tablet Pantoprazole 40 mg once a day before breakfast for five days. For symptomatic relief, antiallergic medicine like tablet Allegra 120 mg once a day preferably bedtime till this resolves. Also, for cough syrup like Alex 2 teaspoon SOS will be helpful. For a stuffy nose, you may use Xylometazoline nasal drops, a drop in each nostril SOS. Also, avoid using over-the-counter other than Paracetamol like Ibuprofen, Diclofenac. Paracetamol may be used 650 mg three times a day accordingly.

Hi doctor, My age is 20 years and weight is around 40 kg. I have a problem in my mouth for the past 3 to 4 years. In my mouth, there is continually leaking saliva. Below my tongue, I see a lot of wanes and some skin parts taken out like a shark fin. Now I can see my roots of teeth. Skin that is inside my mouth feels a little bit bloated and teeth shape was like printed on it. On the lower lip, I can feel some bubble inside the lip.

Q. What is the reason for continually leaking saliva with a bubble in lower lip?

Hi. I have seen your pictures (attachment removed to protect patient identity). You have malfunctioning of the salivary gland that is causing blisters at the lower side of your tongue and most probably on the lip as well. Put an oral gel Chlorhexidine gluconate with or without Metronidazole on the lower lip ulcer. This may help in healing temporarily. Visit an oral and maxillofacial surgeon in your area. Then he will do some tests and radiographs and will treat this disease accordingly. This is not the case to be treated by a general dentist. That is why visiting oral and maxillofacial surgeon is recommended. Take care. Stay happy and blessed. Give me the followup after visiting the surgeon.

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 is the reason for continually leaking saliva with a bubble in lower lip? ### Input: Hi doctor, My age is 20 years and weight is around 40 kg. I have a problem in my mouth for the past 3 to 4 years. In my mouth, there is continually leaking saliva. Below my tongue, I see a lot of wanes and some skin parts taken out like a shark fin. Now I can see my roots of teeth. Skin that is inside my mouth feels a little bit bloated and teeth shape was like printed on it. On the lower lip, I can feel some bubble inside the lip. ###Response: Hi. I have seen your pictures (attachment removed to protect patient identity). You have malfunctioning of the salivary gland that is causing blisters at the lower side of your tongue and most probably on the lip as well. Put an oral gel Chlorhexidine gluconate with or without Metronidazole on the lower lip ulcer. This may help in healing temporarily. Visit an oral and maxillofacial surgeon in your area. Then he will do some tests and radiographs and will treat this disease accordingly. This is not the case to be treated by a general dentist. That is why visiting oral and maxillofacial surgeon is recommended. Take care. Stay happy and blessed. Give me the followup after visiting the surgeon.

Hello doctor, I have pain in the inside of my vagina when I pee and lower back and stomach pain that comes and goes. Is this normal?

Q. I have vaginal pain while urinating along with stomach and back pain. Is it fine?

Hi. It could be sexually transmitted infection or pelvic infection. Have high vaginal swab urinalysis, urine culture. Strict hygiene. Soft comfortable undergarments. Use condoms to avoid sexually transmitted infection. Avoid cosmetics locally, just use a soft razor for hair removal. Lots of water and Cranberry juice to avoid UTI. After collection of the swab, have medications, tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg eight hourly for 14 days. Collect reports and discuss here. STI or PID. Urinalysis, urine culture, HVS (high vaginal swab). UTI or PID. STI or PID. Oral antibiotics.

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 vaginal pain while urinating along with stomach and back pain. Is it fine? ### Input: Hello doctor, I have pain in the inside of my vagina when I pee and lower back and stomach pain that comes and goes. Is this normal? ###Response: Hi. It could be sexually transmitted infection or pelvic infection. Have high vaginal swab urinalysis, urine culture. Strict hygiene. Soft comfortable undergarments. Use condoms to avoid sexually transmitted infection. Avoid cosmetics locally, just use a soft razor for hair removal. Lots of water and Cranberry juice to avoid UTI. After collection of the swab, have medications, tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg eight hourly for 14 days. Collect reports and discuss here. STI or PID. Urinalysis, urine culture, HVS (high vaginal swab). UTI or PID. STI or PID. Oral antibiotics.

Hello doctor, I am taking Triphala churna in morning empty stomach and in at night bedtime for constipation. Now my problem is at which time should I take Bramha rasayan. I have to take Triphala two times for constipation and digestion issues. Please suggest me the time for Bramha rasayan.

Q. I am taking Triphala churna twice a day. When can I take Bramha rasayan?

Hello. I just read your query. See if you have mild to moderate constipation then take two teaspoons of Triphala powder at bedtime with lukewarm water. Do not eat anything after taking Triphala powder. You do not need to take it two times if it is solving your problem. So you can take Brahma rasayan in the morning one teaspoon or as advised by your physician half an hour before breakfast with lukewarm milk or lukewarm water.

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 taking Triphala churna twice a day. When can I take Bramha rasayan? ### Input: Hello doctor, I am taking Triphala churna in morning empty stomach and in at night bedtime for constipation. Now my problem is at which time should I take Bramha rasayan. I have to take Triphala two times for constipation and digestion issues. Please suggest me the time for Bramha rasayan. ###Response: Hello. I just read your query. See if you have mild to moderate constipation then take two teaspoons of Triphala powder at bedtime with lukewarm water. Do not eat anything after taking Triphala powder. You do not need to take it two times if it is solving your problem. So you can take Brahma rasayan in the morning one teaspoon or as advised by your physician half an hour before breakfast with lukewarm milk or lukewarm water.

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

Q. How long should my husband and I wait to try for a baby if we did cocaine?

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

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

Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?

Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?

Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries 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. Can Yasmin birth control pill be used as an emergency contraceptive pill? ### Input: Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? ###Response: Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->

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

Q. Please explain the poisonous effect of phenol ingestion.

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

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 explain the poisonous effect of phenol ingestion. ### Input: Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. ###Response: Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->

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

Q. For how long should I take Kalachikai powder to overcome PCOD problem?

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

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. For how long should I take Kalachikai powder to overcome PCOD problem? ### Input: Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? ###Response: Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->

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

Q. Why do periods get delayed after first time sex?

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

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 periods get delayed after first time sex? ### Input: Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? ###Response: Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->

Hello doctor, I am 21 years old with acne prone skin. I have lots of acne scars and pits from popping pimples when younger. I tried benzoyl peroxide and did not work. What medical procedure can stop pimples and heal the pits and scars? I am suffering from this for the past six to seven years.

Q. Is there any medical procedure to heal acne, pits and scars?

Hello. Chronic acne with resultant scarring is an indication for treatment with oral Isotretinoin besides topical antiacne preparations like Benzoyl peroxide or Clindamycin. For scarring, there are cosmetic procedures like laser resurfacing or dermabrasion.

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 medical procedure to heal acne, pits and scars? ### Input: Hello doctor, I am 21 years old with acne prone skin. I have lots of acne scars and pits from popping pimples when younger. I tried benzoyl peroxide and did not work. What medical procedure can stop pimples and heal the pits and scars? I am suffering from this for the past six to seven years. ###Response: Hello. Chronic acne with resultant scarring is an indication for treatment with oral Isotretinoin besides topical antiacne preparations like Benzoyl peroxide or Clindamycin. For scarring, there are cosmetic procedures like laser resurfacing or dermabrasion.

Hello doctor,I have pimples, red, and brown spots on the face. Moderate acne. Mainly on chin, cheeks, sides of the nose and between eyebrows. Is it hormonal acne? How do I fix it? Large pores on the face but dehydrated, sensitive skin. Red pimples with white pus. Varies from large to small sizes. Leaves large brown acne scars that still have not faded. Not painful but sensitive to touch and harsh acne treatments. After changing products, the face is irritated and red, and the skin feels sticky. Combination skin, with oil on T-zone. Acne mainly on the chin area. Is it hormonal acne? How do I fix it?

Q. Can hormonal changes cause pimples, red, and brown spots on the face?

Hi. I have seen your query. With your description, it seems you have developed grade 2 to 3 acne. See acne concentrated over chin indicate hormonal acne. If you can share a few pictures, it will be helpful in exact grading of acne, which further leads to proper treatment. You can use 1 % Clindamycin gel during the morning and use 3.5 % Microbenz gel during the night. Use face care face wash twice daily. Not to use oily spicy foods and junk foods, take lots of water daily which will hydrate your skin.

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 hormonal changes cause pimples, red, and brown spots on the face? ### Input: Hello doctor,I have pimples, red, and brown spots on the face. Moderate acne. Mainly on chin, cheeks, sides of the nose and between eyebrows. Is it hormonal acne? How do I fix it? Large pores on the face but dehydrated, sensitive skin. Red pimples with white pus. Varies from large to small sizes. Leaves large brown acne scars that still have not faded. Not painful but sensitive to touch and harsh acne treatments. After changing products, the face is irritated and red, and the skin feels sticky. Combination skin, with oil on T-zone. Acne mainly on the chin area. Is it hormonal acne? How do I fix it? ###Response: Hi. I have seen your query. With your description, it seems you have developed grade 2 to 3 acne. See acne concentrated over chin indicate hormonal acne. If you can share a few pictures, it will be helpful in exact grading of acne, which further leads to proper treatment. You can use 1 % Clindamycin gel during the morning and use 3.5 % Microbenz gel during the night. Use face care face wash twice daily. Not to use oily spicy foods and junk foods, take lots of water daily which will hydrate your skin.

Hello doctor, My urethra and labia were suddenly sore and itchy. Now it has a yellow-green discharge from the urethra. What medication should I use?

Q. My urethra and labia got suddenly sore and itchy with yellow-green discharge. Please help.

Hi. It could be a pelvic infection, sexually transmitted infection with or without urine infection. Have urinalysis, urine culture, high vaginal swab, strict hygiene. Soft comfortable undergarments. Sitz bath to relieve irritation (sit in warm water recurrently). Drink plenty of water. Avoid condoms to reduce sexually transmitted infection. After HVS (high vaginal swab) collection have tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg 8 hourly for 14 days. Follow HVS report and discuss here for any more treatment. Have a complete check-up and regular treatment of any health issue you have. Sexually transmitted infection, UTI, PID. HVS, urine culture, and urinalysis. Antibiotics after tests, follow reports, discuss here. Strict hygiene, soft comfortable undergarments, sitz bath, use condoms to avoid transmission of infection, plenty of water.

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 urethra and labia got suddenly sore and itchy with yellow-green discharge. Please help. ### Input: Hello doctor, My urethra and labia were suddenly sore and itchy. Now it has a yellow-green discharge from the urethra. What medication should I use? ###Response: Hi. It could be a pelvic infection, sexually transmitted infection with or without urine infection. Have urinalysis, urine culture, high vaginal swab, strict hygiene. Soft comfortable undergarments. Sitz bath to relieve irritation (sit in warm water recurrently). Drink plenty of water. Avoid condoms to reduce sexually transmitted infection. After HVS (high vaginal swab) collection have tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg 8 hourly for 14 days. Follow HVS report and discuss here for any more treatment. Have a complete check-up and regular treatment of any health issue you have. Sexually transmitted infection, UTI, PID. HVS, urine culture, and urinalysis. Antibiotics after tests, follow reports, discuss here. Strict hygiene, soft comfortable undergarments, sitz bath, use condoms to avoid transmission of infection, plenty of water.

Hello doctor, I am wondering if I have BPD as I do have all the symptoms (with anger issues, fear of abandonment, suicidal or impulsive tendencies, and idealization the most prominent) as well as have passed multiple credible psychological tests. I am currently not on any medication and no formal investigations or diagnosis has been done. It seems to be getting worse lately, as with my recent break-up. However, even back when we were together, I was told that I act like someone who is borderline, and it has become a major issue and reason for our break-up.

Q. Can anger issues, fear of abandonment, suicidal or impulsive tendencies be due to BPD?

Hi. I can only say that if a psychiatrist has labeled you as a borderline then only you should worry about being one. I would advise you to stop being judgmental about yourself and stop being bothered about how the world judges you. From the description which you have provided, I can say that you are having adjustment disorder and nothing else. So stop worrying, psychotherapy would help you a lot and you will have to be more descriptive about how you feel now so that I can help you. You can consult a psychiatrist also if you want.

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 anger issues, fear of abandonment, suicidal or impulsive tendencies be due to BPD? ### Input: Hello doctor, I am wondering if I have BPD as I do have all the symptoms (with anger issues, fear of abandonment, suicidal or impulsive tendencies, and idealization the most prominent) as well as have passed multiple credible psychological tests. I am currently not on any medication and no formal investigations or diagnosis has been done. It seems to be getting worse lately, as with my recent break-up. However, even back when we were together, I was told that I act like someone who is borderline, and it has become a major issue and reason for our break-up. ###Response: Hi. I can only say that if a psychiatrist has labeled you as a borderline then only you should worry about being one. I would advise you to stop being judgmental about yourself and stop being bothered about how the world judges you. From the description which you have provided, I can say that you are having adjustment disorder and nothing else. So stop worrying, psychotherapy would help you a lot and you will have to be more descriptive about how you feel now so that I can help you. You can consult a psychiatrist also if you want.

Hi doctor, The patient is my wife.

Q. There is low TLC after delivery. Why?

Hi. Kindly find answers of your questions as below. Your total leukocyte count and platelet were low initially. But gradually it has been improved so suggest recovery of any unnoticed infection. Moreover, the peripheral smear examination report was normal (attachment removed to protect patient identity) and not showing any abnormal cells that warrant further investigation. You have to still repeat CBC after few days. The TSH is high, so hypothyroidism should be ruled out. For that repeat TSH estimation after few days and investigate with T3, T4 estimation as well. If there is any abnormality, then gradually all counts go down or high and peripheral smear shows abnormal cells if blood cancer is present. It is difficult to say one reason for low WBC. But the infection can be possible. If no cause is evident then ANA estimation can be done to do work up for autoimmune disease. If your CBC values do not fall within the range in the next few days then hematologist can be consulted for a detailed evaluation. If hypothyroidism is confirmed then Levothyroxine should be started.

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. There is low TLC after delivery. Why? ### Input: Hi doctor, The patient is my wife. ###Response: Hi. Kindly find answers of your questions as below. Your total leukocyte count and platelet were low initially. But gradually it has been improved so suggest recovery of any unnoticed infection. Moreover, the peripheral smear examination report was normal (attachment removed to protect patient identity) and not showing any abnormal cells that warrant further investigation. You have to still repeat CBC after few days. The TSH is high, so hypothyroidism should be ruled out. For that repeat TSH estimation after few days and investigate with T3, T4 estimation as well. If there is any abnormality, then gradually all counts go down or high and peripheral smear shows abnormal cells if blood cancer is present. It is difficult to say one reason for low WBC. But the infection can be possible. If no cause is evident then ANA estimation can be done to do work up for autoimmune disease. If your CBC values do not fall within the range in the next few days then hematologist can be consulted for a detailed evaluation. If hypothyroidism is confirmed then Levothyroxine should be started.

Hello doctor, I am a 24-year-old with type 1 diabetes looking to conceive. I am currently 145 pounds and 5'6" tall. What do I need to do? Currently, I am taking Insulin.

Q. I have type 1 diabetes and trying to conceive. What measures are to be taken?

Hi. How are you doing? Before you plan to conceive, just try to lose some weight. For the height of 152 cms, ideal weight is 52 to 57 kg. I am sure this will reduce your requirement of Insulin too. As pregnancy progresses the dose of Insulin will need titration. Try to lose that weight not by changing your diet, but by increasing or changing your daily exercise schedule (a lot of cardiac exercises). One month before you start trying, start on tablet Folic acid 5 mg per day, as this will reduce the risk of fetal anomalies, early pregnancy loses. Have a baseline HbA1c. Only when it is < 6.5 %, which signifies the blood sugars of the previous three months, then you try for pregnancy. You can have a complete blood count to rule out any underlying anemia, etc. All the best.

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 type 1 diabetes and trying to conceive. What measures are to be taken? ### Input: Hello doctor, I am a 24-year-old with type 1 diabetes looking to conceive. I am currently 145 pounds and 5'6" tall. What do I need to do? Currently, I am taking Insulin. ###Response: Hi. How are you doing? Before you plan to conceive, just try to lose some weight. For the height of 152 cms, ideal weight is 52 to 57 kg. I am sure this will reduce your requirement of Insulin too. As pregnancy progresses the dose of Insulin will need titration. Try to lose that weight not by changing your diet, but by increasing or changing your daily exercise schedule (a lot of cardiac exercises). One month before you start trying, start on tablet Folic acid 5 mg per day, as this will reduce the risk of fetal anomalies, early pregnancy loses. Have a baseline HbA1c. Only when it is < 6.5 %, which signifies the blood sugars of the previous three months, then you try for pregnancy. You can have a complete blood count to rule out any underlying anemia, etc. All the best.