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### Instruction: Answer this question truthfully ###Input: Hello doctor,My mother is 57 years old. She is having skin infection around his face, neck, and ear area and she is a cardiac patient.For the past two days she is taking Surfaz-SN ointment (Clotrimazole, Beclomethasone Dipropionate, and Neomycin sulfate cream), Zenflox- OZ (Ofloxacin and Ornidazole), and Allegra 120 mg. Please help. ### Response: Hello. Your mother has herpes zoster. It is caused by varicella zoster virus which causes chickenpox earlier in life and gets reactivated later in life to cause herpes zoster. She has to take tablet Valacyclovir 1 gm thrice a day for seven days. For the pain, tablet Diclofenac 50 mg at night ( if severe, twice a day). Apply Fusidic acid cream twice a day over it to avoid secondary bacterial infection. Varicella zoster virus. Herpes zoster. Tablet Valacyclovir 1 gm thrice a day for one week, Diclofenac 50 mg at night for one week (twice a day if severe pain) along with tablet Rabeprazole 20 mg in the morning empty stomach. Follow up after one week.

Hello doctor,My mother is 57 years old. She is having skin infection around his face, neck, and ear area and she is a cardiac patient.For the past two days she is taking Surfaz-SN ointment (Clotrimazole, Beclomethasone Dipropionate, and Neomycin sulfate cream), Zenflox- OZ (Ofloxacin and Ornidazole), and Allegra 120 mg. Please help.

Hello. Your mother has herpes zoster. It is caused by varicella zoster virus which causes chickenpox earlier in life and gets reactivated later in life to cause herpes zoster. She has to take tablet Valacyclovir 1 gm thrice a day for seven days. For the pain, tablet Diclofenac 50 mg at night ( if severe, twice a day). Apply Fusidic acid cream twice a day over it to avoid secondary bacterial infection. Varicella zoster virus. Herpes zoster. Tablet Valacyclovir 1 gm thrice a day for one week, Diclofenac 50 mg at night for one week (twice a day if severe pain) along with tablet Rabeprazole 20 mg in the morning empty stomach. Follow up after one week.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a generalized anxiety disorder and panic disorder. It is mostly under control, but I get very nervous at the doctor. I have had a BP reading as high as 167/105. My doctor says its just because I was nervous. Is this true? I am not overweight, I exercise regularly, I am not hypertensive, I eat healthily, I am only 18 and neither of my parents has high BP. So, was it that high because of anxiety? Could a heart problem cause it to be that high? ### Response: Hello, Welcome to Chat Doctor forum. You may have high BP just for once. It may be due to anxiety. Persons with anxiety and depression may have high BP. You should do BP monitoring for one week. Check your BP twice a day for one week and note it down. Or at least once a month for four to six months. If you still have persistent high BP then go for hypertension management. And if you have an anxiety disorder, then treat it as early as you can. It will surely help lower your BP. You are too young to have high BP. You must monitor your BP. The long-term high BP can lead to various organ damage. For more information consult a psychiatrist online

Hello doctor,I have a generalized anxiety disorder and panic disorder. It is mostly under control, but I get very nervous at the doctor. I have had a BP reading as high as 167/105. My doctor says its just because I was nervous. Is this true? I am not overweight, I exercise regularly, I am not hypertensive, I eat healthily, I am only 18 and neither of my parents has high BP. So, was it that high because of anxiety? Could a heart problem cause it to be that high?

Hello, Welcome to Chat Doctor forum. You may have high BP just for once. It may be due to anxiety. Persons with anxiety and depression may have high BP. You should do BP monitoring for one week. Check your BP twice a day for one week and note it down. Or at least once a month for four to six months. If you still have persistent high BP then go for hypertension management. And if you have an anxiety disorder, then treat it as early as you can. It will surely help lower your BP. You are too young to have high BP. You must monitor your BP. The long-term high BP can lead to various organ damage. For more information consult a psychiatrist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am eager to get my reports examined and get your opinion. Reports attached for your reference. I would be more glad to seek your advice on my LFT/KFT and diabetes reports. What is required to bring all parameters to normal? I work for an IT company and mostly sedentary lifestyle. Hardly I walk for 3 to 4 km in the morning. No smoking, moderate alcohol, vegetarian. I feel tired most of the time, disturbed sleep, unknown reasons for weight increase from 82 kg to 87 kg in the last couple of months. Currently, on Ecosprin 150 mg and Fibbitor 20 (daily once in the morning) for eight years due to MI and was administered check angio. Please advice. ### Response: Hi, Welcome to Chat Doctor forum. You have diabetes mellitus (type 2). This occurs due to deficiency of insulin which is secreted by the pancreas. You will require reduction of your weight, regular walk at a brisk pace for about 45 minutes to one hour daily for most days of the week. You should be on antidiabetic ChatDoctor. You already have had an MI as per your history so you have to be extra careful with your weight and diabetes. You can continue the

Hello doctor,I am eager to get my reports examined and get your opinion. Reports attached for your reference. I would be more glad to seek your advice on my LFT/KFT and diabetes reports. What is required to bring all parameters to normal? I work for an IT company and mostly sedentary lifestyle. Hardly I walk for 3 to 4 km in the morning. No smoking, moderate alcohol, vegetarian. I feel tired most of the time, disturbed sleep, unknown reasons for weight increase from 82 kg to 87 kg in the last couple of months. Currently, on Ecosprin 150 mg and Fibbitor 20 (daily once in the morning) for eight years due to MI and was administered check angio. Please advice.

Hi, Welcome to Chat Doctor forum. You have diabetes mellitus (type 2). This occurs due to deficiency of insulin which is secreted by the pancreas. You will require reduction of your weight, regular walk at a brisk pace for about 45 minutes to one hour daily for most days of the week. You should be on antidiabetic ChatDoctor. You already have had an MI as per your history so you have to be extra careful with your weight and diabetes. You can continue the

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 41-year-old male. I have been elected for an EKG because I am a pilot and need a medical certificate. I have hypertension that is controlled easily with 10 mg Propranolol a day and 10 mg Lisinopril a day. My BP is 117/70 with 66 BPM. There are no symptoms of chest pain or shortness of breath ever. Yesterday during a routine visit I asked physicians assistant for a 12 lead EKG as I have heard it is a good thing to do. Never had any symptoms, slightly overweight, BP great with 10 mg of Propanolol and 10 mg of Lisinopril. I had an abnormal EKG and asked if I have ever experienced the symptoms of a heart attack? I have a copy of my EKG which is machine printed that reads \"abnormal old anterior infarct.\" I have an appointment with a cardiologist but I am going crazy until next week. Should I be worried? ### Response: Hello. The interpretation you saw was a machine interpretation and they sometimes ChatDoctor. Your ECG (electrocardiogram) is absolutely fine. However, get an ECG for a final confirmation. For more information consult a cardiologist online

Hello doctor,I am a 41-year-old male. I have been elected for an EKG because I am a pilot and need a medical certificate. I have hypertension that is controlled easily with 10 mg Propranolol a day and 10 mg Lisinopril a day. My BP is 117/70 with 66 BPM. There are no symptoms of chest pain or shortness of breath ever. Yesterday during a routine visit I asked physicians assistant for a 12 lead EKG as I have heard it is a good thing to do. Never had any symptoms, slightly overweight, BP great with 10 mg of Propanolol and 10 mg of Lisinopril. I had an abnormal EKG and asked if I have ever experienced the symptoms of a heart attack? I have a copy of my EKG which is machine printed that reads \"abnormal old anterior infarct.\" I have an appointment with a cardiologist but I am going crazy until next week. Should I be worried?

Hello. The interpretation you saw was a machine interpretation and they sometimes ChatDoctor. Your ECG (electrocardiogram) is absolutely fine. However, get an ECG for a final confirmation. For more information consult a cardiologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I want to ask about halitosis. I already went to the dentist and the dentist said that the problem is not in the mouth and it could be in my stomach so here I am. I hope you can help me because I am at my wit\\s end right now. How do I know if it is in the stomach? What should I do? I do not think it is acid reflux because I already take PPIs for more than one month and it seems to be still there. Please help me. ### Response: Hi, Welcome to Chat Doctor forum. Halitosis or bad breath usually originates from oral or nasal passages. The cause of it is bacterial decay of residual food and debris. Most common causes of halitosis are periodontal diseases, dental caries, oral cavity infection, and coated or uncleaned tongue or decreased salivation. Other causes which are thought of after ruling out the above are a tonsillar abscess, any esophageal pathology which allows collection of residual food in esophageal like a diverticulum or motility disorder like achalasia. Lung pathology like lung abscess can also be the cause of halitosis. Gastritis due to H.pylori can also cause halitosis. Also, bezoars in the stomach can also be a cause.

Hello doctor,I want to ask about halitosis. I already went to the dentist and the dentist said that the problem is not in the mouth and it could be in my stomach so here I am. I hope you can help me because I am at my wit\\s end right now. How do I know if it is in the stomach? What should I do? I do not think it is acid reflux because I already take PPIs for more than one month and it seems to be still there. Please help me.

Hi, Welcome to Chat Doctor forum. Halitosis or bad breath usually originates from oral or nasal passages. The cause of it is bacterial decay of residual food and debris. Most common causes of halitosis are periodontal diseases, dental caries, oral cavity infection, and coated or uncleaned tongue or decreased salivation. Other causes which are thought of after ruling out the above are a tonsillar abscess, any esophageal pathology which allows collection of residual food in esophageal like a diverticulum or motility disorder like achalasia. Lung pathology like lung abscess can also be the cause of halitosis. Gastritis due to H.pylori can also cause halitosis. Also, bezoars in the stomach can also be a cause.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I found out that I was four weeks pregnant last Tuesday. I took Misoprostol sublingually three times on three hours interval. Later that evening, I had serious cramps and diarrhea. I bled a little and passed out blood clots twice. Then the next day, I noticed I was passing out blood tissues. I felt the drug did not work. Two days after, I took another 4-pill of Misoprostol. I had fever for some few hours plus diarrhea and cramps. I bled a little few hours later. Was the abortion successful or not? ### Response: Hello, Welcome to Chat Doctor forum. Medical abortion is available once a pregnancy is detected via ultrasound (usually around five weeks) up to nine weeks (63 days) gestation. The abortion is achieved using a combination of two medications which work together to terminate a pregnancy. If you feel it is incomplete abortion, I suggest you meet your doctor and get a scan done to confirm that the abortion is complete. If it is not complete, the doctor may advise you what to do next. If it is crossed nine weeks, he may plan a surgical method. Please consult your gynecologist at the earliest. He/she will examine and treat you accordingly. For more information consult an internal medicine physician online

Hi doctor,I found out that I was four weeks pregnant last Tuesday. I took Misoprostol sublingually three times on three hours interval. Later that evening, I had serious cramps and diarrhea. I bled a little and passed out blood clots twice. Then the next day, I noticed I was passing out blood tissues. I felt the drug did not work. Two days after, I took another 4-pill of Misoprostol. I had fever for some few hours plus diarrhea and cramps. I bled a little few hours later. Was the abortion successful or not?

Hello, Welcome to Chat Doctor forum. Medical abortion is available once a pregnancy is detected via ultrasound (usually around five weeks) up to nine weeks (63 days) gestation. The abortion is achieved using a combination of two medications which work together to terminate a pregnancy. If you feel it is incomplete abortion, I suggest you meet your doctor and get a scan done to confirm that the abortion is complete. If it is not complete, the doctor may advise you what to do next. If it is crossed nine weeks, he may plan a surgical method. Please consult your gynecologist at the earliest. He/she will examine and treat you accordingly. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 23-year-old girl and my physician has prescribed me Inderal and Cheer Up at night for a month. Will these medicines lead to a gain in my weight because I have my wedding after two months and I do not want to put any extra pound. ### Response: Hi. While Cefiget (Cefixime) is fine to give in a urinary tract infection. If you are having UTI for more than two months, rather than taking an empirical (experimental) antibiotics, you should go for a urine culture and sensitivity testing. Hope you are not suffering from any psychiatric illness. Otherwise, I do not see any indication of prescribing Cheerup (Escitalopram), Lacosbar (Lacosamide) and Inderal (Propranolol). Those medications are given to patients suffering from neuro-psychiatrist manifestation (except for Propranolol). Both Escitalopram and Lacosamide are associated with an increase in suicidal tendencies, while Escitalopram also affects sexual function and can cause loss of libido, and can cause anorgasmia in females. However, no effect on body shape or weight gain has been observed with Lacosamide and Propranolol, but Escitalopram can cause weight gain in about 1 % individuals.

Hello doctor,I am a 23-year-old girl and my physician has prescribed me Inderal and Cheer Up at night for a month. Will these medicines lead to a gain in my weight because I have my wedding after two months and I do not want to put any extra pound.

Hi. While Cefiget (Cefixime) is fine to give in a urinary tract infection. If you are having UTI for more than two months, rather than taking an empirical (experimental) antibiotics, you should go for a urine culture and sensitivity testing. Hope you are not suffering from any psychiatric illness. Otherwise, I do not see any indication of prescribing Cheerup (Escitalopram), Lacosbar (Lacosamide) and Inderal (Propranolol). Those medications are given to patients suffering from neuro-psychiatrist manifestation (except for Propranolol). Both Escitalopram and Lacosamide are associated with an increase in suicidal tendencies, while Escitalopram also affects sexual function and can cause loss of libido, and can cause anorgasmia in females. However, no effect on body shape or weight gain has been observed with Lacosamide and Propranolol, but Escitalopram can cause weight gain in about 1 % individuals.

### Instruction: Answer this question truthfully ###Input: Hello doctor, Yesterday I ate some pizza and drank tea at around 9 pm at a party. I had a feel like there was something stuck at my upper stomach and had a little pain. I was ignoring it, but then I got worried it might be something bad. So I forced myself to vomit, and I kept vomiting for half an hour. I am not sure, but maybe there was a bit of blood. I felt a strong burn after that, and it got worse. I felt a sharp pain on the right chest every time I swallow. I am worried. ### Response: Hello, Welcome to Chat Doctor forum. 1) Your symptom is suggestive of a small linear esophageal tear due to forceful vomiting. 2) In this condition, linear tear develops on the inner wall of the lowermost part of the esophagus. This is responsible for a small amount of blood in vomit and pain in the chest. 3) You should take semi-solid foods for a few days to promote healing of this tear. Otherwise, no specific treatment is required. 4) If pain is severe, then you can try antacid syrup to smoothen the lower part of the esophagus, which gives relief from pain and also promotes healing. 5) Also, remember, never induce forceful vomiting.

Hello doctor, Yesterday I ate some pizza and drank tea at around 9 pm at a party. I had a feel like there was something stuck at my upper stomach and had a little pain. I was ignoring it, but then I got worried it might be something bad. So I forced myself to vomit, and I kept vomiting for half an hour. I am not sure, but maybe there was a bit of blood. I felt a strong burn after that, and it got worse. I felt a sharp pain on the right chest every time I swallow. I am worried.

Hello, Welcome to Chat Doctor forum. 1) Your symptom is suggestive of a small linear esophageal tear due to forceful vomiting. 2) In this condition, linear tear develops on the inner wall of the lowermost part of the esophagus. This is responsible for a small amount of blood in vomit and pain in the chest. 3) You should take semi-solid foods for a few days to promote healing of this tear. Otherwise, no specific treatment is required. 4) If pain is severe, then you can try antacid syrup to smoothen the lower part of the esophagus, which gives relief from pain and also promotes healing. 5) Also, remember, never induce forceful vomiting.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am taking Larin Fe as a birth control pill. It is a combined monophasic pill with three weeks of active pills and one week of inactive pills. I currently started pill packs a week back but wanted to change it to a weekend to avoid weekend withdrawal bleeding. How can I do so without losing the effectiveness of the pill? My idea was to wait until my placebo week which starts on a weekday and then to take the placebos only up until weekend and start a new pack then. Would this work without changing the effectiveness of my pill? ### Response: Hi. You can stop the active pill on Wednesday instead. Take placebo pill on Thursday, Friday, Saturday and start a new pack from Sunday. The plan of preponding periods is bewildering to the body. It might take you a few (2 to 3) cycles to tune your periods in a new cycle. Repeat the same thing in the next cycle by stopping the active pills one day prior, that is, 20th day, while starting the new pack on Sundays every time. So in four cycles, your dates will be as per your schedule with stable efficacy of the pills too. I hope, I could help you with your query. Please revert back, if want a shorter alternative.

Hi doctor,I am taking Larin Fe as a birth control pill. It is a combined monophasic pill with three weeks of active pills and one week of inactive pills. I currently started pill packs a week back but wanted to change it to a weekend to avoid weekend withdrawal bleeding. How can I do so without losing the effectiveness of the pill? My idea was to wait until my placebo week which starts on a weekday and then to take the placebos only up until weekend and start a new pack then. Would this work without changing the effectiveness of my pill?

Hi. You can stop the active pill on Wednesday instead. Take placebo pill on Thursday, Friday, Saturday and start a new pack from Sunday. The plan of preponding periods is bewildering to the body. It might take you a few (2 to 3) cycles to tune your periods in a new cycle. Repeat the same thing in the next cycle by stopping the active pills one day prior, that is, 20th day, while starting the new pack on Sundays every time. So in four cycles, your dates will be as per your schedule with stable efficacy of the pills too. I hope, I could help you with your query. Please revert back, if want a shorter alternative.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My son is 2 months old and he is suffering with dry cough over the last 3 days. We consulted local doctor and he advised TA-65 capsule which can be taken by mixing one capsule in 10 cc of distilled water. He advised to use 2 mL of this mixture for 3 days. My question is how exactly does TA-65 work for cough? ### Response: Hello, Welcome to Chat Doctor forum. Your kid is probably suffering from some throat infection or lung infection (respiratory infection). TA - 65 is a telomerase activator, it comes in capsule form. It is used to boost immune system, skin and given for sexual improvement. It has no role in cough and it is not given in chil ChatDoctor. I advice you to not to give this medicine to a child. You should probably consult a different pediatrician there as rest of medication like antibiotics or medicated nebulization or any investigation needed. It cannot be advised without examining the child. Viral infection of respiratory tract. 1. CBP (complete blood picture).2. CRP (C-reactive protein).3. Chest x-ray if required. 1. Upper respiratory infection.2. Bronchiolitis. 1) Kufril LS

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

Hello, Welcome to Chat Doctor forum. Your kid is probably suffering from some throat infection or lung infection (respiratory infection). TA - 65 is a telomerase activator, it comes in capsule form. It is used to boost immune system, skin and given for sexual improvement. It has no role in cough and it is not given in chil ChatDoctor. I advice you to not to give this medicine to a child. You should probably consult a different pediatrician there as rest of medication like antibiotics or medicated nebulization or any investigation needed. It cannot be advised without examining the child. Viral infection of respiratory tract. 1. CBP (complete blood picture).2. CRP (C-reactive protein).3. Chest x-ray if required. 1. Upper respiratory infection.2. Bronchiolitis. 1) Kufril LS

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 30 year old female. For the past few weeks, I have had an unrelenting back pain between my shoulder blades. I also have a sharp, tearing chest pain above my left breast area or along my sternum on my right side. The sharp pain will last a few minutes, then stop. At times, it radiates to my shoulder. When it happens, my pulse and blood pressure increase for a few minutes and I feel short of breath. What could this be? I had PE ten years ago but the pain was not quite the same. ### Response: Hello, Welcome to Chat Doctor forum. After reviewing your health query, I want to add that there may be anything from a list of possibilities. So, as the next best step, you need to consult your PCP (primary care physician) and get referrals to consultations for a pulmonologist, a cardiologist and/or a gastroenterologist. Your PCP is capable of ruling out at the preliminary level on his own. He would refer you either to all of the aforementioned specialists or only one of them as he feels comfortable with. Once ruled out, we can better assist you and this hopefully will all be managed accordingly. Hope this helps. Please feel free to ask me more if you need further assistance.

Hello doctor,I am a 30 year old female. For the past few weeks, I have had an unrelenting back pain between my shoulder blades. I also have a sharp, tearing chest pain above my left breast area or along my sternum on my right side. The sharp pain will last a few minutes, then stop. At times, it radiates to my shoulder. When it happens, my pulse and blood pressure increase for a few minutes and I feel short of breath. What could this be? I had PE ten years ago but the pain was not quite the same.

Hello, Welcome to Chat Doctor forum. After reviewing your health query, I want to add that there may be anything from a list of possibilities. So, as the next best step, you need to consult your PCP (primary care physician) and get referrals to consultations for a pulmonologist, a cardiologist and/or a gastroenterologist. Your PCP is capable of ruling out at the preliminary level on his own. He would refer you either to all of the aforementioned specialists or only one of them as he feels comfortable with. Once ruled out, we can better assist you and this hopefully will all be managed accordingly. Hope this helps. Please feel free to ask me more if you need further assistance.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Is the window period for HIV more extended when the symptoms of acute infection take a long time to show? I was tested for HIV by rapid test at 10 and 15 weeks after exposure (both negative), but have symptoms by week 9, and worse symptoms by the 13th week. Can I be calm with these results? ### Response: Hello. The symptoms of acute HIV infection appear relatively for a short duration and resolve within a few days. These can appear anywhere around two to six weeks. Your signs at nine weeks could be a coincidental finding, and there could be numerous causes for the symptoms. The tests performed these days for HIV are highly sensitive and specific and gives accurate results. Majority of the people who are infected with HIV develop antibodies by two to eight weeks. The literature says approximately\\x80\\x8b 5 % develop by three months. With your negative HIV rapid test at 10 and 15 weeks after exposure, you can surely relax and calm. However, there are recommendations, and I also suggest to my patients to repeat the HIV test at six months of high-risk exposure. I hope your query is answered, but if you still have any other question, please revert. Take care.

Hello doctor,Is the window period for HIV more extended when the symptoms of acute infection take a long time to show? I was tested for HIV by rapid test at 10 and 15 weeks after exposure (both negative), but have symptoms by week 9, and worse symptoms by the 13th week. Can I be calm with these results?

Hello. The symptoms of acute HIV infection appear relatively for a short duration and resolve within a few days. These can appear anywhere around two to six weeks. Your signs at nine weeks could be a coincidental finding, and there could be numerous causes for the symptoms. The tests performed these days for HIV are highly sensitive and specific and gives accurate results. Majority of the people who are infected with HIV develop antibodies by two to eight weeks. The literature says approximately\\x80\\x8b 5 % develop by three months. With your negative HIV rapid test at 10 and 15 weeks after exposure, you can surely relax and calm. However, there are recommendations, and I also suggest to my patients to repeat the HIV test at six months of high-risk exposure. I hope your query is answered, but if you still have any other question, please revert. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,Last Wednesday night, I got palpitations. I took Rivotril 5 mg and slept. Next day I rushed to my physician. He prescribed me Ciplar 10 mg tablet and advised me to take one tablet daily after breakfast. Palpitations did not happen from past three months. My doctor advised me to continue the tablet and said nothing to worry. But I am worried as what could be the reason for my palpitations. I am disturbed by thinking that will I get heart attack? I am sleepless now. Please help. ### Response: Hi. Palpitations in the absence of loss of consciousness/blackout/sudden fall are not considered as malignant. Occasional non-recurrent palpitations may not be significant at all. Hence you need to see if you have any of these alarming symptoms or these palpitations are recurrent or not. On the background of structurally normal heart - your normal ECG and ECHO study (attachment removed to protect patient identity) with no other cardiac symptoms, absence of alarming symptoms and absence of recurrence, speak of a non-cardiac cause. These may be related to stress, thyroid disorder and certain medications. I would suggest you to upload your recent ECG if possible. Revert back with your report and answers to a cardiologist online

Hi doctor,Last Wednesday night, I got palpitations. I took Rivotril 5 mg and slept. Next day I rushed to my physician. He prescribed me Ciplar 10 mg tablet and advised me to take one tablet daily after breakfast. Palpitations did not happen from past three months. My doctor advised me to continue the tablet and said nothing to worry. But I am worried as what could be the reason for my palpitations. I am disturbed by thinking that will I get heart attack? I am sleepless now. Please help.

Hi. Palpitations in the absence of loss of consciousness/blackout/sudden fall are not considered as malignant. Occasional non-recurrent palpitations may not be significant at all. Hence you need to see if you have any of these alarming symptoms or these palpitations are recurrent or not. On the background of structurally normal heart - your normal ECG and ECHO study (attachment removed to protect patient identity) with no other cardiac symptoms, absence of alarming symptoms and absence of recurrence, speak of a non-cardiac cause. These may be related to stress, thyroid disorder and certain medications. I would suggest you to upload your recent ECG if possible. Revert back with your report and answers to a cardiologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My father is 87 years old and has been diagnosed with a benign meningioma of his brain. He had an MRI done recently and it showed that the tumor has grown. He is supposed to undergo radiation therapy soon. Do you know what would cause the tumor to grow? What is the prognosis? Is radiation therapy safe and effective in stopping the tumor from growing? What is the percentage? Would he need a certain type of radiation (like proton therapy) so that it would not affect the surrounding brain tissues and cells? ### Response: Hello. I read carefully your question and would explain that we cannot determine what made the tumor grow, but you should know that the growth speed depends on the tumor type. There are different types of benign meningioma, which grow at different speeds. A biopsy would help determine the type of meningioma and the better treatment options. Regarding radiation therapy, I would like to know if he is going to do gamma knife or just fractional radiotherapy. Gamma knife is radiation, similar to surgery. While fractional radiotherapy is usually used after surgery and helps treat tumor residual or recurrence. Open surgery may be at a higher risk compared to gamma knife, considering your father\\s age. Hope to have clarified some of your uncertainties. For more information consult a neurologist online

Hello doctor,My father is 87 years old and has been diagnosed with a benign meningioma of his brain. He had an MRI done recently and it showed that the tumor has grown. He is supposed to undergo radiation therapy soon. Do you know what would cause the tumor to grow? What is the prognosis? Is radiation therapy safe and effective in stopping the tumor from growing? What is the percentage? Would he need a certain type of radiation (like proton therapy) so that it would not affect the surrounding brain tissues and cells?

Hello. I read carefully your question and would explain that we cannot determine what made the tumor grow, but you should know that the growth speed depends on the tumor type. There are different types of benign meningioma, which grow at different speeds. A biopsy would help determine the type of meningioma and the better treatment options. Regarding radiation therapy, I would like to know if he is going to do gamma knife or just fractional radiotherapy. Gamma knife is radiation, similar to surgery. While fractional radiotherapy is usually used after surgery and helps treat tumor residual or recurrence. Open surgery may be at a higher risk compared to gamma knife, considering your father\\s age. Hope to have clarified some of your uncertainties. For more information consult a neurologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,My daughter is 1 month and 26 days old. Her birth weight was 3.05 kg. Her current weight is 4.4 kg. She spits the milk after burping also. She has been diagnosed with laryngomalacia. I wanted to know whether it a matter of concern or not. ### Response: Hi. The current weight of the child is absolutely normal according to the birth weight of the child. There is no need to worry about this. Babies often spit very little amount of milk after feeding even after burping, this is a normal thing. If it is problematic, then the weight of the child does not increase. Since the weight of the child is normal according to age, I think this is normal and we should not worry about this. Also working should be done for around 10 minutes for effective results. Laryngomalacia is a condition in which the muscles of the larynx are weak and as a result, there is stridor sound during breathing. This is not a serious issue. Laryngomalacia usually gets corrected around eight months of age. Sometimes calcium levels are low which can result in stridor like sound, so calcium level should be done in the child. If low, then calcium needs to be started.

Hi doctor,My daughter is 1 month and 26 days old. Her birth weight was 3.05 kg. Her current weight is 4.4 kg. She spits the milk after burping also. She has been diagnosed with laryngomalacia. I wanted to know whether it a matter of concern or not.

Hi. The current weight of the child is absolutely normal according to the birth weight of the child. There is no need to worry about this. Babies often spit very little amount of milk after feeding even after burping, this is a normal thing. If it is problematic, then the weight of the child does not increase. Since the weight of the child is normal according to age, I think this is normal and we should not worry about this. Also working should be done for around 10 minutes for effective results. Laryngomalacia is a condition in which the muscles of the larynx are weak and as a result, there is stridor sound during breathing. This is not a serious issue. Laryngomalacia usually gets corrected around eight months of age. Sometimes calcium levels are low which can result in stridor like sound, so calcium level should be done in the child. If low, then calcium needs to be started.

### Instruction: Answer this question truthfully ###Input: Hello doctor,If I have vaginal prolapse, will I be fitted with a pessary the day of discovery or will I be told to return another day? I am not really sure if you have a uterine prolapse but I seem to have several similar symptoms which includes, the feeling that you are sitting on a ball, increased discharge, constipation (what I believe to be the leading cause, since I have had chronic constipation as a child), a pulling or heavy feeling in the pelvis, the sense of something coming out of my vagina (when I checked with a mirror it looked like something was right at the entrance of my vagina). I have already made an appointment to consult my gynecologist. However, I just wanted to know how long it would take to treat this problem. ### Response: Hello, Welcome to Chat Doctor forum. Yes, they may treat prolapse with pessary on the same day. As this is not a lengthy procedure, pessary insertion takes a few minutes to be done. But delays can be expected just in case a right size and shaped (according to your vagina size) pessary is not available right at the time of your presentation to the clinic. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.

Hello doctor,If I have vaginal prolapse, will I be fitted with a pessary the day of discovery or will I be told to return another day? I am not really sure if you have a uterine prolapse but I seem to have several similar symptoms which includes, the feeling that you are sitting on a ball, increased discharge, constipation (what I believe to be the leading cause, since I have had chronic constipation as a child), a pulling or heavy feeling in the pelvis, the sense of something coming out of my vagina (when I checked with a mirror it looked like something was right at the entrance of my vagina). I have already made an appointment to consult my gynecologist. However, I just wanted to know how long it would take to treat this problem.

Hello, Welcome to Chat Doctor forum. Yes, they may treat prolapse with pessary on the same day. As this is not a lengthy procedure, pessary insertion takes a few minutes to be done. But delays can be expected just in case a right size and shaped (according to your vagina size) pessary is not available right at the time of your presentation to the clinic. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My mom aged 45 years, is having a fever for almost two months. The temperature used to vary from 99-100 degrees Celcius in the night times and gradually it comes down. She was weighing 105 kg and now she is 88 kg. Now, she is having bone pain and light fever in the night when there is a pain in the bone. She has been advised with calcium and iron tablets. She is also getting her regular periods. Menopause has not reached yet. Kindly advise. ### Response: Hello, Welcome to Chat Doctor forum. The fact that she has been having fever off and on for the last two months and is a low-grade fever especially in evenings with accompanied weight loss and bone pains indicates a possibility of tuberculosis infection. It is better to get her Mantoux test and ADA (adenosine deaminase) levels done to rule out the same. As she has been in a colder country the possibility is unlikely, if she has been staying with you for more than six months or if she has recently visited you two months back then there is all possibility of her having contracted the infection from India and she carried it with her. Keep her well hy ChatDoctor. Please follow up with the reports.

Hi doctor,My mom aged 45 years, is having a fever for almost two months. The temperature used to vary from 99-100 degrees Celcius in the night times and gradually it comes down. She was weighing 105 kg and now she is 88 kg. Now, she is having bone pain and light fever in the night when there is a pain in the bone. She has been advised with calcium and iron tablets. She is also getting her regular periods. Menopause has not reached yet. Kindly advise.

Hello, Welcome to Chat Doctor forum. The fact that she has been having fever off and on for the last two months and is a low-grade fever especially in evenings with accompanied weight loss and bone pains indicates a possibility of tuberculosis infection. It is better to get her Mantoux test and ADA (adenosine deaminase) levels done to rule out the same. As she has been in a colder country the possibility is unlikely, if she has been staying with you for more than six months or if she has recently visited you two months back then there is all possibility of her having contracted the infection from India and she carried it with her. Keep her well hy ChatDoctor. Please follow up with the reports.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am having some kind of infection (itchy red skin) on my penis hood. I visited one urologist for the same problem. Liver function tests, sugar and thyroid tests werte done. All were normal. He advised me to use Miconazole nitrate gel. I used it and got instant relief. I used it for 20 days, but there is a problem. Whenever I stop using Miconazole nitrate gel, my problem returns. What could be the reason?Earlier I used Sternon-G gel, but there was no relief. ### Response: Hi, Welcome to Chat Doctor forum. You must be suffering from balanitis (fungal infection) that is why Miconazole 2 % antifungal cream worked. Do not apply Sternon G (Betamethasone and Gentamicin) as it contains steroid. Please send the current condition clinical photographs so that the oral medications can be advised. Are you diabetic? Does your partner suffer from itching problem in the groin area? You can apply Miconazole 2% cream or Sertaconazole 2% cream or Clotrimazole 1% twice daily. Consult your specialist doctor, discuss with him or her and take medications with their consent. For more information consult a dermatologist online

Hello doctor,I am having some kind of infection (itchy red skin) on my penis hood. I visited one urologist for the same problem. Liver function tests, sugar and thyroid tests werte done. All were normal. He advised me to use Miconazole nitrate gel. I used it and got instant relief. I used it for 20 days, but there is a problem. Whenever I stop using Miconazole nitrate gel, my problem returns. What could be the reason?Earlier I used Sternon-G gel, but there was no relief.

Hi, Welcome to Chat Doctor forum. You must be suffering from balanitis (fungal infection) that is why Miconazole 2 % antifungal cream worked. Do not apply Sternon G (Betamethasone and Gentamicin) as it contains steroid. Please send the current condition clinical photographs so that the oral medications can be advised. Are you diabetic? Does your partner suffer from itching problem in the groin area? You can apply Miconazole 2% cream or Sertaconazole 2% cream or Clotrimazole 1% twice daily. Consult your specialist doctor, discuss with him or her and take medications with their consent. For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had protected sex with my partner six days before. I consumed one tablet of Ovral l within 24 hours of the intercourse as a safety measure and because that was the only tablet available immediately. We have a doubt that the condom may have broken and do not want to risk being pregnant. Is that one tablet of Ovral l enough to avoid it? (Similar to I-pill or unwanted 72). Also, because I got scared I consumed two tablets of Ovral l today morning. I need help with the right information and further guidance to avoid pregnancy and any side effects caused by these pills. ### Response: Hi. The dose of Levonorgestrel is quite low in Ovral L compared to Unwanted 72. So the effectiveness for prevention of pregnancy, the two tablets of Ovral L may be sufficient. Now onward, please use regular protection and do not depend much on Unwanted 72. If the 72 hours have not passed, then you can take Unwanted 72 else or equal amount of Levonorgestrel, if it is already more than 72 hours then wait and watch for your scheduled time of the menses and if you miss your period then consult a gynecologist immediately. Take care.

Hello doctor,I had protected sex with my partner six days before. I consumed one tablet of Ovral l within 24 hours of the intercourse as a safety measure and because that was the only tablet available immediately. We have a doubt that the condom may have broken and do not want to risk being pregnant. Is that one tablet of Ovral l enough to avoid it? (Similar to I-pill or unwanted 72). Also, because I got scared I consumed two tablets of Ovral l today morning. I need help with the right information and further guidance to avoid pregnancy and any side effects caused by these pills.

Hi. The dose of Levonorgestrel is quite low in Ovral L compared to Unwanted 72. So the effectiveness for prevention of pregnancy, the two tablets of Ovral L may be sufficient. Now onward, please use regular protection and do not depend much on Unwanted 72. If the 72 hours have not passed, then you can take Unwanted 72 else or equal amount of Levonorgestrel, if it is already more than 72 hours then wait and watch for your scheduled time of the menses and if you miss your period then consult a gynecologist immediately. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,The last few days my wife says that she feels sick. After that, I took my wife to the doctor. She suggested a few tests named HB electrophoresis, ferritin, TSH, PPBS, USG lower abdomen, CBC, PBF and urine test.Result ### Response: Hi. The serum ferritin level is not high in every case of hemolytic anemia. Your electrophoresis report is suggestive of HbE (attachment removed to protect patient identity). It is a case of a mild form of hemolytic anemia. In that case, the ferritin level might not be raised. Along with low ferritin, your red blood cells count is also low. Usually, in hemoglobinopathy, red blood cells count is high. So your wife\\s complete diagnosis is HbE trait with secondary iron deficiency anemia. So you can give your wife Iron tablets to raise the hemoglobin level and ferritin level. HbE is not a major hemolytic disease, so you need not worry about your child or future child although your child acquires HbE trait. HbE trait patient lives a normal life. I strongly recommend you to get investigated for hemoglobinopathy by electrophoresis because if you have trait then your child can acquire HbE disease. So revert back with your electrophoresis report as well. Take care.

Hello doctor,The last few days my wife says that she feels sick. After that, I took my wife to the doctor. She suggested a few tests named HB electrophoresis, ferritin, TSH, PPBS, USG lower abdomen, CBC, PBF and urine test.Result

Hi. The serum ferritin level is not high in every case of hemolytic anemia. Your electrophoresis report is suggestive of HbE (attachment removed to protect patient identity). It is a case of a mild form of hemolytic anemia. In that case, the ferritin level might not be raised. Along with low ferritin, your red blood cells count is also low. Usually, in hemoglobinopathy, red blood cells count is high. So your wife\\s complete diagnosis is HbE trait with secondary iron deficiency anemia. So you can give your wife Iron tablets to raise the hemoglobin level and ferritin level. HbE is not a major hemolytic disease, so you need not worry about your child or future child although your child acquires HbE trait. HbE trait patient lives a normal life. I strongly recommend you to get investigated for hemoglobinopathy by electrophoresis because if you have trait then your child can acquire HbE disease. So revert back with your electrophoresis report as well. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,What are the causes of sleep disturbances? What are some ways to tell if your sleep troubles are sleep anxiety and not a hormonal problem? What is the difference between sleep disturbances that are caused by hormones vs stress? How might someone address each of these different causes of sleep disturbances? ### Response: Hello. First, we should know the patient\\s gender. Then, if female, ask if the sleep problems are all the time or more evident prior to periods due date? Then, I would ask both female and male patients to run a thyroid function test. While female patients to also check sexual hormone levels in the blood. Stress makes it difficult to fall asleep and keep asleep and altering sleep quality. Hormonal changes will cause an increase in body heat (which becomes not stable) and a ChatDoctor. Estrogen will cause an increase in body fat in women more around the tummy. This will cause snoring and sleep apnea. We should ask patients more details about their sleep like, is it difficult to fall asleep? Why? Do you wake up during the night? How many times if yes? Why? In this way, we will find more details about the sleeping problems my patients are having. Sometimes, they can sleep but they are so anxious and feel not enough to sleep.

Hello doctor,What are the causes of sleep disturbances? What are some ways to tell if your sleep troubles are sleep anxiety and not a hormonal problem? What is the difference between sleep disturbances that are caused by hormones vs stress? How might someone address each of these different causes of sleep disturbances?

Hello. First, we should know the patient\\s gender. Then, if female, ask if the sleep problems are all the time or more evident prior to periods due date? Then, I would ask both female and male patients to run a thyroid function test. While female patients to also check sexual hormone levels in the blood. Stress makes it difficult to fall asleep and keep asleep and altering sleep quality. Hormonal changes will cause an increase in body heat (which becomes not stable) and a ChatDoctor. Estrogen will cause an increase in body fat in women more around the tummy. This will cause snoring and sleep apnea. We should ask patients more details about their sleep like, is it difficult to fall asleep? Why? Do you wake up during the night? How many times if yes? Why? In this way, we will find more details about the sleeping problems my patients are having. Sometimes, they can sleep but they are so anxious and feel not enough to sleep.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am suffering from AVS for the last two months and have been suggested to undergo core decompression. But according to some physiotherapist, by seeing my MRI, it can be treated using some exercises as my femoral shape has not changed or collapsed. I cannot understand what should I do. I am 35 years old. ### Response: Hi. Avascular necrosis is an irreversible disease. Once the process has started, it cannot be reverted. The rate of progress depends on person to person. The treatment depends on symptoms and quality of life. Initially, the patient experiences only pain and range of motion is not limited. The pain is because of raised pressure inside bone and since the shape of the head is maintained, so the range of motion is good. So in this case, core decompression helps in reducing the pressure and in turn pain. But, this surgery does not stop or slow the progression of the disease. In the later stages when the shape of the head is deformed and there is pain and hence the quality of life is severely affecting, then the only option left will be the hip replacement. I would be able to help you more in the decision if you could tell me what are your symptoms and what all you feel you are not able to do in your daily life.

Hi doctor,I am suffering from AVS for the last two months and have been suggested to undergo core decompression. But according to some physiotherapist, by seeing my MRI, it can be treated using some exercises as my femoral shape has not changed or collapsed. I cannot understand what should I do. I am 35 years old.

Hi. Avascular necrosis is an irreversible disease. Once the process has started, it cannot be reverted. The rate of progress depends on person to person. The treatment depends on symptoms and quality of life. Initially, the patient experiences only pain and range of motion is not limited. The pain is because of raised pressure inside bone and since the shape of the head is maintained, so the range of motion is good. So in this case, core decompression helps in reducing the pressure and in turn pain. But, this surgery does not stop or slow the progression of the disease. In the later stages when the shape of the head is deformed and there is pain and hence the quality of life is severely affecting, then the only option left will be the hip replacement. I would be able to help you more in the decision if you could tell me what are your symptoms and what all you feel you are not able to do in your daily life.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My 15 months old son fell from a queen size bed and landed on his face. His lips swole up. He cried and seemed hard to calm down. He is now sleeping. This all occurred about one hour ago. He is responding to touch. He seeme very sleepy. But I do not know if it is because of falling or because it is late. I am afraid. ### Response: Hi, Welcome to Chat Doctor forum. I can understand your situation. It is good that at present she is stable. Let me give you some information about it. He may be tired so he slept. It is possible that lip swelling can cause pain so need to give pain killer like Paracetamol. Sometimes in small baby like him it is possible that due to some trauma there may be some brain injury or inside bleeding. It is a very rare chance that your son has it but watch for some symptoms like persistent vomiting, seizure (fits), extremely irritability, prolonged sleeping, abnormal behavior or if you feel that he is not looking normal then rush to the nearest medical facility. Sometimes, these kinds of symptoms can take some time to appear. So be vigilant. I am giving this information not to panic you but to be more proactive. Make all child safety measures now onwards.

Hello doctor,My 15 months old son fell from a queen size bed and landed on his face. His lips swole up. He cried and seemed hard to calm down. He is now sleeping. This all occurred about one hour ago. He is responding to touch. He seeme very sleepy. But I do not know if it is because of falling or because it is late. I am afraid.

Hi, Welcome to Chat Doctor forum. I can understand your situation. It is good that at present she is stable. Let me give you some information about it. He may be tired so he slept. It is possible that lip swelling can cause pain so need to give pain killer like Paracetamol. Sometimes in small baby like him it is possible that due to some trauma there may be some brain injury or inside bleeding. It is a very rare chance that your son has it but watch for some symptoms like persistent vomiting, seizure (fits), extremely irritability, prolonged sleeping, abnormal behavior or if you feel that he is not looking normal then rush to the nearest medical facility. Sometimes, these kinds of symptoms can take some time to appear. So be vigilant. I am giving this information not to panic you but to be more proactive. Make all child safety measures now onwards.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have red spots on my chest for the last two weeks. They are not itching, but I am worried about that. Is this some sort of rash or just chest acne? Should I be worried? Please help. ### Response: Hi. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. If you did not have any fever or viral in the recent past, these are quite unlikely to be some associated rash. If these are only on the upper chest and not on other body areas like legs, arms, etc., you need not worry. 1. These could be acne if you have acne on the face, upper arms, shoulders, etc.2. If they occurred immediately after waxing or shaving of chest hair then it can be folliculitis. In that case there should be little pus points or some discomfort or pain.3. These could also be due to seborrheic dermatitis or pityriasis especially if you suffer from troublesome dan ChatDoctor. 4. For acne you will require antibiotics and for seborrheic antifungal combinations. Let me know if there are any associated features, so that appropriate creams can be prescribed to you Revert back with detailed answers to a dermatologist online.-

Hi doctor,I have red spots on my chest for the last two weeks. They are not itching, but I am worried about that. Is this some sort of rash or just chest acne? Should I be worried? Please help.

Hi. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. If you did not have any fever or viral in the recent past, these are quite unlikely to be some associated rash. If these are only on the upper chest and not on other body areas like legs, arms, etc., you need not worry. 1. These could be acne if you have acne on the face, upper arms, shoulders, etc.2. If they occurred immediately after waxing or shaving of chest hair then it can be folliculitis. In that case there should be little pus points or some discomfort or pain.3. These could also be due to seborrheic dermatitis or pityriasis especially if you suffer from troublesome dan ChatDoctor. 4. For acne you will require antibiotics and for seborrheic antifungal combinations. Let me know if there are any associated features, so that appropriate creams can be prescribed to you Revert back with detailed answers to a dermatologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have ringworm for the past seven months. It comes and goes. I have used many creams tablets. No use. But finally, I found a cream named Valerate-C. It is a very effective cream. If I apply it once at night, it solves the itching problem overnight. The infection also reduces for a week. After a week or 10 days, the infection starts again. I tried using it continuously for two weeks. When I stop using infection comes again after two weeks. I am stopping using because of its lacking. I could not find that cream anywhere. I only find that in my village. I cannot stay in my village every time. I bought that cream many times bulky (four creams). After the completion, the infection starts again after two weeks. Please solve my problem. How can I kill ringworm\\s root? I have used Sapat lotion also. It is just burning the skin and the infection. After four days or a week, the infection starts again. Please help me. ### Response: Hi. Please take a picture of the lesion and send to us. The cream you are using is a combination of steroid and antifungal. You may get similar creams everywhere. For more information consult an allergy specialist online Take care.

Hello doctor,I have ringworm for the past seven months. It comes and goes. I have used many creams tablets. No use. But finally, I found a cream named Valerate-C. It is a very effective cream. If I apply it once at night, it solves the itching problem overnight. The infection also reduces for a week. After a week or 10 days, the infection starts again. I tried using it continuously for two weeks. When I stop using infection comes again after two weeks. I am stopping using because of its lacking. I could not find that cream anywhere. I only find that in my village. I cannot stay in my village every time. I bought that cream many times bulky (four creams). After the completion, the infection starts again after two weeks. Please solve my problem. How can I kill ringworm\\s root? I have used Sapat lotion also. It is just burning the skin and the infection. After four days or a week, the infection starts again. Please help me.

Hi. Please take a picture of the lesion and send to us. The cream you are using is a combination of steroid and antifungal. You may get similar creams everywhere. For more information consult an allergy specialist online Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have thyroid problems for the past five to six years. At present, I am taking tablet Thyronorm 25 mcg. For the past one month, I have low energy levels along with stiffness and pain in the muscles, especially in the upper back and neck. So I got my blood tested for vitamin D and thyroid profile. The results are attached. TSH is out of range, and vitamin D seems to be very low. ### Response: Hi. I went through your reports (attachment removed to protect patient identity). I have noticed that your TSH (thyroid stimulating hormone) level is very high. It indicates that your thyroid hormones levels are not in the sufficient range. Hence, we need to increase the dose of Thyronorm. I recommend you to take tablet Thyronorm 50 mcg (Thyroxine) every morning in the empty stomach daily. Also, your vitamin D levels are also low. I recommend you to start taking Vitamin D supplements. Take capsule D-Rise 60K (Vitamin D3) one tablet weekly once for three months. Once your thyroid and vitamin levels get normalized, your low energy levels and muscle stiffness will get relieved. Repeat TSH after two months. For more information consult an endocrinologist online Take care.

Hi doctor,I have thyroid problems for the past five to six years. At present, I am taking tablet Thyronorm 25 mcg. For the past one month, I have low energy levels along with stiffness and pain in the muscles, especially in the upper back and neck. So I got my blood tested for vitamin D and thyroid profile. The results are attached. TSH is out of range, and vitamin D seems to be very low.

Hi. I went through your reports (attachment removed to protect patient identity). I have noticed that your TSH (thyroid stimulating hormone) level is very high. It indicates that your thyroid hormones levels are not in the sufficient range. Hence, we need to increase the dose of Thyronorm. I recommend you to take tablet Thyronorm 50 mcg (Thyroxine) every morning in the empty stomach daily. Also, your vitamin D levels are also low. I recommend you to start taking Vitamin D supplements. Take capsule D-Rise 60K (Vitamin D3) one tablet weekly once for three months. Once your thyroid and vitamin levels get normalized, your low energy levels and muscle stiffness will get relieved. Repeat TSH after two months. For more information consult an endocrinologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,Now I am six weeks pregnant. I had two miscarriages before. I have some spotting and brown discharge with clots seen continuous from the fifth week to now. Two days before I went for scanning and a perfect heartbeat was seen, no subchorionic hemorrhage was there. But still, small spotting and clots were seen. What is the reason for this? And will it affect the fetus? Any birth defects? Or any problems? Please answer. Will it end with miscarriage? I have one other doubt, that whether trisomy or other chromosomal abnormalities of the fetus can be identified? How to identify? And which stage of pregnancy it can identify? ### Response: Hi, Welcome to Chat Doctor forum. Please take Progesterone supplements and adequate rest. Avoid having sex and lifting heavy weights, or bumpy ChatDoctor. If properly treated and taken good supplements, miscarriage will be prevented. Trisomy and chromosomal anomalies can be detected by 12 to 13 weeks and for the rest of the development details can be found on TIFFA scan (targetted imaging for fetal anomalies) around 20 weeks. However, if you have a doubt then get back to me. Take care. For more information consult an obstetrician and gynaecologist online

Hi doctor,Now I am six weeks pregnant. I had two miscarriages before. I have some spotting and brown discharge with clots seen continuous from the fifth week to now. Two days before I went for scanning and a perfect heartbeat was seen, no subchorionic hemorrhage was there. But still, small spotting and clots were seen. What is the reason for this? And will it affect the fetus? Any birth defects? Or any problems? Please answer. Will it end with miscarriage? I have one other doubt, that whether trisomy or other chromosomal abnormalities of the fetus can be identified? How to identify? And which stage of pregnancy it can identify?

Hi, Welcome to Chat Doctor forum. Please take Progesterone supplements and adequate rest. Avoid having sex and lifting heavy weights, or bumpy ChatDoctor. If properly treated and taken good supplements, miscarriage will be prevented. Trisomy and chromosomal anomalies can be detected by 12 to 13 weeks and for the rest of the development details can be found on TIFFA scan (targetted imaging for fetal anomalies) around 20 weeks. However, if you have a doubt then get back to me. Take care. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have a strange feeling in my left testicle. I ordered a vacuum penile pump, and I used it only for two days. After that, I threw it away fearing an injury, as it turned my urine red. After five days, I went to a doctor, because I had a strange feeling in my testes, but I did not have pain. The doctor gave me tablet Diclofenac 100 mg and Cystone tablet. I started taking these tablets, but after two days, I have pain in my left testis and pubic area. I also had pain on the base of my penis and erection problem. So, I went back to the same doctor, who gave me Paracetamol and Nimesulide. I got a little relief, but after a month, I still have little pain. My testes are red, and I have pain in my pubic bone area. My erection is normal now. Is this because of the injury from the penile pump? I am attaching my ultrasound report. What should I do? Please help. ### Response: Hi, Welcome to Chat Doctor forum. Thanks for your query. I have seen the attached ultrasound (attachment removed to protect patient identity). Thanks. For more information consult an internal medicine physician online

Hi doctor,I have a strange feeling in my left testicle. I ordered a vacuum penile pump, and I used it only for two days. After that, I threw it away fearing an injury, as it turned my urine red. After five days, I went to a doctor, because I had a strange feeling in my testes, but I did not have pain. The doctor gave me tablet Diclofenac 100 mg and Cystone tablet. I started taking these tablets, but after two days, I have pain in my left testis and pubic area. I also had pain on the base of my penis and erection problem. So, I went back to the same doctor, who gave me Paracetamol and Nimesulide. I got a little relief, but after a month, I still have little pain. My testes are red, and I have pain in my pubic bone area. My erection is normal now. Is this because of the injury from the penile pump? I am attaching my ultrasound report. What should I do? Please help.

Hi, Welcome to Chat Doctor forum. Thanks for your query. I have seen the attached ultrasound (attachment removed to protect patient identity). Thanks. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 31 and I am going to marry a girl who is 33 years (two years elder to me). If we do not want to plan for a baby for one or two years after we get married, will she face any problems during pregnancy as she will be above 35 years? Also, will the baby have any problems growing up? ### Response: Hello. I went through your query and understand your anxiety. Actually, the chances of conception and having a healthy pregnancy decrease after the age of 30. After 35, the risk of having babies with Down\\s syn ChatDoctor. So it is best advised medically to conceive sooner. Both your health and medical parameters will be able to establish better on your chances of having a healthy pregnancy later on. Personally, I have had patients conceive naturally or with minimum medical help even at 35 and 40 and have had successful pregnancies and healthy babies. But, statistics do show that as the quality of sperm and ovum decline with age, so does the chance of conception and healthy pregnancy. I hope this information has been beneficial. Let me know if I can help you in any other way. For more information consult an obstetrician and gynaecologist online

Hi doctor,I am 31 and I am going to marry a girl who is 33 years (two years elder to me). If we do not want to plan for a baby for one or two years after we get married, will she face any problems during pregnancy as she will be above 35 years? Also, will the baby have any problems growing up?

Hello. I went through your query and understand your anxiety. Actually, the chances of conception and having a healthy pregnancy decrease after the age of 30. After 35, the risk of having babies with Down\\s syn ChatDoctor. So it is best advised medically to conceive sooner. Both your health and medical parameters will be able to establish better on your chances of having a healthy pregnancy later on. Personally, I have had patients conceive naturally or with minimum medical help even at 35 and 40 and have had successful pregnancies and healthy babies. But, statistics do show that as the quality of sperm and ovum decline with age, so does the chance of conception and healthy pregnancy. I hope this information has been beneficial. Let me know if I can help you in any other way. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I think I have cell carcinoma. It started a year ago. Tried antibiotic cream, antiseptic cream, fungi cream, etc. In the last two weeks, it has spread. It crusts over, then falls off, and then weeps or bleeds. Very sore and itchy. ### Response: Hi. I have gone through your case (attachment removed to protect patient identity). Right now, your lesion has taken the shape of a scar. The diagnosis of carcinoma can only be made on biopsy and you are already on a dermatologist\\s list. So, do not panic and be patient. In my opinion, it is just a local spread which has occurred during the last two weeks. And this is because, whenever we itch harshly, any lesion can ooze and form the crust which is beyond the lesion margin as blood spreads easily and crust is ChatDoctor. So, it seems to you that it is spreading. However, from the above explanation, the diagnosis of carcinoma cannot be excluded as it is based only on biopsy. Be patient. Suggest you keep on applying Sudocrem (Antiseptic cream). Do not apply anything else until you see a doctor. Moreover, it does not look to be an aggressive lesion, so relax. For more information consult a dermatologist online

Hello doctor,I think I have cell carcinoma. It started a year ago. Tried antibiotic cream, antiseptic cream, fungi cream, etc. In the last two weeks, it has spread. It crusts over, then falls off, and then weeps or bleeds. Very sore and itchy.

Hi. I have gone through your case (attachment removed to protect patient identity). Right now, your lesion has taken the shape of a scar. The diagnosis of carcinoma can only be made on biopsy and you are already on a dermatologist\\s list. So, do not panic and be patient. In my opinion, it is just a local spread which has occurred during the last two weeks. And this is because, whenever we itch harshly, any lesion can ooze and form the crust which is beyond the lesion margin as blood spreads easily and crust is ChatDoctor. So, it seems to you that it is spreading. However, from the above explanation, the diagnosis of carcinoma cannot be excluded as it is based only on biopsy. Be patient. Suggest you keep on applying Sudocrem (Antiseptic cream). Do not apply anything else until you see a doctor. Moreover, it does not look to be an aggressive lesion, so relax. For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a blood pressure of 130/80 presently. Earlier I had a BP of 160/96 after which I started taking Stamlo 5 once per day on doctors advice. However, in between, I had dizziness, nausea, and vomiting due to which I met another doctor who changed Stamlo 5 to Aquazide 12.5 biweekly (only on Sunday and Thursday). Will I have a severe problem with my BP as the dosage seems too low? He also suggested taking Stamlo 2.5 everyday instead. What should I follow? ### Response: Hi. I can well understand your worries. I have reviewed your query details. If all the side effects are just due to overdosage of Amlodipine (brand name Stamlo 5 mg) then better is to take 2.5 mg (taking a half dose). If the problem resolves, it is fine. If not, then we can go for other medications. My personal opinion is, it looks like you are having problems due to little higher dosage than you need. So keep taking Stamlo but half the dosage (that is 2.5 mg and this is all what your physician also agreed to). Take care.

Hello doctor,I have a blood pressure of 130/80 presently. Earlier I had a BP of 160/96 after which I started taking Stamlo 5 once per day on doctors advice. However, in between, I had dizziness, nausea, and vomiting due to which I met another doctor who changed Stamlo 5 to Aquazide 12.5 biweekly (only on Sunday and Thursday). Will I have a severe problem with my BP as the dosage seems too low? He also suggested taking Stamlo 2.5 everyday instead. What should I follow?

Hi. I can well understand your worries. I have reviewed your query details. If all the side effects are just due to overdosage of Amlodipine (brand name Stamlo 5 mg) then better is to take 2.5 mg (taking a half dose). If the problem resolves, it is fine. If not, then we can go for other medications. My personal opinion is, it looks like you are having problems due to little higher dosage than you need. So keep taking Stamlo but half the dosage (that is 2.5 mg and this is all what your physician also agreed to). Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was given the hCG trigger shot on the 5th of last month after showing a good follicle in response to Letrozole. I first showed positive for pregnancy on the 19th of last month with an hCG result of 17. On the 2nd of this month, I had a transvaginal ultrasound with no visible gestational sac and no indication of ectopic pregnancy as well as an hCG of 806. I was told that the pregnancy was abnormal and that a molar pregnancy was suspected. A D and E was suggested and was told that if my HCG levels still increased, then I will be treated for possible ectopic pregnancy. My pathology reports came back to a normal gestational sac and no signs of a molar pregnancy. Genetic results are still pending. Looking at the reports now, they had indicated pregnancy of unknown location as the cause for the procedure. Is that the usual course of treatment based on my clinical presentation? I am afraid that they had prematurely ended what could have been a viable pregnancy. ### Response: Hello. How are you doing? I am extremely sorry for your loss. Hope I have clarified your query. Do write back if any more queries. All the best. For more information consult an infertility specialist online

Hello doctor,I was given the hCG trigger shot on the 5th of last month after showing a good follicle in response to Letrozole. I first showed positive for pregnancy on the 19th of last month with an hCG result of 17. On the 2nd of this month, I had a transvaginal ultrasound with no visible gestational sac and no indication of ectopic pregnancy as well as an hCG of 806. I was told that the pregnancy was abnormal and that a molar pregnancy was suspected. A D and E was suggested and was told that if my HCG levels still increased, then I will be treated for possible ectopic pregnancy. My pathology reports came back to a normal gestational sac and no signs of a molar pregnancy. Genetic results are still pending. Looking at the reports now, they had indicated pregnancy of unknown location as the cause for the procedure. Is that the usual course of treatment based on my clinical presentation? I am afraid that they had prematurely ended what could have been a viable pregnancy.

Hello. How are you doing? I am extremely sorry for your loss. Hope I have clarified your query. Do write back if any more queries. All the best. For more information consult an infertility specialist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 26 year old male. I am working in the night shift since last six months due to which I have a sleep disorder and constipation problem. I cannot sleep more than three to four hours in a day and I have lost my weight. Please suggest me to recover. ### Response: Hello. Adequate sleep is essential for proper functioning of the body and as a result of prolonged lack of adequate sleep your body\\s circadian rhythm has been affected. Hence constipation and even weight loss. I am assuming you may have lost a bit of appetite or cannot eat on time either. Now, it is important to get six to eight hours of sleep every day. Even if you cannot sleep at night, you must ensure at least six hours of sleep by making up during the day. Also, try to get some meditation or yoga which helps immensely in these cases and helps to restore the body\\s circadian rhythm. Half an hour of meditation if done properly equals to two hours of sleep. Also, ChatDoctor. And take your meals on time. If you have to do night shifts at a stretch, please ensure that you get to sleep during the day and also do mediation. Hopefully this will help. For more information consult a general practitioner online Take care.

Hello doctor,I am a 26 year old male. I am working in the night shift since last six months due to which I have a sleep disorder and constipation problem. I cannot sleep more than three to four hours in a day and I have lost my weight. Please suggest me to recover.

Hello. Adequate sleep is essential for proper functioning of the body and as a result of prolonged lack of adequate sleep your body\\s circadian rhythm has been affected. Hence constipation and even weight loss. I am assuming you may have lost a bit of appetite or cannot eat on time either. Now, it is important to get six to eight hours of sleep every day. Even if you cannot sleep at night, you must ensure at least six hours of sleep by making up during the day. Also, try to get some meditation or yoga which helps immensely in these cases and helps to restore the body\\s circadian rhythm. Half an hour of meditation if done properly equals to two hours of sleep. Also, ChatDoctor. And take your meals on time. If you have to do night shifts at a stretch, please ensure that you get to sleep during the day and also do mediation. Hopefully this will help. For more information consult a general practitioner online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,For the past one year, I have been suffering a pain in the middle-upper wrist area where I could not support myself while getting up from the chair. I went to an orthopedist and was given some medication and wrist brace with metal support to stabilize the movement. The pain started declining for six months, but it did not go. I did an MRI for it, and another orthopedic surgeon recommended PRP injection with a month cast as he could see it as a partial TFCC. After the injection and one month cast, 15 sessions of physiotherapy, the pain persisted, so another MRI was done to check the progress.The MRI comparison showed the following ### Response: Hello, Welcome to Chat Doctor forum. I have gone through your medical history in detail. It seems that you are having stage 2-3 avascular necrosis of lunate (Kienbock\\s disease). I do not feel that you should wait as the disease progresses irreversibly. So it will not come back to normal by any means. I would suggest an immediate surgery (either bone decompression ChatDoctor. The last stage needs bone excision and fusion of other bones. If you could get the latest x ray of the wrist, I can precisely tell you which surgery is needed.

Hello doctor,For the past one year, I have been suffering a pain in the middle-upper wrist area where I could not support myself while getting up from the chair. I went to an orthopedist and was given some medication and wrist brace with metal support to stabilize the movement. The pain started declining for six months, but it did not go. I did an MRI for it, and another orthopedic surgeon recommended PRP injection with a month cast as he could see it as a partial TFCC. After the injection and one month cast, 15 sessions of physiotherapy, the pain persisted, so another MRI was done to check the progress.The MRI comparison showed the following

Hello, Welcome to Chat Doctor forum. I have gone through your medical history in detail. It seems that you are having stage 2-3 avascular necrosis of lunate (Kienbock\\s disease). I do not feel that you should wait as the disease progresses irreversibly. So it will not come back to normal by any means. I would suggest an immediate surgery (either bone decompression ChatDoctor. The last stage needs bone excision and fusion of other bones. If you could get the latest x ray of the wrist, I can precisely tell you which surgery is needed.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have been diagnosed with a genital wart a few months ago. This wart looked like a dark brown flat mole with a lesion next to it. It was located in the middle and underside of my penis. The dermatologist removed the wart.Recently, I noticed a few fleshy-looking masses near the area of circumcision. I am not sure if these masses were always there or if they were genital warts or if they are just a side effect of the Aldara cream I used for my diagnosed wart. Please note that the Aldara cream caused a rash on my scrotum and other areas of my penis. However, the rash is completely gone with the possible exception of the spot near my circumcision.In addition to the fleshy masses, it looks like there are areas where the skin has silver streaks as if the skin has pulped too tightly. I would like to submit a picture to understand what these fleshy masses are. Are they genital warts? Are they skin tags? Are they an effect of the Aldara cream? ### Response: Hello, Welcome to Chat Doctor forum. I have gone through the images (attachment removed to protect patient identity). Kindly send a good quality image. Secondly, can you please tell me genital warts were removed by which procedure? For more information consult a dermatologist online

Hello doctor,I have been diagnosed with a genital wart a few months ago. This wart looked like a dark brown flat mole with a lesion next to it. It was located in the middle and underside of my penis. The dermatologist removed the wart.Recently, I noticed a few fleshy-looking masses near the area of circumcision. I am not sure if these masses were always there or if they were genital warts or if they are just a side effect of the Aldara cream I used for my diagnosed wart. Please note that the Aldara cream caused a rash on my scrotum and other areas of my penis. However, the rash is completely gone with the possible exception of the spot near my circumcision.In addition to the fleshy masses, it looks like there are areas where the skin has silver streaks as if the skin has pulped too tightly. I would like to submit a picture to understand what these fleshy masses are. Are they genital warts? Are they skin tags? Are they an effect of the Aldara cream?

Hello, Welcome to Chat Doctor forum. I have gone through the images (attachment removed to protect patient identity). Kindly send a good quality image. Secondly, can you please tell me genital warts were removed by which procedure? For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 25-year-old female. I found a quarter-sized hard nonmobile lump under my nipple a day ago. Is that an usual spot to get breast cancer? ### Response: Hi, Welcome to Chat Doctor forum. It is usually uncommon to have breast cancer in this age group. It looks most likely a benign breast lesion or a localized infection. You have not given many details about this lump such as skin or nipple color change, any nipple discharge, whether you are married/unmarried or breastfeeding mother, any family history of breast or ovarian cancer which may be helpful in identifying high-risk breast lumps. Nothing to worry about, but it is recommended to visit a mammalogist or a General surgeon and let them examine this breast lesion. If needed they will put you on close follow up or investigate further with ultrasound breast or MRI breast. The significant risk factors for developing breast cancer are. 1. A family history of breast cancer.2. Obesity.3. Certain genetic syn ChatDoctor. 4. Any previous breast lump.5. Hormone replacement therapy, history of estrogen intake.6. Early menarche or late menopause. In case you have any family history of breast or ovarian cancer then you must go for genetic counseling also.

Hi doctor,I am a 25-year-old female. I found a quarter-sized hard nonmobile lump under my nipple a day ago. Is that an usual spot to get breast cancer?

Hi, Welcome to Chat Doctor forum. It is usually uncommon to have breast cancer in this age group. It looks most likely a benign breast lesion or a localized infection. You have not given many details about this lump such as skin or nipple color change, any nipple discharge, whether you are married/unmarried or breastfeeding mother, any family history of breast or ovarian cancer which may be helpful in identifying high-risk breast lumps. Nothing to worry about, but it is recommended to visit a mammalogist or a General surgeon and let them examine this breast lesion. If needed they will put you on close follow up or investigate further with ultrasound breast or MRI breast. The significant risk factors for developing breast cancer are. 1. A family history of breast cancer.2. Obesity.3. Certain genetic syn ChatDoctor. 4. Any previous breast lump.5. Hormone replacement therapy, history of estrogen intake.6. Early menarche or late menopause. In case you have any family history of breast or ovarian cancer then you must go for genetic counseling also.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 32 years now and my wife is 31. Today in pregnancy test kit, result came as double red line (a red line for C and a red line for T). Is this positive for pregnancy? Actually yesterday is her date for periods, but this has also not occurred yet. What precautions should we take? We were planning to travel by car (nano) to native by tomorrow for about 8 hours journey. Is it advisable now to travel by car or should we cancel it? Also kindly advise her what to eat and what to avoid? Also how to take care of herself? ### Response: Hi. The (UPT Kit) urine pregnancy test kit with two red lines indicates a positive result and that she is at present pregnant. The confirmation for an intrauterine pregnancy can be further done with a transvaginal ultrasound scan. She should be placed on tablet Folic Acid hence and may be started on tablet Micronized Progesterone daily for pregnancy support. Travel by nano for eight hours in this early pregnancy is not advised at all. As the pregnancy is way too small and the bumps on roads and breaks while ChatDoctor. So, traveling by car is completely not advisable till at least 14-16 weeks of pregnancy.

Hi doctor,I am 32 years now and my wife is 31. Today in pregnancy test kit, result came as double red line (a red line for C and a red line for T). Is this positive for pregnancy? Actually yesterday is her date for periods, but this has also not occurred yet. What precautions should we take? We were planning to travel by car (nano) to native by tomorrow for about 8 hours journey. Is it advisable now to travel by car or should we cancel it? Also kindly advise her what to eat and what to avoid? Also how to take care of herself?

Hi. The (UPT Kit) urine pregnancy test kit with two red lines indicates a positive result and that she is at present pregnant. The confirmation for an intrauterine pregnancy can be further done with a transvaginal ultrasound scan. She should be placed on tablet Folic Acid hence and may be started on tablet Micronized Progesterone daily for pregnancy support. Travel by nano for eight hours in this early pregnancy is not advised at all. As the pregnancy is way too small and the bumps on roads and breaks while ChatDoctor. So, traveling by car is completely not advisable till at least 14-16 weeks of pregnancy.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 28 years and 6\\1\" tall with weight 85 kg. I had frenuloplasty a few days back and feeling normal about it. Sometimes I get erections, and it hurts a lot as the stitches may be the reason. I want to admit that I had a premature ejaculation issue as well before the surgery. Was it because of this short frenulum, and will it be better now? Also, I was unable to penetrate the vagina easily. Will it be rectified? If no what else should I do?Please suggest. ### Response: Hello, Welcome to Chat Doctor forum. I can understand your concern about your symptoms. Yes, for a few weeks you will be having pain. The premature ejaculation could be because of the short frenulum, now after the procedure we will know it for sure. If your premature ejaculation persists, we can think of the other causes. Yes, you will be better after surgery with proper foreplay and appropriate lubrication you can easily penetrate since you just had the procedure. We need to wait for the recovery to to think about other cause of your issue and work on it. I hope I have answered your query. If you have further doubts, I would be happy to help you.

Hello doctor,I am 28 years and 6\\1\" tall with weight 85 kg. I had frenuloplasty a few days back and feeling normal about it. Sometimes I get erections, and it hurts a lot as the stitches may be the reason. I want to admit that I had a premature ejaculation issue as well before the surgery. Was it because of this short frenulum, and will it be better now? Also, I was unable to penetrate the vagina easily. Will it be rectified? If no what else should I do?Please suggest.

Hello, Welcome to Chat Doctor forum. I can understand your concern about your symptoms. Yes, for a few weeks you will be having pain. The premature ejaculation could be because of the short frenulum, now after the procedure we will know it for sure. If your premature ejaculation persists, we can think of the other causes. Yes, you will be better after surgery with proper foreplay and appropriate lubrication you can easily penetrate since you just had the procedure. We need to wait for the recovery to to think about other cause of your issue and work on it. I hope I have answered your query. If you have further doubts, I would be happy to help you.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have had a feeling of a lump in my throat for over a month with a feeling of trouble swallowing. There is no pain and I can get food down but it feels like it takes more time to get the food down. I went to a hospital and they did a CAT scan of my throat and said there are no tumors. It feels like I have to throw up but when I try to, it feels like I am going to throw up a ball and cannot. I got this pressure in my nose and throat/chest when I tried to throw up the other day. Also, I saw small blood streaks in the saliva while I was trying to throw up. I have not seen blood any other time besides then. ### Response: Hello, Welcome to Chat Doctor forum. Swallowing is a process which starts at the mouth and ends at the stomach. CT scan for your throat just investigates the pharynx and the upper esophagus. You have to investigate the whole track. A barium swallow is so helpful as it can detect strictures and masses along the swallowing tract. Barium swallow scan is cheap, safe and fast. The second step is pharyngoscopy and it may be needed or not according to the barium swallowing scan. For more information consult an ENT otolaryngologist online

Hello doctor,I have had a feeling of a lump in my throat for over a month with a feeling of trouble swallowing. There is no pain and I can get food down but it feels like it takes more time to get the food down. I went to a hospital and they did a CAT scan of my throat and said there are no tumors. It feels like I have to throw up but when I try to, it feels like I am going to throw up a ball and cannot. I got this pressure in my nose and throat/chest when I tried to throw up the other day. Also, I saw small blood streaks in the saliva while I was trying to throw up. I have not seen blood any other time besides then.

Hello, Welcome to Chat Doctor forum. Swallowing is a process which starts at the mouth and ends at the stomach. CT scan for your throat just investigates the pharynx and the upper esophagus. You have to investigate the whole track. A barium swallow is so helpful as it can detect strictures and masses along the swallowing tract. Barium swallow scan is cheap, safe and fast. The second step is pharyngoscopy and it may be needed or not according to the barium swallowing scan. For more information consult an ENT otolaryngologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am on dialysis for kidney failure and I have noticed a fluctuation in my monthly blood work for the creatinine and BUN levels. At the beginning of the year, my creatinine was 11 and it has decreased every month to 7. I was also making more urine as I went along. All of a sudden, last month my creatinine jumped back up to 10. I have not changed anything in my routine or treatments. Does anyone have any ideas? ### Response: Hello, Welcome to Chat Doctor forum. I have worked as a chief in a hemodialysis center for 20 months. Once the kidneys have failed and the patient is hooked up on dialysis, the creatinine value is always high. At this time we do not care about the creatinine values because once we start dialysis on a patient, it is assumed that his kidneys have incurred permanent damage and he cannot come back to normalcy. At this juncture, we use the patient\\s creatinine value as a measure of protein intake. If a dialyzing patient\\s creatinine value is high, it is assumed that he is having good protein intake through diet and high creatinine value is desirable in dialysis patients, since intake of much proteins gives them a long life. When creatinine value ChatDoctor. So the

Hello doctor,I am on dialysis for kidney failure and I have noticed a fluctuation in my monthly blood work for the creatinine and BUN levels. At the beginning of the year, my creatinine was 11 and it has decreased every month to 7. I was also making more urine as I went along. All of a sudden, last month my creatinine jumped back up to 10. I have not changed anything in my routine or treatments. Does anyone have any ideas?

Hello, Welcome to Chat Doctor forum. I have worked as a chief in a hemodialysis center for 20 months. Once the kidneys have failed and the patient is hooked up on dialysis, the creatinine value is always high. At this time we do not care about the creatinine values because once we start dialysis on a patient, it is assumed that his kidneys have incurred permanent damage and he cannot come back to normalcy. At this juncture, we use the patient\\s creatinine value as a measure of protein intake. If a dialyzing patient\\s creatinine value is high, it is assumed that he is having good protein intake through diet and high creatinine value is desirable in dialysis patients, since intake of much proteins gives them a long life. When creatinine value ChatDoctor. So the

### Instruction: Answer this question truthfully ###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, Welcome to Chat Doctor forum. 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 hy ChatDoctor.

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?

Hi, Welcome to Chat Doctor forum. 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 hy ChatDoctor.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am suffering from irritation on the back of my neck. Sometimes, it extends up to the throat. But, I do not have any problem in speaking or swallowing. Please help. ### Response: Hi,Welcome to ChatDoctorI understand that you have some irritation at the back of your neck that extends to your throat sometimes. However, there is no difficulty in swallowing or speaking. As a first step, I would suggest you take a course of antibiotics and anti-inflammatory tablets. Amoxicillin-Clavulanic Acid (dosage based on age and weight) and trypsin-chymotrypsin combination can work if it is an infective origin for the irritation. If the same does not resolve, then we have to think of other causes. Malignancy can be a reason which may often be accompanied by loss of weight and appetite. Pain also will frequently present in such a case.Any problem with the vertebra, like TB, spondylolisthesis, etc., can also present similar symptom with minute variation along with additional symptoms. For diagnosing the same we require to do an MRI scan of the neck. Kindly give all the details as I have listed. I suggest you go ahead with a course of antibiotics and see if there is a resolution of symptoms.

Hi doctor,I am suffering from irritation on the back of my neck. Sometimes, it extends up to the throat. But, I do not have any problem in speaking or swallowing. Please help.

Hi,Welcome to ChatDoctorI understand that you have some irritation at the back of your neck that extends to your throat sometimes. However, there is no difficulty in swallowing or speaking. As a first step, I would suggest you take a course of antibiotics and anti-inflammatory tablets. Amoxicillin-Clavulanic Acid (dosage based on age and weight) and trypsin-chymotrypsin combination can work if it is an infective origin for the irritation. If the same does not resolve, then we have to think of other causes. Malignancy can be a reason which may often be accompanied by loss of weight and appetite. Pain also will frequently present in such a case.Any problem with the vertebra, like TB, spondylolisthesis, etc., can also present similar symptom with minute variation along with additional symptoms. For diagnosing the same we require to do an MRI scan of the neck. Kindly give all the details as I have listed. I suggest you go ahead with a course of antibiotics and see if there is a resolution of symptoms.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I was due for my periods on 8th, but did not get till 16th. So, I went for pregnancy test which came out negative. On 17th, I got my periods with blood clots and crampy stomach pain which was not usual for me. Was it a miscarriage? If yes, what may be the reason? ### Response: Hi, Welcome to Chat Doctor forum. I have gone through your query and can understand your health concern. As per your query, the pregnancy test was negative. So, no need to worry. It is not a miscarriage. To be on a safer side and to confirm that it is not miscarriage, I suggest you to check your serum beta-hCG (human chorionic gonadotropin) level. High levels confirm pregnancy. You can do this test if you are in doubt. Menstruation can be delayed due to many factors. Such as hormonal imbalance and stress can delay menses. Sometimes, delayed menses can cause heavy bleeding. I think your case too the same. If there is heavy bleeding and you feel sick and dizzy, then check your hemoglobin level. If the menses continues for more number of days, then consult a gynecologist. For more clarifications consult a general practitioner online

Hi doctor,I was due for my periods on 8th, but did not get till 16th. So, I went for pregnancy test which came out negative. On 17th, I got my periods with blood clots and crampy stomach pain which was not usual for me. Was it a miscarriage? If yes, what may be the reason?

Hi, Welcome to Chat Doctor forum. I have gone through your query and can understand your health concern. As per your query, the pregnancy test was negative. So, no need to worry. It is not a miscarriage. To be on a safer side and to confirm that it is not miscarriage, I suggest you to check your serum beta-hCG (human chorionic gonadotropin) level. High levels confirm pregnancy. You can do this test if you are in doubt. Menstruation can be delayed due to many factors. Such as hormonal imbalance and stress can delay menses. Sometimes, delayed menses can cause heavy bleeding. I think your case too the same. If there is heavy bleeding and you feel sick and dizzy, then check your hemoglobin level. If the menses continues for more number of days, then consult a gynecologist. For more clarifications consult a general practitioner online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a problem. My teeth are brittle because if I eat something hard they sometimes break or I would feel a hole developing and this is stressing me out because I have already taken out three of them and now another one is close to being totaled. Earlier today I ate something and I think it damaged them. I am tired of taking them out. ### Response: Hi, Welcome to Chat Doctor forum. There must be one of a few reasons for this chipping off of teeth rapidly. You might have calcium and vitamin D deficiency. To rule out this, you can get serum vitamin D laboratory test done. If there is deficiency then I recommend you medicines for it. Another reason might be the hereditary cause, that means even when you maintain your oral hygiene, brush properly, eat less sugary stuff and chocolates, still teeth are breaking off suggests it is because of genes you have got from your parents or grandparents. They would be more prone to damage and their teeth would be weak as well. In this case, you cannot do anything but visit a dentist properly and get all services done before-hand to avoid further damage. Can you provide me with a clinical picture of teeth? So I may suggest accurately what should be your line of treatment. Stay happy and blessed. Take care.

Hello doctor,I have a problem. My teeth are brittle because if I eat something hard they sometimes break or I would feel a hole developing and this is stressing me out because I have already taken out three of them and now another one is close to being totaled. Earlier today I ate something and I think it damaged them. I am tired of taking them out.

Hi, Welcome to Chat Doctor forum. There must be one of a few reasons for this chipping off of teeth rapidly. You might have calcium and vitamin D deficiency. To rule out this, you can get serum vitamin D laboratory test done. If there is deficiency then I recommend you medicines for it. Another reason might be the hereditary cause, that means even when you maintain your oral hygiene, brush properly, eat less sugary stuff and chocolates, still teeth are breaking off suggests it is because of genes you have got from your parents or grandparents. They would be more prone to damage and their teeth would be weak as well. In this case, you cannot do anything but visit a dentist properly and get all services done before-hand to avoid further damage. Can you provide me with a clinical picture of teeth? So I may suggest accurately what should be your line of treatment. Stay happy and blessed. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,The head of my penis is itchy and there are few red spots in certain areas on the head. This has been happening for the past week or so. I have stopped applying soap to the area and I wash it with lukewarm water twice a day and apply Candid-B thereafter. The itchiness went away after three to four days but as I stopped doing that, the itching has been back.Initially, I had some pain while retracting my foreskin and my foreskin was kind of swollen but there was no pain and swelling. At times, I find a white substance around the foreskin when I try to retract it. Should I continue applying Candid-B for few more days? And what other precautions should I take so that it does not happen in the future? ### Response: Hello. With your description, I feel you are suffering from a fungal infection of your genitalia. Kindly stop Candid-B cream (Beclometasone Topical and Clotrimazole Topical). It has steroids in it. This gives you temporary relief from itching but promotes fungal growth. However, I cannot precisely diagnose your condition without having seen your clinical picture. I would suggest you attach a clinical picture along with your query. I would suggest you use For more information consult a dermatologist online

Hello doctor,The head of my penis is itchy and there are few red spots in certain areas on the head. This has been happening for the past week or so. I have stopped applying soap to the area and I wash it with lukewarm water twice a day and apply Candid-B thereafter. The itchiness went away after three to four days but as I stopped doing that, the itching has been back.Initially, I had some pain while retracting my foreskin and my foreskin was kind of swollen but there was no pain and swelling. At times, I find a white substance around the foreskin when I try to retract it. Should I continue applying Candid-B for few more days? And what other precautions should I take so that it does not happen in the future?

Hello. With your description, I feel you are suffering from a fungal infection of your genitalia. Kindly stop Candid-B cream (Beclometasone Topical and Clotrimazole Topical). It has steroids in it. This gives you temporary relief from itching but promotes fungal growth. However, I cannot precisely diagnose your condition without having seen your clinical picture. I would suggest you attach a clinical picture along with your query. I would suggest you use For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am late on my period. My last period was two months back. Generally, my period is late, irregular and maximum it goes for 45 days. I have never been late so much. It is almost 50 days.I have a kid of 2 yrs and do not want to have another one. I did the pregnancy test at home twice and it came negative. I am not sure whether I am pregnant or not. If yes, then is it a safe time for abortion?For my first kid, the pregnancy test at home used to be always positive. So, I am not sure what to do. I have booked an appointment next week with a gynecologist. I have heard that medical abortion is only possible within 7 weeks. So, what will happen in my case? ### Response: Hi. If the pregnancy test is negative, then the chance of pregnancy is almost nil. The period may be late due to many reasons including anxiety and stress. Pregnancy test becomes positive by the fifth week. So, you will be able to get abortion two weeks after the test becomes positive, if by chance. So, you have time to check with the gynecologist. For more information consult an obstetrician and gynaecologist online

Hello doctor,I am late on my period. My last period was two months back. Generally, my period is late, irregular and maximum it goes for 45 days. I have never been late so much. It is almost 50 days.I have a kid of 2 yrs and do not want to have another one. I did the pregnancy test at home twice and it came negative. I am not sure whether I am pregnant or not. If yes, then is it a safe time for abortion?For my first kid, the pregnancy test at home used to be always positive. So, I am not sure what to do. I have booked an appointment next week with a gynecologist. I have heard that medical abortion is only possible within 7 weeks. So, what will happen in my case?

Hi. If the pregnancy test is negative, then the chance of pregnancy is almost nil. The period may be late due to many reasons including anxiety and stress. Pregnancy test becomes positive by the fifth week. So, you will be able to get abortion two weeks after the test becomes positive, if by chance. So, you have time to check with the gynecologist. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My blood pressure runs at about 135/70 mg/dl and drops to about 125/60 mg/dl when I wake from sleep at night. I am on Candesartan 32 mg and Reaptan (Arginine plus Amlodipine) for blood pressure. I also take Duodart for prostate issues which contains the alpha-blocker Tamsulosin. I am concerned that my diastolic pressure gets too low, particularly when sleeping. This has been going on for few months. My blood tests are normal including the thyroid tests. If I had to drop one of my blood pressure tablets which one will increase my diastolic reading to maintain the good systolic blood pressure? ### Response: Hello, Welcome to Chat Doctor forum. Thanks for your query. You take Reaptan (Perindopril Arginine and Amlodipine). It is completely contraindicated to take both Perindopril and Candesartan at the same time. I strongly recommend that you stop Candesartan. Tamsulosin is good for both your prostate and blood pressure. Also, it is advisable to take Reaptan in the morning and Tamsulosin in the evening. For more information consult a general medicine physician online

Hello doctor,My blood pressure runs at about 135/70 mg/dl and drops to about 125/60 mg/dl when I wake from sleep at night. I am on Candesartan 32 mg and Reaptan (Arginine plus Amlodipine) for blood pressure. I also take Duodart for prostate issues which contains the alpha-blocker Tamsulosin. I am concerned that my diastolic pressure gets too low, particularly when sleeping. This has been going on for few months. My blood tests are normal including the thyroid tests. If I had to drop one of my blood pressure tablets which one will increase my diastolic reading to maintain the good systolic blood pressure?

Hello, Welcome to Chat Doctor forum. Thanks for your query. You take Reaptan (Perindopril Arginine and Amlodipine). It is completely contraindicated to take both Perindopril and Candesartan at the same time. I strongly recommend that you stop Candesartan. Tamsulosin is good for both your prostate and blood pressure. Also, it is advisable to take Reaptan in the morning and Tamsulosin in the evening. For more information consult a general medicine physician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I suffer from daily headaches, dizziness, lightheadedness, and fatigue. My platelet count is 514, and my iron binding capacity is 506. My doctor says it is normal and referred me to hematologist due to the high platelet count. However, all my test results show that things are high or low. ### Response: Hello. May I know since how long you are having headache and dizziness? Your platelet count is slightly high. Your Hb level slight low and iron binding capacity increased. So iron deficiency anemia could be the possible cause for dizziness and headache and for that Iron tablets can be prescribed like Ferrous ascorbate. Platelet count can be high in iron deficiency anemia, post-hemorrhage, inflammation in the body, infection, etc., like secondary cause. Your physical examination should be done. Check your blood pressure and sugar level as well. Your otological ear examination also has to be done that can lead to referred headache and dizziness. So, just now secondary cause can be the possibility for high platelet count by IL (interleukin) 6 release. After Iron therapy, repeat your CBC. Let me know if you are having any bleeding problem. For more information consult a hematologist online Take care.

Hi doctor,I suffer from daily headaches, dizziness, lightheadedness, and fatigue. My platelet count is 514, and my iron binding capacity is 506. My doctor says it is normal and referred me to hematologist due to the high platelet count. However, all my test results show that things are high or low.

Hello. May I know since how long you are having headache and dizziness? Your platelet count is slightly high. Your Hb level slight low and iron binding capacity increased. So iron deficiency anemia could be the possible cause for dizziness and headache and for that Iron tablets can be prescribed like Ferrous ascorbate. Platelet count can be high in iron deficiency anemia, post-hemorrhage, inflammation in the body, infection, etc., like secondary cause. Your physical examination should be done. Check your blood pressure and sugar level as well. Your otological ear examination also has to be done that can lead to referred headache and dizziness. So, just now secondary cause can be the possibility for high platelet count by IL (interleukin) 6 release. After Iron therapy, repeat your CBC. Let me know if you are having any bleeding problem. For more information consult a hematologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I just had blood work done. The tests for my liver came back deranged and I have to have another test next week. My LFTs have always been normal. The night before I had the test I drank a lot and got tipsy. There was a hangover the next day. Could this be the reason for my deranged levels? I am assuming deranged means not normal or really bad results. Can you clarify the meaning of deranged? I am currently taking Vyvanse, Strattera, and Spironolactone. Please help. ### Response: Hello. Yes, deranged in medical terms means abnormal and likely in your case there must be elevated liver enzymes like SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic-pyruvic transaminase). Likely, the cause is alcohol only. It directly affects one\\s liver. In short term, such damage recovers within a week period but the chronic high consumption may lead to permanent damage. So you should repeat LFTs (liver function tests) after a week. Also, get an ultrasound of the liver done to look for chronic damage. Have you consumed any other ChatDoctor. For more information consult a general medicine physician online

Hello doctor,I just had blood work done. The tests for my liver came back deranged and I have to have another test next week. My LFTs have always been normal. The night before I had the test I drank a lot and got tipsy. There was a hangover the next day. Could this be the reason for my deranged levels? I am assuming deranged means not normal or really bad results. Can you clarify the meaning of deranged? I am currently taking Vyvanse, Strattera, and Spironolactone. Please help.

Hello. Yes, deranged in medical terms means abnormal and likely in your case there must be elevated liver enzymes like SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic-pyruvic transaminase). Likely, the cause is alcohol only. It directly affects one\\s liver. In short term, such damage recovers within a week period but the chronic high consumption may lead to permanent damage. So you should repeat LFTs (liver function tests) after a week. Also, get an ultrasound of the liver done to look for chronic damage. Have you consumed any other ChatDoctor. For more information consult a general medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was diagnosed with blepharitis. I also have seborrhoeic dermatitis (perhaps rosacea as well), and my condition has improved greatly. Recently, I got very bad allergy symptoms, my eyes and nose became extremely itchy, causing me to sneeze a lot. This morning when I woke up, I had trouble in opening one of my eyes due to a dark yellow eye discharge. Apart from being itchy, my eye was blood red and dry (only one eye). I have never had this much discharge before, especially after I started cleaning my eyelids for treating my blepharitis. It really terrified me. Could this be bacterial conjunctivitis due to the color of the discharge and the fact that only one eye was affected? What are other possible explanations? ### Response: Hi, Welcome to Chat Doctor forum. I have gone through the attached pictures (attachment removed to protect patient identity). Yes, it is nothing but common bacterial conjunctivitis. Since you have blepharitis, you are more likely to get conjunctivitis. Also, blepharitis, in turn, is related to seborrhoeic dermatitis. What I can assure you is bacterial conjunctivitis is treated easily with antibiotic eye ChatDoctor. Try using Gatifloxacin eye

Hello doctor,I was diagnosed with blepharitis. I also have seborrhoeic dermatitis (perhaps rosacea as well), and my condition has improved greatly. Recently, I got very bad allergy symptoms, my eyes and nose became extremely itchy, causing me to sneeze a lot. This morning when I woke up, I had trouble in opening one of my eyes due to a dark yellow eye discharge. Apart from being itchy, my eye was blood red and dry (only one eye). I have never had this much discharge before, especially after I started cleaning my eyelids for treating my blepharitis. It really terrified me. Could this be bacterial conjunctivitis due to the color of the discharge and the fact that only one eye was affected? What are other possible explanations?

Hi, Welcome to Chat Doctor forum. I have gone through the attached pictures (attachment removed to protect patient identity). Yes, it is nothing but common bacterial conjunctivitis. Since you have blepharitis, you are more likely to get conjunctivitis. Also, blepharitis, in turn, is related to seborrhoeic dermatitis. What I can assure you is bacterial conjunctivitis is treated easily with antibiotic eye ChatDoctor. Try using Gatifloxacin eye

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have not had a fever for many years (around 15 years or more if I remember correctly). I read somewhere that I should get immunoglobulin checked because I have not got a fever for years. Will it be useful to do this test? If yes, then which ones should I get done as there are multiple tests for immunoglobulin-like G, M, and A? Please advice. ### Response: Hello, Welcome to Chat Doctor forum. I really do not understand who has given you this information. If you did not get a fever since the last 15 years, is it not a good thing? Fever is a body\\s defense mechanism when you acquire any infection. Not getting fever means you have been taking good care of yourself and you are healthy. I do not think that you need to get any tests done. Please meet a local doctor or your family doctor and discuss your concerns with them personally. If you want to get some tests done, you can do a general full body health check. It will definitely tell you a lot about how you are doing health wise. Much more recommended considering the current stress at workplaces and personal lifestyle. Feel free to get back to me in case you have any other queries. For more information consult a general practitioner online

Hello doctor,I have not had a fever for many years (around 15 years or more if I remember correctly). I read somewhere that I should get immunoglobulin checked because I have not got a fever for years. Will it be useful to do this test? If yes, then which ones should I get done as there are multiple tests for immunoglobulin-like G, M, and A? Please advice.

Hello, Welcome to Chat Doctor forum. I really do not understand who has given you this information. If you did not get a fever since the last 15 years, is it not a good thing? Fever is a body\\s defense mechanism when you acquire any infection. Not getting fever means you have been taking good care of yourself and you are healthy. I do not think that you need to get any tests done. Please meet a local doctor or your family doctor and discuss your concerns with them personally. If you want to get some tests done, you can do a general full body health check. It will definitely tell you a lot about how you are doing health wise. Much more recommended considering the current stress at workplaces and personal lifestyle. Feel free to get back to me in case you have any other queries. For more information consult a general practitioner online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I and my fiancee had unprotected sex a month back. I had an orgasm before having but not during sex. She has PCOD so her periods are irregular. She went to the doctor and doctor suggested having Regestrone 5 mg three tablets for three days. She started taking it 13 days later and finished after three days. The day before yesterday, she got her periods. But she did not have blood clots and flow is very slow. Is there any chance of pregnancy? ### Response: Hi. How are you doing? As she has PCOD (polycystic ovarian disease), her ovulation date cannot be predicted. So there is always a chance of pregnancy. But as she had bleeding after having tablet Regestrone, pregnancy is not possible. Bleeding after having hormones will be thicker and lesser than normal, that is expected. Once the bleeding occurs, the inner lining of the uterus has fully been shed, so there is no chance of a possible pregnancy to get implanted on the post bleeding, thinned out uterine inner lining. So I do not see any chance of her being pregnant. But if you are still not satisfied or want a further confirmation, have her blood serum beta hCG tested. This can detect the smallest of pregnancy anywhere in the body.

Hello doctor,I and my fiancee had unprotected sex a month back. I had an orgasm before having but not during sex. She has PCOD so her periods are irregular. She went to the doctor and doctor suggested having Regestrone 5 mg three tablets for three days. She started taking it 13 days later and finished after three days. The day before yesterday, she got her periods. But she did not have blood clots and flow is very slow. Is there any chance of pregnancy?

Hi. How are you doing? As she has PCOD (polycystic ovarian disease), her ovulation date cannot be predicted. So there is always a chance of pregnancy. But as she had bleeding after having tablet Regestrone, pregnancy is not possible. Bleeding after having hormones will be thicker and lesser than normal, that is expected. Once the bleeding occurs, the inner lining of the uterus has fully been shed, so there is no chance of a possible pregnancy to get implanted on the post bleeding, thinned out uterine inner lining. So I do not see any chance of her being pregnant. But if you are still not satisfied or want a further confirmation, have her blood serum beta hCG tested. This can detect the smallest of pregnancy anywhere in the body.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am taking my second-day pill of my Krimson 35 for PCOS. I had unprotected sex with my husband, and we are not planning for a baby now. Should I take I-pill also along with Krimson 35 to avoid pregnancy? ### Response: Hello, Welcome to Chat Doctor forum. Krimson 35 (Cyproterone, Ethinyl Estradiol) is used as an oral contraceptive pill as well. It should be started from day one of the periods. So if you are having periods and started Krimson as well from day one and had unprotected sex, then there are fewer chances of pregnancy or conception. There are fertile periods in each cycle and first five days of periods in which there is menstrual bleed are included in the infertile period of sequence, so fewer chances of pregnancy if you have started Krimson in periods. You can further clarify if Krimson not taken on the second day, then kindly mention which day you have started Krimson. Please have complete treatment of any health issues if you have, follow some recreational activities and quit recreational ChatDoctor. Have a balanced diet, weight, and BMI. Send scan and detailed sex hormonal markers reports as well. As above. With detailed history and reports.

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

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

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a relatively healthy 68-year-old female who has been having episodes of tachycardia while at rest. This started three months ago. I also have dizziness while reclining mostly at night. I do have medicated high blood pressure, osteoporosis, and GERD. I do seem to tire easier also. I play tennis three days a week and walk over 10,000 steps every day. My watch indicated 12 times I have had tachycardia. Should I go to a cardiologist about this? ### Response: Hello, Welcome to the ChatDoctor. You have dizziness problem while lying down if you have frequent episodes of dizziness in lying down position than positional vertigo can be possible. For which physiotherapy can be beneficial. You need to check your blood sugar and hemoglobin level as well. You have mentioned that you have a high blood pressure problem. So persistent hypertension can cause a light headache and dizziness. If blood pressure not controlled by exercise, then medicine needs to be given for that.For tachycardia, you need to investigate with 12 lead standard ECG testing. You can consult nearby internal medicine specialist for your detailed evaluation as discussed above. I hope I have answered your question. Let me know if I can assist you further. Take care.

Hello doctor,I am a relatively healthy 68-year-old female who has been having episodes of tachycardia while at rest. This started three months ago. I also have dizziness while reclining mostly at night. I do have medicated high blood pressure, osteoporosis, and GERD. I do seem to tire easier also. I play tennis three days a week and walk over 10,000 steps every day. My watch indicated 12 times I have had tachycardia. Should I go to a cardiologist about this?

Hello, Welcome to the ChatDoctor. You have dizziness problem while lying down if you have frequent episodes of dizziness in lying down position than positional vertigo can be possible. For which physiotherapy can be beneficial. You need to check your blood sugar and hemoglobin level as well. You have mentioned that you have a high blood pressure problem. So persistent hypertension can cause a light headache and dizziness. If blood pressure not controlled by exercise, then medicine needs to be given for that.For tachycardia, you need to investigate with 12 lead standard ECG testing. You can consult nearby internal medicine specialist for your detailed evaluation as discussed above. I hope I have answered your question. Let me know if I can assist you further. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had smegma since 1.5 years which resulted into balanitis (that is what I think as per symptoms like difficulties in pulling foreskin, cuts, pain, rash swelling, etc.) and recently I applied Candid cream (non steroidal) twice a day for 10 days and smegma seems to be gone and also balanitis seems to be fine. But my foreskin and glans still becomes red and I can see small red spots after rubbing penis to clean. Also just saw a blister at the opening of urethra (it is little inside and need to spread the opening to see it). What could be the reason? ### Response: Hi. Can you tell me if there is any burning, pain, discharge, itching or difficulty in passing urine? Are you able to retract your foreskin up completely? Is there history of sexual exposure? Are you married? When we rub on penis head or foreskin, it can become red as the skin is very thin and sensitive. The skin lining the urethral opening is usually pink or red. Sometimes what we think is a blister may be normal mucosal skin. If there is a blister or ulcer, see your doctor or a urologist. Let me know answers to the above questions. Take care.

Hello doctor,I had smegma since 1.5 years which resulted into balanitis (that is what I think as per symptoms like difficulties in pulling foreskin, cuts, pain, rash swelling, etc.) and recently I applied Candid cream (non steroidal) twice a day for 10 days and smegma seems to be gone and also balanitis seems to be fine. But my foreskin and glans still becomes red and I can see small red spots after rubbing penis to clean. Also just saw a blister at the opening of urethra (it is little inside and need to spread the opening to see it). What could be the reason?

Hi. Can you tell me if there is any burning, pain, discharge, itching or difficulty in passing urine? Are you able to retract your foreskin up completely? Is there history of sexual exposure? Are you married? When we rub on penis head or foreskin, it can become red as the skin is very thin and sensitive. The skin lining the urethral opening is usually pink or red. Sometimes what we think is a blister may be normal mucosal skin. If there is a blister or ulcer, see your doctor or a urologist. Let me know answers to the above questions. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am trying to reduce my weight and belly fat, but I am not able to reduce my belly fat successfully. I am also getting kidney stones frequently and undergone surgery just two weeks back and also six months back. I want to reduce my belly fat without getting kidney stones. Let me brief about my details. I work for 12 hours, 15 days day shift and other 15 days I have night shifts. During day shifts, morning I have oats, afternoon I used to take fruits (mix of papaya, sweet melon and apple) and dinner (banana and an apple). Sometimes, I take avocado, pomegranate in the place of sweet melon. Weekly once I do have non-vegetarian like chicken and sea foods. I am 31 years old and a bachelor. My physical activities are walking during the break time (15 minutes walk during three breaks). My nature of job is sitting in the control room and no physical activity involved. Kindly suggest me whether my diet is proper and how to balance it for better results. ### Response: Hi. High protein, high fat containing foods and rich junk foods. 1. Diet.2. Exercises mild to moderate. Follow up after 15 days to a dietician online.- Take care.

Hello doctor,I am trying to reduce my weight and belly fat, but I am not able to reduce my belly fat successfully. I am also getting kidney stones frequently and undergone surgery just two weeks back and also six months back. I want to reduce my belly fat without getting kidney stones. Let me brief about my details. I work for 12 hours, 15 days day shift and other 15 days I have night shifts. During day shifts, morning I have oats, afternoon I used to take fruits (mix of papaya, sweet melon and apple) and dinner (banana and an apple). Sometimes, I take avocado, pomegranate in the place of sweet melon. Weekly once I do have non-vegetarian like chicken and sea foods. I am 31 years old and a bachelor. My physical activities are walking during the break time (15 minutes walk during three breaks). My nature of job is sitting in the control room and no physical activity involved. Kindly suggest me whether my diet is proper and how to balance it for better results.

Hi. High protein, high fat containing foods and rich junk foods. 1. Diet.2. Exercises mild to moderate. Follow up after 15 days to a dietician online.- Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,A while ago, I started noticing milky discharge from my breast, the discharge continued for about three months. After two months I started to develop red burning rashes on my breast. The rash first appeared as a single ringworm like red rashes on my breast and no improvement for two days now and rashes have increased at the sides of my two breasts. What could cause this? And are these two occurrences related? I applied a triple effect cream (Bmn plus cream) on it, that is when it started to produce blisters. Please help. ### Response: Hello. I can understand your concern. Milk secretion in nonpregnant women is galactorrhea that can occur due to causes like increased prolactin levels in the body, prolactinomas, continuous usage of antacid like ChatDoctor. Rubbing of clothes to the nipple can also lead to discharge. Tight innerwear, allergy to fabric material lead to skin rashes, etc. can aso be the cause for the discharge. So, you, please consult your gynecologist once, get examined and go for serum prolactin levels and if needed sonomammography. With this work up the possible cause of your problem can be identified and treated. I hope I have answered your query. Take care. Take care.

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

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

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had a root canal done in one of my lower right teeth. It was done in one sitting with the help of a laser. Everything was fine for a week. Then, one day my right jaw started aching and I was not able to open the jaw more than half an inch. There wa mild pain below the ear and it increased while chewing.My dentist says it is spasm and it has nothing to do with RCT (root canal treatment). I am taking Flexon MR and doing few muscle exercises keeping the jaw in movement.What is the solution?How long will it take to heal?I am worried will it become permanent? ### Response: Hello. Yes, it can be due to muscle spasm but as it started after one week then it can also be due to infection in the root canal treated tooth. So, first of all, the exact cause needs to be ruled out. If Flexon MR (Ibuprofen, Paracetamol, and Chlorzoxazone) and muscle exercises are not resolving the problem then an X-ray of the tooth should be done to check for any infection. It can heal mostly within a week. No, it cannot become permanent and both conditions - infection and muscle spasm are treatable. For more information consult a dentist online

Hello doctor,I had a root canal done in one of my lower right teeth. It was done in one sitting with the help of a laser. Everything was fine for a week. Then, one day my right jaw started aching and I was not able to open the jaw more than half an inch. There wa mild pain below the ear and it increased while chewing.My dentist says it is spasm and it has nothing to do with RCT (root canal treatment). I am taking Flexon MR and doing few muscle exercises keeping the jaw in movement.What is the solution?How long will it take to heal?I am worried will it become permanent?

Hello. Yes, it can be due to muscle spasm but as it started after one week then it can also be due to infection in the root canal treated tooth. So, first of all, the exact cause needs to be ruled out. If Flexon MR (Ibuprofen, Paracetamol, and Chlorzoxazone) and muscle exercises are not resolving the problem then an X-ray of the tooth should be done to check for any infection. It can heal mostly within a week. No, it cannot become permanent and both conditions - infection and muscle spasm are treatable. For more information consult a dentist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,After unsafe exposure, I got 49 days ELISA antibody test done, 71 days HIV proviral DNA PCR test, 87 days ELISA antibody test. All were negative. The antibody test I took is not a fourth generation test. Is it conclusive or should I take another test? If I repeat the HIV test after six months what is the chance of staying negative? I am facing the problem like small bumps in the tongue, from the last two days a little bit of pain below ear region and it is a little swollen. Is it due to HIV? I am stressed, scared, full of tension. These are hampering my life. I do not know what to do. Today I am in the 107th day of exposure. ### Response: Hi. Your tests are conclusive and you are not infected. No need for further tests. Ear ache and tongue papilla are not due to HIV and may be a simple bacterial infection. Consult ENT specialist for an examination to rule out otitis externa. You will remain negative even after six months and one-year post exposure and no need for further testing. Weight loss may be a stress-related issue. Just leave this HIV issue here and you will regain weight soon. Take care.

Hello doctor,After unsafe exposure, I got 49 days ELISA antibody test done, 71 days HIV proviral DNA PCR test, 87 days ELISA antibody test. All were negative. The antibody test I took is not a fourth generation test. Is it conclusive or should I take another test? If I repeat the HIV test after six months what is the chance of staying negative? I am facing the problem like small bumps in the tongue, from the last two days a little bit of pain below ear region and it is a little swollen. Is it due to HIV? I am stressed, scared, full of tension. These are hampering my life. I do not know what to do. Today I am in the 107th day of exposure.

Hi. Your tests are conclusive and you are not infected. No need for further tests. Ear ache and tongue papilla are not due to HIV and may be a simple bacterial infection. Consult ENT specialist for an examination to rule out otitis externa. You will remain negative even after six months and one-year post exposure and no need for further testing. Weight loss may be a stress-related issue. Just leave this HIV issue here and you will regain weight soon. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My whole body gets itchy after sex. Earlier it used to be random, but now it is almost every time. My face, neck, chest, legs, even hands, and arms are involved. I am 29 years old. ### Response: Hello, Welcome to Chat Doctor forum. According to your statement, you are suffering from allergy just after sex. You did not mention here whether your partner uses condoms or not. You may be allergic to the condoms or any added ingredient like spermicide that you or your partner used. Although it is possible to be allergic to any type of condoms. Latex is the main common culprit. Between 1-6% people of your race are allergic or sensitive to latex like you. Again, spermicide are commonly used in gels, suppositories, and lubricants. Nonoxynol-9 is the most common active ingredient in spermicide is known to cause irritation or allergy to some people especially when used frequently. By using skin prick test, RAST test, etc, it can be determined which ingredient is responsible for your allergic reaction. Latex causing allergy will be subsided with one to four days. Your partner can use condoms of latex-free ingredients. You can also take anti-allergic medication too.

Hello doctor,My whole body gets itchy after sex. Earlier it used to be random, but now it is almost every time. My face, neck, chest, legs, even hands, and arms are involved. I am 29 years old.

Hello, Welcome to Chat Doctor forum. According to your statement, you are suffering from allergy just after sex. You did not mention here whether your partner uses condoms or not. You may be allergic to the condoms or any added ingredient like spermicide that you or your partner used. Although it is possible to be allergic to any type of condoms. Latex is the main common culprit. Between 1-6% people of your race are allergic or sensitive to latex like you. Again, spermicide are commonly used in gels, suppositories, and lubricants. Nonoxynol-9 is the most common active ingredient in spermicide is known to cause irritation or allergy to some people especially when used frequently. By using skin prick test, RAST test, etc, it can be determined which ingredient is responsible for your allergic reaction. Latex causing allergy will be subsided with one to four days. Your partner can use condoms of latex-free ingredients. You can also take anti-allergic medication too.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 18 years old and I once in my lifetime applied toothpaste on my bottom eyelid trying to help with the dark circles I had but then I had an irritation there and the next morning I had a scab which later fell off and left an indentation on my end eye that looks like an ugly wrinkle. Can this be treated to remove the wrinkle with a cream? Because this small indentation is causing other wrinkles near it. Please help with a depth answer. It would mean a lot. ### Response: Hi, Welcome to Chat Doctor forum. I understand your concern. The indentation below the eyelids as I can see the picture (attachment removed to protect patient identity) could have been due to two things. Toothpaste that you had applied might have caused contact dermatitis and in turn skin thinning in that area. The other reason could be that there is loss of tissue under the lower eyelid skin. You could use Vitamin C serum under the eyes. This helps you lighten dark circles as well as minimize indentation. You can also place plain wet wipes over closed eyes to maintain hy ChatDoctor. If the indentation and wrinkles are too loose, you can get fillers done from your dermatologist. Contact dermatitis, tissue atrophy None As described above Avoid frequent rubbing of eyes and use of harsh products

Hello doctor,I am 18 years old and I once in my lifetime applied toothpaste on my bottom eyelid trying to help with the dark circles I had but then I had an irritation there and the next morning I had a scab which later fell off and left an indentation on my end eye that looks like an ugly wrinkle. Can this be treated to remove the wrinkle with a cream? Because this small indentation is causing other wrinkles near it. Please help with a depth answer. It would mean a lot.

Hi, Welcome to Chat Doctor forum. I understand your concern. The indentation below the eyelids as I can see the picture (attachment removed to protect patient identity) could have been due to two things. Toothpaste that you had applied might have caused contact dermatitis and in turn skin thinning in that area. The other reason could be that there is loss of tissue under the lower eyelid skin. You could use Vitamin C serum under the eyes. This helps you lighten dark circles as well as minimize indentation. You can also place plain wet wipes over closed eyes to maintain hy ChatDoctor. If the indentation and wrinkles are too loose, you can get fillers done from your dermatologist. Contact dermatitis, tissue atrophy None As described above Avoid frequent rubbing of eyes and use of harsh products

### Instruction: Answer this question truthfully ###Input: Hi doctor,My wife is losing protein in the urine. The result is ++. She usually remains tired and also has pain in some part of the body like back pain or head pain. She also has a lot of black pigmentation marks on her body. Is pigmentation marks cause any serious problem? Can you please tell me its side effects? And what are the issues we can face in future due to this problem? And does it have any treatment? Because already one doctor has told us that there is no treatment for this problem and my wife will get ill sooner due to protein loss, and there is also 20 % chances of kidney failure in the future. Is it true? ### Response: Hi, Welcome to Chat Doctor forum. Protein in urine can be due to a nephrotic syn ChatDoctor. Blood pressure, blood albumin level, and random blood sugar should be measured. Her urine test shows some pus cells (attachment removed to protect patient identity). I suggest using antibiotics like Bactrim (Sulfamethoxazole and Trimethoprim) for five days. Is there any history of respiratory infection in the last three weeks? Sometimes we may need to take a sample from the kidney to find out the exact cause. For more information consult an internal medicine physician online

Hi doctor,My wife is losing protein in the urine. The result is ++. She usually remains tired and also has pain in some part of the body like back pain or head pain. She also has a lot of black pigmentation marks on her body. Is pigmentation marks cause any serious problem? Can you please tell me its side effects? And what are the issues we can face in future due to this problem? And does it have any treatment? Because already one doctor has told us that there is no treatment for this problem and my wife will get ill sooner due to protein loss, and there is also 20 % chances of kidney failure in the future. Is it true?

Hi, Welcome to Chat Doctor forum. Protein in urine can be due to a nephrotic syn ChatDoctor. Blood pressure, blood albumin level, and random blood sugar should be measured. Her urine test shows some pus cells (attachment removed to protect patient identity). I suggest using antibiotics like Bactrim (Sulfamethoxazole and Trimethoprim) for five days. Is there any history of respiratory infection in the last three weeks? Sometimes we may need to take a sample from the kidney to find out the exact cause. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I started growing hair on my neck when I was about 12, and since then I have pulled the hairs out with my finger, dug the skin with my nails to get the hairs out of the bumps, used razors and also tweezers. Now my skin looks horrible is scarred up pretty mad. I am embarrassed at how my neck seems to be a woman. The hairs grow so much, and I get hair bumps as well. I want to clear my skin up, so it does not look all bump and scard. ### Response: Hello, Welcome to Chat Doctor forum. You have a case of pseudofolliculitis barbae, although a term reserved for male beard condition, you got it because of tampering and ill hair removing practices. Treatment includes manual correction of ingrown hair (visit your dermatologist) under magnification. Your hairs have changed their direction due to pulling. Once pulled out, they will grow normally and will not cause redness and bumps within the skin. Go for laser hair removal, which will take care of both hair growth as well as ingrown hair. Make sure it is a laser and not an IPL (intense pulse light) device. Things can be normal if you start following the right path. I hope this answers your query.

Hello doctor,I started growing hair on my neck when I was about 12, and since then I have pulled the hairs out with my finger, dug the skin with my nails to get the hairs out of the bumps, used razors and also tweezers. Now my skin looks horrible is scarred up pretty mad. I am embarrassed at how my neck seems to be a woman. The hairs grow so much, and I get hair bumps as well. I want to clear my skin up, so it does not look all bump and scard.

Hello, Welcome to Chat Doctor forum. You have a case of pseudofolliculitis barbae, although a term reserved for male beard condition, you got it because of tampering and ill hair removing practices. Treatment includes manual correction of ingrown hair (visit your dermatologist) under magnification. Your hairs have changed their direction due to pulling. Once pulled out, they will grow normally and will not cause redness and bumps within the skin. Go for laser hair removal, which will take care of both hair growth as well as ingrown hair. Make sure it is a laser and not an IPL (intense pulse light) device. Things can be normal if you start following the right path. I hope this answers your query.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am having an allergic reaction (hives) to Fluconazole. What can be done to reverse the side effect of this medication? I already went to the doctor over five times in the last three weeks. This is going on for four weeks. All the doctor does is give me itching medication. I am itching really bad. ### Response: Hello. It can be a reaction to Fluconazole, but we should rule out other causes as well. As you mentioned that you are not responding to itching medicines like antihistaminics, you need to be started on steroids like Prednisolone. But before starting steroids, I suggest you visit a dermatologist for examination, confirmation of diagnosis and get some blood test done like hemogram including WBC count and ANA (antinuclear antibody) levels, liver function test and renal function tests to rule out infection as steroids may be detrimental. Until then you can have tablet Montair LC (Levocetirizine plus Montelukast combination) one at bedtime, which is a higher antiallergic medicine, and Lactocalamine lotion for topical application. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope this helps you. For more information consult an internal medicine physician online Take care.

Hello doctor,I am having an allergic reaction (hives) to Fluconazole. What can be done to reverse the side effect of this medication? I already went to the doctor over five times in the last three weeks. This is going on for four weeks. All the doctor does is give me itching medication. I am itching really bad.

Hello. It can be a reaction to Fluconazole, but we should rule out other causes as well. As you mentioned that you are not responding to itching medicines like antihistaminics, you need to be started on steroids like Prednisolone. But before starting steroids, I suggest you visit a dermatologist for examination, confirmation of diagnosis and get some blood test done like hemogram including WBC count and ANA (antinuclear antibody) levels, liver function test and renal function tests to rule out infection as steroids may be detrimental. Until then you can have tablet Montair LC (Levocetirizine plus Montelukast combination) one at bedtime, which is a higher antiallergic medicine, and Lactocalamine lotion for topical application. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope this helps you. For more information consult an internal medicine physician online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I went to see my optician and my left eye had an IOP of 22 and the right had 20. These seem to be the average numbers going back six years at two-year intervals. He dilated the eyes and inspected and took photos of the optic nerves. He said everything looked healthy and said to come back in two years. Is this a normal procedure? Of note, I also had the visual field test upon request two years ago which was good as well. Should I be seeing him sooner than two years or just sit and trust that everything is good? I sometimes take Lorazepam for anxiety. Please help. ### Response: Hello, Welcome to Chat Doctor forum. The pressure readings you told me are within normal limits. Since the ophthalmologist you saw did a detailed fundus examination and told you everything was fine and also your fields are fine. So, I think you do not have anything to worry about. Also if nobody has any history of glaucoma in your family, it would be another point that you should not worry. Get your IOP (Intraocular Pressure) checked every six months or so and a yearly fields test. I think it would be enough to keep your anxiety away. For more information consult an eye care ophthalmologist online

Hello doctor,I went to see my optician and my left eye had an IOP of 22 and the right had 20. These seem to be the average numbers going back six years at two-year intervals. He dilated the eyes and inspected and took photos of the optic nerves. He said everything looked healthy and said to come back in two years. Is this a normal procedure? Of note, I also had the visual field test upon request two years ago which was good as well. Should I be seeing him sooner than two years or just sit and trust that everything is good? I sometimes take Lorazepam for anxiety. Please help.

Hello, Welcome to Chat Doctor forum. The pressure readings you told me are within normal limits. Since the ophthalmologist you saw did a detailed fundus examination and told you everything was fine and also your fields are fine. So, I think you do not have anything to worry about. Also if nobody has any history of glaucoma in your family, it would be another point that you should not worry. Get your IOP (Intraocular Pressure) checked every six months or so and a yearly fields test. I think it would be enough to keep your anxiety away. For more information consult an eye care ophthalmologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I shall be thankful to you if you please answer few of my queries. How CMIA combo for HIV testing is done? How much it is reliable at 175 and 180 post incidence. INDEX was .14 and .08, respectively. What are the chances of error in the result? (Done at two different labs). Even after three years, I have no medical issue. Please give me awareness on procedure reliability. ### Response: Hi, Welcome to Chat Doctor forum. Below are the specific answers for your questions. CMIA is based on chemiluminescence principle and it is performed on an automated analyzer. It is the most effective technique nowadays to rule out HIV. CMIA can almost 100 % rule out HIV after 90 days of exposure. Usually, in most of the patients, CMIA can be effective after six weeks of exposure. So after 175 days of exposure, you need not to worry about HIV. The index value is cut off value based on which the result is given. The chance of error is very less. After testing for two times the chance of error is almost nil. After three years of exposure there is no medical issue, so the chances of HIV is very less.

Hello doctor,I shall be thankful to you if you please answer few of my queries. How CMIA combo for HIV testing is done? How much it is reliable at 175 and 180 post incidence. INDEX was .14 and .08, respectively. What are the chances of error in the result? (Done at two different labs). Even after three years, I have no medical issue. Please give me awareness on procedure reliability.

Hi, Welcome to Chat Doctor forum. Below are the specific answers for your questions. CMIA is based on chemiluminescence principle and it is performed on an automated analyzer. It is the most effective technique nowadays to rule out HIV. CMIA can almost 100 % rule out HIV after 90 days of exposure. Usually, in most of the patients, CMIA can be effective after six weeks of exposure. So after 175 days of exposure, you need not to worry about HIV. The index value is cut off value based on which the result is given. The chance of error is very less. After testing for two times the chance of error is almost nil. After three years of exposure there is no medical issue, so the chances of HIV is very less.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I might be a hypochondriac, and I do have quite severe OCD. What I wanted to ask was if I had sex while still being on a strong pill and then around a week and a half later I stopped taking it (my doctor said it is active for quite some time after quitting it) could I still be pregnant? Even if eight pregnancy tests were done in a span of three months said it is negative and I had my period as regular? I am 21 years old, always had digestive problems and a bloated belly, which is why probably I am being driven crazy but still want a professional opinion. ### Response: Hi. At the time of sex, you were on the pill so the chance of pregnancy is nil. Because sperms usually do not survive in your womb for more than three to four days after sex, and during that time you were on the pill. Moreover, eight pregnancy tests done in a span of three months were negative and you had the period as regular. So relax you are not pregnant. For digestive problems, you can do ultrasound test of the abdomen. Also, I can suggest chewing cardamom as a whole to reduce bloating. For more information consult an obstetrician and gynaecologist online Take care.

Hello doctor,I might be a hypochondriac, and I do have quite severe OCD. What I wanted to ask was if I had sex while still being on a strong pill and then around a week and a half later I stopped taking it (my doctor said it is active for quite some time after quitting it) could I still be pregnant? Even if eight pregnancy tests were done in a span of three months said it is negative and I had my period as regular? I am 21 years old, always had digestive problems and a bloated belly, which is why probably I am being driven crazy but still want a professional opinion.

Hi. At the time of sex, you were on the pill so the chance of pregnancy is nil. Because sperms usually do not survive in your womb for more than three to four days after sex, and during that time you were on the pill. Moreover, eight pregnancy tests done in a span of three months were negative and you had the period as regular. So relax you are not pregnant. For digestive problems, you can do ultrasound test of the abdomen. Also, I can suggest chewing cardamom as a whole to reduce bloating. For more information consult an obstetrician and gynaecologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a query about the medication prescribed to me, and I need a second opinion. My diagnoses are bipolar 1 and ADHD. I take daily,1. Lithium 1600 mg.2. Lamotrigine 300 mg.3. Amisulpride 400 mg.4. Haloperidol 4 mg.5. Sertraline 200 mg.6. Pregabalin 400 mg.7. Propranolol 80 mg.8. Lisdexamfetamine 60 mg.9. Procyclidine 15 mg.10. Diazepam 10 mg (PRN).Is that too much medication? Do some of these counteract with each other? ### Response: Hello. The rule of thumb in psychiatry is to prescribe medicine for an adequate duration and adequate dose, before considering it ineffective or plan to change. If your doctor has previously tried one medication for proper dose and duration now, he can add another ChatDoctor. If you are not in a depression or not a rapid cycler, Sertraline can be tapered down. If you are in remission, Lamotrigine can be slowly stopped. I found no counteracting

Hello doctor,I have a query about the medication prescribed to me, and I need a second opinion. My diagnoses are bipolar 1 and ADHD. I take daily,1. Lithium 1600 mg.2. Lamotrigine 300 mg.3. Amisulpride 400 mg.4. Haloperidol 4 mg.5. Sertraline 200 mg.6. Pregabalin 400 mg.7. Propranolol 80 mg.8. Lisdexamfetamine 60 mg.9. Procyclidine 15 mg.10. Diazepam 10 mg (PRN).Is that too much medication? Do some of these counteract with each other?

Hello. The rule of thumb in psychiatry is to prescribe medicine for an adequate duration and adequate dose, before considering it ineffective or plan to change. If your doctor has previously tried one medication for proper dose and duration now, he can add another ChatDoctor. If you are not in a depression or not a rapid cycler, Sertraline can be tapered down. If you are in remission, Lamotrigine can be slowly stopped. I found no counteracting

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am six weeks three days pregnant. I went for an ultrasound and found the uterus is bulky and anteverted. Single gestational sac is seen high up in the uterus. Yolk sac has been identified but the fetal pole is not seen. Good decidual reaction is seen. Suggestive of sonography after two weeks. However, the gynecologist said it is a reason to worry and do not have a chance of success. Please suggest. ### Response: Hello, Welcome to Chat Doctor forum. I have gone through your query and reports (attachment removed to protect patient identity). Since your gestational sac and yolk sac are evident, there is nothing to worry about. The delay in the process could be because of late implantation. Another positive factor is that there is good decidual reaction. You can wait for a week or two and repeat the scan. Because the fetal pole and cardiac activity will be evident from six to seven weeks. Post seven weeks, if you cannot find the fetal pole or cardiac activity, then we can think. So, please do not lose hope. Continue taking Folic acid and Progesterone supplements. However, if you have a doubt then get back to me. Take care. For more information consult an obstetrician and gynaecologist online

Hi doctor,I am six weeks three days pregnant. I went for an ultrasound and found the uterus is bulky and anteverted. Single gestational sac is seen high up in the uterus. Yolk sac has been identified but the fetal pole is not seen. Good decidual reaction is seen. Suggestive of sonography after two weeks. However, the gynecologist said it is a reason to worry and do not have a chance of success. Please suggest.

Hello, Welcome to Chat Doctor forum. I have gone through your query and reports (attachment removed to protect patient identity). Since your gestational sac and yolk sac are evident, there is nothing to worry about. The delay in the process could be because of late implantation. Another positive factor is that there is good decidual reaction. You can wait for a week or two and repeat the scan. Because the fetal pole and cardiac activity will be evident from six to seven weeks. Post seven weeks, if you cannot find the fetal pole or cardiac activity, then we can think. So, please do not lose hope. Continue taking Folic acid and Progesterone supplements. However, if you have a doubt then get back to me. Take care. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have found this spot on my tongue for the past seven months and for the most part, has not really changed. No symptoms, but can sometimes feel the bumps when I run my finger over it. Does this look like it is a frictional problem or something worse? I am guessing friction based on what I have been told before but want to confirm with another opinion. ### Response: Hi, Welcome to Chat Doctor forum. I had gone through your question and understand your concern. As per your photographs (attachment removed to protect patient identity), it does not look like any severe problem. This could be the friction or irritational in nature due to a sharp tooth edge. This lesion only looks like hyperkeratotic and nothing else. So, there is no need to worry about it. Please let me know if there is any sharp tooth edge, also if there is any swelling under your mandible (chin). You can also take high Vitamin A diet like carrot or Vitamin A supplements for at least a month, it will be helpful and the lesion will disappear soon. Sharp tooth edge or faulty brushing technique. Traumatic ulcer. Frictional hyperkeratosis. Enameloplasty, if there is a sharp tooth edge. Brushing (modified Bass technique). Use ultrasoft toothbrush.

Hello doctor,I have found this spot on my tongue for the past seven months and for the most part, has not really changed. No symptoms, but can sometimes feel the bumps when I run my finger over it. Does this look like it is a frictional problem or something worse? I am guessing friction based on what I have been told before but want to confirm with another opinion.

Hi, Welcome to Chat Doctor forum. I had gone through your question and understand your concern. As per your photographs (attachment removed to protect patient identity), it does not look like any severe problem. This could be the friction or irritational in nature due to a sharp tooth edge. This lesion only looks like hyperkeratotic and nothing else. So, there is no need to worry about it. Please let me know if there is any sharp tooth edge, also if there is any swelling under your mandible (chin). You can also take high Vitamin A diet like carrot or Vitamin A supplements for at least a month, it will be helpful and the lesion will disappear soon. Sharp tooth edge or faulty brushing technique. Traumatic ulcer. Frictional hyperkeratosis. Enameloplasty, if there is a sharp tooth edge. Brushing (modified Bass technique). Use ultrasoft toothbrush.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I had a problem of nose block and my ENT surgeon suggested me to go for a nose operation. As per doctor instruction, operation of my nose was carried out before three months. Now my nose is almost fine, but still I feel that something is there in my throat. I also feel itchy throat and every 10 minutes I need to make a sound to get relief of this itching. After nose operation, my ENT surgeon suggested Levocet M for my throat problem. He advised me to take daily one tablet at night for six months and slowly throat problem will be cured. I am taking Levocet M for the last three months, but still my throat problem remains the same. Please suggest me whether should I continue or stop this tablet. Is there any side effect if I am taking this medicine for a long time? Please suggest me what should I do. Will you recommend me to take any other medicine? ### Response: Hello. Your symptoms seem to suggest that you are suffering from allergy. Levocet M (Levocetirizine and Montelukast) is given for the same purpose. It is true that the medicine should be taken for a few months regularly. It has minimal side effects, like ChatDoctor. Take care.

Hi doctor,I had a problem of nose block and my ENT surgeon suggested me to go for a nose operation. As per doctor instruction, operation of my nose was carried out before three months. Now my nose is almost fine, but still I feel that something is there in my throat. I also feel itchy throat and every 10 minutes I need to make a sound to get relief of this itching. After nose operation, my ENT surgeon suggested Levocet M for my throat problem. He advised me to take daily one tablet at night for six months and slowly throat problem will be cured. I am taking Levocet M for the last three months, but still my throat problem remains the same. Please suggest me whether should I continue or stop this tablet. Is there any side effect if I am taking this medicine for a long time? Please suggest me what should I do. Will you recommend me to take any other medicine?

Hello. Your symptoms seem to suggest that you are suffering from allergy. Levocet M (Levocetirizine and Montelukast) is given for the same purpose. It is true that the medicine should be taken for a few months regularly. It has minimal side effects, like ChatDoctor. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 34 year old male. My weight is 68 kg. I am married and have two kids. Because, of the disturbance made by my kids, I was not able to sleep well sometimes. So, I just started taking tablet Alprazolam 0.25 mg. Now I have been trying to gradually stop taking the medicine. So, I had 0.25 mg on the alternate days and in between 0.5 mg twice a day. I have a feeling that my body has got addicted to tablet Alprazolam. Because, from the day I stopped taking the tablet, I am not able to sleep even a little bit. Yesterday too, I tried without medicine. But, I could not sleep. Then at midnight, I had 0.5 mg and then slept for 4 hours. Please help. Thank you in advance. ### Response: Hi, Welcome to Chat Doctor forum.I can understand your concerns. Alprazolam is a habit forming ChatDoctor. I would suggest you to take Zolpidem for disturbed sleep. Zolpidem is less addictive compared to Alprazolam. I will suggest you the following measures to get a sound sleep. Please try.

Hello doctor,I am a 34 year old male. My weight is 68 kg. I am married and have two kids. Because, of the disturbance made by my kids, I was not able to sleep well sometimes. So, I just started taking tablet Alprazolam 0.25 mg. Now I have been trying to gradually stop taking the medicine. So, I had 0.25 mg on the alternate days and in between 0.5 mg twice a day. I have a feeling that my body has got addicted to tablet Alprazolam. Because, from the day I stopped taking the tablet, I am not able to sleep even a little bit. Yesterday too, I tried without medicine. But, I could not sleep. Then at midnight, I had 0.5 mg and then slept for 4 hours. Please help. Thank you in advance.

Hi, Welcome to Chat Doctor forum.I can understand your concerns. Alprazolam is a habit forming ChatDoctor. I would suggest you to take Zolpidem for disturbed sleep. Zolpidem is less addictive compared to Alprazolam. I will suggest you the following measures to get a sound sleep. Please try.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have twice in the last two weeks scratched the cornea of my eye. The first time was two weeks ago when I was wearing my contacts for an extended time (no more than normal) and started feeling severe pain, tearing, swelling of my right eye. It felt like the contact in my eye folded over (it was not). Slightly sensitive. It took a couple of days and I was back to normal but had not worn my contacts again until the day before, when I wore for a short time, no problem. Yesterday, I wore them all day and had the same reaction of dry eye, tearing, extreme pain, scratchy eyes, extremely light sensitive and very swollen eye. Do I need to go to a doctor for treatment or will it heal on its own? How long should I wait before I wear my contacts again? ### Response: Hello. It looks like you have a huge epithelial defect due to trauma caused by contact lenses. But the possibility of infection can only be ruled out by examining your eye. It would have been great if you would have attached a photograph but, let me suggest some medication that will cover both the defect and infection, if present. If no relief is obtained in a couple of days, then visit an ophthalmologist.

Hello doctor,I have twice in the last two weeks scratched the cornea of my eye. The first time was two weeks ago when I was wearing my contacts for an extended time (no more than normal) and started feeling severe pain, tearing, swelling of my right eye. It felt like the contact in my eye folded over (it was not). Slightly sensitive. It took a couple of days and I was back to normal but had not worn my contacts again until the day before, when I wore for a short time, no problem. Yesterday, I wore them all day and had the same reaction of dry eye, tearing, extreme pain, scratchy eyes, extremely light sensitive and very swollen eye. Do I need to go to a doctor for treatment or will it heal on its own? How long should I wait before I wear my contacts again?

Hello. It looks like you have a huge epithelial defect due to trauma caused by contact lenses. But the possibility of infection can only be ruled out by examining your eye. It would have been great if you would have attached a photograph but, let me suggest some medication that will cover both the defect and infection, if present. If no relief is obtained in a couple of days, then visit an ophthalmologist.

### Instruction: Answer this question truthfully ###Input: Hello doctor,After how many days of periods, sex should not happen to avoid pregnancy? ### Response: Hello. Your question actually pertains to a natural birth control method called rhythm method calendar method (you can search it on net). Let me tell you the safe days are the days you can actually have sex in order not to get pregnant but, this method is not full proof and there are failure rates too. Consider first day of your cycle (menstrual cycle) as the day from which you began to bleed. You keep a track of your cycles and determine your shortest and longest cycle but before that know it that your cycles must be regular. Substract 20 from your shortest cycle and 10 from your longest cycle and you get your safe days. Eg. Shortest is 26 Longest is 30. 26-20= 6 30-10= 20. Days 6 to 20 is unsafe for you. Rest all will be safe to have sex to avoid pregnancy. There are many other calculations for calendar which you yourself can search but my recommendations will be five days after the last day of your first cycle that is when the bleeding stops will be the safest (though not 100 percent).

Hello doctor,After how many days of periods, sex should not happen to avoid pregnancy?

Hello. Your question actually pertains to a natural birth control method called rhythm method calendar method (you can search it on net). Let me tell you the safe days are the days you can actually have sex in order not to get pregnant but, this method is not full proof and there are failure rates too. Consider first day of your cycle (menstrual cycle) as the day from which you began to bleed. You keep a track of your cycles and determine your shortest and longest cycle but before that know it that your cycles must be regular. Substract 20 from your shortest cycle and 10 from your longest cycle and you get your safe days. Eg. Shortest is 26 Longest is 30. 26-20= 6 30-10= 20. Days 6 to 20 is unsafe for you. Rest all will be safe to have sex to avoid pregnancy. There are many other calculations for calendar which you yourself can search but my recommendations will be five days after the last day of your first cycle that is when the bleeding stops will be the safest (though not 100 percent).

### Instruction: Answer this question truthfully ###Input: Hello doctor,On having sex I start to lose my erection, when I wear condoms also I do not feel anything after wearing condom. It was my first time and I did not feel any pleasure while entering a vagina. Is this a major issue? Should I get it checked? ### Response: Hi. First of all, you should understand erectile dysfunction. You are just 23. At your age ED will never come unless you are in some influence of liquor or ChatDoctor. Other than these two reasons, ED can also happen due to performance anxiety. Anyone can feel anxiety and apprehension when they go for first time sex. That is natural. Not knowing what to do and how to do, not having sexual experience, worry about getting pregnant, worry about failure, worry about satisfying that partner, worry about what will happen if others come to know, etc., there are so many stressful anxious questions inside your mind. All these combines to create performance anxiety and ED happens. So do not worry about that one incident. Regarding condom, while wearing condom, men naturally have lesser pleasure because of the sheet between penis wall and the vaginal hole. Do not worry too much about it because the more you worry, more the problem will trouble you. Take care. Take care.

Hello doctor,On having sex I start to lose my erection, when I wear condoms also I do not feel anything after wearing condom. It was my first time and I did not feel any pleasure while entering a vagina. Is this a major issue? Should I get it checked?

Hi. First of all, you should understand erectile dysfunction. You are just 23. At your age ED will never come unless you are in some influence of liquor or ChatDoctor. Other than these two reasons, ED can also happen due to performance anxiety. Anyone can feel anxiety and apprehension when they go for first time sex. That is natural. Not knowing what to do and how to do, not having sexual experience, worry about getting pregnant, worry about failure, worry about satisfying that partner, worry about what will happen if others come to know, etc., there are so many stressful anxious questions inside your mind. All these combines to create performance anxiety and ED happens. So do not worry about that one incident. Regarding condom, while wearing condom, men naturally have lesser pleasure because of the sheet between penis wall and the vaginal hole. Do not worry too much about it because the more you worry, more the problem will trouble you. Take care. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have one question. My girlfriend is already on krimson 35 due to PCOD. After we made love, she missed her periods. Now, she is also complaining of morning sickness and pain in lower back. All symptoms are same as she reported five months back when she was pregnant and doctor advised pills for three days for chemical abortion. We feel that she is pregnant again. What we shall do as we are not ready to have child right now? Shall we take that same abortion pill again? Will there be any health complication? Please guide. ### Response: Hello, Welcome to Chat Doctor forum. One information I should share with you at first is Krimson 35 (Ethinyl estradiol) is not only an anti-PCOS (polycystic ovarian syn ChatDoctor. So, if your girlfriend is regularly having these pills, you need not be concerned about pregnancy. But, there exists risk regarding pregnancy only if she is an irregular user. PCOS. 1. Urine pregnancy test.2. Serum LH (luteinizing hormone), FSH (follicle stimulating hormone), TSH (thyroid stimulating hormone) and prolactin estimation. Revert back after the tests to an obstetrician and gynaecologist online.-

Hello doctor,I have one question. My girlfriend is already on krimson 35 due to PCOD. After we made love, she missed her periods. Now, she is also complaining of morning sickness and pain in lower back. All symptoms are same as she reported five months back when she was pregnant and doctor advised pills for three days for chemical abortion. We feel that she is pregnant again. What we shall do as we are not ready to have child right now? Shall we take that same abortion pill again? Will there be any health complication? Please guide.

Hello, Welcome to Chat Doctor forum. One information I should share with you at first is Krimson 35 (Ethinyl estradiol) is not only an anti-PCOS (polycystic ovarian syn ChatDoctor. So, if your girlfriend is regularly having these pills, you need not be concerned about pregnancy. But, there exists risk regarding pregnancy only if she is an irregular user. PCOS. 1. Urine pregnancy test.2. Serum LH (luteinizing hormone), FSH (follicle stimulating hormone), TSH (thyroid stimulating hormone) and prolactin estimation. Revert back after the tests to an obstetrician and gynaecologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,I need to know whether my child is affected by TB or bronchitis? I have attached his ESR, blood test, TST and chest x-ray. Kindly suggest. ### Response: Hi, Welcome to ChatDoctor. I have seen the reports. (attachment removed to protect patient identity). The very first thing why you suspected that your child may have TB (tuberculosis)? What are the problems he is having like prolonged cough, are any swelling in the neck or any contact with a person who is known for lung TB? Looking at his weight, he seems to be growing well. Except for MT (Mantoux tuberculin test) which 15 mm positive, all other tests are normal, x-ray findings are non-specific. Best if you can get his sputum test to isolate germs (in this age group it is done by gastric lavage), or if he has significantly large glands in his neck, then a needle biopsy of the gland which a safe and easy procedure. There is a very fast and accurate test known as PCR (polymerase chain reaction) to confirm the presence of TB germs. If there is a contact with a confirmed case of lung TB, then with this MT result, you need to start medication. I hope this helps.

Hello doctor,I need to know whether my child is affected by TB or bronchitis? I have attached his ESR, blood test, TST and chest x-ray. Kindly suggest.

Hi, Welcome to ChatDoctor. I have seen the reports. (attachment removed to protect patient identity). The very first thing why you suspected that your child may have TB (tuberculosis)? What are the problems he is having like prolonged cough, are any swelling in the neck or any contact with a person who is known for lung TB? Looking at his weight, he seems to be growing well. Except for MT (Mantoux tuberculin test) which 15 mm positive, all other tests are normal, x-ray findings are non-specific. Best if you can get his sputum test to isolate germs (in this age group it is done by gastric lavage), or if he has significantly large glands in his neck, then a needle biopsy of the gland which a safe and easy procedure. There is a very fast and accurate test known as PCR (polymerase chain reaction) to confirm the presence of TB germs. If there is a contact with a confirmed case of lung TB, then with this MT result, you need to start medication. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have an itchy bump around the nail of one of my toes, the second one. It has happened in the past years, usually when the season gets warmer. It started about a month ago and grew into a quite itchy, sensitive and swollen area. It is now turning to purple. I tried antifungals before, but it was hard to know whether they made a difference. Please help. ### Response: Hi, Welcome to Chat Doctor forum. I have read your concern and examine your pictures (attachment removed to protect patient identity). Ingrowing nail. 1. Gram staining and culture.2. Potassium hy ChatDoctor. 1. Acute paronychia without obvious abscess can be treated nonsurgically like in your case.2. I suggest tablet Augmentin 625 mg thrice daily (combination of Amoxicillin and Clavulanic acid) for 5 days and 1% Clotrimazole plus Fusidic acid cream twice daily for one week.Consult your specialist doctor, discuss with him or her and take the medicine with consent. Cut the nail from the side as it grows from the side and cause recurrent problem. Also, do not use tight foot wear. Revert back after a week to a dermatologist online.-

Hello doctor,I have an itchy bump around the nail of one of my toes, the second one. It has happened in the past years, usually when the season gets warmer. It started about a month ago and grew into a quite itchy, sensitive and swollen area. It is now turning to purple. I tried antifungals before, but it was hard to know whether they made a difference. Please help.

Hi, Welcome to Chat Doctor forum. I have read your concern and examine your pictures (attachment removed to protect patient identity). Ingrowing nail. 1. Gram staining and culture.2. Potassium hy ChatDoctor. 1. Acute paronychia without obvious abscess can be treated nonsurgically like in your case.2. I suggest tablet Augmentin 625 mg thrice daily (combination of Amoxicillin and Clavulanic acid) for 5 days and 1% Clotrimazole plus Fusidic acid cream twice daily for one week.Consult your specialist doctor, discuss with him or her and take the medicine with consent. Cut the nail from the side as it grows from the side and cause recurrent problem. Also, do not use tight foot wear. Revert back after a week to a dermatologist online.-

### Instruction: Answer this question truthfully ###Input: Hello I feel pain at my lower left side of abdomen,, Also It's hard to pee ( feeling burning) the symptoms looks like I have Urolithiasis. I need to make sure ### Response: Hi, I understand your concerns. You are finding it difficult to pee and there is a burning sensation. These may be due to urinary tract infection (more likely) or stones. In your urine report there are a few microorganisms and red blood cells are also present -these are suggestive of urinary tract infection. Please get an urine culture sensitivity report and an ultrasound of kidney,ureter and urinary bladder. Plenty of fluids is advisable and antibiotics have to be taken on basis of your culture report. Signs and symptoms of kidney stones can include severe pain, nausea, vomiting, fever, chills and blood in your urine. Diagnosis of stones is based on urinalysis and radiologic imaging, usually noncontrast helical CT. Treatment is with analgesics, antibiotics for infection, medical expulsive therapy, and, sometimes, shock wave lithotripsy or endoscopic procedures. Hope this helps. UTI UTI Urine Culture sensitivity Ultrasound of kidney,ureter and urinary bladder. Urolothiasis UTI Plenty of fluidsAnd antibiotics according to urine culture report. Plenty of fluids,genital hygeine.

Hello I feel pain at my lower left side of abdomen,, Also It's hard to pee ( feeling burning) the symptoms looks like I have Urolithiasis. I need to make sure

Hi, I understand your concerns. You are finding it difficult to pee and there is a burning sensation. These may be due to urinary tract infection (more likely) or stones. In your urine report there are a few microorganisms and red blood cells are also present -these are suggestive of urinary tract infection. Please get an urine culture sensitivity report and an ultrasound of kidney,ureter and urinary bladder. Plenty of fluids is advisable and antibiotics have to be taken on basis of your culture report. Signs and symptoms of kidney stones can include severe pain, nausea, vomiting, fever, chills and blood in your urine. Diagnosis of stones is based on urinalysis and radiologic imaging, usually noncontrast helical CT. Treatment is with analgesics, antibiotics for infection, medical expulsive therapy, and, sometimes, shock wave lithotripsy or endoscopic procedures. Hope this helps. UTI UTI Urine Culture sensitivity Ultrasound of kidney,ureter and urinary bladder. Urolothiasis UTI Plenty of fluidsAnd antibiotics according to urine culture report. Plenty of fluids,genital hygeine.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have a total sperm count of 38.4. I am addicted to alcohol, and I took a drink four days ago. I am trying for a baby for two months. I have a history of seizure. I am taking Levera 500 mg, Oxetol 450 mg and Cloba 20 mg. Could I take Folic acid? Can you check my report and help me out? ### Response: Hello, Welcome to Chat Doctor forum. I have seen the reports (attachment removed to protect patient identity), and it is evident that your sperm count is low along with high abnormal forms as well. This is called oligoasthenozoospermia. You have to avoid alcohol completely if you wish to increase your sperm count levels and have to be on antioxidant supplementation with Carnitine, Lycopene and Ubidecarenone (Coenzyme Q10) to increase your sperm counts in the next two to three months. You should not stop your seizure medications at all. I suggest the following for improving your sperm count. Consult your doctor, discuss with him or her and take treatment with consent. Review semen analysis after a month. Avoid alcohol and smoking completely if you wish to conceive as a couple.

Hi doctor,I have a total sperm count of 38.4. I am addicted to alcohol, and I took a drink four days ago. I am trying for a baby for two months. I have a history of seizure. I am taking Levera 500 mg, Oxetol 450 mg and Cloba 20 mg. Could I take Folic acid? Can you check my report and help me out?

Hello, Welcome to Chat Doctor forum. I have seen the reports (attachment removed to protect patient identity), and it is evident that your sperm count is low along with high abnormal forms as well. This is called oligoasthenozoospermia. You have to avoid alcohol completely if you wish to increase your sperm count levels and have to be on antioxidant supplementation with Carnitine, Lycopene and Ubidecarenone (Coenzyme Q10) to increase your sperm counts in the next two to three months. You should not stop your seizure medications at all. I suggest the following for improving your sperm count. Consult your doctor, discuss with him or her and take treatment with consent. Review semen analysis after a month. Avoid alcohol and smoking completely if you wish to conceive as a couple.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Since the last 10 months, my periods are very irregular. I get periods only once every three to four months. I am on treatment for abdominal TB since the last one and a half years. I take Sompraz D20 on an empty stomach in the morning. I take Duonase nasal spray (two puffs in each nostril) twice a day. I take Immunace Forte after lunch and Libotryp at bedtime. So, why are my periods not regular? Is this a side effect of my medicine or could it be due to a disease? Recently, I was also prescribed Uprise-D3 (60000) once a month for six months. My recent 25-OH vitamin D total is 21.1 ng/mL. I also have sudden weight gain. My weight in the last one and a half years increased from 57 kg to 81 kg. I also have a chronic nose block. ### Response: Hello. Your irregular periods can be due to your obesity. You need to lose some weight. You have a history of TB (tuberculosis). So, there may be chances that your uterus might have got affected due to that. I suggest the following tests

Hello doctor,Since the last 10 months, my periods are very irregular. I get periods only once every three to four months. I am on treatment for abdominal TB since the last one and a half years. I take Sompraz D20 on an empty stomach in the morning. I take Duonase nasal spray (two puffs in each nostril) twice a day. I take Immunace Forte after lunch and Libotryp at bedtime. So, why are my periods not regular? Is this a side effect of my medicine or could it be due to a disease? Recently, I was also prescribed Uprise-D3 (60000) once a month for six months. My recent 25-OH vitamin D total is 21.1 ng/mL. I also have sudden weight gain. My weight in the last one and a half years increased from 57 kg to 81 kg. I also have a chronic nose block.

Hello. Your irregular periods can be due to your obesity. You need to lose some weight. You have a history of TB (tuberculosis). So, there may be chances that your uterus might have got affected due to that. I suggest the following tests

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have had permanent cramps and a constant ache in both buttocks. I have pain down the back of the legs in the calf and when I walk it feels like it is about to cramp and I get pain in front of the thigh. I have a constant aching feel. When I press my skin on both thighs it feels sore. I had it for over two months. I have pain on both sides of my thighs and legs regardless of if I am sitting or resting.I got admitted to the hospital for two weeks and they did an MRI scan on my spine and found nothing. They did a lumbar puncture and found nothing. They also did a nerve examination and nothing was found. I am currently on Gabapentin, Codeine, and Paracetamol. ### Response: Hi. It looks like a nerve compression to me. If all investigations are normal, it does not mean it cannot be nerve compression. It could be meralgia paresthesia or neuralgia. I would recommend you to take Vitamin B12 shots. Also, discuss with your doctor to prescribe you a combination of Pregabalin along With Nortryptilline in the night. This may take a few weeks to months to recover. I hope this helps. Take care.

Hello doctor,I have had permanent cramps and a constant ache in both buttocks. I have pain down the back of the legs in the calf and when I walk it feels like it is about to cramp and I get pain in front of the thigh. I have a constant aching feel. When I press my skin on both thighs it feels sore. I had it for over two months. I have pain on both sides of my thighs and legs regardless of if I am sitting or resting.I got admitted to the hospital for two weeks and they did an MRI scan on my spine and found nothing. They did a lumbar puncture and found nothing. They also did a nerve examination and nothing was found. I am currently on Gabapentin, Codeine, and Paracetamol.

Hi. It looks like a nerve compression to me. If all investigations are normal, it does not mean it cannot be nerve compression. It could be meralgia paresthesia or neuralgia. I would recommend you to take Vitamin B12 shots. Also, discuss with your doctor to prescribe you a combination of Pregabalin along With Nortryptilline in the night. This may take a few weeks to months to recover. I hope this helps. Take care.

### Instruction: Answer this question truthfully ###Input: Respected doctor,My father is suffering from a chronic liver disease. I have attached his case summary with this query. He is in the ICU for the last four days. As per the doctor, my father may remain in this state for an indefinite period of time because his liver is not functioning. So, I want to get a second opinion and want to know, whether there is a way to revive his liver and make it function properly. ### Response: Hi. As per the records, he is suffering from stage-3 liver disease, that is an end-stage liver disease. His current problems need to be medically supported. This will result in temporary improvement of his condition. However, issues like infection, blood loss, fluid accumulation in the body, etc., will be frequent from now. The definite treatment ahead is liver transplantation. If you are ready to proceed with evaluation and transplant, then I would suggest considering treatment at a transplant center. Else, medical optimization, which is going on now will be alright. Was an endoscopy done for him? Also blood, abdominal fluid, and urine culture tests? If yes, please send them across. Hope your queries have been cleared. Do review if you have any further queries. For more information consult a medical gastroenterologist online

Respected doctor,My father is suffering from a chronic liver disease. I have attached his case summary with this query. He is in the ICU for the last four days. As per the doctor, my father may remain in this state for an indefinite period of time because his liver is not functioning. So, I want to get a second opinion and want to know, whether there is a way to revive his liver and make it function properly.

Hi. As per the records, he is suffering from stage-3 liver disease, that is an end-stage liver disease. His current problems need to be medically supported. This will result in temporary improvement of his condition. However, issues like infection, blood loss, fluid accumulation in the body, etc., will be frequent from now. The definite treatment ahead is liver transplantation. If you are ready to proceed with evaluation and transplant, then I would suggest considering treatment at a transplant center. Else, medical optimization, which is going on now will be alright. Was an endoscopy done for him? Also blood, abdominal fluid, and urine culture tests? If yes, please send them across. Hope your queries have been cleared. Do review if you have any further queries. For more information consult a medical gastroenterologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am an unmarried woman. My plan is to get into marriage life after two years. Currently, I have been taking Isotretinoin for the past 20 days. I have heard that it may cause infertility in women. Does Isotretinoin cause future birth defect? Will it affect my future pregnancy? ### Response: Hello, Welcome to Chat Doctor forum. Actually, it is known that Isotretinoin can cause severe birth defects in the baby if taken during pregnancy. So, you must not take it, if you are pregnant. And if you have taken, then some doctor will advice termination also in early pregnancy. But, there is no study done specifically to find correlation between Isotretinoin and infertility. And if done, then there is no correlation found significantly. So, you can use Isotretinoin if you are not pregnant. If you are planning for pregnancy, then stop using at least two to three months before. If you have acne and you are taking treatment for that, then let me tell you that try to lose some weight if possible. It will also decrease your problem. As far as future pregnancy is concerned, do not take Isotretinoin in pregnancy and stop before pregnancy.

Hi doctor,I am an unmarried woman. My plan is to get into marriage life after two years. Currently, I have been taking Isotretinoin for the past 20 days. I have heard that it may cause infertility in women. Does Isotretinoin cause future birth defect? Will it affect my future pregnancy?

Hello, Welcome to Chat Doctor forum. Actually, it is known that Isotretinoin can cause severe birth defects in the baby if taken during pregnancy. So, you must not take it, if you are pregnant. And if you have taken, then some doctor will advice termination also in early pregnancy. But, there is no study done specifically to find correlation between Isotretinoin and infertility. And if done, then there is no correlation found significantly. So, you can use Isotretinoin if you are not pregnant. If you are planning for pregnancy, then stop using at least two to three months before. If you have acne and you are taking treatment for that, then let me tell you that try to lose some weight if possible. It will also decrease your problem. As far as future pregnancy is concerned, do not take Isotretinoin in pregnancy and stop before pregnancy.

### Instruction: Answer this question truthfully ###Input: Hello doctor,May I know if you have done urethroplasty in the distal penile urethra using the excision and primary anastomosis (EPA) technique? Are you personally familiar with any such case? If so, was the surgery successful? Did the surgery cause penile curvature? If so, how many degrees did it had? What was the stricture length? Thanks. ### Response: Hi. I am a Urologist and I have performed urethroplasties. But, excision and primary anastomosis is the procedure of choice only in short segment urethral strictures and they occur in the majority of traumatic urethral strictures that occur in the proximal urethra. Such a stricture in distal urethra is rare. However, I had to do excision and primary anastomosis in an iatrogenic distal penile urethral injury, wherein the surgeon had badly damaged distal penile urethra during an attempt to dilate the distal urethra. I was called intraoperative. The urethral plate was badly damaged in that case for only 1 cm. I did excise that part and anastomosed end to end and the result was excellent and there was no postoperative chordee (bending). Other than this case, I have not done any EPA in distal urethra. Take care.

Hello doctor,May I know if you have done urethroplasty in the distal penile urethra using the excision and primary anastomosis (EPA) technique? Are you personally familiar with any such case? If so, was the surgery successful? Did the surgery cause penile curvature? If so, how many degrees did it had? What was the stricture length? Thanks.

Hi. I am a Urologist and I have performed urethroplasties. But, excision and primary anastomosis is the procedure of choice only in short segment urethral strictures and they occur in the majority of traumatic urethral strictures that occur in the proximal urethra. Such a stricture in distal urethra is rare. However, I had to do excision and primary anastomosis in an iatrogenic distal penile urethral injury, wherein the surgeon had badly damaged distal penile urethra during an attempt to dilate the distal urethra. I was called intraoperative. The urethral plate was badly damaged in that case for only 1 cm. I did excise that part and anastomosed end to end and the result was excellent and there was no postoperative chordee (bending). Other than this case, I have not done any EPA in distal urethra. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Everytime I have sex I get a vaginal tear. I did not have sex or wear a tampon for 10 weeks to let it heal. I had sex again last night and it tore again. I do not have an issue with lubrication, so I am not sure what to do. ### Response: Hello. Vaginal tears after sex are mainly dependent on several causes like vaginal ChatDoctor. , and sometimes it may also be caused by the use of recreational medicine like Viagara by the partner. Vaginal tears could be superficial and deep. Superficial tears usually result after having sex and they usually heal by themselves in few hours to 1 to 2 days and then usually do not bleed heavily. Deeper cuts usually occur during childbirth. As you mentioned that it took 10 days to heal your previous tear then it sounds alarming. Was there any heavy bleeding or pus coming through it? And how long have you been facing this problem? Can I have a look at any picture of tear? I would suggest you that if you do not have any issues with lubrication (which is the most common cause of vaginal tear during sex) then you must get yourself assessed by the local doctor and get tear examined to determine the actual cause and appropriate treatment.

Hello doctor,Everytime I have sex I get a vaginal tear. I did not have sex or wear a tampon for 10 weeks to let it heal. I had sex again last night and it tore again. I do not have an issue with lubrication, so I am not sure what to do.

Hello. Vaginal tears after sex are mainly dependent on several causes like vaginal ChatDoctor. , and sometimes it may also be caused by the use of recreational medicine like Viagara by the partner. Vaginal tears could be superficial and deep. Superficial tears usually result after having sex and they usually heal by themselves in few hours to 1 to 2 days and then usually do not bleed heavily. Deeper cuts usually occur during childbirth. As you mentioned that it took 10 days to heal your previous tear then it sounds alarming. Was there any heavy bleeding or pus coming through it? And how long have you been facing this problem? Can I have a look at any picture of tear? I would suggest you that if you do not have any issues with lubrication (which is the most common cause of vaginal tear during sex) then you must get yourself assessed by the local doctor and get tear examined to determine the actual cause and appropriate treatment.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Yesterday, unfortunately, I slept with my mobile phone under my testicles. I slept like that for five hours. I have heard of mobile radiations causing harm to the sperm and testicular cells by affecting the DNA. My problem is that my wife and I are both 34 years old and are planning for conception. Now, because of this incident, how long should I wait to plan for conception? How long will it take for spermatogonial stem cells to recover if they are affected? I am asking this as I have an autistic child and I cannot afford to take any risk and also our reproductive age is passing by. ### Response: Hello. I read your query and understand your concerns. First of all, I would like to inform you that spermatogenesis is a long process and the sperm cells produced already may be available for the next two and a half months (72 days). So, considering this fact that you had a radiation exposure, it will be ideal to avoid conception for the next two to three months. However, radiation exposure by phone is very much limited and there is little data to support mutation by phone radiation. I hope this helps you. For more information consult an an ChatDoctor. /ask-a-doctor-online/an

Hello doctor,Yesterday, unfortunately, I slept with my mobile phone under my testicles. I slept like that for five hours. I have heard of mobile radiations causing harm to the sperm and testicular cells by affecting the DNA. My problem is that my wife and I are both 34 years old and are planning for conception. Now, because of this incident, how long should I wait to plan for conception? How long will it take for spermatogonial stem cells to recover if they are affected? I am asking this as I have an autistic child and I cannot afford to take any risk and also our reproductive age is passing by.

Hello. I read your query and understand your concerns. First of all, I would like to inform you that spermatogenesis is a long process and the sperm cells produced already may be available for the next two and a half months (72 days). So, considering this fact that you had a radiation exposure, it will be ideal to avoid conception for the next two to three months. However, radiation exposure by phone is very much limited and there is little data to support mutation by phone radiation. I hope this helps you. For more information consult an an ChatDoctor. /ask-a-doctor-online/an

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a question about syphilis.I am 29 years old, female. I am not sexually active but I got engaged recently and my fianc\\xc3\\xa9 had previous relationships. He only kisses me sometimes which I am worried that by kissing some disease might be transferred to me from him. I got skin rash on my palms and feet 5 days ago. And when I was searching I came across syphilis. Can syphilis be transmitted through a kiss? I went to a doctor and he told me it is a skin virus HFMV and gave me antibiotic cream. I did not mention the kissing part to him. But he took blood test, crp was normal, also blood count test was normal. I did not mention this to my partner yet. I am really worried that it could be some other disease. ### Response: Hello, Welcome to Chat Doctor forum. Syphilis cannot be transmitted through kissing. It is only transmitted through oral, anal and genital sex. However, syphilis can cause oral ulcers. If you kissed someone with an active oral ulcer, then the risk of getting syphilis through kissing may occur. Is there anything else I can help you with? Or anything that is not clear to you? I would gladly clarify them.

Hello doctor,I have a question about syphilis.I am 29 years old, female. I am not sexually active but I got engaged recently and my fianc\\xc3\\xa9 had previous relationships. He only kisses me sometimes which I am worried that by kissing some disease might be transferred to me from him. I got skin rash on my palms and feet 5 days ago. And when I was searching I came across syphilis. Can syphilis be transmitted through a kiss? I went to a doctor and he told me it is a skin virus HFMV and gave me antibiotic cream. I did not mention the kissing part to him. But he took blood test, crp was normal, also blood count test was normal. I did not mention this to my partner yet. I am really worried that it could be some other disease.

Hello, Welcome to Chat Doctor forum. Syphilis cannot be transmitted through kissing. It is only transmitted through oral, anal and genital sex. However, syphilis can cause oral ulcers. If you kissed someone with an active oral ulcer, then the risk of getting syphilis through kissing may occur. Is there anything else I can help you with? Or anything that is not clear to you? I would gladly clarify them.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a-20-year-old female. I am pregnant and suffering from depression and my main \\trigger\\ is lack of sleep and tiredness. I am aware that I am having a child. I am signing up for sleepless nights so my main concern is antidepressants and the effect they might have while breastfeeding. ### Response: Hi, Welcome to Chat Doctor forum. I have read your post thoroughly and I have to tell you that depression during pregnancy must be dealt with carefully. Pregnancy itself causes mood swings and there are episodes of depression, as a consequence of hormonal fluctuation. The best ways to deal with this during pregnancy vary from patient to patient depending on their level of depression. Provided your history with this and the suicidal attempts, you may need to be on antidepressants, which even though are generally considered unsafe for the fetus, a few are of pregnancy safety category C. Meaning, category C ChatDoctor. Needless to say, these are prescription medications and I recommend you to see a psychiatrist who can evaluate your present situation and decide on that. Please note, that if you ever feel like you need medication during pregnancy, do not hesitate to consider the safer options because harboring something like depression can make it worse and cause more harm to the fetus than the

Hello doctor,I am a-20-year-old female. I am pregnant and suffering from depression and my main \\trigger\\ is lack of sleep and tiredness. I am aware that I am having a child. I am signing up for sleepless nights so my main concern is antidepressants and the effect they might have while breastfeeding.

Hi, Welcome to Chat Doctor forum. I have read your post thoroughly and I have to tell you that depression during pregnancy must be dealt with carefully. Pregnancy itself causes mood swings and there are episodes of depression, as a consequence of hormonal fluctuation. The best ways to deal with this during pregnancy vary from patient to patient depending on their level of depression. Provided your history with this and the suicidal attempts, you may need to be on antidepressants, which even though are generally considered unsafe for the fetus, a few are of pregnancy safety category C. Meaning, category C ChatDoctor. Needless to say, these are prescription medications and I recommend you to see a psychiatrist who can evaluate your present situation and decide on that. Please note, that if you ever feel like you need medication during pregnancy, do not hesitate to consider the safer options because harboring something like depression can make it worse and cause more harm to the fetus than the

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a tickly dry cough since yesterday and some nasal congestion. Please suggest me a suitable medicine as I have to go for a vacation. ### Response: Hello. It is likely a viral infection of the throat and nose. At present, you should have betadine gargles four times a day and tablet Allegra (Fexofenadine) 120 mg once a day for three to four days for nasal congestion. For cough, you can have syrup Alex (Chlorpheniramine, Phenylephrine, Paracetamol, and Caffeine) two teaspoons whenever needed up to three times a day. Avoid cold food items. If you develop fever or body aches I suggest you can have tablet Paracetamol 500 mg whenever needed up to three times a day. If your problem persists more than two to three days, then you should also have antibiotics like tablet Azithromycin 500 mg once a day along with some antacid like tablet Pantoprazole 40 mg before breakfast once a day for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope this helps you and get back if you have any doubts. For more information consult a general medicine physician online

Hello doctor,I have a tickly dry cough since yesterday and some nasal congestion. Please suggest me a suitable medicine as I have to go for a vacation.

Hello. It is likely a viral infection of the throat and nose. At present, you should have betadine gargles four times a day and tablet Allegra (Fexofenadine) 120 mg once a day for three to four days for nasal congestion. For cough, you can have syrup Alex (Chlorpheniramine, Phenylephrine, Paracetamol, and Caffeine) two teaspoons whenever needed up to three times a day. Avoid cold food items. If you develop fever or body aches I suggest you can have tablet Paracetamol 500 mg whenever needed up to three times a day. If your problem persists more than two to three days, then you should also have antibiotics like tablet Azithromycin 500 mg once a day along with some antacid like tablet Pantoprazole 40 mg before breakfast once a day for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope this helps you and get back if you have any doubts. For more information consult a general medicine physician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,This is in regard to my mother. She is 51 years old. Her weight is 112 kg. She has severe pain in the lumbar spine till her bottom and not the legs. She had done an MRI of her spine earlier and got detected with slipped discs. Recently, she did another MRI of her brain and whole screening of spine. I want you to explain the conclusion of the brain MRI. The report was round to oval T2 hyperintense foci in bilateral deep peritrigonal and right frontal white matter. Please explain in detail and also please tell me what treatment would it require. Also, she has slipped discs, frozen shoulder and muscle knots. Please tell a solution for muscle knots. Due to frozen shoulder, she cannot lift her right hand. She had injections, but did not get relief. From a while back, she is showing forgetfulness, no balance and cannot lead a normal life at all. I am sending the copies of the MRI and also attached her current medication list. I will be awaiting your reply. Thank you. ### Response: Hello. I had gone through all the data posted (attachment removed to protect patient identity). I would like to keep my answer as simple as possible so that you can understand easily.

Hi doctor,This is in regard to my mother. She is 51 years old. Her weight is 112 kg. She has severe pain in the lumbar spine till her bottom and not the legs. She had done an MRI of her spine earlier and got detected with slipped discs. Recently, she did another MRI of her brain and whole screening of spine. I want you to explain the conclusion of the brain MRI. The report was round to oval T2 hyperintense foci in bilateral deep peritrigonal and right frontal white matter. Please explain in detail and also please tell me what treatment would it require. Also, she has slipped discs, frozen shoulder and muscle knots. Please tell a solution for muscle knots. Due to frozen shoulder, she cannot lift her right hand. She had injections, but did not get relief. From a while back, she is showing forgetfulness, no balance and cannot lead a normal life at all. I am sending the copies of the MRI and also attached her current medication list. I will be awaiting your reply. Thank you.

Hello. I had gone through all the data posted (attachment removed to protect patient identity). I would like to keep my answer as simple as possible so that you can understand easily.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 28 year old male and had unprotected anal-vaginal intercourse with a sex worker, me being the active partner. I was put on PEP immediately within 11 hours post exposure and the first dose of PEP was the tablet TLE (Tenofovir/Lamuvidine/Efavirenz), given to me on the morning of 10th. I was asked to follow up the next day with an HIV specialist and she changed my PEP regime to a combination of Tenofovir/Emtricitabine and Dolutegravir as they are more effective. As I was worried and had fever for two days, I did an HIV PCR RNA test qualitative exactly after 10 days from exposure. The results came back \\not detected\\. ### Response: Hello, Welcome to Chat Doctor forum. I have noted your concern. Perhaps your question was not completely typed. Anyways, your PEP regime of Tenofovir/Emtricitabine and Dolutegravir is recommended one. Continue with it for 28 days. As far as the HIV PCR RNA test is concerned it is not a reliable test while on PEP. You need to wait for your PEP to be over before testing. Regards.

Hi doctor,I am a 28 year old male and had unprotected anal-vaginal intercourse with a sex worker, me being the active partner. I was put on PEP immediately within 11 hours post exposure and the first dose of PEP was the tablet TLE (Tenofovir/Lamuvidine/Efavirenz), given to me on the morning of 10th. I was asked to follow up the next day with an HIV specialist and she changed my PEP regime to a combination of Tenofovir/Emtricitabine and Dolutegravir as they are more effective. As I was worried and had fever for two days, I did an HIV PCR RNA test qualitative exactly after 10 days from exposure. The results came back \\not detected\\.

Hello, Welcome to Chat Doctor forum. I have noted your concern. Perhaps your question was not completely typed. Anyways, your PEP regime of Tenofovir/Emtricitabine and Dolutegravir is recommended one. Continue with it for 28 days. As far as the HIV PCR RNA test is concerned it is not a reliable test while on PEP. You need to wait for your PEP to be over before testing. Regards.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I did a pregnancy test last week, and it was positive. The next day at work I notice pinkish spots when I wipe. The next morning I started heavy bleeding with small clots, but I had no pain. The bleeding only lasted for three days. I need help. I am not sure if I am still pregnant or if I had a miscarriage. ### Response: Hi, Welcome to Chat Doctor forum. Sorry to hear about that and it sounds like a miscarriage. That day when urine was tested, mostly the second line was not as dark as the first. It means the hormone level was not high enough. Once you have heavy bleeding, it means the inner lining of the uterus has gone, and so pregnancy cannot stay on. The most common cause of such an early bleeding or miscarriage is anembryonic gestation or blighted ovum. Here, the egg or the sperm had some defect, and so, the embryo or the baby had some congenital problem compromising its health. Hence, it was not producing enough of hormones to support itself in the uterus. Just for confirmation have a home urine pregnancy test after bleeding fully stops. If the pregnancy has failed, then the line will be lighter or have disappeared. Also, you cannot see anything on the scan.

Hi doctor,I did a pregnancy test last week, and it was positive. The next day at work I notice pinkish spots when I wipe. The next morning I started heavy bleeding with small clots, but I had no pain. The bleeding only lasted for three days. I need help. I am not sure if I am still pregnant or if I had a miscarriage.

Hi, Welcome to Chat Doctor forum. Sorry to hear about that and it sounds like a miscarriage. That day when urine was tested, mostly the second line was not as dark as the first. It means the hormone level was not high enough. Once you have heavy bleeding, it means the inner lining of the uterus has gone, and so pregnancy cannot stay on. The most common cause of such an early bleeding or miscarriage is anembryonic gestation or blighted ovum. Here, the egg or the sperm had some defect, and so, the embryo or the baby had some congenital problem compromising its health. Hence, it was not producing enough of hormones to support itself in the uterus. Just for confirmation have a home urine pregnancy test after bleeding fully stops. If the pregnancy has failed, then the line will be lighter or have disappeared. Also, you cannot see anything on the scan.

### Instruction: Answer this question truthfully ###Input: Hello doctor,About a month ago, right below the left shoulder blade started itching. No rashes, bruising or anything abnormal. A few days ago that same area became tender to touch. Again nothing was visible. Now that area hurts all the time. It feels sore, sometimes it starts to feel like the muscle is tingling (like pins and needles) and feels numb from time to time and it itches every so often. If I put pressure on that area it hurts more. I have tried over the counter pain killers and it does not seem to help. The pain comes and goes on its own. Not taking any medication. ### Response: Hi, Welcome to Chat Doctor forum. With the description given, it looks more of a neurological problem rather than a skin problem. If there are no rashes and only tingling sensation and pain, etc., over skin of lower shoulder blade, then most likely you are having notalgia paraesthetica. It is a superficial nerve disorder of the skin. For now, you can try a local anesthetic cream called EMLA which has Lidocaine and Prilocaine. Try it for a week or two. If no improvement, then please consult your local physician. You may need some oral medication which is not available over-the-counter.

Hello doctor,About a month ago, right below the left shoulder blade started itching. No rashes, bruising or anything abnormal. A few days ago that same area became tender to touch. Again nothing was visible. Now that area hurts all the time. It feels sore, sometimes it starts to feel like the muscle is tingling (like pins and needles) and feels numb from time to time and it itches every so often. If I put pressure on that area it hurts more. I have tried over the counter pain killers and it does not seem to help. The pain comes and goes on its own. Not taking any medication.

Hi, Welcome to Chat Doctor forum. With the description given, it looks more of a neurological problem rather than a skin problem. If there are no rashes and only tingling sensation and pain, etc., over skin of lower shoulder blade, then most likely you are having notalgia paraesthetica. It is a superficial nerve disorder of the skin. For now, you can try a local anesthetic cream called EMLA which has Lidocaine and Prilocaine. Try it for a week or two. If no improvement, then please consult your local physician. You may need some oral medication which is not available over-the-counter.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My brother having a problem. When he was 3 years old he underwent an operation in the bladder. I have attached all the summary for your reference. Now he is 25 years old, still, he cannot control the urine for sometimes. Could you please suggest what we can do for this? Please help. ### Response: Hi. I have read through your query in detail. Please find my observations below. Your brother was treated for a tethered cord with a lipoma in close proximity to the cord at the sacral region. It means that he had a fat-containing tumor in the lower end of the spinal cord. These are birth and developmental problems that cannot be completely treated. At 25 years of age, he can get another MRI (magnetic resonance imaging) scan of lower back done and discuss it with a neurosurgeon if there is any persisting area where there is pressure on the spinal cord or the nerves. Usually, if any pressure effect on the nerves or cord is present now then they can think of releasing the pressure and this might improve his symptoms. If his condition is not possible to be treated after discussing and doing an MRI scan then the only way is to pass urine at regular intervals and avoiding an over distended bladder.

Hello doctor,My brother having a problem. When he was 3 years old he underwent an operation in the bladder. I have attached all the summary for your reference. Now he is 25 years old, still, he cannot control the urine for sometimes. Could you please suggest what we can do for this? Please help.

Hi. I have read through your query in detail. Please find my observations below. Your brother was treated for a tethered cord with a lipoma in close proximity to the cord at the sacral region. It means that he had a fat-containing tumor in the lower end of the spinal cord. These are birth and developmental problems that cannot be completely treated. At 25 years of age, he can get another MRI (magnetic resonance imaging) scan of lower back done and discuss it with a neurosurgeon if there is any persisting area where there is pressure on the spinal cord or the nerves. Usually, if any pressure effect on the nerves or cord is present now then they can think of releasing the pressure and this might improve his symptoms. If his condition is not possible to be treated after discussing and doing an MRI scan then the only way is to pass urine at regular intervals and avoiding an over distended bladder.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My dad is 78 years old. Recently, (one month back) he had acute left medullary infarct with hyperacute infarct of the midbrain. After which he is unable to open both of his eyelids on his own but can see when we lift the eyelids, also his voice was very low.After a month now his speech has improved but the eyelids issue is still there. Can you please suggest any treatment for his eyelids to open? ### Response: Hello. As you have described, your father had brain infarct after that he developed all symptoms related to eye right. So let me explain you that in case of stroke or infarct in the brain there will be involvement of cranial nerves also. The cranial nerve which is responsible for elevation of eyelid will also get affected in such situations like stroke. So the same thing has happened here in your father\\s case. So for treatment of his eyelids, only surgery you can plan but you should consult oculoplastic surgeon for that. He is the one who will measure all the parameters and depending on that he will tell you which surgery he should undergo. So my advice is you should take your father to an oculoplastic surgeon for this problem. I hope this helps. Take care.

Hello doctor,My dad is 78 years old. Recently, (one month back) he had acute left medullary infarct with hyperacute infarct of the midbrain. After which he is unable to open both of his eyelids on his own but can see when we lift the eyelids, also his voice was very low.After a month now his speech has improved but the eyelids issue is still there. Can you please suggest any treatment for his eyelids to open?

Hello. As you have described, your father had brain infarct after that he developed all symptoms related to eye right. So let me explain you that in case of stroke or infarct in the brain there will be involvement of cranial nerves also. The cranial nerve which is responsible for elevation of eyelid will also get affected in such situations like stroke. So the same thing has happened here in your father\\s case. So for treatment of his eyelids, only surgery you can plan but you should consult oculoplastic surgeon for that. He is the one who will measure all the parameters and depending on that he will tell you which surgery he should undergo. So my advice is you should take your father to an oculoplastic surgeon for this problem. I hope this helps. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have 8 mm renal calculi in the right upper ureter. Please help. ### Response: Hi, Welcome to Chat Doctor forum. CT KUB (kidneys, ureter, and bladder) is 95% accurate to diagnose urinary stones. Usually, stones form in the kidney and ChatDoctor. Since your right kidney is blocked, I need to check on your kidney functions by doing a blood test called creatinine level, especially if you have other medical problems like diabetes or hypertension. I also want to make sure you do not have urinary infections after this if kidney functions are normal and no infection then we can try medical therapy for 4-6 weeks with capsule Tamsulosin (Contiflo) 0.4 mg at night daily for six weeks the possibility of passing the stone is 25%. If you need more urgent treatment with a 70% stone clearance rate will be shock wave lithotripsy. If you got pain again in spite of medication or you got high creatinine level then endoscopic ureteroscopy DJ stent will be the best first-line option. On follow up after treatment you need needs calcium level, phosphate, and uric acid. I hope this helps. Creatinine, urine analysis, and culture. Hy

Hello doctor,I have 8 mm renal calculi in the right upper ureter. Please help.

Hi, Welcome to Chat Doctor forum. CT KUB (kidneys, ureter, and bladder) is 95% accurate to diagnose urinary stones. Usually, stones form in the kidney and ChatDoctor. Since your right kidney is blocked, I need to check on your kidney functions by doing a blood test called creatinine level, especially if you have other medical problems like diabetes or hypertension. I also want to make sure you do not have urinary infections after this if kidney functions are normal and no infection then we can try medical therapy for 4-6 weeks with capsule Tamsulosin (Contiflo) 0.4 mg at night daily for six weeks the possibility of passing the stone is 25%. If you need more urgent treatment with a 70% stone clearance rate will be shock wave lithotripsy. If you got pain again in spite of medication or you got high creatinine level then endoscopic ureteroscopy DJ stent will be the best first-line option. On follow up after treatment you need needs calcium level, phosphate, and uric acid. I hope this helps. Creatinine, urine analysis, and culture. Hy

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 33 years old. I usually feel healthy after picking up a large box. Before a week, I got a sharp pain in the middle of my waist at the back. Then I was not able to bend, and I had very limited moving. I went to a chiropractor. He told me that I need to do 25 to 30 sessions of decompressing, three times a week, on an electric bed that he has. Do I need to have such an intensive decompression process? Can I do a spinal decompression on my own in my home? Before ten months, I had a CT scan. I found that my three discs are bulging at the lower vertebrae. ### Response: Hi, Welcome to Chat Doctor forum. As long as you do not have any leg pain (electric or shooting type) or associated numbness you can do this without the intensive chiropractor sessions. Take muscle relaxants, ice the muscles which are in spasm, take painkillers like Tramadol for severe pain, and Paracetamol regularly, in addition to any available NSAID (non-steroidal anti-inflammatory ChatDoctor. Please have precautions to avoid lifting and do only gentle stretches for the back. For more information consult a chiropractor online

Hi doctor,I am 33 years old. I usually feel healthy after picking up a large box. Before a week, I got a sharp pain in the middle of my waist at the back. Then I was not able to bend, and I had very limited moving. I went to a chiropractor. He told me that I need to do 25 to 30 sessions of decompressing, three times a week, on an electric bed that he has. Do I need to have such an intensive decompression process? Can I do a spinal decompression on my own in my home? Before ten months, I had a CT scan. I found that my three discs are bulging at the lower vertebrae.

Hi, Welcome to Chat Doctor forum. As long as you do not have any leg pain (electric or shooting type) or associated numbness you can do this without the intensive chiropractor sessions. Take muscle relaxants, ice the muscles which are in spasm, take painkillers like Tramadol for severe pain, and Paracetamol regularly, in addition to any available NSAID (non-steroidal anti-inflammatory ChatDoctor. Please have precautions to avoid lifting and do only gentle stretches for the back. For more information consult a chiropractor online

### Instruction: Answer this question truthfully ###Input: Hello doctor,How is it possible that I got heart palpitations from caffeine use (5.8 mg/kg a day)? Could it be that I also used Wellbutrin? ### Response: Hello, Welcome to Chat Doctor forum. Yes, both these caffeine and Wellbutrin commonly causes palpitations. Even a lower dose of caffeine can cause palpitations and there is no as such dose relationship with respect to palpitations. It may lead to all your symptoms. Also, anxiety or stress is usually an additional factor which may cause or worsen the palpitations. Usually, palpitations like these are usually benign and non-life-threatening although they may be troublesome. Considering your comorbidities, it is better to evaluate these, not just due to palpitations but also as screening cardiac test, and to rule out the possibility of cardiac arrhythmia. So, you should have a baseline ECG especially during palpitations and may need 24 hours Holter monitoring if not able to get ECG during palpitations. Also, you may alternatively use mobile-based rhythm monitors like Alivecor Kardia or other monitors. Also, you should get one echo done to look for the status of heart and its valve. So, try to reduce caffeine consumption as much as possible and see the response.

Hello doctor,How is it possible that I got heart palpitations from caffeine use (5.8 mg/kg a day)? Could it be that I also used Wellbutrin?

Hello, Welcome to Chat Doctor forum. Yes, both these caffeine and Wellbutrin commonly causes palpitations. Even a lower dose of caffeine can cause palpitations and there is no as such dose relationship with respect to palpitations. It may lead to all your symptoms. Also, anxiety or stress is usually an additional factor which may cause or worsen the palpitations. Usually, palpitations like these are usually benign and non-life-threatening although they may be troublesome. Considering your comorbidities, it is better to evaluate these, not just due to palpitations but also as screening cardiac test, and to rule out the possibility of cardiac arrhythmia. So, you should have a baseline ECG especially during palpitations and may need 24 hours Holter monitoring if not able to get ECG during palpitations. Also, you may alternatively use mobile-based rhythm monitors like Alivecor Kardia or other monitors. Also, you should get one echo done to look for the status of heart and its valve. So, try to reduce caffeine consumption as much as possible and see the response.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I had a temporary crown on a tooth on the upper right side almost a week ago due to extreme sensitivity and pain when biting down. My dentist said that I had a microfracture and so he placed the crown. I am still experiencing pain when I bite down but less sensitivity than before. However, now I am also going through a general pain in my lower jaw on that side too. It is not coming from any one tooth, but it does seem to be radiating from the back. Could the crown cause this? I am currently on Hydrocodone, Verapamil and Spironolactone. I wake up in the morning with pain on that side, but only since having the temporary crown put on. I did have some nerve damage to that side of my face from a partial parotidectomy two years ago. However, it has never affected my teeth. ### Response: Hi. I have read through your complaint and the relevant details. 1. A carbon strip will be placed on the crowned side to check your bite, and accordingly, the crown height will be adjusted with still maintaining the shape of the crown.2. Temporary crown has to be changed to the permanent crown as per the treatment plan was given to you. Take care.

Hi doctor,I had a temporary crown on a tooth on the upper right side almost a week ago due to extreme sensitivity and pain when biting down. My dentist said that I had a microfracture and so he placed the crown. I am still experiencing pain when I bite down but less sensitivity than before. However, now I am also going through a general pain in my lower jaw on that side too. It is not coming from any one tooth, but it does seem to be radiating from the back. Could the crown cause this? I am currently on Hydrocodone, Verapamil and Spironolactone. I wake up in the morning with pain on that side, but only since having the temporary crown put on. I did have some nerve damage to that side of my face from a partial parotidectomy two years ago. However, it has never affected my teeth.

Hi. I have read through your complaint and the relevant details. 1. A carbon strip will be placed on the crowned side to check your bite, and accordingly, the crown height will be adjusted with still maintaining the shape of the crown.2. Temporary crown has to be changed to the permanent crown as per the treatment plan was given to you. Take care.