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Q. Q. What should I do to reduce my weight gained due to genetic hypothyroidism? Hi doctor, I am a 22-year-old female who was diagnosed with hypothyroidism (genetic) when I was 12. Over the past five years, I have become around 50 pounds overweight and all of my attempts to lose have seemed to fail so I have given up, but my weight has stayed the same. There is so much information put there about losing weight with hypothyroidism but it all seems to conflict. I am so unsure as to what type of exercise and diet I should follow as a result but I still would like to lose weight, but most importantly have my body feel better. What can I do? I am currently on Levothyroxine, Buspar, and Benedryl.

Hi. You have really done well with the hypothyroidism problem. Your levels are normal with less medications which are very good. As it is genetically induced, it is very difficult to lose weight. My advice to you is, you should focus on maintaining normal levels of TSH (thyroid-stimulating hormone) and try to remain active, having a positive outlook in life. Or else, it will become very difficult to balance your life with the symptoms of hypothyroidism. Even though your weight has not reduced, be very careful in not putting on weight here afterward. Everyday brisk walking for 1 hour. If you have body pain, alternate with exercises and walking. Avoid all kinds of junk foods, processed, bakery products, rich sweets, fatty foods, sodas, alcohol, and smoking. Avoid partying and binge eating. Follow the food timings properly. Have small frequent meals. In between snacks should be strictly fruits or any kind of low-calorie foods. Have unsalted nuts around five daily. It can give a glow to your dry skin. Everyday water intake should be around 1.5-2 liters. You can use flax seeds. Powder it and mix it in your food. It is a fiber which will give you fullness. Use turmeric, fenugreek seeds, or powder every day. It is a good antioxidant and fenugreek helps in reducing cholesterol levels. Include low-fat milk, curd every day. Egg white, lean chicken, or fish can be taken daily in moderation (anyone). Organ meats need to be avoided. Is your menstrual cycle normal? Please get back if you have any other complaints. Follow up after 15 days.

Q. Q. I have started to get lots of acne on my face, particularly on my forehead. Please help me. Hi doctor! I used to have clear skin but since I moved to a new place, I started to have lots of acne on my face particularly on my forehead. I thought it would disappear once I went back home, but it only got worse. I did some research and assumed that it was caused by drinking too much cow's milk, but it has been since since I stopped and they would still not go away. I also noticed that I get deep acne whenever I'm nearing my period, along with the usual small red bumps. I bought an acne soap and have been using it for a month now but I'm not sure if it works. I hope you can help me because it has been affecting my mental state lately :((((

Hi there Acne has multifactorial etiology. Only acne soap does not improve if ypu have grade 2 or more grade acne. You need to have oral and topical medications. This before writing medicines i need to confirm your grade of acne. For mild grade topical clindamycin or retenoic acud derivative would suffice whereas for higher grade acne you need oral medicines aluke doxycycline azithromycin or isotretinoin. Acne vulgaris Cleansing face with antiacne face wash

Q. Q. Why do I have uncomfortable feeling between the middle of my spine and left shoulder blade? Hello doctor,I am having an uncomfortable feeling in between the middle of my spine and left shoulder blade. It seems to get stiff, and my bones pop a lot around there, and it is very uncomfortable to sit in specific ways feels like my bones shift, well the other night it seemed as if my shoulder would pop out of place causing more stiffness after a while of dealing with it. I ended up feeling a popping sensation, where the stiffness was an instant relief. It was so shocking it put my anxiety through the roof. I thought I was going to die because my whole body was shaking and tingling. What am I dealing with? Right now I have no pain or tender near that area still relief but curious on what happened and why I got this shock and that popping feeling so loud it scared me half to death.

Hello. The popping and discomfort what you felt is either because of improper scapulothoracic mobility or may be due to facet joint irritation in the neck with intervertebral hypermobility. Which could have caused due to stiffness in the chest muscles, shoulder stiffness, etc. I would recommend you to do a lot of icing in the chest and back muscles. Maintain your neck and upper back posture by doing some back retraction work. Gently stretch your neck and chest. Gently massage your chest and shoulders to relieve tension in the muscles. I hope this is helpful for now. Kindly revert in case you need any help in this regard.

Q. Q. I had a surgery which ended up with some failures. What can I do to fix it? Hello doctor,I had an emergency surgery six months ago punched through a window right arm cut both arteries cut radial nerve with ulnar damage and cut bicep tendon nerves back now almost full thumbs up the only issue is bicep. My question is there something I can do to fix it like lengthening surgery, or am I stuck? I am a boxer supposed to go Olympics this year. My surgeon focused on the nerve and did not care help. PS pronator is still little and has not fully recovered.

Hello. If you are saying it is already six months since the surgery and if you are doing regular physiotherapy, still has not gained much of the actions, then it is not worth waiting anymore. There are many muscle transfer surgeries which can give you the desired movements and help you in day today activities. But you have to remember that post such operations you will require time to train the brain and get the full use of such movements. That will take time. Do not want to demotivate you, but tremendous training and hard work might be required to reach the pre trauma stage of your boxing.

Q. Q. Kindly explain about Beta Strep. Hello doctor, My culture from my gynecologist came back, showing that I have a yeast infection as well as Beta Strep. I was hoping for more information on Beta Strep. I have never heard of it, and there is a lot of information when I searched that is making me confused a little. I am not experiencing any symptoms, either. I feel perfectly fine.

Hello. There are lots of bacteria and other organisms that colonize healthy skin. Yeast a fungus also is a commensal in our body. Just the presence of these organisms is of no significance. The colony count is needed, which is high, will need a course of antibiotics, which can be decided by culture and sensitivity. But after a surgery like what you had, or any significant stress or use of lots of antibiotics (as would have happened after surgery) or use of steroids or diabetes, all infections show an altered balance between good and bad bacteria. You do not need any treatment for this. Just wait for your body to develop those good bacteria, and gradually, all tests will come negative. If you have any symptoms, treat as per need. Avoid unnecessary antibiotics use. They will further delay the recovery. I hope I have clarified your query, do write back if any more questions.

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

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

Q. Q. I have stomach pain and bloating after taking Augmentin 625. Why? Age - 33 years Height - 164 cms Weight - 67 Kg I am suffering from sore throat so I took Augmentin 625 before 12-13 days back but found no improvement but I started suffering from Stomach pain and excessive gases. Now I am taking below medicines as per prescribed by ENT specialist that are 1.Allegra M tablet 2.Rinifol capsule 3.Esoz D 40 capsule 4.Acinil O surup for ten days.Two days remaning to finish course. Stomach pain and blown stomach due to gas is still there.

Hello. I welcome you to icliniq. Well it is not uncommon to have Gastric upsets after a course of antibiotic. And antibiotic like augmentin are notorious to cause this. This occur secondary to effect of augmentin on decreasing the amount of lactobacillus microorganism which are normally present in the human gut and help digest the food. You should take yougurt, Kefir (fermented yougurt), Kefir. and there are certain diets with probiotic activity you can start taking it. Plus take Tab Ecotec twice daily for 4 weeks, and Tab Levosulpiride 75 mg once daily half hour before meals.for 2 weeks. You can continue with acinil O syp. while rest of your current medication can be stopped. I hope this will correct your microbiota and will bring the same healthiness as before. good day Antibiotic induced dysbiosis Small intestinal bacterial overgrowth Antibiotic induced dysbiosis Let me know in one week time how you respond to above regimen, if persistent of symptoms I would consider testing and giving some safe antibiotic therapy for 2 weeks.

Q. Q. Can a painless tooth be extracted since it has a hole in it? Hello doctor,Can I pull out hard teeth out no pain because I got a hole in my teeth? Whenever I use to eat something, it got stuck in it and caused severe pain. Kindly give me some advice about pulling it out without any pain.

Hello. I had gone through your question, and I can understand your concern. If the pain occurs only when you eat food and it gets stuck into it, it is reversible pulpitis. For that, you do not need to get it extracted. You need to get it filled, and it will cost you less than that of pulling (extraction). Second, you will save your tooth too. My suggestion is to get dental filling done as soon as possible. If you want to get it removed, you need to visit a doctor (dentist), and there will be no pain because during extraction local anesthesia is given.

Q. Q. What does the darker pigmentation at the armpits indicate? Hello doctor, My reverse elbow armpits have developed a darker (my skin color is fair) pigmentation. This pigmentation has also affected the whole of my groin area. Some dots of such pigmentation have also come up under my extreme armpits. What should I do now? What is this condition? Can you diagnose the state conclusively?

Hello. I understand your concern. The pictures are a bit hazy. But from the given images, it looks like a fungal infection by the name of pityriasis versicolor. I would also need to see your chest, upper back, and shoulders to be sure. Kindly send clear photos of the same to make a conclusive diagnosis. Meanwhile, you can start using the following medicines. 1. Tab Fluconazole 400 mg start and repeat once after a week. 2. 2 % Ketoconazole lotion apply for 5-7 mins and wash off once a day.

Q. Q. I get fever during rainy and winter season. Why? Hello doctor, During rainy and winter season get frequent fevers. Most of the times I get it diagnosed, and every time doctors tell it is only viral fever. Fevers generally come twice a month. I take Paracetamol and Cefixime usually (on the advice of doctors). Generally, the illnesses go in 10 days. This has been happening from the last three years. Can you suggest any cure for it? I am a small time businessman, and this is affecting my financials. Regarding my medical history, I am a premature baby of seven months. As told by my mom and relatives, I remained alive on medicines with great difficulty. And also from childhood, I used to get skin diseases frequently, and for that, I think I was regularly administered antibiotics.

Hello. I need to know a few things, 1. Do you feel feverish, or does the thermometer record a temperature? 2. What other symptoms do you get? Runny or blocked nose, sore throat, throat pain with swallowing, headaches, body pains, etc. 3. Does anyone else around you (family members, co-workers, etc.) develop similar symptoms before or after you do? 4. Do you get any tests done like blood tests or X-rays during those episodes? From your description, it appears that you are getting frequent viral upper respiratory tract infections. These are acquired from other patients through the air (coughing, sneezing, etc.). They are usually short-lived and last no more than five to seven days. Since more than 300 different viruses can cause similar symptoms, you can get infected multiple times each time with a different virus. The same virus cannot affect you again. Unfortunately, antibiotics do not work against viruses. They are meant for bacterial infections only. However, doctors continue to prescribe antibiotics unnecessarily, and this has led to the emergence of widespread bacterial resistance. Other than symptomatic treatment, no medicine can cure or prevent these infections. They are self-limited, and you will get better even if you do not take any medication. The older you get, the less frequently you will get these infections as your body will be building up defenses with every disease. No household tips or vitamin supplements have been proven to work. Premature birth can lead to increased frequency of infections, but unless the infections are bacterial, not much can be done about them. Please get back to me with answers to the above questions and also attach any test reports you may have.

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

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

Q. Q. Why is my free PSA abnormal? Hello doctor, 50 years old, 5.8 inches, 260 lbs. On blood pressure pills. My doctor is out of town for a few weeks. I reviewed PSA test results and apparently I have one abnormal reading out of three. PSA total 0.5, PSA free 0.1, PSA % free 20. The PSA % free 20 is in red indicating abnormal. What does this mean? What causes it to be abnormal?

Hi. Free PSA should be more than 15 % to rule out prostate cancer. Free PSA is an additional tool used when PSA is above 2.5 and we want to check whether high PSA is due to benign prostate growth or due to prostate cancer. Some laboratories use 25 % cutoff, but most have 15 % cutoff value. Since your total PSA is quite low and free PSA is above 15 %, you should not worry. If in doubt, repeat after a few months.

Q. Q. When should I stop Clexane and Ecosprin should before delivery? Hello doctor, Presently I am on my 34 th weeks of pregnancy. LMP was before eight months. I had an IUD of more than 37 weeks before two years. Present medications are Clexane 20, and Ecosprin 75 daily. As per my doctor's planning, I should go for C-section between 36 to 37 weeks. Now when I should stop my Claxene and Ecospirin? This medication is given by my gynecologist after analyzing my boh panel report which states lupus anticoagulant by DRVTT is 45.50. No lupus-like anticoagulant present, APTT is 31.30 and PTT-LA is 98.80. Kindly advice.

Hello. I feel that it would be the best if you do not stop these medicines without the advice of your doctor who recommended these and made a plan for your pregnancy because self-treatment strategy will lead to no benefits. And both of these drugs are safe to use, so you do not have to worry. Furthermore, for your knowledge, aspirin is usually stopped at 35 to 36 weeks of pregnancy, and Clexane (Enoxaparin sodium) is being continued until delivery, and even after that. So I would again say that please take advice from your particular doctor before stopping any of these medications as your pregnancy is very precious. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.

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

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

Q. Q. As I am having a history of miscarriages, will taking hCG injections help me to continue pregnancy? Hello doctor, My lmp was on five months ago. I was spotting for three days during my lmp and got a positive strip test after seven days. My beta hCG level on the day of a positive result was 126, and after two days, it was 125. I am being told that I will get periods in two weeks but told to continue folic acid and multivitamin and come for ultrasound in three weeks if no periods come. I have a history of miscarriages, and I am 35 years old. Can hCG injections help me or should I consult another doctor? Have I miscarried or there are still chances?

Hello. Unfortunately what your doctor has said is right. Spotting in early pregnancy is normal. But a fall or no rise beta HCG is a poor sign. Beta hCG is a hormone produced from fetal tissue. At a level of 25 mIU/mL urine test is positive it doubles in 48 hours. So if the result of 7th is 125, then on 9th it should have been around 250 or more. Only healthy fetal tissue can produce an adequate amount of this hormone, so indirectly we get to know the health of the embryo even without seeing it. So it just means the fetal tissue is not growing. There can be lab errors, so to be on a safer side doctor has asked you to come for scan, to confirm. If you are worried about the repeated miscarriages, have yourself and your partner checked for any problem. Causes like blood sugar levels, thyroid hormone problems, or prolactin hormone abnormalities, any structural problems in the uterus or any problem in semen. Do not lose hope, if you are getting pregnant without much help, no matter what the outcome is, then you will surely have babies. I hope I have clarified your query, do write back if any more questions.

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

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

Q. Q. Is it likely for HIV symptoms to show up after 5 to 6 weeks of possible exposure? Hello doctor, I am a 31 year old male, and my query is regarding possible HIV exposure. Four months back, I had a sexual encounter with two female partners. I had insertive vaginal sex and received oral sex. Intercourse had lasted for about five minutes twice with each partner. Condoms were used throughout and were changed for every partner. I do not recall any of the condoms breaking or slipping off completely. About a week or so after the encounter, I experienced some health-related concerns, one after another.I got an eye stye, inside of the eyelid, which was little painful and irritating. It went away in a week. I got a boil, nearly an inch in diameter, in the lower abdomen, which subsided in a week. I also got a white area behind the wisdom tooth. This area was painful during the initial 3 to 4 days, then the pain subsided, and the white area started growing bigger. OPG and clinical examination suggested impacted wisdom tooth and trauma caused by friction of upper and lower wisdom teeth. So, I got both the wisdom teeth extracted. Now, it is normal.I also had a skin tag in the underarm area, which turned painful, hard, and dark purplish. One or two light reddish spots in the adjoining area. They resolved in 7 to 8 days. I have high blood pressure and triglycerides. My triglycerides were 292, which dropped to 195 after 10 days without medication. I got a severe headache one night, which went away next morning. I feel light-headed while walking, staring at the computer, etc., but not when lying down for 5 to 6 days. This happened concurrently with the diagnosis of high triglycerides and BP. I also have diarrhea type condition, that is, I have bowel movements thrice a day, which lasted for 9 to 10 days. My gastroenterologist remarked ‘no abnormalities detected.’ I took antibiotics and other medicines for the dental problem few days before this.I do not have a fever or any unusual skin rash. I do not have unusual body ache or weight loss or loss of appetite. I also do not have any apparent swollen glands. My creatinine and TSH test reports are normal. My LDL is normal, and HDL is little lower than normal. Assuming either of my partners was HIV positive, what is the chance of me contracting his? Does any of the above health concerns related to HIV? Does HIV symptoms, if any, appear together or can appear one after another? What is the most likely period after exposure when symptoms appear, if at all? In other words, is it likely for HIV symptoms to show after 5 to 6 weeks? I realize HIV infection can be confirmed only by a test. However, I sincerely request a prompt and clear response to the above queries, which will help me cut down the fear. Thank you.

Hi. The answers to your queries are as follows: Hope your queries are answered, but please do not hesitate to ask or call anytime for any further query. Best wishes.

Q. Q. Is it normal to have cobblestone appearance at the back of throat after tonsillectomy? Hello doctor, I had tonsillectomy about a month ago. I had been healing but I am concerned about my healing process. My uvula has gotten smaller and has strange color plus I see cobblestone at the back of throat and blue or dark red color surrounding soft palate. And there are visible blue or red blood vessels everywhere around the palate and arch.

Hi. All these are normal after tonsillectomy surgery. I will suggest some steps to relieve some of the symptoms you are facing. Gargles with Benzydamine mouth wash diluted in water few times daily will help soothe the area and relieve pain. You may also take Tylenol for a few days for the pain relief. To relieve inflammation (the engorged blood vessels and cobblestone formation) you can take a combination of Trypsin Chymotrypsin Bromelain Rutopside. This medicine will relieve inflammatory cells and products from the area. Cobblestone formation is normal after the surgery. Regarding the reduced length of the uvula and the scarring on the palate, I would say, they are due to bad surgical technique. We carefully dissect the tonsil out of the pillars so that there is nil scarring of pillars and change to the uvula. We use a coblator for the purpose that minimizes bleeding and postoperative pain.

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

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

Q. Q. A 10-year-old girl obsess spanking frequently. Is this due to Asperger's syndrome? Hello doctor, I am afraid that my 10-year-old daughter might have Asperger's syndrome. She obsesses over spankings all day long. She watches videos of spankings all day long also, and she fantasizes of getting hit. She even spanks her brothers and sisters. I can tell it gives her some pleasure. She has no friends, and she wants to sit fantasizing about it if she does not have an iPad to look it up. She also obsesses a specific type of people. Does she have Asperger's? Is this a symptom of it or something?

Hello. Your daughter is into the screen most of the time, and hence, it will be her primary advisor. She is just modeling what she sees and is quite common at this age. Try to minimize her interaction with the screen. She requires more human interaction. Put her in extracurricular activities to the maximum. Spend time with the child talking to her, and she will like it. Do not punish her, as it will have a negative impact, and the behavior can increase because of scolding. She will slowly get out of it. You can review with me for further follow-up.

Q. Q. We are trying to get pregnant but we lack high libido. Please help. Hello doctor, Trying to get pregnant from last one year. All the tests for both of us are fine. The only problem is we are not very high on libido.

Hello. By saying that all tests were normal, I hope you mean 1. Blood sugars, thyroid profile, and prolactin hormone levels. 2. Husband's semen analysis. 3. Wife's scan of uterus and ovaries. 4. Fallopian tube patency tested with HSG (hysterosalpingography) or laparoscopy. Now for loss of libido, the following reasons are to be addressed. 1. Above mentioned blood tests. 2. Kindly seriously think of shedding few kgs. Your expected body weight is 52 to 57 kgs. 3. Try to reduce any physical or mental stress. Diabetes has to be ruled out with HbA1c. If all these are normal, there is no reason for you to worry, and you will surely get pregnant. I hope I have clarified your query, do write back if any more questions.

Q. Q. How to diagnose celiac disease from deamidated gliadin IgG level? Hi doctor, My friend had his deamidated gliadin IgG antibody test done recently. The test result is 152. Does it mean that the person is having celiac disease?

Hi. Deamidated gliadin IgG antibody level of more than 30 is diagnostic of celiac disease. Since the number mentioned by you is 152, it indicates that the person is having celiac disease.

Q. Q. Can sound from a loudspeaker cause any effect on my eardrum? Hi doctor, I went to a chant few days back. There the loudspeaker was very loud. The very next day I noticed that there is ringing in my left ear. Now, it has been four days, but it has not gone. Can you help me? I am very scared. Has it caused any effect on my eardrum? Please see to it. Thank you.

Hello. From your history of noise exposure and symptoms, it is suggestive of acoustic trauma. It occurs after a single exposure to very intense sound which cause damage to the organ of corti or damage the hair cells. Symptoms include ringing sensation in ear known as tinnitus and hearing loss. Treatment depends on severity of symptoms. If only tinnitus is present, protect the ear from further damage and also take some neuroprotective drugs. But, first you need to do a pure tone audiometry (PTA) to assess the severity. 1. PTA. 2. Tympanometry. Acoustic trauma. 1. Capsule Zincosule-4G (Multivitamin) once daily. 2. Tablet Defcort (Deflazacort) 12 mg once daily for seven days. Avoid loud sounds.

Q. Q. I had unprotected sex during my infertile days. Can I be pregnant? Hi doctor, I am 32 years old female. I had unprotected intercourse 14 days back with no ejaculation from his end. I took an I-pill the next day at 8 PM for precaution. Those were my infertile days as my last period occurred 36 days ago. It has been more than a month; still I have not got my periods. Could you suggest some ways to get back my periods? Thank you.

Hi. Please wait for a week for your period to start. If it does not start by then, you will have to do urine pregnancy test to rule out pregnancy. Period could have been delayed due to stress. Another rare possibility is that of pregnancy. Though you mentioned the days you had sex as your infertile days, sometimes occasionally ovulation could be delayed making the days fertile. Still you had taken emergency pill (though it is highly effective in preventing pregnancy, protection offered is not absolute). So, there can be little chance of pregnancy which you need to rule out first. If you want to rule out pregnancy earlier, you can do blood beta-hCG test, negative result of which will rule out pregnancy. Other option as I told is to wait for a week. If pregnancy test comes negative and still period does not start, you can induce period by taking tablet Medroxyprogesterone acetate 10 mg twice daily for five days. Period generally starts within a week of last dose of tablet. It will not induce period if you are pregnant.

Q. Q. I am bleeding with clots after using MTP kit. Is this normal? Hello doctor, I am 25 years old and had a pregnancy for five weeks. Four months back, I had used MTP kit. The problem is, even now I am having bleeding. Is this normal? How to sort this problem if it is not normal? Looking forward for your valuable feedback. Thank you.

Hi. I understand your situation. This much of bleeding is considered unusual. Either the process of abortion has been incomplete, because of which the uterus is still trying to expel out the products of conception. Or you have some blood problem. Are you still passing clots? Or is it plain blood that is coming? Also, if you could tell me exactly how you proceeded to take the medicine it would give an idea of the cause of bleeding. For the time being, take tablet Tranexamic acid 500 mg, thrice a day. This will stop the bleeding, but not cure the problem. So, till the time we know exactly what is wrong, you can take this tablet. Incomplete abortion. Ultrasound pelvis for retained products of conception (RPOC) and CBC (complete blood count).

Q. Q. How do I fade the acne marks without laser treatment? Hello doctor, I have used Benzoyl peroxide gel for my acne and it has almost cleared. But, the acne left some red marks and blemishes on my cheek. I wanted to fade that redness on my skin. In the past, I used Epiduo gel. Please suggest me a product and guide me to remove that redness without laser treatment. Thank you.

Hi. There is redness and some pus filled acne too (attachment removed to protect patient identity).

Q. Q. I am 13 weeks pregnant. Kindly explain about subseptate uterus. Hello doctor, I am 13 weeks pregnant. I have been diagnosed with subseptate uterus with the live fetus in the left horn. Baby is good, with heartbeat and growth. My doctor has advised me proper rest and some medicines. I want to know in detail about this subseptate uterus.

Hello. Let me start with a few basic facts and further clinical correlates and effects. Every lady has two uterine tubes, which fuse at birth, and over time, the wall between the two tubes disappear. Now the uterus is converted into a single cavity uterus. The upper ends of tubes remain separate as two fallopian tubes. Sometimes the fusion is complete, but the partition does not disappear. If the tubes do not touch others or do not fuse at all, then you get bicornuate uterus. But if only the wall is partially removed, it forms subseptate uterus. If the wall does not disappear at all, then the septate uterus is formed. Now in both the last two conditions, the main problem is that the space inside the uterus is compromised. The best option was to have a hysteroscopic resection of septa then get pregnant. Having rest makes no difference. At 14 to 16 the week, she can undergo an elective cervical cerclage. Due to septa, uterus loses its polarity, and she is prone to cervical insufficiency. As space inside the uterus is compromised, she can have preterm pains, preterm labor. Due to septate, the baby presentation may not be head down. I hope I have clarified your query, do write back if any more questions.

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

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

Q. Q. What causes respiratory problem in a 36-year-old? Hello doctor, My mother is 36 years old, and she is suffering from the respiratory problem from last two days, her hemoglobin count is 9.6, can you please tell what causes this problem?

Hello. I have read through your question and would like to tell you that respiratory problems can be due to allergic or due to infection. Her Haemoglobin could be due to dietary deficiency. Give her iron-rich diet like dates, banana, and green leafy vegetables. If the respiratory problem is due to infection, then she may need an antibiotic course. For now, steam inhalation will help to relieve her. Steam inhalation with menthol twice daily. If her condition does not improve in two days, get her checked by a physician. If her Hemoglobin does not improve in one month, get a complete blood profile done to know the cause of anemia. I hope that answers your question. If you have any further questions, please feel free to write.

Q. Q. During orthodontic treatment, when will they remove the blue fillings? Hello doctor, Today is my fourth day of braces, so I was just wondering when my blue fillings will be removed. The blue fillings purpose is to prevent me from biting down on the braces, but when will they get removed? Also, when will I feel comfortable biting down on my fillings, since my teeth are sore and it hurts, or when will I get actually to chew since I can only swallow?

Hello. Blue fillings or bites are removed when your teeth are better aligned, and deep bite (if present) is improved or corrected enough to prevent interference of upper teeth to lower braces. It takes a while to get used to the blue bites, usually 7 to 14 days. However, chewing continues to be less effective for longer. It is advisable to eat soft foods and supplement with nutritious juices and smoothies.

Q. Q. Current dose of Synthyroid is 150 mg. What is the recommended dose to get normal thyroid level? Hello doctor,My 24 years old daughter born without a thyroid and treated with Synthroid since birth has a TSH level of 23.980 uIU/mL and T4 Free of 1.57 mg/dl on the current dose of Synthroid 150 mcg. Her weight is 150 lbs and height 5' 4". Her endocrinologist increased her dose to 300 mcg, thinking her dose had been 250 mcg (incorrect). What is the correct dose to return to normal thyroid levels for this condition at her age and weight?

Hello. It is better to increase the dose by 25 mcg, i.e. 175 mcg if she was using 150 mcg till date escalating the dose or thyroid medication will be like 25 to 50 mcg at a time. Not double the dose causes severe sickness. As you mentioned, she was Synthroid (Levothyroxine). It is better to continue the medication to maintain a normal thyroid level for a long time. After using this medication 175 mcg, it is better to repeat the thyroid profile after six weeks to check for that thyroid level.

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

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

Q. Q. What causes pain during dehydration in a sickle cell anemia patient? Hello doctor, Sickle cell anemia is my problem. My age is 30 years, while dehydration time, I am getting pain. Is this issue dangerous?

Hello. Yes, sickle cell anemia is a disease where RBC shape changes while dehydration and oxygen level goes down in body. Usually red blood cell will be round and plate shape. During dehydration and less oxygen time the shape of the red blood cell becomes sickle shape. Now RBC will stick together and block the blood vessels and produce ischemia. So to reduce the obstruction, you need fluids more. If obstruction is in lung, spleen, kidney or any organ, it is dangerous and severe painful. So avoid dehydration conditions, do not do severe exercise, avoid going to hill stations where oxygen is less. Drink adequate water.

Q. Q. Is there any risk in giving DTwP booster dose to a baby diagnosed with seizure? Hello doctor, At birth, my son was diagnosed with a seizure. Now he is 18 months old. I am fearing about DTwP booster dose side effect. Earlier three doses had reaction of muscle stiffness and fever.

Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. Muscle stiffness and fever can occur after a DPT vaccination and is not a contraindication for vaccination. Contraindication for DPT vaccination are seizures, inconsolable crying, and central nervous system infection or encephalitis after giving DPT vaccination. If you want to be on safer side then go for acellular vaccine instead of whole cell vaccine. You should give DTaP vaccine instead of DwPT vaccine. Take care.

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

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

Q. Q. I am trying to conceive for the past one year with autoimmune hypothyroidism. Please help. Hello doctor, I am not able to conceive after trying for almost one year. I was diagnosed with pituitary microadenoma and I am on medication. My prolactin levels have now reached normal levels after two months taking medication. I suffer from hypothyroidism and on medication. I have had this for five years now and it is well within the limits as per my endocrinologist now. This is due to an autoimmune disease where my TPO (thyroid peroxidase) antibodies were high during the diagnosis five years ago. My husband and I would like to know how should we best prepare for pregnancy and what to look out for. We would have preferred to visit the clinic. Unfortunately, I am not in a position to visit the doctor due to travel restrictions. It would be great to get in touch with a specialist. I am currently on Euthrox 100 mcg, Cabergoline 0.25 mg once a week, and Folic acid 450 mg daily.

Hello. I have gone through all your reports (attachment removed to protect patient identity) and your prolactin and thyroid levels are well in control. What is missing in the follicular monitoring profile of the dummy cycle and also your husband's semen analysis test? You have been following the correct protocol using LH kits for ovulation and post LH surge if a natural trial or timed intercourse did not work then husband's semen analysis becomes mandatory. Then when both male and female infertility causes are ruled out then comes mechanical causes where positions and version of uterus need to be considered and measures implemented. Anyways please send these two remaining reports before we can proceed further.

Q. Q. What causes eye swelling in the morning with itching? Hello doctor, I have been getting a swollen eye once a week, usually in the mornings. I feel a slight irritation beforehand, itchiness. Then my eyelid swells to the size of a golfball. The eye is not red, I can see perfectly, there is no sign of cuts or scrapes. No discharge, maybe a little dryness beforehand. Please help.

Hello. You are describing an allergic reaction of the eye to some factor. If you are not also suffering from sneezing and dry cough at night then you can use antihistamine eye drops such as Pataday once daily or Patanol or Zyrtec twice daily for a period of 10 days. If you have started using any kind of new cream or make up around the eyes, change it into something hypoallergenic. Best of luck.

Q. Q. What is the reason for on and off toe swelling in a diabetic? Hello doctor,My mother-in-law 72 years old. She gets swelling in her toe on and off for the past year. Recently there was pus inside, and she is having pain. After soaking the toe in hot water and betadine, discharge came out, but it is relapsing again. She had antibiotic too. She has diabetes but under control with medication.

Hello. She has an infection in the nail bed space. Need to focus on three things. 1. Her diabetics need better control. Better diet modification with medicines. HBA1c is too high. 2. The nail needs to be trimmed well regularly, and the area needs to be cared well daily. She may not have a proper sensation at the region due to diabetes. So regular inspection and care is mandatory. She should not walk barefoot, and slippers need to be correctly selected. 3. She needs control of infection. Visit a nearby surgeon (preferably podiatric) for the drainage of pus if present. Take an X-ray to rule out bone involvement and also need to check the blood supply to the region. I hope your queries have been cleared. Please review if any further questions.

Q. Q. I am suffering from chest pain and I heard a sloshing in my chest. Why? Hello doctor, I am an 18-year-old female, taking no medications, and I am 5'3" in height and 180 lbs weight. Since last night, I am having severe chest pains. I cannot sleep, and when I try to eat, my chest hurts more. It hurts all the time, but the severity comes and goes in spurts. I am not sure if this has anything to do with the chest pain, but just today, I was lying on my right side and moved to my left side, and I heard and felt a sloshing in my chest or upper abdomen area. What could it be?

Hello. Thanks for providing clear and consistent history about your current medical condition. I can reflect on what you mentioned that it is related to Excedrin as it can cause gastric upset by increasing the secretion of HCl (hydrochloric acid) in the stomach. I suggest that you stop taking Excedrin for the coming period (at least a month), take some dietary precautions including avoiding caffeine, spicy food, dark chocolate, mint, fizzy drinks mainly cola containing ones, deeply fired, chili and spicy food. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) like Voltaren tablets and even injection and aspirin as well. Take the medication mentioned in the treatment part. In case, the condition continues, you need to visit your doctor (general physician or GIT specialist) for further evaluation. Gastritis, Peptic ulcer, and GERD(gastroesophageal reflux disease). Zantac (Ranitidine) 150 mg tablet one tablet two times a day for seven to ten days.

Q. Q. I am diagnosed with migraine. Kindly provide me second opinion. Hello doctor,I am a 15-year-old male with a height of 148 cm and weight 44 kg. I am diagnosed with migraine, and I want a second opinion.

Hello. Migraine is a diagnosis based on symptoms given by the patients. The symptoms are a severe headache, dizziness, vomiting some patients also get migraine by a loud sound, acidity, and excessive heat or cold. If you are having other symptoms like pain in the neck or back or shoulder, excessive acidity or deteriorating eyesight, then maybe the diagnosis of migraine can be challenged. If not Fepanil (Paracetamol) is good medicine, use it as advised by your doctor. If you have any other questions, please feel free to ask.

Q. Q. I am 33 weeks pregnant and suffering from dental abscess. Kindly help. Hello doctor,I have a dental abscess, and I am 33 weeks pregnant. It is so painful that I cannot eat, sleep, drink, or do anything. My dentist cannot do anything about it until next month. I was wondering if the emergency room can do something about it.

Hello. You could ask your dentist or go to the emergency room to prescribe Antibiotics like Augmentin 625 mg thrice a day for five days along with Tylenol (paracetamol). This will help in pain relief and then go to the dentist to get the tooth extracted. Do not delay, as the pain and infection will affect your baby's growth as you would be avoiding normal diet and infection would not allow nutrition to pass onto your baby. It is okay to take during pregnancy if so much infection and pain are there.

Q. Q. I have sour burps and motions. Please help. Hello doctor, I am suffering from sour burps and motions. Kindly help.

Hello, Welcome to the icliniq.com. Kindly answer the following questions to guide you further. 1. Do you have a fever, abdominal pain, nausea complaint? 2. What is the frequency of your motion? 3. Is there any blood in stool? 4. What is the duration of your symptoms? 5. Have you taken any treatment so far? You can revert with answers. Meanwhile, you can be prescribed antacid like Pantoprazole and Dimethicone (Polydimethylsiloxane) containing acid MPS syrup. I hope this will help you.

Q. Q. When should I dispose the gauze after a tooth have been pulled? Hello doctor, How long should I keep gauze in after a tooth is pulled?

Hello. After a tooth is extracted, it is advisable to keep the gauze in the site for 30 minutes, in the same position. After 30 minutes, do not spit, take the gauze through your hand and discard. This is to arrest bleeding and help in clot formation by pressure method, and spitting will lead to dislodgement of the clot. So, be careful with splitting (do not do it forcefully) for at least one day. I hope you have got the other instructions from your dentist.

Q. Q. What causes TMJ disorder after wearing of braces? Hello doctor,I got my braces a year ago, and before that, I did not have any problem in my jaw articulation. Since my orthodontist gave me elastics to put I have TMJ disorder, my left articulation crack every time I open my mouth or eat or speak (I have decided not to put the elastics so that it does not get worse) and I am a bit worried. What causes this? Can this be fixed?

Hello. Based on the given history, it can be due to the extra force you gave to open the mouth while on elastics. Based on your age, it can be due to an impacted wisdom tooth. Sometimes, this can be due to any muscle problem too (myofascial pain dysfunction syndrome), mostly due to physical stress in that area or emotional or mental stress. As for now, do not open your mouth very wide, like during yawning, etc. This is curable. Do not worry much. Do you have pain along with the click? I would suggest you talk to your orthodontist or general dentist or oral and maxillofacial surgeon to get a final diagnosis after a clinical examination done by them. If possible, send me your OPG (orthopantomogram) and lateral TMJ (open and closed mouth) X-rays to guide you further.

Q. Q. I consume marijuana and I am 22 weeks preganent. How long will it stay in my system? Hello doctor,I am 22 weeks pregnant. Due date is after three months. I smoked marijuana for the first few months to help with severe morning sickness. I stopped smoking probably last month. I went to a gynecologist this month, and they took a urine sample in which they tested for drugs and marijuana was the only one I tested positive for.After two weeks of my appointment, I smoked once to help with a bout of morning sickness and have not since then. And I have planned not to do ever again during my pregnancy. My next appointment is after one week. Will I be threatened with CPS because of my positive urine from last time? And will they test my urine at my next visit? I am only 18, and I am very nervous. I am concerned because before I got pregnant, I smoked marijuana every day since I was 15. How long will it stay in my system? How can I safely detox it from my body?

Hello. My advice to you that please stop taking marijuana, if you love your baby, then please stop it right now, because it affects your baby growth. And why you want your baby to suffer because of you, so please stop it and the other thing there is no safe antidote of marijuana. So better is to stop it, and yes, marijuana remains in your body system for up to three weeks. Please take medicine regularly and do USG (ultrasound) regularly and please for your child please stop to take marijuana.

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

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

Q. Q. I am trying for conceive but I have adenomyosis and ovaries endometrioma. Please advice. Hello doctor, I am a 38-year-old female. Trying for conception since eight years of marriage. Before three months I have been diagnosed with adenomyosis and both ovaries endometrioma I did laparoscopy and hysteroscopy for the same in the month of may and after that they put me on conjugated estrogen tablets and Decca peptide injection after 20 days of the operation but after a month of the operation during my periods I had severe pain and PMS. I had my BP raised severe palpitations along with severe bleeding and have painful periods like before operation I am concerned after operation why there are so many such problems. I asked my gynecologist about this, but he said show to your physician I went to my family physician he started bp medicines. He said it is a temporary increased. But I am concerned about my health now and wants to get rid of all this problem. My gynecologist said conception is the only remedy to solve adenomyosis and endometriosis. I want to have a normal life because I am on bed rest for three months. Please help.

Hello. Let me start by saying that, as your doctor said, pregnancy is the best solution for all these problems. I do not see any need for bed rest. If BP reading is regular, try to reduce and gradually stop the medicine. Reports of infertility workup are missingHave your periods day three or fourth FSH (follicle stimulating hormone) and AMH (antimullerian hormone), to find what is your ovarian reserve. I hope your husband's semen report is normal. If everything is fine, please go ahead with ovulation induction with hormone IUI (intrauterine device). This would increase pregnancy chance by four times, thereby resolving other complaints. Do not waste time on other treatments. Try to get pregnant before you lose the benefits of surgery. I cannot comment on pain, as details of findings before surgery and surgical procedure is missing. I hope I have clarified your query, do write back if any more questions and for your feedback.

Q. Q. I had spotting on the next day of my unprotected sex. Is this a sign of pregnancy? Hello doctor, I had unprotected sex on my infertile day, but I was quite scared, so I took post-pill a week later I had another unprotected sex this time in my fertile days but did not receive the post-pill immediately next day I saw a slight spotting which prompted me into taking the emergency pill. Now a week later, I have been bleeding for two days. I hope this is not a sign of pregnancy. Please help me understand it better.

Hello. Ideally, the emergency contraceptive pill is to be taken within 72 hours of last intercourse to be effective 99 %. It is of no importance if taken after a week. Nevertheless, the bleeding which you got mid cycle before you took the pill was likely to be an ovulation bleed as you had sex in your safe period, then you took the high dose progesterone emergency pill, which initiated a progesterone withdrawal after two days in the form of bleeding as expected. This rules out pregnancy as you had a withdrawal bleed, but it is always best in such cases to get a serum beta hCG test done to be conclusively sure.

Q. Q. 3-year-old son has diarrhea for a week. Is this something serious? Hello doctor, My 3-year-old son had diarrhea for a week. He has thrown up a couple of times throughout the week as well. He was eating and drinking normally and has appetite. There does not seem to be any blood in the stool. And his belly ache goes away after each diarrhea episode which he has many each day. He is usually drinking as well. His doctors seem to believe that it is a viral infection and will go away in time. We just started a bland diet for him. Should I be overly worried? He is active and wants to eat and drink. So is this something more serious than we think or am I too worried?

Hello. If there is no blood in stools, it is mostly viral. It usually gets settle in five days. Important here is maintaining hydration. Make sure you give him plenty of fluid, ORS (oral rehydration solution). If he is vomiting, you can ask your doctor to prescribe Ondansetron. Give him probiotics and keep a watch on urine output. If he is passing adequate urine, then there is no point of worry.

Q. Q. What are the ways to stop sugar addiction? Hello doctor, I am having sugar addiction. I always eat candy non-stop and chips and soda, but I am so addicted that I failed the 30-day sugar free challenge in the first three hours itself. I need help, how can I stop this addiction if all my ways are failing everytime I keep trying.

Hello. Sugar is not an illicit drug, but the brain acts in a similar manner to other substance abuse and addictions. Another reason you could be craving sugar regularly is due to how it makes you feel after consuming it. Generally, a sugary treat causes a rush of both glucose and endorphins in your blood. One of the best things you can do to fight your sugar addiction is to start by swapping sweet foods for healthy alternatives like vegetables. Yes, vegetables can be sweet, but the natural sugars you find in carrots, beets, sweet potatoes, and peas are so much lower than what you will find in treats such as gummies, cookies, or donuts. At the same time, they’ will satisfy your craving for sweetness and you can train yourself to eat these healthier choices over-addictive sugary desserts. The last small tip for fighting your sugar addiction is to generate a plan for how you will eat. You can write this plan out, post it somewhere, or simply keep a mental note of it, but a plan can help you to succeed in various situations. For example, keep carrot sticks cut up in your fridge so that after work, you can plan to snack on those instead of cookies. Or if you are going out to brunch, decide that your plan is to order an omelet with vegetables so that pancakes (basically, a maple syrup delivery device) is not an option. The idea here is to have a plan for how you will succeed in various scenarios that typically create problems for you.

Q. Q. What causes a soft spot in the middle of forehead in a baby? Hello doctor, My daughter has a soft spot in the middle of her forehead for the past nine months but can only be noticed when she raises her eyebrows or if the lighting is right. When sliding a finger over it you cannot feel anything, the forehead feels normal even when she has her eyebrows raised. It looks like a soft slightly raised lump when you can notice it. I have taken her to the doctors but they could not see anything. I had to show them photos as sometimes it really stands out, other times you cannot see it. What should I do?

Hello. Small spot in center of forehead is seen in some pictures (attachment removed to protect patient identity). As you know skull is made up of 16 small bones, these bones are attached with cartilages and get ossified with times. Due to some gaping, this swelling is seen. Give your kid Calcirol sachet once a week for five weeks, dissolve in two spoon water. Syrup Ostebon (Calcium) one teaspoon full twice a day. Feris drops 1 ml once a day. Zincovit drops one ml once a day. Vitanova drops 0.5 ml once a day. All the above for six months.

Q. Q. Is it possible to have infertility due to low progesterone levels? Hello doctor, I recently took a women's health test to test my hormones. I just got my results back and my Progesterone level is extremely low where as my Estradiol level is in the normal range. I have dealt with many irregular periods since I was young and have not been able to conceive a child with my husband and now I think I know why. I was wondering if my results can be looked at by a doctor to give me anymore information on what is going on with my test results. I am only 25.

Hello. The reports are fairly normal including the hormonal profile but the progesterone levels (attachment removed to protect patient identity). If these levels are from the proliferative phase then they can be considered normal, however, if from the luteal phase, then they are definitely low. Considering that LH was 11, this test may have been done around day 10 to 14 of your cycle, was it? In cases of progesterone deficiency, one tends to get anovulatory cycles and also shortened cycles with mid cycle bleeds and irregular shedding with often passage of clots, so if not so and if you are experiencing delayed irregular cycles then cause is likely PCOS and not progesterone per se. Also, important in any fertility evaluation is the the male fertility factor. It is important to learn if the semen analysis report of your partner is normal or not, whether the quality and quantity of his sperms are good or not, so please share his semen analysis report as well for review.

Q. Q. My intraocular pressure is getting high in the last six years. Why? Hello doctor,Over the past six years or so, my intraocular pressure (both eyes) has risen to 16, to 19, and now to 21. Will it continue to increase still? Kindly help.

Hello. As you might have been informed, increased eye pressure is mainly associated with the disease called glaucoma. This chronic symptomless disease is very drastic to the optic nerve and might lead to irreversible damage, and in the end, cause blindness. However, this eye disease is never diagnosed or established based on eye pressure measurements and requires a detailed and comprehensive examination including many diagnostic tests like, visual fields, gonioscopy, OCT (optical coherence tomography), multiple measurements of eye pressure during at least three consecutive days and these tests might be repeated twice and even thrice in the first year and then every six months if the only suspicion remains. If you have not undergone these tests, please do, and if you require a second opinion, please upload the results of all these tests and I will gladly provide you with my opinion.

Q. Q. What can be done for swollen gums where wisdom tooth is erupting? Hello doctor, I think my right side bottom wisdom tooth is coming as there is a ball on the back side of my gum that is really swollen. It almost feels like a pimple and the area around it has white lines on the inner cheek wall. What should I do?

Hello. If there is not much pain, it is better to let it grow fully. It may take a month or two to fully come out. If it does not, and the area gets painful then better to get an X-ray done for its exact position. Use warm salt water gargle twice a day for a week or two. Use a chewing gum on that side, it helps in faster growth of the tooth into occlusion.

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

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

Q. Q. Kindly have a look on my chest X-ray and explain. Hello doctor, I had severe cough and mucus formation which was in yellow. The doctor had prescribed antibiotics, Salbutamol tablet and allergy tablets. Now that cough has reduced but I feel some heaviness at the back right hand side and when waking up in the morning. While I had visited the doctor they had adviced me to take an X-ray. Later they said there is slight pneumonia and to continue antibiotics (Azithromycin) for five days. Also, I have completed my antibiotics dose for four days, still left with one more day. Cough is not there currently and better. I am attaching X-ray that was taken for your advice. Would like to have a second opinion on the X-ray report.

Hello. In attached X-ray report (attachment removed to protect patient identity), there is presence of slight consolidation in right side. So, it is suggestive of pneumonia like infection. For that, you need to complete antibiotic course. If clinically improved well, then no need for further work up.

Q. Q. Which one should I opt for a vision problem, a laser treatment or specs? Hello doctor, I would like to know to weather the laser treatment is better than continuing specs for vision. What would be the drawbacks of laser treatment, is it very complicated?

Hello. This is quite a common question youngsters ask. The best answer to this is it depends on you and your daily activities, profession, and lifestyle, etc. For example, if you want to take up professional sports, modeling, enjoy adventure sports, few jobs in the armed forces, getting a surgery done would be quite necessary. On the other hand, if you want to pursue higher studies and professions where you work a lot with computers and work on fine parts like watchmaking, then surgery would put you at a slight disadvantage as it slightly reduces image quality and increases chances of getting dry eye diseases. Some surgeons also prefer wearing glasses as it protects against infection and blood spurts during operations. With the latest equipment and techniques, laser refractive surgery is quite safe, and outcomes are good. The risk involved is very less. Although a power of - 5.0 is on the higher side, we can still expect good results given that your corneas are suitable for the surgery. The main thing to consider is of course long term outcomes are, 1. As a woman, your power will naturally change during pregnancy and lactation, and this happens to all women. Some have more, others less. This is unpredictable. 2. Surgery only corrects you for distance vision. Another natural change in eyes is presbyopia. Here you need to wear reading glasses. So even if you were to get surgery now, you would only remain glasses free for up to around 40 years of age after which you need reading glasses. I hope this answers your doubts. In case you have any further questions please let me know.

Q. Q. What are the tests I have to undergo after having unprotected oral sex? Hello doctor,I had an oral sex with a girl without protection, and I licked her vagina too, later I came to know she has PSV which she had undergone treatment and she was cured, I came to know risks of the STD's via oral sex and I was suggested to have test after four weeks, but they did not tell what test I have to go through in detail. My query is, what is the list of a test I have to go through? Please give me the names of the test in detail, so that I can approach a lab for testing.

Hello. There are many tests, but the below mentioned are usually done to rule out the infection. These are a screening test. 1. Test for HIV. Tridot test. 2.Test for gonorrhea (urine or oral swab) and chlamydia. 3. Test for Hepatitis B (HBsAg) and C virus. 4. Test for syphilis such as VDRL (venereal disease research laboratory test) and if required RPR (rapid plasma reagin) test. 5. Test for HPV (human papilloma virus). Herpes virus test is usually not required if no symptoms are present or there is no outbreak of it. I hope this clarifies your concern. Ask again if anything unanswered,

Q. Q. Is Bimatoprost safe enough for optical nerve damage? Hello doctor, My mother, is 76 years old, currently suffering from low, blurry vision (both near sight and far sight). Her BP, sugar, and thyroid are normal. A year before, she was critically suffered from urosepsis with AKI, DM II, pleural effusion, etc. but recovered. Though she has the first stage of renal failure and ventricular ectopic in ECG now. Recently she visited an eye hospital where she was told that her eye problem is mainly due to gradual damage of optical nerve, which is irreversible and the doctor cannot do much. In this respect, she was tested with digital fundus photography and OCT (Retina -Tessellated fundus in the right eye, FR dull in left eye). As per doctor's mention, I come to know that she has some cataract in the right eye (nuclear sclerosis grade II diagnosed in both eye) which need to operate soon for better vision, but I am not sure about it as it is not written in prescription as a diagnosis. She is advised to take a drop of Bimatoprost 0.01 % in both eyes every day to control optical damage. Now, I like to know is this medicine helpful if she complains with optical nerve damage without glaucoma or cataract. Is there any other solution to save her vision or further damage at least.

Hello. I understand your concerns, and I am very sorry to hear about your mother's eye changes. I am afraid that the changes in the optic nerve are indeed irreversible and according to the reports is near total. This is known by the part of the reports that say CDR 0.9 in both eyes. To explain it in a very simple manner, the eye is like a camera, both have lenses, and just like the camera has a film, the eye has the retina. If there is a problem in both the lens and the film, simply changing the lens would not improve the quality of the picture as the film (retina) is also compromised. But in few cases may improve to a limited, yet unknown extent. The problem also gets compounded with her poor general condition with heart problems along with the recent sepsis. So operating on her cataract is quite risky. Regarding the eye drops, Brimonidine eye drops have been known to help in neuroprotection and may help in the preservation of whatever optic nerve function is left, theoretically. So this would be the thought process behind this plan of management given to the overall condition. As far as the next step in managing, it depends on the daily activities of your mother and if at all she feels her current vision is not enough for her to carry out the daily routine activities. In case you need more information, please let me know.

Q. Q. Other than Sutent, which medicine can I opt for papillary renal cell carcinoma? Hello doctor,My father is recently diagnosed with papillary renal cell carcinoma type 1, and he has no BP or sugar. However, he had undergone bypass surgery ten years ago. Our doctor has suggested targeted therapy is better for him as there is another mass found in the lungs too. Our doctor has prescribed Sutent 37.5 mg, to begin with, and slowly increase it to 50 mg.However, due to our financial conditions, we cannot afford Sutent as it is pretty expensive for us. As we do not have any insurance. Is this the only drug available for this type of cancer, or do we have any other affordable and similar drugs with minimal side effects? We want to get your suggestion on this. Kindly help.

Hello. As per history given above. Your father as metastatic renal cell carcinoma. I would have liked to have few additional markers like his general condition, report of CBC (complete blood count) and LFT (liver function test), RFT (renal function test) to look at his risk score. In metastatic RCC, in first-line settings we have three TKI (Tyrosine kinase inhibitor) that are approved and commonly used. Namely, Sunitinib, Pazopanib, and Cabozantinib. Sunitinib and pazopanib have almost the same progression-free and survival benefit. Cabozantinib has benefit in progression, but final overall survival was the same as sunitinib. Toxicities are bit different for Pazopanib with more chances of hepatitis, weight loss, and diarrhea. If you are not affording for Sunitinib, then I would say Pazopanib would be better as it is cheaper with similar benefits and slightly different toxicities. Cabozantinib is costlier and not yet available. I hope it helps. I would be happy to help you further if you have any more queries or questions regarding toxicities of these drugs. TKI.

Q. Q. How to hide the gap that will occur due to the wearing of braces? Hello doctor,I am going to get braces soon, and I am going to have a large gap, is there anything a dentist could make to hide my gap?

Hello. Braces are placed to align your teeth more esthetically and camouflage the malpositioned teeth. From your question what I have understood is either you have a large gap already, and for that, you do not have to worry, braces will close it, or you are saying that during treatment you are going to have a gap because of the teeth removal. In that case, I want you to know that a few teeth are removed during orthodontic braces treatment to get space for the rest of the teeth to move and align themselves, and ultimately the gap will be closed. So, in both cases, the gap will be minimized or closed. You do not have to worry. Maintain proper oral hygiene, be careful with the brackets, do not break them, follow the advice of the orthodontist and do not miss any follow-ups as these minor steps will help the treatment to finish on time or maybe a little earlier too. Now, if you can elaborate on your question, I can answer more precisely. A picture of the gap will be helpful also.

Q. Q. What is the treatment for a 11-year-old patient with combined type 1 and 2 diabetes? Hello doctor, The patient is 11 years old, and right from birth, he is suffering from type 1 and 2 diabetics. Initially, he was on injection and now on tablets every day. As per the doctor, his pancreas is not working from his birth. Can you please let me know if there is any treatment available for this? Also, can the bone marrow blood infusion technique help in treating this issue permanently?

Hello. Yes, there is a procedure called pancreatic transplant. It must be taking place in your place as well. You can click on the individual hospital website and check if they have a pancreatic transplant facility, but it could be very expensive. But let me tell you one thing that even after any transplant, the patient has to take immunosuppressive medications all his life and compared to that the diabetes pills are still a better option.

Q. Q. Is it safe to get a filling fixed while running a low-grade fever from a UTI? Hello doctor, Can I get a filling fixed while running a low-grade fever from a UTI?

Hello. Theoretically, yes. But, practically I would not suggest you get it done as you will not be comfortable (mainly because of the water spray from the handpiece or drilling machine) and that will make it difficult for the dentist too. If it is an emergency or you do not have accompanying stuffed nose or difficulty in breathing through the nose, then you can go for filling. Depends on your comfort level and severity of your condition. I hope this has helped.

Q. Q. What should be done when a 5-year-old has a fever of 102° with TLC 16700? Hello doctor,My son is having a fever of 102°. He is 5 years and 4 months old. Since last two days, his temperature is not reducing. We have given Ibuprofen plus paracetamol syrup. Tablet Zedocef (100) DT 1 tablet twice a daily for five days after food. Syprup Ondem 5 ml thrice daily 1/2 hour before food, syrup Ibuprofen, paracetamol 7.5 ml 6 hours once after food. We tested his blood, but there was no malaria or typhoid. But his TLC is 16700. He is not taking any food, but sometimes he drinks ORS. So suggest us what to do?

Hello. You are already giving multiple antibiotics and antipyretics. The TLC (total leucocyte count) count in the report is on the higher side, which suggests some bacterial infection. Continue with the advised treatment. Some times fever may take three to four days to respond. Continue to give Ibugesic plus for each episode of fever for now. Cold sponging also helps to bring down the temperature. Get a repeat CBC (complete blood count) and Urine microscopy done. If fever is persisting and not responding to oral medication. The child may require admission for starting IV antibiotics. A complete clinical examination by the pediatrician to find out foci of infection is recommended.

Q. Q. I am suffering from angiomas on the back. Kindly help. Hello doctor, I have angiomas on the back. Kindly help.

Hello. Yes, these are cherry angioma. What do you want to know specifically about these? These are harmless and will require electrocautery if you want them to get removed. No creams or oral medications are effective.

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

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

Q. Q. Will taking antibiotics cause diarrhea or loose stools? Hello doctor,I took antibiotics about a month ago, and ever since the fourth day of antibiotic treatment, I have been suffering from diarrhea or loose stools. On the fourth day, I had bad cramps and loose stools that lasted from the fourth day to the seventh day. This then returned afterward with even worse pains, but this time, I had yellow stool followed by diarrhea. Ever since I have been having loose stools on and off that is foul smelling and mushy. Is this because of the antibiotics, or is it an infection?

Hello. Your diarrhea could be a direct side effect of the antibiotic, in which case, it should resolve after stopping the antibiotic. It could also be due to a condition called Clostridium difficile infection (C. diff for short). C. diff is a bacterium typically found in the intestines of most people. But under certain circumstances (frequent exposure to antibiotics), a couple of strains of this bacteria can multiply and produce toxins (called C diff toxin A and B). This can provide diarrhea-sometimes bloody, with crampy abdominal pain. I suggest getting tested for C diff. You need to submit a stool sample for C diff toxin. If it is positive, there are treatments for it includes oral Vancomycin, Fidaxomicin, or Metronidazole. I hope this helps.

Q. Q. I have a strong history of cancer. Should I concern about the sore in my leg? Hello doctor, I have sore on my leg for a long time. More than a year, I did shave part of my leg at one point. It became like a sore, but I have a strong history of cancer.

Hello. I have gone through your case. In my opinion, your lesion should be biopsied as early as possible as you have a long-standing history of cutaneous cancer, and I fear it could be slow-growing skin cancer. I have two to three differential diagnosis. 1. Nodular squamous cell carcinoma. 2. Nodular non melanocytic melanoma. 3. Basal cell carcinoma. 4. Keratoacanthoma. 1.Sun-exposed area. 2.White race and, 3 Past history of cancer Biopsy. Need excision as early as possible.

Q. Q. Kindly suggest diet for my 18 months old son with beta thalassemia intermedia. Hello doctor,My son is 1 and a half years old. A few months ago we came to know that his Hb is 4.3 and Hb F is 92 percent and that he has beta thalassemia intermedia. He was immediately transfused once. Now he is taking vitamin C, and Hydroxy and Folic acid and his Hb are 10.2. Please suggest some diet for him to maintain his health.

Hello. As your child is suffering from thalassemia intermedia, you should avoid giving iron rich food and food that leads to an increase in iron absorption.The foods which decrease its absorption are, (i) cereals and (ii) dairy products. The foods which increase the absorption are, (i) fruit and vegetables rich in vitamin C, (ii) meat, fish, shellfish and poultry and (iii) pickles, sauerkraut, soy sauce, vinegar, and alcohol. You can also supplement the child with folic acid 1 mg a day. Give nutritious diet and vegetarian protein sources, avoid meat and liver. Have a regular follow-up with your pediatrician for Hb level and iron overload.

Q. Q. My problem of bad breath persists even after teeth cleaning. What to do? Hello doctor,I tried teeth cleaning, I avoided non-veg foods and beverage drinks, which produce gas, and I am eating a balanced diet. My bad breath problem is since for the past five years till now, so in this period I realize that I have a white layer on my tongue and when I smell my tongue then I feel very bad breath. Also, I have a hole on my throat back of the tongue, and something comes through that way like thick water and when I smell it so bad.Another is when I eat something, then that smell lasts for a long time. What to do? I have been spent more money to avoid bad breath, so give me a suggestion to get rid of it. Bad breath is the main reason for my unsuccessfulness. Sometimes thinking about this problem, I become depreciate. I needed your help.

Hello. The white coating on your tongue is mostly due to bacteria and debris. And, it seems that you might have a dry mouth. All this must be causing bad breath. Clean or scrape your tongue regularly, maintain proper oral hygiene, drink a lot of water and even empty stomach will cause bad breath, so have food regularly on time. Do mouth rinse with lukewarm water and salt or lukewarm water and a bit of mouthwash diluted in the water. But, better to avoid continuous use of mouthwash as this itself can cause dry mouth sometimes, and discoloration of teeth. Get a consultation from a dentist regarding dry mouth, to rule it out. If you have dry mouth, a Sialogogue (to increase salivary flow) will be prescribed by the dentist. Do not worry. You will be fine. If possible, send me a picture of your tongue and teeth.

Q. Q. Is it possible to get extreme nausea, acid reflux, fatigue, and weight loss due to gallstone? Hello doctor, I am 41 years old, male. I have symptoms of extreme nausea, acid reflux, fatigue, and weight loss. Ultrasound shows gallstone. I have enclosed the report. The doctor wants to do a HIDA scan and remove the gallbladder. Are my symptoms due to gallstone? Is there a substitute test for a HIDA scan? Should I go for surgery? Please advise diagnosis and treatment.

Hello. First, gallstones in itself require treatment. The only treatment for 10 mm size stone is surgery. Medication will not reduce it. Untreated gallstone at your age may lead to complications. Your second query regarding whether symptoms of acid reflux are associated with gallstones are not. That is difficult to answer. There is an association of the two but difficult to directly link causation of acid reflux to gallstones. Hence, your symptoms may or may not rebate after surgery. Some patients although do show symptom relief. You should also undergo an upper GI endoscopy if your symptoms are persistent after discussion with a gastroenterologist.

Q. Q. Is it possible for PCOS patient with regular periods to conceive? Hello doctor, I was diagnosed with PCOS at 16, but have had successful pregnancies (other things I had zero breast change and less than once a day of milk production). We have never used any form of birth control yet our youngest is now almost 5. We have been actively trying for almost two years now. My periods during the last six months have been on time and consistent. I am 31. Why are we not able to get pregnant after two babies?

Hello. As I have learned that your last pregnancy was five years back and that your menses have been regular since last six months and you have been trying for last two years without any use of contraceptive practices to conceive. This qualifies for secondary infertility treatment. Now the first thing which needs to be checked is to get your partner's semen analysis done to check for quantity and quality of sperms as of now. There are chances that the count may have gone down or the quality may have depreciated which can be treated accordingly. In middle age men, such male infertility is common and needs to be addressed first before a lady is subjected to tests and examinations for evaluation of secondary infertility. Hence, it is requested that you may please get his semen analysis and culture test done first and review with reports. In the meantime, you may send across any ultrasound pelvis reports or hormonal profile tests (from the last six months) that you may have undertaken for review (if the element of PCOS still persists or not). Semen analysis and culture for the male partner. Male infertility. Secondary infertility. As per reports (awaited).

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

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

Q. Q. I have underdeveloped jaw bones, scoliosis, and swollen face. Please help. Hi doctor, I am 20 years old. I have one kid and I am seven months pregnant. Since I started puberty, I got a lot of health problems. The left side of my underjaw is not fully grown. It feels like pieces are missing. You can also see the big difference between the left side of my chin and the right side. My cheekbones are also not fully grown. I have poor blood circulation and my face gets very very swollen. Mostly in the morning, my face looks quite normal and my skin color as well. Later, in the day, my face gets swollen and big and also when I eat and when I eat a lot and unhealthy it gets more swollen. When I lay down the swelling lessens. I also have mental stress and an anxiety and I have a scoliosis. I get tired quickly and my skin is very dry. I have dark or purple undereyes and dark patches on my ankles, knees, etc.

Hello. I just read your query. See the issues like scoliosis, underjaw shape, and underdeveloped cheekbones are anatomical issues which are related to the natural structure of your body. They can not be corrected with the help of medication. You may take help from artificial modern techniques, which you can learn from a nearby physician. The poor blood circulation, swelling on face, stress and anxiety, tiredness can all be related to pregnancy. I advise you not to take any random treatment or any supplement without consulting your gynecologist. This is the crucial time of your pregnancy. So visit a nearby gynecologist and ask for the help for all the issues you are having.

Q. Q. What are the ways to control anxiety while driving? Hello doctor, I have been suffering with obsessive compulsive disorder- OCD, fear of germs, ordering things, obsessive thoughts. I also have anxiety while driving car at higher speeds. I have been diagnosed with Fibromyalgia which is lined to general stress, anxiety levels, which causes the muscles to be held tight. I have been able to accomplish most of the daily tasks and be successful in life. However, the anxiety while driving is troubling me. I need to reduce anxiety while driving, while also maintaining focus. Also, the general level of anxiety or stress is causing other physical ailments. Due to muscles being in constant state of tension. Currently, I do not take any medication. Only supplements 5-HTP (Seratonin) and one sleep aid (Melatonin).

Hi. I understand you experience OCD symptoms, general anxiety symptoms and specific driving anxiety and some anxiety related physical problems. What is your current profession? Your job timings? Family members? For how many years you are having 0CD symptoms? GAD symptoms? Stress? Why? Exercise? Relaxation? Any therapy? Family support? Any other anxiety triggering factors than driving? Sleep? Physical intimacy? Please reply. Take care.

Q. Q. There is a reddish-sticky part on my foreskin even after having medications. Why? Hello doctor, I am 39 years old. Since more than a month I had a blister on my foreskin, and I noticed a reddish-sticky part in my foreskin. I saw this after sex because it was painful (but it was not hard sex at all). The blister went away, but the reddish-sticky part stayed. I had also burning and heat in the skin of my testicles. I went to the doctor, and he found an infection. I had antibiotics pills and fungal cream. After a week, everything was improved, but the reddish-sticky part was still there, but the doctor said everything was fine. But it is not. I went to another two doctors (a urologist and a dermatologist), and they said everything is fine. The dermatologist prescription was Vaseline, that was two weeks ago, and this stays. I am worrying about cancer, and I asked them a biopsy, but they refused. Since before five months I also had a red rash in the gland coming and going, but for more than a month, it has not happened again.

Hello. I understand that you are concerned, but I can assure you that in the photographs there is no feature suggestive of any cancer. I understand that you had a blister after intercourse, that might be friction blister as other cause of blister in genitals include herpes, but that present as multiple tiny blisters. Recurrent glans rash can be candida, but right now, I cannot see any changes. It might feel sticky and thin after healing of a blister for some time, but there is nothing to worry. And certainly, there are no features of cancer. Just use some good moisturizer or use the following. 1. Cetaphil moisturizing cream.

Q. Q. Is it advisable to use Neomycin during first month of pregnancy? Hello doctor, My wife is currently on her sixth month of pregnancy. I am pretty much concerned about using Neomycin 0.5 % and Clobetasol 0.05 % ointment during the first month of our pregnancy. We had itching and burning sensation. We used approximately 4 g of ointment in total. She applied some ointment over her inguinal area and me over head of penis and we also had intercourse after that. This happened two times. Would this have caused vaginal absorption of Neomycin and damaged the fetus? Or as it was the month of conception would it have damaged the sperms, egg or the fertilized egg? I read some articles where topical Neomycin has caused ototoxicity, nephrotoxicity and reduced spermatogenesis in males. Should I have terminated the pregnancy earlier? Should I monitor the baby after birth for these toxicities? We did three scans so far dating scan, NT scan and anomaly scan which are normal.

Hello. There are possibilities of absorption per vaginally and I agree there are reports of ototoxicity and nephrotoxicity but as she is six months pregnant now and all scans are normal so there are no morphological anomalies in the child but as far as ear hearing abnormalities are concerned, that cannot be detected by scans. Also, as on date after 20 weeks of gestation, pregnancy cannot be terminated by law unless gross abnormalities are evident in the foetus and permission would have to be sought by high court only.

Q. Q. My Hb is 8 to 9 with normal MCV and spleen enlargement. Please advice. Hello doctor, My Hb is 8 to 9 always, and MCV is on the normal range, on CBC. I have enlarged spleen (moderate to severe) since childhood and chronic since then. I have a history of blood transfusions but had transfused only 6 to 7 times. My brother has the same problem with the same symptoms also. He is 31, and I am 34 years old. My mother is anemic with Hb 7.5 to 9.0 always, with normal MCV on CBC. She is 51 years old. Father has normal HB 14 always.

Hello, Welcome to the icliniq.com. You have to rule out iron deficiency anemia and hemolytic anemia in your case. You need to investigate further as follow. You can revert with reports once done.If you have hemolytic anemia than hemoglobin level usually remains in the borderline range.If your above reports suggest towards iron deficiency anemia than iron tablet will recover your anemia completely. So revert with reports once done. Meanwhile, you can be prescribed ferrous ascorbate tablet for your anemia.I hope I have answered your question. Let me know if I can assist you further.

Q. Q. Does vaginal itching after sex indicate STD? Hello doctor,I had sex with a prostitute last week. I used a condom, but I played her vagina with my hand. I came back home that night and had sex with my wife again. I also played her vagina with my hand. Next day, she had her periods and felt itchy at her vagina (I think genital herpes). So she scratched her vagina, and it became a damaged spot under the vagina. But it is better now and is about to heal. Is this STD or not?

Hello. It may be normal, but I cannot deny from STD (sexually transmitted disease), and it may be herpes and vaginitis too. 1. Apply Betnovate-N locally up to deep in the vagina, after proper wash two times a day till required. 2. Ciplox TZ (Ciprofloxacin, Tinidazole) two times a day after food for three days. 3. Candid veginal tablet at night for six nights.It will be fine. And it means you believe in polygamy, which is one day become dangerous. Be loyal, and you can use her ten times a day. So she will remain healthy so as you. If she has vaginitis, you also can get the infection.

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

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

Q. Q. I am having PCOS, and trying to conceive for eight months. What is the treatment? Hello doctor, I am 33 years old. I have been trying to conceive for eight months from now. I have monthly periods and positive OPKs and BBT shifts, but periods are also very light, basically spotting. I had an Ultrasound which showed a few cysts, had mildly elevated testosterone, normal LH and FSH, normal estrogen, low progesterone. My PCP is not convinced. I have PCOS but I am wondering if that is still a possibility and what I should anticipate for treatment in the future (clomid vs. progesterone therapy, etc.)?

Hello. The fact that you are getting positive OPKs each cycle indicates that you have an anovulatory cycle or in simple terms that you are ovulating regularly. PCOD (polycystic ovarian syndrome) cannot be diagnosed alone with just small cysts in ovaries, rather one should have around 10 to 12 multiple small subcenterimetric follicles lining the periphery of the ovary during midcycle scan, one should have featyres of clinical hyperandrogenism like acne, hirsutism (excessive facial and body hair), acanthosis and most importantly oligomenorrhoea or irregular menses. Testosterone alone does not justify the diagnosis. However, if o e needs to be sure, then AMH (ante Mullerian hormone) test can be done, which is more than four indicates PCOD. As mentioned that you are on thyroid medications, I believe your TSH levels are less than five. Please share your ultrasound and hormonal profile reports for review. Now, it would also be essential to check for your partner's semen analysis for quality and quantity of sperms. I am not sure if you have any kids before or not as you have not mentioned, but if you do not yet, then semen analysis of your partner would be mandatory, as your reports are relatively normal. Progesterone deficiency can be treated, and even Clomid can be contemplated only of the male infertility factor has been ruled out first.

Q. Q. Are tonsil stones, sore throat, and swollen gums symptoms of oral or throat cancer? Hello doctor, I have tonsil stones, sore throat, swollen gums, and dry cough. Is this the symptoms of oral or throat cancer?

Hello. A recurrent sore throat can occur in a number of pathologies. Most often it is as a result of some local pathology like Rhinosinusitis, nasopharyngitis, tonsillitis, GERD (gastroesophageal reflux disease), LPR (laryngopharyngeal reflux). Rather than relapsing and recurring course malignancies tend to have a progressive course. Further age is a crucial factor. Younger people usually do not have malignancies. Your doctor must have checked your throat, and he would for sure have picked something if there was any such thing. GERD and LPR are mainly known to cause recurrent sore throat. Malignancy is the last thing one would suspect at your age.

Q. Q. What are the chances of developing a heart attack in a GAD patient? Hello,I am a 28-year-old female. I always worried about her heart. I have GAD specifically focus on health anxiety and often experience heart attack symptoms so much so that I have gone to my doctor and the ER many times (always to be cleared). I continue to worry whenever the symptoms come back. I have been cleared so many times, but still, fear that something could go wrong or something might have been missed. Is there a chance that I could develop a risk of a heart attack without making any major changes?

Hello. A heart attack usually occurs in those with risk factors for ischemic heart disease such as high BP, high sugar, high cholesterol, family history of a heart attack in young age, etc. Your tests are normal thats good. To estimate the lifetime risk of development of atherosclerotic diseases such as stroke and heart attack, have a fasting lipid profile done and send to me.

Q. Q. Will sharing water bottle cause transmission of genital herpes? Hello doctor, My cousin was diagnosed with genital herpes a few days back. She also has a sore throat currently that the doctor thought was strep throat but the strep test was negative. I shared a water bottle with her recently. Could I have contracted herpes from sharing the water bottle?

Hello. The sharing of water bottle is not known to spread herpes. Genital herpes spread through sexual route. The viral infection also can cause sore throat like influenza infection. It will give streptococcus negative test.

Q. Q. I slept for long hours after taking Zyprexa. Is it normal? Hi doctor, I take on a daily basic- 100 mg Ixel, 60 mg Paxet, 0.5 mg Clonazapem. My psychiatrist told me to take 5 mg of Zyprexa in cases of SOS. I do not have any psychotic symptoms. He told me it was meant to knock me down, so I could have relief from stress and I could sleep. I took this pill (first time ever) and I slept for 20 hours (I was awake for one hour in between). Then I was awake for three hours feeling really bad, dizzy, spaced out, tired. Then I slept for another nine hours. I still felt bad and restless for a day, but slowly I got less tired and more alert. I guess it is not normal. It was even quite scary. In the meanwhile, should I avoid this pill or maybe reduce it?

Hello. I can understand your problem. You are on high dose of Paroxetine and are also taking Milnacipran, Clonazepam and if even with these medicines the symptoms are persisting, then there is no harm in adding a low dose antipsychotic drug like Olanzapine. Olanzapine in low dose has great efficacy in depressive symptoms, anxiety disorders and in resistant depression symptoms. The drug is associated with excessive sedation and this is the reason you slept for very long duration after taking this drug. In that case one option is to reduce the dose of the drug to 2.5 mg and give this a try. This should help you without causing unnecessary sedation. But, I am not sure if the drug will help much in anxiety if used in SOS basis. The drug should be used regularly after dinner and Clonazepam dose can be skipped which can be kept for use on SOS basis. You can have a talk with your psychiatrist for this.

Q. Q. I had LASIK done. My vision is all right, but I feel burning sensation in my eyes. Hi doctor, I had LASIK done for my eyes two months back. My vision is all right but, I feel a burning sensation at the corners of the eyes (corners from where tear comes). After 20 days of LASIK, (back then) whenever I put any eye drops my eyes started burning. Due to the burning sensation, my eyes started watering. I had consulted many doctors, and they prescribed eye drops like Systane Ultra, L-Pred, and Eubri. But no eye drops help me. I do not know what to do. Sometimes I also get redness in the eyes. Is it dryness or something else?

Hi. LASIK when it is done, corneal nerves will be cut. These corneal nerves take several months to regenerate. This can lead to continuous dryness and irritation in the eyes. Eyes also become hypersensitive. Systane ultra is artificial tear eye drops which is a substitute given for this dryness. But, the burning sensation in the corners can be due to an allergic reaction. L-Pred may help that. Please avoid rubbing your eyes in case of irritation, as it may take a long time for healing the corneal flap; they create in LASIK. Sometimes, eye drops may themselves can cause an allergic reaction to your eye and can cause irritation. You can use different company drops of same content medicine to avoid this problem. Try Levocetirizine tablets. You can a send a picture of your eyes for a detailed evaluation.

Q. Q. Does ventricular ectopic beats lead to cardiac arrest? Hello doctor,My heart is normal, but I have ventricular ectopic beats. Could these cause cardiac arrest and kill me at the age of 23? I worry about it every day. Kindly advice.

Hello. It is unusual for ventricular ectopics alone to cause cardiac arrest. Still, it depends on various factors like cause of ectopics, the morphology of ectopics, frequency of ectopics LV function on Echo. What symptoms do you have? Please provide your ECG and Echocardiography report. You have uploaded your photo as an attachment (attachment removed to protect patient identity).

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

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

Q. Q. I have pain and clicking sound in knee. What does my MRI show? Hello doctor, I would like to get help reading knee MRI. Based on physical examination: Acute medial meniscus tear. Pain, clicking sound and cannot do activities.

Hi. Please note the images are sub-optimal for giving a professional report as we need to see the images in detail at the workstation computer (attachment removed to protect patient identity). However, my observations after viewing the images sent by you are the following: Your MRI knee is showing a mild knee joint effusion and is the likely cause of your pain an discomfort. The medial meniscus shows a suspicious area of signal abnormality in in the anterior horn root area and is not a serious concern. The rest of the meniscus is looking normal. The anterior cruciate ligament is intact, however there can changes from a mild strain of the ligament.

Q. Q. How can wisdom tooth pain be treated? Hello doctor, I am having wisdom tooth pain and I am currently traveling. Can you please suggest some good pain relief medicine and once I am back home, I shall get it treated. Please find the attached X-ray.

Hi. Do not worry. I checked your attachment (attachment removed to protect patient identity). Pain is due to impacted wisdom tooth which has also damaged adjacent tooth leading to caries. You may require disimpaction and restoration of adjacent tooth by root canal. Right now you take the following medicines: Ofloxacin 200 mg with Ornidazole 500 mg BD for five days. Tablet Acelofenac 100 mg with Paracetamol 325 mg, Serratidopeptidase 15 mg BD for five days after taking food. Tablet Pantoprazole 40 mg OD for five days. Mouthwash Hexidine three times daily for 30 seconds by rinsing oral cavity. You are also advised to maintain good oral hygiene.

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

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

Q. Q. Why am I having thick white and greenish vaginal discharge with itching? Hello doctor, I think I might have an yeast infection, I have thick white discharge, itching, and today the discharge is a little greenish. What should I do?

Hi, Welcome to iclinq.com. If its appearance is like curd, then probably it is yeast and you can take a single dose of tablet Canestein 150 mg to treat it.

Q. Q. How can I manage dry eye? Hello doctor, I have a problem in my eyes. My right eye is dry and left is normal. I use Systane Ultra eye drop from the last one year and Omega 3 capsule from last three months. No result was found. No improvement was found. Please suggest me how I can get relief in my right eye? I want to overcome dryness in my eyes.

Hello. Unfortunately, dry eye is a chronic condition and does not go away. First of all, you should use the eye drop in both eyes and not only on the one you feel the dryness in, second of all, the minimal quantity of drops that might help you during the day is four times but there are no limits, you can even use it every hour. The other option is to have punctum plugs inserted and that might reduce the quantity of drops you have to use or to use the only available medication for this condition which is called Restasis. For a more detailed advice please provide me with more information such as schirmer test results atleast.

Q. Q. Why am I having a yellow thick foul smelling vaginal discharge? Hi doctor, I have a yellow thick foul smelling discharge. It has been a while but it seems to be a problem. My partner also mentioned that I have extra smell compared to his previous partners. Why is this?

Hello. You are suffering from bacterial vaginosis which is a bacterial infection. This can be confirmed with a high vaginal swab culture and shall require a course of antibiotics for a week with avoidance of intercourse during treatment. Try using alkaline vaginal washes to clean yourself and avoid chemical soaps. Meet your gynecologist for a local examination and prescription.

Q. Q. What is the skin rash that itch sometimes in a child? Hello doctor,My daughter has just started kindergarten three weeks ago and came home today with a rash all over her arms, hands, and feet and one by her lip. She feels fine otherwise but they itch sometimes. Our 7-year-old neighbor just got over strep and impetigo and I am wondering if this could be that. It seems to look similar to the hand, foot, and mouth. She has already missed three days of school for a cold but I do not want to send her if she is contagious.

Hi. I have seen your query and examined your given pictures (attachment removed to protect patient identity). It seems your son has a hand, foot, and mouth disease, and does not look like impetigo. HFMD (hand, foot, and mouth disease) is a viral infection caused by the coxsackie virus. It is a self-limiting disease and takes around 5 to 7 days to subside. Symptomatic treatment can be taken like topical Lactocalamine lotion local application twice daily and Orasep (Chlorhexidine gluconate) mouth gel local application twice for five days after consulting your gp or near by dermatologist,

Q. Q. Is it possible to treat hydrosalpinx by natural methods? Hello doctor,Is hydrosalpinx treatable by natural methods? If possible, what should I do?

Hello. I think you are talking about hydrosalpinx. It is a temporary or permanent blockage of single or both fallopian tube. It is one of the major cause of infertility. It can be managed naturally through ayurvedic medicines and some specific Panchakarma procedure, Uttar Basti of medicated oil like Yavakshara oil. It helps to resolve blockage and open the fallopian tube. There are several causes to such conditions. Some of them are pelvic inflammatory disease, gonorrhoeal infection, etc. Ultrasonography, and hysterosalpingogram. PCOD (polycystic ovary disease), and hypothyroidism. Uttar basti with medicated oil like Yavakshara oil is the safe and successful treatment of hydrosalpinx. Avoid spicy and fried junk foods. Avoid cold drinks soft drinks ice-cream etc. Do regular kapalbhati Mandukasana and Ardha matsyendrasana as well as pranayana like anuloma viloma nadi shodhan and bhramari.

Q. Q. I have diarrhea following constipation for a long time. Why? Hi doctor, I am having a slightly upset stomach with bloating for the past four months. I thought I had a bug. Two weeks later, it seemed much better. However, my bowel movements did not return to normal. I had mostly constipation for about a month (even though my stomach did not feel as upset anymore). Then after that month, things flipped and now for the last four weeks at least, I have had movements that are almost diarrhea (very soft, formed only slightly). Colour does not seem abnormal and there is not a bad smell and I do not see oil drops in the toilet bowl. Every morning I have this. I also am having increasing stomach reactions. Every time I put food into my mouth, the gurgling starts. I am not feeling this is a food intolerance as it happens instantly no matter what I eat. I also get a lot of bloating due to the gas. I will, of course, be following up with my doctor, but wanted to ask here. I have a history of breast cancer, so I easily get concerned about cancers (I realize that breast cancer does not often spread to the bowels, but I am still worried about another cancer). I am not a person with a strong history of gastrointestinal upset. I did go through about 7 to 8 weeks of something about seven years ago and never really had a true explanation. Those symptoms accompanied many other symptoms such as nerve pain, twitching, cramping. I felt as though I was having an autoimmune type reaction and am now wondering if it was tied to hormonal changes as my periods changed at the very same time as I had those symptoms (perimenopause). I am currently on Letrozole for hormone positive breast cancer targeted therapy. I had my ovaries out two years ago. So my body is definitely experiencing a massive drop in estrogen over the past two years. I am wondering if you have any thoughts on what this could be? No blood in the stool.

Hi. Your history fits into the acid peptic disease. I do not find any sign of cancer over here (attachment removed to protect patient identity). I would recommend you the following. A combination of Pantoprazole and Domperidone once daily for a few days. A good probiotic, to take a soft and bland diet, to walk after all meals. I would also recommend you to get your thyroid profile checked.

Q. Q. I have acne. Can I use Pantoprazole with Cutein? Hello doctor, I have acne for around five years. Now I am using Cutein tablets. I suddenly got a burning sensation in my stomach. So, now I am using Pantoprazole tablets along with Cutein. Is that effective or injurious?

Hi. Cutein tablet contains Iron as one of the ingredients, along with some other vitamins. The iron tablets can give increased acid in the stomach and indigestion. But, if you take both Cutein and Pantoprazole tablets together, the iron will not get absorbed. Therefore, first take Cutein tablet on empty stomach in the morning, and then 30 minutes later take Pantoprazole.

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

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

Q. Q. Can a rough foreplay be a cause for a bump inside my vagina? Hello doctor,I am a 24-year-old female. I was engaged in some foreplay with someone last weekend. And they fingered me hard. Last night, I noticed a tiny bump on the inside of my vagina. It is a pea-sized right against the wall. It is completely painless, and I would not have even noticed it was there had I not put one of my fingers inside myself.Is it possible that this is just a cyst from the rough foreplay? It feels a bit smaller than it did last night, but I cannot tell. It almost feels like a pimple, But it is on the inside of my vagina, and I can only feel it by pressing my finger against it. What could this be?

Hello. Yes, probably it is due to injury caused by fingering. And if it is not painful and not causing any discomfort, then you only have to wait until it resolves spontaneously. And the other option is that after a few days say three to four days you can get yourself examined by your local doctor to make sure that there is nothing more than that and this swelling has been resolved entirely. I hope it has helped you should you require any further queries. Please do not hesitate to contact me.