Timbrt/Liver-Text-OA huggingface dataset:
Question: will antibiotics reduce the effect of oral contraceptive pills?
Answer: while some antibiotics do induce hepatic enzymes to decrease the efficacy of contraceptive pills amoxicillin is not one of them and can be safely used without the fear of contraceptive failure. however it is important to stick to the contraceptive schedule. if you have taken crisanta (ethinyl estradiol) regularly without missing any pills then you can rely on it completely. if you have missed a couple of pills or more then it will be prudent to use a backup method like condom. crisanta has to be used regularly as advised. there is no modification in the course or dosage necessary. no backup contraceptive required if you have not missed any pills in this cycle and have been taking crisanta for more than one cycle. for further information consult an obstetrician and gynaecologist online --> <link>
Tags: antibiotics
Question: will diabetes during pregnancy affect the baby?
Answer: we are here to help you. diabetes is a big problem and so the pregnancy during diabetes is labeled as high risk pregnancy. it is very uncertain to know what side effect might occur. however the side effects can vary from person to person. it is very difficult to comment about what actually might have happened to the baby. if the sugar level gets low during cesarean section then yes the baby is at risk. high blood sugar instantly does not stop the heart or affect the baby. it affects the mother by making her more prone to infection and diabetic ketoacidosis (body produces excess ketones). uncontrolled blood sugar during pregnancy will affect the baby. for further doubts consult an internal medicine physician online --> <link>
Tags: diabetes
Question: i had diabetes during pregancy 4 years back. when my baby was born the sugar levels were normal
Answer: it is well known that diabetes during pregnancy is a forerunner for diabetes in later life. it is good that you checked your blood levels faithfully after your delivery and that is why you were able to identify the high levels. having found out about these high levels it is time for you to meet a physician or diabetologist to start treatment. the target sugar level for fasting is 100 and for 2 hours after a meal is 140 mg/dl. adhering to a strict diet and regular exercise may reverse diabetes completely in early stages. you have not mentioned your age or desire for future pregnancy. in either case we can help you. for further information consult a diabetologist online --> <link>
Tags: diabetes
Question: will exercise or diet help me in normal delivery?
Answer: the following aid in normal delivery: your stature must be tall. there should be adequate pelvis. the baby should be in vertex position. this can be predicted only when you cross 37 weeks. you can have a normal diet and regular antenatal exercises till then. yoga also helps but you are too early in pregnancy to predict the same. for further follow up consult a gynaecologist online --> <link>
Tags: exercises
Question: i want to know whether my liver is in bad condition.
Answer: the liver is a workhouse for metabolism of protein and fat (lipids). when there is an excess of lipid in your blood than the capacity to metabolize by the liver the excessive lipids start to accumulate in hepatic cells known as fatty liver. this is an ongoing process if not taken proper steps to prevent it. i am sure that your liver is not in bad condition at all and it can be reverted to normal metabolism by regular exercise intermittent fasting use of omega fatty acids containing oils in diet reducing fat content in diet and by avoiding alcohol. the probable causes:diet and alcohol. investigations to be done:lft (liver function tests) and ultrasonography abdomen. probable diagnosis:fatty liver. treatment plan:conservative treatment. preventive measures:1. regular exercise. 2. intermittent fasting. 3. use of omega fatty acids containing oils in the diet. 4. reducing fat content in diet. 5. avoiding alcohol. regarding follow up:for further information consult a medical gastroenterologist online. ---> <link>
Tags: omega fatty acids
Question: how do i recover from excess saliva production?
Answer: the causes of hypersalivation include excessive starch intake reflux disease pancreatitis liver disease oral infections and decreased saliva clearance. so before trying any medication try some lifestyle modification. if that did not help then you can use some medication. hope this will help you and wishing you a faster recovery. treatment plan:1. avoid high starch food like potato bread cereals rice and corn. 2. maintain oral hygiene. 3. avoid spicy and fried foods. regarding follow up:revert back for further information to an ent otolaryngologist online. ---> <link>
Tags: oral hygiene maintenance
Question: what is the reason for my disturbed sleep and morning drowsiness?
Answer: i have gone through your query. you are suffering from two problems. one is nasal block and the other is sleep disturbance which may be insomnia. you can stop xaria plus (combination of montelukast and fexofenadine). instead of that you can take flutiflo-ft - fluticasone nasal spray once daily along with nasoclear nasal drops as and when required. sleep disturbance may be due to insomnia and so need sleep hygiene. stop drinking coffee or tea in the evening do regular exercises in the evening and sleep in the lateral position. try simple changes to your daytime and pre-bedtime routine. keep a regular sleep schedule go to sleep and get up at the same time each day including the weekends. set aside enough time for sleep. most people need at least seven to eight hours each night in order to feel good and be productive. make sure your bedroom is dark cool and quiet. cover electrical displays use heavy curtains or shades to block light from windows or try a sleep mask to shield your eyes. turn off your television smartphone and computer a few hours before your bedtime. the type of light these screens emit can stimulate your brain suppress the production of melatonin and interfere with your body’s internal clock. will try conservative management initially and if not improving then you may need sleep study and medications like melatonin. i want to know whether you have snoring. the probable causes:stress related sleep disorder. investigations to be done:sleep study after one month. differential diagnosis:obstructive sleep apnea (osa). probable diagnosis:insomnia. treatment plan:conservative management like sleep hygiene avoid coffee and tea and do regular exercises. regarding follow up:revert back after a month to a sleep medicine physician online. ---> <link>
Tags: fexofenadine
Question: is there a permanent cure for pulmonary hypertension?
Answer: both rheumatoid arthritis and pulmonary hypertension are chronic diseases. as there is no permanent cure for it the aim of treatment in such case is control of symptoms only. medicines help only to control the symptoms. you are a known rheumatoid arthritis patient and now have developed pulmonary hypertension which is idiopathic. now to manage breathlessness you are using long-term oxygen support. this is just the progression of both diseases which makes it difficult to manage. at present you are taking tablet sildenafil 20 mg twice daily. i would like to recommend tablet ambrisentan (pulmonext) 5 mg once daily with tablet tadalafil 20 mg daily if liver function test is normal. i strongly suggest you to discuss these drugs with your pulmonologist and make sure you are taking the tablet under his guidance only. continuous oxygen supplementation should be given to keep oxygen saturation above 95%. close monitoring of all vital parameters is very important. regular checkup with cardiologist for monitoring pulmonary artery pressure recommended. these medications will help to reduce the need of oxygen to some extent and help to improve exercise intolerance. as i told treatment of pah (pulmonary arterial hypertension) is very complex and runs long. so close supervision with pulmonologist is very important. monitoring liver and renal function along with the use of these drugs is necessary to avoid side effects. for further information consult a pulmonologist online --> <link>
Tags: rheumatoid arthritis
Question: why is the medication for schizophrenic disorder causing weight loss and lethargy?
Answer: it seems that you are suffering from a bipolar affective disorder and currently in the depression phase. according to me your thyroid disturbances should have been treated while taking lithium rather than discontinuing it as lithium is the best medicine for your condition. loss of appetite is due to magnesium valproate tablets as it causes liver dysfunction. i suggest you get a liver function test done. i would advise you try increasing magnesium valproate to minimum 500 mg twice daily and also increase amisulpride in low dose. consult your specialist doctor discuss with him or her and increase the dosage with their consent. before starting bupropion you should have tried minimum effective doses of current medication. i would like to see your recent thyroid profile for better understanding. revert with more information to a psychiatrist online --> <link>
Tags: weight loss
Question: can i have pineapple to cure acid reflux?
Answer: acid reflux also known as gerd (gastroesophageal reflux disease) is a condition related mostly to the esophageal sphincter incompetence. low to moderate grades of gerd are treated first with antacid drugs which is the best and the first non-invasive solution. severe cases require surgery to reinforce the sphincter. as for the pineapple there are controversial opinions among doctors. some of them do not recommend it because it is a highly acidic fruit and can worsen the symptoms. while others recommend it as it may have good effects due to bromelain. you can try it for a week and see how your heartburn goes through. if you decide to avoid drugs and use foods then i would recommend you high calcium foods and basic ones such as milk which buffer the acids. also you have to eat in small portions several times avoid spicy fatty and acidic foods and also avoid late evening meals. use antacids if these measures fail. for further information consult a general medicine physician online --> <link>
Tags: gerd
Question: should i take prevacid in the night for gerd?
Answer: you should try a combination of lansoprazole and domperidone for one month. avoid fasting and having spicy food. take small and frequent meals. investigations to be done:1. cbc (complete blood count). 2. lft (liver function tests). 3. upper gastrointestinal endoscopy. differential diagnosis:dyspepsia (indigestion). probable diagnosis:gerd (gastroesophageal reflux disease). regarding follow up:revert back after 15 days to a medical gastroenterologist online. ---> <link>
Tags: gerd
Question: which is a better birth control pill than ortho-cyclen?
Answer: i think you should first get investigated for the cause of heavy bleeding. get your routine blood tests like cbc (complete blood count) blood sugar thyroid profile coagulation profile and liver function tests along with a scan of abdominal organs and pelvis. if you have problem with estrogen and progesterone combination which is present in tablet ortho-cyclen then you can start with progesterone tablets containing norethisterone from day 5 to 25 continuously for control of bleeding. another best way for this treatment as well as birth control is the use of mirena (levonorgestrel intrauterine contraceptive device). you can discuss this with your doctor. for further information consult an obstetrician and gynaecologist online --> <link>
Tags: heavy bleeding
Question: how to find out the reason for extreme sweating muscle stiffness and cramp?
Answer: for better understanding i need more details from you. do you get high blood pressure with these episodes? is there any flushing? do you have diabetes? is there any medical problem that runs in the family? you can get kidney function hba1c urine analysis urine osmolality tsh (thyroid-stimulating hormone) liver function and plasma metanephrines during this episode. revert back with the answers to the above questions to an endocrinologist online --> <link>
Tags: urine analysis
Question: i have been burping with stomach pain and discomfort. what can be the reason?
Answer: after going through your concerns carefully i feel your symptoms may be due to any one of the following. gerd (acid reflux). small intestinal bacterial overgrowth. ibs (irritable bowel syndrome). i suggest you tablet pantoprazole 40 mg and zenflox-oz (combination of ofloxacin and ornidazole) for 14 days. consult your specialist doctor discuss with him or her and take treatment with consent. the fact that your symptoms disappear after taking zenflox-oz it means that your symptoms are due to large or small bowel infections. i would suggest you do hydrogen breath test to rule out or confirm small intestinal bacterial overgrowth. for further queries consult a medical gastroenterologist online --> <link>
Tags: stomach pain
Question: i got slight epidermal prick while tattooing. is the risk of infection high?
Answer: there are lot of medical issues which can occur from tattooing like hiv infection tetanus hepatitis b and c and allergic reactions. nowadays tattooists reduced such risks by following universal precautions working with single use items and sterilizing their equipment after each use. as you mentioned your piercing was done only till the epidermis the infection is highly unlikely (very very less chance) that you will contact any infection. even if the needle was infected it requires contact with body fluids like blood. so you can relax. still i would like to make the following points:- in case of an hiv infection the test takes about 2-3 months to be positive. hence there is no way to find out if you got infected which is again highly unlikely. there is something called post-exposure prophylaxis (pep) given to individuals who have been exposed to the virus and includes three drugs given only under doctor's supervision. you can discuss this with your doctor. if you frequently get a tattoo done make sure your tetanus and hepatitis b vaccines are up-to-date. always have clear knowledge about the infections spread by tattooing like hiv and hepatitis and their mode of spread. take care and stay safe. for further doubts consult a hiv aids specialist online --> <link>
Tags: hiv infection
Question: we are not sure about my friend's diagnosis. kindly help.
Answer: one thing for sure is that he is having periodic hemolysis with adequate bone marrow response and he has a severe vitamin b12 deficiency. his corrected rpi (reticulocyte production index) is 2. 7% which means that his bone marrow is responding to the anemia appropriately. the broad differential here would be medication induced hypothyroidism vitamin b12 folate deficiency lead poisoning alcoholism and hemolysis due to ssd (sickle cell disease) or liver disease since he has transaminitis and elevated bilirubin. elevated ldh (lactate dehydrogenase) elevated reticulocyte count and low haptoglobin are indicators of hemolysis. he has splenomegaly as well which again favors either a chronic liver disease or most likely hemolysis. however the only tricky portion is his low wbc (white blood count). i do not think that it is a bone marrow process. it is more like peripheral destruction or nutritional deficiency. i do see that the vitamin b12 is very low at 209 and he has a normal g6pd level (glucose-6-phosphate dehydrogenase). i also reviewed that his bm was normal and his electrophoresis does not comment upon the sickle cell s or c disease. please mention whether he had any additional testing or work up for hemolytic anemia. i would like to know if he had a tsh done. why is he taking medications (all of them) including prednisolone azathioprine rituximab and mycophenolate? why is he not taking the vitamin b12 and vitamin d? these medications are toxic to bm and should not be used without a concrete diagnosis. revert back with the answers to the above questions to an internal medicine physician online --> <link>
Tags: vitamin b12 deficiency
Question: after delivery how long should i wait to get my tooth pulled?
Answer: you can go for tooth extraction in a week or two after child birth as the amount of local anesthesia that can reach the breast milk is very less and does not cause any serious complication. however you should once consult a neonatologist or your obstetrician and gynecologist to confirm depending on the medical health of your newborn. and then you can proceed for extraction without any worries. all the best for your delivery. for further doubts consult a dentist online --> <link>
Tags: conception and pregnancy
Question: does my mri explain as to why am i feeling lost and confused?
Answer: your mri of the brain is normal except some sinusitis. i would like to ask a few questions. since when are you experiencing these symptoms? do you have a headache or vomiting? is there any history of seizures or loss of consciousness? how is your sleep? are you taking any medication? i would suggest you get the following investigations done. eeg (electroencephalogram). contrast study of mri brain. if required lumbar puncture and csf (cerebrospinal fluid) examination. thyroid profile. anti-tpo (thyroperoxidase) antibodies. kidney and liver function test. vitamin b12 level. the differential diagnosis of your condition are as follows: depression. limbic encephalitis. encephalopathy. revert with more information to a neurologist online --> <link>
Tags: mri
Question: my wife has thyroid and not able to reduce weight. please help.
Answer: i read your query and understand your concerns. from the available values it appears that her thyroid function test is within normal limits but slightly at lower side. no medication is required in regard to thyroid as she does not have any symptoms related to thyroid function like fatigue irritability amenorrhea depression weight gain despite low intake of food dry skin and loss of hair to name a few. in case she has any symptoms then a trial of 25 mcg thyroxine (levothyroxine) should be attempted on a daily basis. for further doubts consult a general practitioner online --> <link>
Tags: reduce weight
Question: does my ecg look like i have ever had a heart attack?
Answer: it is good to see your detailed history for which i have asked for. firstly your ecg is perfectly normal. for anything to be wrong in case of ecg the changes should be present in at least two consecutive leads at a time. in your case whether it is a t-wave or q it is always there in one lead which does not signify anything. as your stress echo and all cardiac enzymes are normal (far superior to ecg in diagnosing a problem) you are cleared from cardiac side. secondly you say that you were prescribed statins (atorvastatin). one of the most common side effects of statins is myalgia (pain in a muscle or group of muscles). the generalized body ache and dull aching in nature is a characteristic feature of myalgia. i request you to consult your doctor and immediately stop atorvastatin. also get your liver function test done. kindly ask your doctor to shift you either on niacin or fenofibrate if you are intolerant to statin. ecg is always interpreted by a doctor. the machine most of the times provide us with artifacts. do not worry; your ecg is perfectly alright. from your history you have severe anxiety levels and attacks called panic attacks. every attack of panic disorder presents with same symptoms as you have mentioned. i can feel that you are obsessed by the thought that you are having any sort of a cardiac ailment. try to overcome your obsession. if you smoke or drink then stop it. try meditation for at least 30 minutes a day and do regular exercise. i suggest tablet paroxetine 12. 5 mg once daily for 21 days and tablet clonazepam 0. 5 mg once daily for 21 days for anxiety. consult your doctor discuss with him or her and take the medicine with consent. panic disorder and your anxiety are induced by obsession and it needs to be treated. the probable causes:1. myalgia induced by statins. 2. panic disorders. 3. obsession induced anxiety. investigations to be done:liver function test. regarding follow up:for further information consult a cardiologist online. ---> <link>
Tags: ecg
Question: suggest me any medicine and guide me reduce weight.
Answer: the best way to reduce weight is by regular physical exercise and balanced diet. you can lose weight by reducing your intake of oily food and sweets. it is also important to space your meals in such a way that you have more frequent small meals (and not heavy meals). regular physical exercise in the form of some cardio and strength training will make you fit and strong. sleep and hydration are equally important when you try to lose weight. ensure that you take lots of fluids and that you get at least 6-8 hours of sleep per day. medicine to lose weight: as a doctor i never really recommend my patients to take medicines to lose weight. only one drug is approved for use in india- orlistat. if you really want to take it you can take tablet orlistat 60mg thrice a day (after your 3 major meals). as i have seen in practice and also research results say that orlistat does not produce too much change in weight. it shows just a small percentage of weight loss when coupled with low-calorie diet and exercise. and orlistat has its own share of side effects: fatty/oily stool oily spotting intestinal gas with discharge a feeling of needing to have a bowel movement right away increased number of bowel movements or poor bowel control. rare but serious side effects can occur: symptoms of liver disease (such as persistent nausea/vomiting severe stomach/abdominal pain dark urine yellowing eyes/skin) symptoms of kidney stones (such as back pain pain while urinating pink/bloody urine). bottom line: i do not recommend medicines for weight loss. i can make a good diet chart and exercise regimen for you if you would like to follow up in which case you will have to get back to me with your details- your daily food routine your work timings your daily sleep cycle the kind of exercises you prefer etc. i hope that answers your question. revert back to a fitness expert online --> <link>
Tags: reduce weight
Question: i had unprotected sex yesterday and i am worried about hiv and other stds. what do i do?
Answer: we do not know the hiv (human immunodeficiency virus) status of the person with whom you had sex and also your baseline hiv status the other thing you mentioned that you do not have medical access for next three months. considering the availability of only lamivudine and zidovudine on your ship and assuming that your baseline status is negative i suggest you the following. to start with zidovudine 300 mg and lamivudine 150 mg twice a day at 12 hours interval postmeal for 28 days. it is recommended to start it as soon as possible within 72 hours of exposure. do not miss a pill. the first side effect with these could be in the form of nausea vomitings and anemia. get your baseline hiv status hepatitis b serology hepatitis c antibody syphilis serology gonorrhea and chlamydia pcr and hemoglobin levels checked whenever feasible. take light meals. i advise you to use a barrier contraceptive (condoms) each time you have sex to avoid the risk of hiv and other stds (sexually transmitted diseases). reduce the number of sexual partners and avoid sexual contact with a person of unknown status. assuming the baseline hiv status is negative repeat your hiv-antibody test at three months and six months interval of exposure. consult your specialist doctor discuss with him or her and start taking the medicines after their consent. for more information consult an hiv aids specialist online --> <link>
Tags: unprotected sex