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<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] Constipation cause bleeding from external hemorrhoids with abdominal pain. Is it diverticulitis?Hi doctor, I am a 22-year-old female who often suffers constipation to the point where I feel like I get minor external hemorrhoids that often bleed. Again, I have not got doctor verification for this but that is what I think. Recently, I have been experiencing pain around the left side of my stomach. I cannot localize it. Sometimes I feel like it is on my back, sometimes the lateral side, and sometimes the front. It usually happens after I eat or pass a stool but I have a minor sensation of discomfort even when I am just sitting. All of this has been getting a lot worse the past couple of days. I often feel nauseated too. I think I may have diverticulitis, however, I am not sure how common it is for my age. I also feel like I have a small localized swelling on the LUQ that hurts when I press on it. I am not sure what is wrong and I really want to go get some tests done but I do not feel safe going to a hospital with certain circumstances.[/INST]Hello. I think you are overthinking about your symptoms. To be conscious is good but to be over conscious may fall in the category of anxiety and is not good. I will advise you to be relaxed. Based on your symptoms, I do not feel anything to be worried of. Considering your age and symptoms of constipation and feeling something more probably pointing towards hemorrhoids or some local pathology. But physical examination and maybe flexible sigmoidoscopy would be appropriate to confirm underlying pathology or maybe online video consultation with gastroenterologist if you are worried about going to the hospital. I will advise you following general measures to follow that will help you. 1) Try to relax. Do not overthink. There is nothing serious we are thinking of. 2) Take fibers. Increase it in the diet in the form of vegetables. Add Ispagol in your diet. 3) Avoid constipation. 4) Take plenty of water. 5) Do regular walk, exercise inside your home if you can not go outside. 6) Do not strain in the restroom. 7) Take a sitz bath daily. Follow me in case you got further queries. </s>

<s> [INST] I am 28 years old and my weight is only 48 kg. What should I do to increase my weight?Hi doctor, I am 27 years old. My weight is 48 kg, and height is 5.8 feet. I am a pure vegetarian. I need to increase my body weight. I am suffering from psychological problems like anxiety. I am not diabetic, BP is normal. I do not smoke and drink. Please suggest foods to increase weight, immunity, and fertility. Kindly advise.[/INST]Hi. How is your eating habits? Your total calorie intake should be around 2200 cal/day. This will include all three meals with a snack in the evening. You can drink any protein supplements at that time. Include ghee two to three teaspoons a day. Cheese or paneer weekly thrice. Exercise every day for 45 minutes to 1 hour. Simplest is brisk walking. Your appetite will increase with exercises. All fruits and vegetables are allowed. Take milkshakes, lassi, protein supplements after your exercise. All kinds of dals and whole pulses are allowed. Whenever you are eating high protein diet follow that by light food. For example, if you are eating channa for breakfast, eat a light lunch. Gradually increase your intake. If you follow my diet, definitely your immune system will become good. Weight gain will happen slowly. Meditation is good for psychological problems. Concentrate on positive things in life. Do not worry too much about your weight. If your overall health is good, it is a very positive sign for you. Follow up after two weeks. </s>

<s> [INST] I get mild left-sided chest pain with low Hb and vitamin B12 levels. Please help.Hello doctor, I am a 39-year-old woman. I have mild pain in the left side of the chest (below the neck and above the breast) and then sensation in the upper back from four days. It comes and goes. Sometimes it goes to the right side of the chest also. I have done my ECG and blood test 6 months ago. ECG and blood sugar were normal. No hypertension but hemoglobin was 10 and Vitamin B 12 was below average. What can I do as in lockdown it is not possible to see the doctor as a person. Please help.[/INST]Hello. I would like to ask you some more questions, do you have symptoms of acid peptic disease or GERD? Or any burning sensation in the epigastric region, the center of your chest (heartburn). If you do, it could also present as chest pain so I will guide you accordingly. I would also like to rule out any muscular pain, for which I will encourage you to take a muscle relaxant and see if it helps. Take tablet Muscoril (Thiocholchicoside 4 mg) one tablet once a day when you experience pain and let me know in the follow up in a couple of days to see if it relieves the pain. Like you said your Vitamin B12 levels are below normal, it could also be neuropathic pain for which I will only advise vitamin B12 supplements (tablet Methycolbalmine once a day for three months) or B complex supplements. You can also improve these levels with diet. Take diet enriched with beef, liver, and chicken. Fish and shellfish such as trout, salmon, tuna fish, and clams. Fortified breakfast cereal. Low-fat milk, yogurt, cheese, and eggs. Since your Hb is also below the ideal levels, take iron-rich foods which are usually Vitamin B12 rich as well. So I will advise diet modification to incorporate these in your everyday routine or take supplements with iron and Vitamin B12 as well. Because anemia can also present with the said symptoms. Lastly, I will encourage you to reduce weight with exercise and changing your diet and switching to a low-fat diet with the addition of more fruits and vegetables to your diet. Try to start with atleast 30-40 minutes of cardio workout every day and work it up from there according to your stamina and you will see the visible change that you feel. You will feel more active and fresh. Try to bring your BMI (body mass index) as close to the normal range as you can. Because obesity itself can cause countless problems as well. I hope this helps. ECG (electrocardiography). Do not lift heavyweights. Take low fat, high fiber diet. After two days. </s>

<s> [INST] Loose motion is not controlled with antibiotics and bland diet. What should I do now?Hello doctor, I am a 39-year-old male. I am 168 cm in height and 68 kg in weight. Since last one month, I have been suffering from intermittent loose motions (yellow colored). There is no vomiting, no fever, or major abdominal pain (except for occasional cramps). Initially, I took a combination of Norfloxacin and Tinidazole for four days, but things did not improve. Thereafter on the prescription of my doctor I took Metronidazole 400 and Dicyclomine 20 mg for a period of 14 days. I also took Lactobacillus tablets for the entire period. During these times I only ate poha, rice, curd, and banana. Also, I took boiled water. It is the fifth day now and I have discontinued the medicines. Despite on such a bland diet (no wheat), I still have at least one to two loose motions in a day. My routine medical tests were done in January this year which was normal. My wife and son also developed loose motion in between for a very brief period. However, they recovered fully within three days. Please advice.[/INST]Hello. I cannot see any red flags in your symptoms. More likely nothing to worry. It is the function of your intestines that is triggered by some infection and you are facing overactive intestine. More likely it is a functional problem unless proven otherwise. I will advise you to keep things simple. Quit all medications. You already took a few antibiotics. Please follow these general guidelines: 1) Add fibers in your diet like vegetables and Ispagol husk two spoons daily. 2) Keep yourself well hydrated. 3) Add yogurt in your diet. 4) Eat less. 5) More important is to keep yourself relaxed. The best way of doing is by doing a walk, exercise. Please start tablet Mebeverin 135 mg before breakfast and dinner for eight days. Tablet Rifaxamine 200 mg after breakfast and dinner. Continue probiotics. Please follow me after one week. I hope you should be fine, otherwise, I will advise you on some tests. </s>

<s> [INST] 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.[/INST]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. </s>

<s> [INST] Why do I get semen leakage in a very young age?Hi doctor, I am a 13-year-old male and I have had semen leakage for about three months. I think it is from weak nerves because last year, I would masturbate a lot but then I stopped because it was becoming painful and I was embarrassed. Then about three months ago, I watched something inappropriate and I ejaculated without doing anything. Then a week later, I started to have semen leakage every day about three to four times a day. I am just very worried and I just want this to be cured and go away. Also, could this affect my eyes in any way? Please help.[/INST]Hi. Let me tell you that the symptoms described by you suggest that you have a nightfall problem. The high quality way to deal with dusk is the use of herbal or selfmade remedies. There are no aspect outcomes for such remedy methods. You ought to have yogurt at least two or three bowls a day. Avoid looking at porn as plenty of porn arouses you sexually. So it is recommended now not to watch porn. Sage tea – having two cups of sage tea a day will limit the probabilities of nocturnal emission. Gooseberry – popularly recognized as amla acts as an anti-oxidant and helps in lowering the nightfall. Gradually the moist goals trouble will be solved. Bathing – it is a recommendation to take bathtub earlier than you go to bed. It helps you have a sound sleep. A sound sleep is very vital for averting nightfall. I hope this helps. </s>

<s> [INST] Should I continue the medicines for PCOS even after my periods get regular?Hello doctor, I was diagnosed with PCOS in January so my gynecologist prescribed me Ginette 35 for six months and Bonemac D3 for one month. But from March my periods are regular without taking medicines but there is sometimes slight pain in my lower abdomen and side abdomen. Should I continue medicines despite having normal and regular periods?[/INST]Hello. If you are having regular periods in terms of flow, duration and regularities and if you have already stopped taking Ginette since March, there is no need to resume its intake immediately unless you need contraception also at the same time or not wanting a pregnancy now. In that case, you need to use an alternative mode of contraception to avoid your pregnancy. Please attach your previous prescriptions blood test and ultrasound scan reports based upon which PCOS was diagnosed. Also, inform your height weight and whether there is excessive hair in the chin, upper lip, chest, and abdomen Follow up with reports again. Also, follow the lifestyle modifications described below. Blood for serum fasting insulin levels. Blood for serum vitamin D3 levels. USG (ultrasound) TVS (transvaginal scan) if not done in the past three months. Continue vitamin D. Avoid junk food spicy and dip fried foods. Low carbohydrates, fat restricted, gluten-free diet is recommended. Regular brisk cardio excercise like walking jogging cycling swimming for at least 30 minutes a day is a must. Take frequent small meals. </s>

<s> [INST] I am 16 years old and having 3 degree scoliosis. Will it stop progressing when I grow further?Hi doctor, I am 16 years old. I just recently discovered that I have scoliosis. I do not know much about it but I will tell you what I know. My scoliosis currently has only a 3-degree curve and I am pretty confident it is a C shaped curve, although I am not sure. What do you think are the chances that my scoliosis will develop into adulthood? Do you think it will stop progressing once I am fully grown?[/INST]Hello. Before going into the progress of scoliosis, I would like to make you some clarity about the facts on it. 1) The Cobb angle is a measure of the curvature of the spine in degrees. This helps to determine what type of treatment is necessary. A Cobb angle of 10 degrees is regarded as a minimum angulation to define scoliosis. 2) A scoliosis curve of 10 to 15 degrees normally does not require any treatment except for regular check-ups. 3) If the scoliosis curve is 20 to 40 degrees, the orthopedic doctor will prescribe a back brace help to keep the spine from developing more of a curve. 4) More than 45 degrees need correction surgery keeping many pedicle screw and osteotomy to correct the curve. I hope you go for x ray done of your spine and it will be easy to measure properly about the curvature. </s>

<s> [INST] My 2. 5 month old kid has tongue tremors. Is this due to SMA?Hello doctor, I have a 2.5-month-old who I recently noticed developed a tongue tremor. I looked up online for the causes and found them as SMA. She has great motor control, we were not doing tummy time as often because she did not like it but have increased it and have seen a big improvement. My doctor believes it is benign tongue tremor, unfortunately, we had a telehealth appointment due to COVID so he was unable to see her but he told me not to worry and to keep an eye if things get worse. I am so scared it is SMA, what else should I be looking for?[/INST]Hello, Welcome to icliniq.com. History noted as above, your 2.5-month-old has developed tongue tremors. Please provide me more detailed history such as preterm or full term, birth weight, normal delivery or LSCS. How is her weight? Is she gaining weight and let me know more about family history or any other in the family suffering from SMA (spinal muscular atrophy). SMA is confirmed only by Genetic testing or by muscle study. There are many types of SMA some of them develop symptoms later in life and a few develop in early life. Keep a watch on her development like head holds muscle tone and power and let me know me know if tongue fasciculation increases and the child becomes more hypotonic. </s>

<s> [INST] My braces are not activated by power chains and creating gaps. Please help.Hello doctor, Why my ortho does not put brackets in power chains while missing one or two spots? I have straight teeth and I am in the sixth year with braces. I think instead of closing gaps, this is creating gaps. Please help.[/INST]Hello. There are different types of power chains that are available for the treatment depending on the interlink space. 1. Short (connects every alternate bracket). 2. Long (connects every third bracket). 3. Closed (connects each bracket). So depending on the stage of your treatment, either of the types can be used which may or may not connect individual brackets. Also, we would require the history of the type of malocclusion you had in the first place as the duration of the treatment varies with the complexity of the malocclusion. Complex malocclusion which require a lot of rotations and closure of gaps may take longer than usual. Also, the density of your alveolar bone and your body's bone remodeling rate affects the duration of final results. So in order to give a definitive diagnosis, we would require your treatment history which includes - 1. Preoperative and post-operative clinic photographs (intraoral and extraoral both). 2. Preoperative dental x-rays (OPG and lateral cephalogram). 3. Treatment history including the types of malocclusion, brackets used, wires used and the movements caused. 4. Oral hygiene maintenance routine that you follow during the braces treatment. Waiting for your reply. Brush twice daily with flouride containing paste. Use of salt water gargles everyday especially after meals.Tongue cleaning on regular basis. A periodic check up with your dentist once every 6 months. A visit to the dentist for oral prophylaxis (teeth cleaning and polishing) once every six months. After providing the required information. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] Constipation cause bleeding from external hemorrhoids with abdominal pain. Is it diverticulitis?Hi doctor, I am a 22-year-old female who often suffers constipation to the point where I feel like I get minor external hemorrhoids that often bleed. Again, I have not got doctor verification for this but that is what I think. Recently, I have been experiencing pain around the left side of my stomach. I cannot localize it. Sometimes I feel like it is on my back, sometimes the lateral side, and sometimes the front. It usually happens after I eat or pass a stool but I have a minor sensation of discomfort even when I am just sitting. All of this has been getting a lot worse the past couple of days. I often feel nauseated too. I think I may have diverticulitis, however, I am not sure how common it is for my age. I also feel like I have a small localized swelling on the LUQ that hurts when I press on it. I am not sure what is wrong and I really want to go get some tests done but I do not feel safe going to a hospital with certain circumstances.[/INST]Hello. I think you are overthinking about your symptoms. To be conscious is good but to be over conscious may fall in the category of anxiety and is not good. I will advise you to be relaxed. Based on your symptoms, I do not feel anything to be worried of. Considering your age and symptoms of constipation and feeling something more probably pointing towards hemorrhoids or some local pathology. But physical examination and maybe flexible sigmoidoscopy would be appropriate to confirm underlying pathology or maybe online video consultation with gastroenterologist if you are worried about going to the hospital. I will advise you following general measures to follow that will help you. 1) Try to relax. Do not overthink. There is nothing serious we are thinking of. 2) Take fibers. Increase it in the diet in the form of vegetables. Add Ispagol in your diet. 3) Avoid constipation. 4) Take plenty of water. 5) Do regular walk, exercise inside your home if you can not go outside. 6) Do not strain in the restroom. 7) Take a sitz bath daily. Follow me in case you got further queries. </s>

<s> [INST] I am 28 years old and my weight is only 48 kg. What should I do to increase my weight?Hi doctor, I am 27 years old. My weight is 48 kg, and height is 5.8 feet. I am a pure vegetarian. I need to increase my body weight. I am suffering from psychological problems like anxiety. I am not diabetic, BP is normal. I do not smoke and drink. Please suggest foods to increase weight, immunity, and fertility. Kindly advise.[/INST]Hi. How is your eating habits? Your total calorie intake should be around 2200 cal/day. This will include all three meals with a snack in the evening. You can drink any protein supplements at that time. Include ghee two to three teaspoons a day. Cheese or paneer weekly thrice. Exercise every day for 45 minutes to 1 hour. Simplest is brisk walking. Your appetite will increase with exercises. All fruits and vegetables are allowed. Take milkshakes, lassi, protein supplements after your exercise. All kinds of dals and whole pulses are allowed. Whenever you are eating high protein diet follow that by light food. For example, if you are eating channa for breakfast, eat a light lunch. Gradually increase your intake. If you follow my diet, definitely your immune system will become good. Weight gain will happen slowly. Meditation is good for psychological problems. Concentrate on positive things in life. Do not worry too much about your weight. If your overall health is good, it is a very positive sign for you. Follow up after two weeks. </s>

<s> [INST] I get mild left-sided chest pain with low Hb and vitamin B12 levels. Please help.Hello doctor, I am a 39-year-old woman. I have mild pain in the left side of the chest (below the neck and above the breast) and then sensation in the upper back from four days. It comes and goes. Sometimes it goes to the right side of the chest also. I have done my ECG and blood test 6 months ago. ECG and blood sugar were normal. No hypertension but hemoglobin was 10 and Vitamin B 12 was below average. What can I do as in lockdown it is not possible to see the doctor as a person. Please help.[/INST]Hello. I would like to ask you some more questions, do you have symptoms of acid peptic disease or GERD? Or any burning sensation in the epigastric region, the center of your chest (heartburn). If you do, it could also present as chest pain so I will guide you accordingly. I would also like to rule out any muscular pain, for which I will encourage you to take a muscle relaxant and see if it helps. Take tablet Muscoril (Thiocholchicoside 4 mg) one tablet once a day when you experience pain and let me know in the follow up in a couple of days to see if it relieves the pain. Like you said your Vitamin B12 levels are below normal, it could also be neuropathic pain for which I will only advise vitamin B12 supplements (tablet Methycolbalmine once a day for three months) or B complex supplements. You can also improve these levels with diet. Take diet enriched with beef, liver, and chicken. Fish and shellfish such as trout, salmon, tuna fish, and clams. Fortified breakfast cereal. Low-fat milk, yogurt, cheese, and eggs. Since your Hb is also below the ideal levels, take iron-rich foods which are usually Vitamin B12 rich as well. So I will advise diet modification to incorporate these in your everyday routine or take supplements with iron and Vitamin B12 as well. Because anemia can also present with the said symptoms. Lastly, I will encourage you to reduce weight with exercise and changing your diet and switching to a low-fat diet with the addition of more fruits and vegetables to your diet. Try to start with atleast 30-40 minutes of cardio workout every day and work it up from there according to your stamina and you will see the visible change that you feel. You will feel more active and fresh. Try to bring your BMI (body mass index) as close to the normal range as you can. Because obesity itself can cause countless problems as well. I hope this helps. ECG (electrocardiography). Do not lift heavyweights. Take low fat, high fiber diet. After two days. </s>

<s> [INST] Loose motion is not controlled with antibiotics and bland diet. What should I do now?Hello doctor, I am a 39-year-old male. I am 168 cm in height and 68 kg in weight. Since last one month, I have been suffering from intermittent loose motions (yellow colored). There is no vomiting, no fever, or major abdominal pain (except for occasional cramps). Initially, I took a combination of Norfloxacin and Tinidazole for four days, but things did not improve. Thereafter on the prescription of my doctor I took Metronidazole 400 and Dicyclomine 20 mg for a period of 14 days. I also took Lactobacillus tablets for the entire period. During these times I only ate poha, rice, curd, and banana. Also, I took boiled water. It is the fifth day now and I have discontinued the medicines. Despite on such a bland diet (no wheat), I still have at least one to two loose motions in a day. My routine medical tests were done in January this year which was normal. My wife and son also developed loose motion in between for a very brief period. However, they recovered fully within three days. Please advice.[/INST]Hello. I cannot see any red flags in your symptoms. More likely nothing to worry. It is the function of your intestines that is triggered by some infection and you are facing overactive intestine. More likely it is a functional problem unless proven otherwise. I will advise you to keep things simple. Quit all medications. You already took a few antibiotics. Please follow these general guidelines: 1) Add fibers in your diet like vegetables and Ispagol husk two spoons daily. 2) Keep yourself well hydrated. 3) Add yogurt in your diet. 4) Eat less. 5) More important is to keep yourself relaxed. The best way of doing is by doing a walk, exercise. Please start tablet Mebeverin 135 mg before breakfast and dinner for eight days. Tablet Rifaxamine 200 mg after breakfast and dinner. Continue probiotics. Please follow me after one week. I hope you should be fine, otherwise, I will advise you on some tests. </s>

<s> [INST] 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.[/INST]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. </s>

<s> [INST] Why do I get semen leakage in a very young age?Hi doctor, I am a 13-year-old male and I have had semen leakage for about three months. I think it is from weak nerves because last year, I would masturbate a lot but then I stopped because it was becoming painful and I was embarrassed. Then about three months ago, I watched something inappropriate and I ejaculated without doing anything. Then a week later, I started to have semen leakage every day about three to four times a day. I am just very worried and I just want this to be cured and go away. Also, could this affect my eyes in any way? Please help.[/INST]Hi. Let me tell you that the symptoms described by you suggest that you have a nightfall problem. The high quality way to deal with dusk is the use of herbal or selfmade remedies. There are no aspect outcomes for such remedy methods. You ought to have yogurt at least two or three bowls a day. Avoid looking at porn as plenty of porn arouses you sexually. So it is recommended now not to watch porn. Sage tea – having two cups of sage tea a day will limit the probabilities of nocturnal emission. Gooseberry – popularly recognized as amla acts as an anti-oxidant and helps in lowering the nightfall. Gradually the moist goals trouble will be solved. Bathing – it is a recommendation to take bathtub earlier than you go to bed. It helps you have a sound sleep. A sound sleep is very vital for averting nightfall. I hope this helps. </s>

<s> [INST] Should I continue the medicines for PCOS even after my periods get regular?Hello doctor, I was diagnosed with PCOS in January so my gynecologist prescribed me Ginette 35 for six months and Bonemac D3 for one month. But from March my periods are regular without taking medicines but there is sometimes slight pain in my lower abdomen and side abdomen. Should I continue medicines despite having normal and regular periods?[/INST]Hello. If you are having regular periods in terms of flow, duration and regularities and if you have already stopped taking Ginette since March, there is no need to resume its intake immediately unless you need contraception also at the same time or not wanting a pregnancy now. In that case, you need to use an alternative mode of contraception to avoid your pregnancy. Please attach your previous prescriptions blood test and ultrasound scan reports based upon which PCOS was diagnosed. Also, inform your height weight and whether there is excessive hair in the chin, upper lip, chest, and abdomen Follow up with reports again. Also, follow the lifestyle modifications described below. Blood for serum fasting insulin levels. Blood for serum vitamin D3 levels. USG (ultrasound) TVS (transvaginal scan) if not done in the past three months. Continue vitamin D. Avoid junk food spicy and dip fried foods. Low carbohydrates, fat restricted, gluten-free diet is recommended. Regular brisk cardio excercise like walking jogging cycling swimming for at least 30 minutes a day is a must. Take frequent small meals. </s>

<s> [INST] I am 16 years old and having 3 degree scoliosis. Will it stop progressing when I grow further?Hi doctor, I am 16 years old. I just recently discovered that I have scoliosis. I do not know much about it but I will tell you what I know. My scoliosis currently has only a 3-degree curve and I am pretty confident it is a C shaped curve, although I am not sure. What do you think are the chances that my scoliosis will develop into adulthood? Do you think it will stop progressing once I am fully grown?[/INST]Hello. Before going into the progress of scoliosis, I would like to make you some clarity about the facts on it. 1) The Cobb angle is a measure of the curvature of the spine in degrees. This helps to determine what type of treatment is necessary. A Cobb angle of 10 degrees is regarded as a minimum angulation to define scoliosis. 2) A scoliosis curve of 10 to 15 degrees normally does not require any treatment except for regular check-ups. 3) If the scoliosis curve is 20 to 40 degrees, the orthopedic doctor will prescribe a back brace help to keep the spine from developing more of a curve. 4) More than 45 degrees need correction surgery keeping many pedicle screw and osteotomy to correct the curve. I hope you go for x ray done of your spine and it will be easy to measure properly about the curvature. </s>

<s> [INST] My 2. 5 month old kid has tongue tremors. Is this due to SMA?Hello doctor, I have a 2.5-month-old who I recently noticed developed a tongue tremor. I looked up online for the causes and found them as SMA. She has great motor control, we were not doing tummy time as often because she did not like it but have increased it and have seen a big improvement. My doctor believes it is benign tongue tremor, unfortunately, we had a telehealth appointment due to COVID so he was unable to see her but he told me not to worry and to keep an eye if things get worse. I am so scared it is SMA, what else should I be looking for?[/INST]Hello, Welcome to icliniq.com. History noted as above, your 2.5-month-old has developed tongue tremors. Please provide me more detailed history such as preterm or full term, birth weight, normal delivery or LSCS. How is her weight? Is she gaining weight and let me know more about family history or any other in the family suffering from SMA (spinal muscular atrophy). SMA is confirmed only by Genetic testing or by muscle study. There are many types of SMA some of them develop symptoms later in life and a few develop in early life. Keep a watch on her development like head holds muscle tone and power and let me know me know if tongue fasciculation increases and the child becomes more hypotonic. </s>

<s> [INST] My braces are not activated by power chains and creating gaps. Please help.Hello doctor, Why my ortho does not put brackets in power chains while missing one or two spots? I have straight teeth and I am in the sixth year with braces. I think instead of closing gaps, this is creating gaps. Please help.[/INST]Hello. There are different types of power chains that are available for the treatment depending on the interlink space. 1. Short (connects every alternate bracket). 2. Long (connects every third bracket). 3. Closed (connects each bracket). So depending on the stage of your treatment, either of the types can be used which may or may not connect individual brackets. Also, we would require the history of the type of malocclusion you had in the first place as the duration of the treatment varies with the complexity of the malocclusion. Complex malocclusion which require a lot of rotations and closure of gaps may take longer than usual. Also, the density of your alveolar bone and your body's bone remodeling rate affects the duration of final results. So in order to give a definitive diagnosis, we would require your treatment history which includes - 1. Preoperative and post-operative clinic photographs (intraoral and extraoral both). 2. Preoperative dental x-rays (OPG and lateral cephalogram). 3. Treatment history including the types of malocclusion, brackets used, wires used and the movements caused. 4. Oral hygiene maintenance routine that you follow during the braces treatment. Waiting for your reply. Brush twice daily with flouride containing paste. Use of salt water gargles everyday especially after meals.Tongue cleaning on regular basis. A periodic check up with your dentist once every 6 months. A visit to the dentist for oral prophylaxis (teeth cleaning and polishing) once every six months. After providing the required information. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] Holter monitor shows supraventricular ectopics and PAC. Do I need antiarrhythmic drug?Hello doctor, I am a 60-year-old male who just received the results of a 24-hour Holter monitor. Key findings include: Sinus rhythm with frequent supraventricular ectopy (2559) which included couplets and one seven beat SVE multiplet. No complex forms. No significant pauses or periods of heart block noted. Constant feeling of missed beats coincides with frequent supraventricular ectopy. Very infrequent ventricular ectopy that was isolated and univocal. Cardiologists not concerned with findings and recommended positive affirmation, distraction, and cognitive behavioral strategies. He was very reluctant to recommend anti-arrhythmic treatment seeing this as overkill. Other matters of interest. Recent stress echo (March) indicated above average fitness for age (14 mets) and reached a maximum heart rate of 160 bpm. Moderate aortic regurgitation (grade 3-4), normal ejection fraction (60), LVEDV (138 mls), no demonstrable ischemia or arrhythmia. The recent PACs are very noticeable and I feel every one of them. I would appreciate a second opinion or advice on whether there is anything else I can do to stop them. I am currently on Atenolol 100 mg, Crestor 40 mg, Effexor 74 mg, and Valium 5 mg.[/INST]Hello. Premature atrial contractions or supraventricular ectopics are not harmful per se other than giving you symptoms. So antiarrhythmics are not usually recommended, so I do not disagree with your treating cardiologist. Beta blocker is the safest option available, although not the most effective one and other options are ablation or antiarrhrythmics. So trying behavioral techniques is a good option. But if it troubles you a lot then you may request low dose antiarrhythmics like Amiodarone for a short period of time, but they may again come back after the drug is stopped. Since there is no atrial fibrillation or SVT (supraventricular tachycardia), antiarrhythmics are absolutely necessary, but the benefit would be in you is just symptomatic, which comes with the risk of side effects. However, you should have Holter at regular intervals like yearly (with echo for aortic regurgitation), or if you notice sustained ectopics or irregular rhythm implying development of fibrillation. You may discuss changing Atenolol to others like Metoprolol and see if its help. You should try to identify triggers like sleep or gastric disturbances, alcohol or smoking (if any), any particular medications (which you are on), stress, etc. Also, if not had recently, thyroid should be tested. So in a nutshell, antiarrhythmics may be avoided, but if not tolerable symptomatically then may be tried. I hope this helps. </s>

<s> [INST] My mother has left arm and shoulder pain where she could not even lift it. Please interpret her ECG.Hello doctor, This is about my 69 years old mother, non-obese, nonhypertensive, nondrinker/smoker. She is not on any medication. She is unable to move her left arm for the past three days and also has shoulder pain, especially when not sitting. There was no injury to the arm. And the trouble moving her arms is such that she cannot even braid her hair. Does this indicate heart disease? Can a finger pulse oximeter reading of the affected arm be of any relevance in ruling out a cardiac issue? What about ECG reading? Please reply.[/INST]Hello, Welcome to ilciniq.com. Please attach the ECG report, it is not attached. Please clarify, whether the pain is prominent feature or inability to move the arm, or is it like that she is not able to move arm because of pain or fear of pain. Now, this is not indicative of heart disease. Left arm pain without chest pain is unlikely to be related to the heart. Also, there would not be any difficulty in moving the arm with a heart attack. So it is unlikely to be related to the heart. The possibilities are, one is cervical and second is shoulder problems like frozen shoulder, or arm dislocation, even if there is no history of obvious trauma (frozen shoulder is more lifely). So she will need, 1. ECG (electrocardiography) to be sure. 2. X-ray of shoulder AP/lateral view and maybe cervical spine if having symptoms. Next, the pulse oximeter will not helpful in ruling out heart disease. However, if she has severe shortness of breath and low oxygen reading then this may indicate heart failure, so indirectly we may infer. However, if the pain is mild and weakness is prominent then it is probably either cervical issue or neurological issue. So get her examined by local doctor and x-ray done. You may use Volini spray or Diclofenac spray. I hope this helps. </s>

<s> [INST] Why do I have blurring of vision even after treating viral conjunctivitis?Hi doctor, I am 24 years old. Three months ago, I got viral conjuctivitis after two weeks everything was fine but eyes got blurred then my doctor recommended me Tobramycin + Fluorometholone acetate suspension and Tear Naturale Forte. Then after using it for one month my vision was clear but then doctor changed eye drops to Tobarest-F and Tear Naturale Forte. Now my vision is getting blurred again. What should I do? Now I have no other problem such as redness, itching, etc., just blurry vision is there. Please help.[/INST]Hello. I have seen the picture. (attachment removed to protect patient identity). You are having post-viral SPK (superficial punctuate keratitis) in your eyes. It is a very common condition after viral conjunctivitis. It is that small whitish scar marks on the cornea which leads to blurred vision. It will take time to resolve. You have to continue drops which have been prescribed by your doctor that is perfect drops only. So no need to worry. It can take three to six months or sometimes one year to resolve. Just continue drops which you are using right now both you should use it daily for at least a month. Then you can taper the frequency of it and slowly you can stop it. Slowly your vision will improve as lesions on the cornea will get resolved. </s>

<s> [INST] My father has mild to moderate abdominal pain for the past 5 days. Please suggest medication.Hello doctor, My father is 71 years old. He having abdominal pain in the middle for the past four to five days. Pain is constant and mild to moderate in intensity. He is not having any issue in passing stools or urine but sometimes complains of burning sensation while passing stools. His appetite is good. No vomiting or diarrhea. No fever. His current medial history includes diabetes and hypertension. He is an Alzheimer patient. Can you please prescribe some medication for his abdominal pain.[/INST]Hello. I can understand you must be very upset about your father's health. Well, you see the abdominal pain in such age is often an alarming finding, and I urge you to get him some investigations before giving any blanket cover of medicines. Common possibilities in his age are: 1. Mesenteric ischemia, which is the narrowing of the blood vessel supplying the blood to abdominal organs. This can frequently occur in old age with diabetes and hypertension. The pain arises because of lack of blood supply to organs like small bowel, large bowel, and others. 2. The second possibility is pain due to any organ within the abdomen which is inflamed commonly the pancreas (a gland over the back of the tummy), and large bowel. 3. And lastly, since he has a problem with constipation the gas accumulation can also be the reason of his abdominal pain. But remember, we cannot say that it is because of gas distension unless we exclude all other possibilities which are more concerning. I suggest you to get investigations which I write below. Only after the investigation, we can be able to diagnose the problem and treat it appropriately. I really hope this set of investigations will help us to approach the problem correctly. Mesenteric ischemia. Pancreatitis, gall bladder or common bile duct stones. Colitis, colonic neoplasia. Gas, constipation related. Compete blood count. Serum amylase and lipase. Liver function tests. Serum lactate level and serum CRP (c-reactive protein). HbA1c (glycated hemoglobin). Lipid profile. Stool for detailed report. Stool for occult blood on consecutive three days. Stool for fecal calprotectin. Capsule Esomeprazole 40 mg half an hour before meals. Ispagol husk two tablespoons full with water daily. Follow up after investigation. </s>

<s> [INST] I get watery eyes, blocked nose and sneezing during particular season. Please help.Hello doctor, My symptoms are watery eyes, blocked nose, sneezing, and runny nose with transparent fluid coming out of my nose. It gets worse when I have something from the refrigerator but I am sure it is not common cold. What other doctors diagnosed was that I have got allergic rhinitis. I feel fine sometimes when I take Montelukast FX but sometimes even Montelukast does not help. This allergy starts from starting June to about September but it is hard to live with a runny nose and sneezing.[/INST]Hi, Welcome to icliniq.com. The symptoms you have mentioned are of allergic rhinitis. But it is just not sneezing and watering of eyes. It causes major complications in your body starting from sinusitis to asthma which becomes permanent to your life. We have to curb it in its initial stages. First complete cleaning of fans in your room and also the pillow covers and bed sheet. Use the mask as much as possible to prevent yourself from dust exposure. Montek FX (Montelukast and Fexofenadine) just gives you symptomatic relief on that day. You have to advance to nasal sprays and nasal washes as a permanent solution. Advance anti-allergic drugs have to be started. I need to know the details of allergies possible and have to remove the source. </s>

<s> [INST] I had wine and took Corticosteroid during early days of pregnany. Will it harm my baby?Hi doctor, I am in week 6 of my pregnancy and I am worried about some things that happened very early in the pregnancy before I knew I was pregnant. I had a few glasses of wine from day 0 to day 20. A total of six maybe and one glass and a half on day 20. I also took corticosteroids (Betamethasone) a single dose of 3 mg due to an allergic reaction on day 20. And as if this was not enough, I was also on antibiotics (Flucloxacillin) which I finished on day 24 of pregnancy. I am so afraid all of this might have had an impact on the baby. Is there a risk my baby might have been affected?[/INST]Hello. As you have not mentioned the date of your last menstrual period, I am assuming by day 0 you mean the starting date of last menstrual cycle. Because we calculate the pregnancy age from that date. So yes, the early pregnancy time is very important because the embryo is developing in that time period. So as per your query, as you mentioned the consumption of wine in the early three weeks, I do not think it is gonna have any effect on the embryo because it is in the preovulatory phase when even the egg is being formed and released. And yes, corticosteroid in high doses when used for chronic medical conditions can have a risk of cleft lip and palate, but a single shot taken for an allergic reaction should not be affecting the baby. Also, the Flucloxacillin is a penicillin group of drug which is usually safe in pregnancy. So be calm and stop worrying about the risks. It will just increase your stress levels. Moreover in early pregnancy, if any embryo is grossly affected by any insult, it either usually aborts early if the exposure has been hazardous, but if the exposure is nonhazardous, it makes through and the baby will be fine. This is called all or none phenomenon in pregnancy. So your exposure to the medications was not that is something very dangerous, so rest assured. And more over your pregnancy has reached until 6 weeks, that is a good sign that the embryo has not been affected by the exposure to the drugs you have been worrying about. Please consult your gynecologist for your antenatal checkup and investigations required to be taken as per your local protocols. USG (ultrasound) for dating and viability. NT (nuchal) scan with dual marker test between 11-13 weeks. Routine antenatal investigations as per your local protocols. Tablet Folic Acid 5 mg daily once after food until 13-14 weeks. Avoid sexual intercourse until 14 weeks. Consult your gynecologist before any medications intake or to review the medications already taking for chronic medical conditions. </s>

<s> [INST] I have oily skin with pimples and white heads leaving brown scars. Please suggest solution.Hello doctor, I have an oily skin type. Recently I am experiencing pimples, white bumps, red dots on my cheeks close to my ears. Sometimes I feel very itchy near the pimples. I have developed one or two new big pimples on my forehead also. When the pimple subsides after a week or two it leaves a reddish brown mark on that area. I feel the need to wash my face very often as it starts feeling very heavy and sticky from all the oil on my face. I used Clear Gel for some time but it is not working on my skin. Not using any other medication at the moment. Kindly help me with the same.[/INST]Hello. Attach a picture of the lesion for details. Use Ahaglow face wash twice daily for 15 days. Are there pustules? Inflammatory red lesions? Photosensitivity? </s>

<s> [INST] My LFT is raised for a year with recent AST, ALP, and GGT showing 200. Please help.Hi doctor, I am 23 years old. It has been more than a year my liver function test result remains high. I have been tested for hepatitis A, B, C, E, and autoimmune hepatitis, but the result all came out negative. My doctor told to take blood test regularly. But, it has been almost a year now, the result still remains high. The lowest result so far I get is AST 90. But my latest liver function test result shows my AST, ALP, and GGT all 200+. May I get any advice on this? I did not take any medication, consume any alcohol, but the result still came out high. I am so worried about that. Please help.[/INST]Hello. I can imagine that you must be very concerned about your persistent elevation of the liver enzymes. As you already have viral etiologies excluded this is time to look for other things which could lead to persistent elevation of the liver enzymes. Notably the Wilson, alpha, antitrypsin deficiency, hemochromatosis, autoimmune hepatitis type II. I want you to upload all your previous investigations, ultrasound reports if done, and any other testing that you have been performed in the past two years. I also suggest you to get following blood tests which would help us excluding the above possibilities. It is possible that you have some testing already and I do not want that you should repeat it but do upload the reports as I can see those. Secondly, despite you had a viral screening that showed nothing abnormal but there are certain other tests like Hb core total which can tell occult or latent infection and cause of your raised enzyme levels. Since the investigation may cause you significant cost it is possible alternative that you can discuss with me in detail, as we can shrink some of those testings by closely inquiring about those causes in history before getting tested. I am sure we would reach a conclusive diagnosis by relevant information you provide and after investigations. Wilson. Hemochromatosis. Autoimmune hepatitis type II. Alpha antitrypsin deficiency. Chronic viral hepatitis. Complete blood count. Liver function test (fresh) and all previous as I can see the trend Hb core total. HbsAb, HbsAg. Serum ceruloplasmin. Serum copper, ferritin, and transferrin saturation. Anti LKM 1 antibody. Serum alpha antitrypsin level. Autoimmune or other metabolic diseases. Follow up after investigations and all previous reports or earlier if want to discuss before getting tested. </s>

<s> [INST] Jardiance for type 2 diabetes is causing penile infection and balanitis. Please suggest an alternate medicine.Hello doctor, I am 30 years old and I am a type 2 diabetic. Right now I take Lantus 30 unit at night. In the morning, I take Gemer DS 2 and after breakfast, I take 12 mg Jardiance. Now my sugar is under control, but because of Jardiance I usually have penile infection and balantitis. I have googled that Jardiance have side effects of these types because it flush out sugar from urine. Can I take any other medicine like Voglibose or other which has good efficacy? Or should I take Novorapid along with Lantus at morning meal?[/INST]Hi, Welcome to icliniq.com. Urinary infection is the most common side effects of the Empagliflozin (Jardiance). Maintaining thorough hygiene and plenty of water. I can advice you for a change in medication but you need to be very vigilant initially for any fluctuations. Your exact blood sugar values might have given a better understanding though. Below I am modifying your medication of Gemer and adding Voglibose. Stop using Jardiance. Be very strict to yourself in having controlled diet with more of fruit and salads. Regular yoga and exercise. Tablet Gemer DS (Glimpiride) 3 mg in the morning 15 minutes before breakfast. Tablet Voglibo (Voglibose) 0.2 mg just before first bite of your breakfast. Rest continue with the same medication at night. You may have some stomach disturbances initially but may settle down eventually. Have good enough amount of curd in your diet. Measure your values especially after four to five days and get back to me for advice so that depending on how you are managing can decide for any modifications or continuation of the same treatment. </s>

<s> [INST] Two teeth missing in my lower jaw. Do I need to extract tooth in upper jaw to get braces?Hello doctor, I have two missing teeth in the left and right side of my lower jaw so I have now 16 teeth upper jaw because I have the wisdom there as well and 12 teeth in lower jaw no wisdom. Can I get the invaslign or just braces will be good and do I have to extract teeth from my upper jaw?[/INST]Hello. I went through your query and the attached image (attachment removed to protect patient identity). You have two lower second premolars extracted with no third molars in the lower jaw. Little bit crowding is seen in both upper lateral incisors that might be the reason for you opting for braces. Well, as a specialist upper tooths have a little bit of space in between the central incisors. Upper front teeth need proximal slicing to facilitate space that space will be enough to realign your both upper lateral to the arch. Although it is just a front profile if possible upload a side profile of your face to evaluate the overjet but I can say just marginal and proximal slicing of the upper front teeth will be enough, and no further extraction needed. Meanwhile, you have missing both lower second premolars. Get a fixed bridge to cover the gaps or else they will shift and get malaligned. Upper third molar are also fine and does not need extraction in the near future. Go for normal braces instead of Invisalign. Normal braces work much better in these cases. I hope this helps. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] My period is delayed for a month with negative HPT. What is the chance of me being pregnant?Hi doctor, My last period was on April 28. It has been almost seven weeks and I still have not had my period yet. I had unprotected sex on May 24 thinking my ovulation day is over but I started getting very paranoid last week. So I took a pregnancy test on June 10th and it was negative. Then I took one more yesterday on June 14th and it was negative, but if I squinted hard enough it could have been positive. I am very paranoid right now because I do not have a supportive family and I do not have health insurance to go to the doctor to get this checked out, and I am not ready to have a child. I am 21 years old living with my very conservative religious immigrant parents and I do not know if I should take the second pregnancy test seriously. I have been stressed out for the past one month which makes me think I am skipping a month but I am still very afraid that there is a chance I may be pregnant. I have no symptoms of pregnancy. Is it likely that I am pregnant?[/INST]Hello, Welcome to iclinq.com. It is unlikely to be a pregnancy. However, get a serum beta HCG (human chorionic gonadotropin) blood test to rule out pregnancy, as PT has some chances of false positivity and false negativity as it is weakly positive. The likely cause of the delay could be hormonal, anemia, weight gain, hypothyroidism, stress, or change in food and exercise pattern can affect the cycle length and pattern. Hormonal. Serum beta HCG. Pregnancy. Delayed cycle (probably hormonal). If beta HCG is negative, then take tablet Medroxy progesterone acetate 10 mg at bedtime for five days. Menses occur one week after the last dose of Progesterone. Weight reduction if BMI >25. </s>

<s> [INST] I am getting acne on my face everyday. How to prevent getting it?Hello doctor, I am getting increasing acne day by day. How to prevent them from coming on my face?[/INST]Hi. Acne is very common in one's teens and twenties. Some continue to have breakouts even later in their life especially if there are some underlying hormonal issues or genetic predisposition. Pimples develop because of increased sebum secretion, inflammation, and bacteria residing on the skin called P. acnes has an important role to play. Treatment requires knowing your detailed history, any hormonal issues, any treatments you have taken in the past, products you use on your face, etc. Oral medicines and creams/gels are used for the treatment of acne. For mild eruptions, creams containing Clindamycin and Nicotinamide may be used. Benzoyl peroxide and Adapalene are other commonly prescribed anti-acne applications. But it is important to discuss with a dermatologist to decide on the correct line of treatment. Meanwhile, eat healthily, avoid excess milk and dairy, chocolates, and junk food. Exercise regularly and sleep well. Also, avoid using oil or greasy applications on the scalp and face and keep cosmetic use to a minimum. I hope this helps. </s>

<s> [INST] I am diabetic and have ED for the last four months. How to improve my erections?I am 53 years old male, I am a diabetic and have ED problem for the last 4 months, I loose my erection very soon. I even tried taking Eract X on two occassions, but it didnt work, but do I have to take it continuosly? Please let me know as to what steps I need to take to improve my erections. Terry[/INST]Hello Dear do you feeling difficult to get erections?? or difficulty to maintain erection for a long time and premature ejaculation?? Diabetic patients with uncontrolled diabetes may lead to erectile dysfunction. So please maintain good diabetic control. Eat green leafy vegetables and fruits. Avoid smoking and alcohol consumption. Do regular exercise and yoga. Use tablet nano leo twice a day for three weeks. If you suffering from premature ejaculation intermittent squeezing and interruption may help need partner co operation. Phosphodiesterase inhibitors may be useful for ED. But don't use your taking cardiac drugs. For anxiety and premature ejaculation tablet dopaxetine 30 mg one hour before bed may useful. Please get it serum testosterone, ultrasound and doppler of penis, Nocturnal tumnesense test may useful to diagnose the problem. If no improvement with medication need prosthetic device insertion or local injection may useful. Take care. </s>

<s> [INST] I am suffering from diarrhea since I gave birth a year back. Is it due to post-traumatic stress?I gave birth a year ago. I have had problems with diarrhea ever since (periodically). I did tests for candida, Helicobacter pylori, bleeding, parasites. All negative. I have a slightly weaker blood count. I did a stomach ultrasound and everything is fine. I suffer from post-traumatic stress and the doctors told me I had diarrhea because of it. I've been taking post-traumatic stress therapy and I've been feeling slightly better, but the diarrhea hasn't stopped in the last month. I go to the toilet 3-5 times a day. In the morning as soon as I wake up I have to go to the toilet and a few more times during the day. I am currently taking the following therapy: - Orvagyl 400 - 3 daily - Probiotic forte - 2 daily - Heferol - 2 daily - C vitamin - 2 daily - Seroxat 20mg - 1 daily - Eglonil 100 mg- 1 daily - Prazepam 10mg - 1 daily[/INST]Hello. I welcome you to icliniq. I can understand you must be upset about your symptoms. Well the part of problem is explained by certain drugs you are taking like heferol which is iron and usually causes gastrointestinal upset some feel constipation and somw feel diarrhea . but drug side effects usually settle once culprit medication is stopped. I do not whether you taking heferol since last year or started recently. and whether you gave a drug free trial to see if it improve your symptoms of diarrhea. There is long list of conditions which can cause intermittent diarrhea the few such example is giardiasis, Food allergies, and allergic gastroenteritis. I want you to upload all previous testing that you have done and provide me more details about your diarrhea before I can be able to suggest you something. Below I write down some investigations that you should get before we meet again. Or if already these tests are available kindly share with me the reports. I will help you to settle your problem. good day giardiasis food allergies celiac small intestinal.bacterial overgrowth functional diarrhea Irritable bowel syndrome complete blood count TSh Ft3 Ft4 serum ferrtin level stool detail report stool for ova and parasites stool for fecal calprotectin stool for c difficle antigen stool for giardiasis antigen stool for fat globules and reducing substance stool for.spot Na and Spot K serum.cr. serum.Na and serum K see me after investigations will decide treatment.plan afterwards see me after investigations will decide treatment.plan </s>

<s> [INST] Can LVH be reversed?Hi, This is regarding my husband who is 35 years of age. Four years back, after a nasal septoplasty surgery, the doctors realized that his blood pressure was very high. After doing all the tests he was diagnosed with moderate concentric LVH. My husband who is 5 feet and 6 inches was 98 kgs then. He was put on hypertension medicines and was on diet and exercise and he visits his cardiologist every 3 months. He has now reduced his weight to 79 kgs. In the ECG report taken last year, the diagnosis is Sinus Arrhythmia, Prolonged P-wave and complete Right Bundle Branch Block. The Echo report at the same time says concentric LVH, No RWM. Normal Valves, Normal LV systolic function (62%). Doctor had advised him to continue with his medicines, diet and exercise. What do you make of the ECG and Echo test? Is it fine to continue with the hypertension medicines, diet and exercise. His blood pressure is under control now. Could the LVH be reversed?[/INST]Hello, I have gone through his reports. So he has hypertension and he needs to be on medication for long term. However in future with weight loss and healthy lifestyle like avoiding fatty oily and high calorie food, plenty of green vegetables and fruits etc. his requirement for antihypertensive may go down. So his future BP readings would guide regarding that, but as of now he should be on regular BP medications with regular BP monitoring. Best BP readings would be 110 to 130 systolic and less than 90 diastolic. Now regarding Ecg and echo, firstly they are all hypertensive changes and not worrisome. Concentric LVH would be there even if BP is under control and it's not going to cause any problems. ECG doesn't show complete RBBB, however there are early RBBB changes which are again likely related to hypertension and not worrisome. Sinus arrhythmia is normal finding and nothing to worry to about prolonged P wave. So there are changes which are not very significant and alarming. So in a nutshell, he should focus on BP control, healthy lifestyle, get his lipid profile tested and he should be subjected to treadmill test after age of 40 years. Hope this helps you and get back if you have any doubts. </s>

<s> [INST] It has been months, and still, my mother's leg wound has not gotten better. Why?hi, i might need a general surgeon for a consult regarding my mother's wound. she is 81 years old, she's had it since end of last year. She has seen 3 doctors and has gone lab tests. based on her lab results, the first doctor (up to the third) has prescribed Mupirocin ointment, antibiotic (which lasted to 20 days) and mefanamic acid (only if she feels pain). Unfortunately, it has not gotten any better. I hope someone can help. thank you She used to have a wound on the same area when she was young (between 8 years old to 10 years old), but it got better but now it is back.[/INST]hello I will definitely help you regarding your mother's problem I have seen the image and lab report of your mother There is a ulcer in her leg medial aspect. as I can see it is a chronic non healing ulcer because the margins are sharp and base is filled by yellow debris. in healing ulcer ulcers are sloppy and base is filled by healthy and red granulation tissue but in your mother case it is of non healing type. there are many reasons for non healing ulcer like old age, diabetes, hypertension and immunodeficiency. as your mother age is 81 year than it may be a probable cause because blood investigation seems to be normal. one more thing I want to tell you that varicose veins are one cause that may present with this type of ulcer in medial side of leg exactly where this ulcer is located. to confirm the diagnosis of varicose veins I need image of whole leg to see the dilated veins. you may go through color Doppler venous both leg to rule out varicose veins. now the treatment part, no role of antibiotics now as there is no active pus discharge one thing that can be done is scraping of the dead floor and margins of ulcer so healing will fasten.it can be done by local surgeon also. you can apply mupirocin ointment. start vitamin c tablet 1 gram daily it enhances immunity and help in healing of ulcer hope it helps get back to me anytime </s>

<s> [INST] I am almost three months late for my period and weight reduction did not help. Why?Hello doctor, I am 19 years old. I am almost three months late for my period and do not know what to do. I read some articles and found out that weight loss triggers periods and I have lost around 50 pounds in the last year, bringing my weight down to 122 pounds. I am super scared about my periods. Also, this morning I had white discharge, can that be a sign of my period may be coming?[/INST]Hello. Yes, excess weight does cause a hormonal disturbance that can lead to delayed periods. But there can be other hormonal changes like thyroid and prolactin that need to be evaluated to look for the cause of the delayed periods. Sometimes stress also can cause a delay. And yes, the consistency of the discharge can be a little thicker during the premenstrual phase if ovulation happens, but we cannot predict just based on that if you would be getting your periods or not. If already three months have lapsed, and if there is no chance for a pregnancy, then it would be advisable to take medication for withdrawal and get yourself evaluated for the irregular menstrual cycle issues. I hope this helps. </s>

<s> [INST] I have on and off chest pain radiating to neck and jaw. Please interpret my ECG.Hello doctor, I have chest pain for more than one month, on and off radiating to neck and jaw sometimes. I also get pain in both shoulders sometimes. I am diabetic and hypertensive. Please explain my ECG reading. I am currently on Irbesartan and Metformin.[/INST]Hello, Welcome to icliniq.com. Your ECG is fine (attachment removed to protect patient identity). There are no significant abnormalities seen in ECG (electrocardiogram). Machine generated report mentioned at the top is frequently inaccurate so not to get panic with it. Now in cardiac pain, the pain usually occurs on exertion and relieves with rest. This is very classical of cardiac pain if it persists for a few minutes and does not last round the clock more than 1-2 days. Now if the pain does not have such characteristic then it may either be related to cervical spondylosis or gastric reflux. If you have any bloating, burping, heartburn, or upper abdominal pain, then it may be related to gastric reflux. Or if this pain increases on neck movements, associated with tingling, numbness sensation in arms then it may be related to cervical pain. However, considering the risk factors like DM (diabetes mellitus), HTN (hypertension), it is better to rule out the possibility of cardiac pain. So you should undergo echo and if normal then treadmill test. </s>

<s> [INST] I get alternate stool pattern with anal pain while passing hard stools. Please help.Hello doctor, Two weeks back, I suffered from loose motion. After injection and saline, I was well but after three days I felt pain in the anus portion because of hard stools. It is very painful and I started talking Taxim and sitz bath and cream that I got from the medical shop. I started applying it after a few days itching started and the pain was gone. In between these days, I just took no masala food like dal, curd, green, and veggies. Yesterday morning I had hard stool and stomach pain and anal pain also started. I have pain on touching while applying the medicine.[/INST]Hello. Well, it is uncommon to have burning in the anus when someone has altered bowel habits. Your symptoms might be occurring secondary to anal fissure for which you rightly took dietary precaution and local cream and sitz bath. Now you just need to keep taking fiber in diet or for temporary use can start syrup. Lactulose 15 ml at night time. Only thing you just need to do is avoid constipation. You can continue Xylocaine 2% four to six hourly for a few more days and then stop. Anal fissure. Follow up if symptoms do not get better in the next three days. </s>

<s> [INST] What could be the reason for chronic diarrhea with tapeworms in a diabetic?Hello doctor, I am a type 1 diabetic and I suffered chronic diarrhea for the past 10 years. Finally, the doctor found tape worms, and eggs in the stool. I had several rounds of praziquantel, last round was 2 weeks ago with 650 mg per day with a break in between. I took supplements of all kinds, and now colonics. I am still passing worms. I have improvements in health, pain, and girth around my stomach also improved but I am frustrated. I cannot seem to get rid of it. Please help.[/INST]Hello. I suppose you must give a brief history of the nature of your diarrhea. Like mostly it is oily and malodorous, watery or gassy? Does it have any relation to meals? Do you feel any abdominal pain, fever, or itching at the anal area? Do you ever have a low Hb? Any loss of weight? What type of worms did you notice on the stool R/E report? And most importantly, is your diabetes controlled? Worm infestation. Complete blood count. Stool routine examination. Diabetic diarrhea. Drink boiled water (after cooling). Personal hand hygiene. Sugar control. Tablet Albendazole 200 mg (two tablets now). Personal hygiene. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] I get recurrent sore throat with swollen tonsils filled with pus. What could this be?Hi doctor, I have been dealing with a recurring sore throat for the past couple of months. My tonsils get sore and swollen with pus and usually, I have a canker sore-like lesion on them as well. I get fatigued with body aches. I took tests for mono and streptococcus but I had neither. I am currently taking Escitalopram and generic Yaz birth control.[/INST]Hello. Now if you are having symptoms at present, then you will need an antibiotic course for it, and treatment of choice is Amoxicillin clavulanate combination for five days. You should also have Betadine gargles four times a day for five days. Presence of pus does mean it is likely a bacterial infection, may not be strep but other bacterias. Now regarding the preventive aspect, firstly there is no reliable way of preventing it other than tonsillectomy. So you should consider this option if this is becoming troublesome for you. Now some points which would help to catch the infection are maintaining hand and oral hygiene, avoiding too cold foods which usually precipitates the infection. You should try to identify the triggers which have precipitated the infection last time like cold foods, street foods, or other triggers. You should consider the use of Chlorhexidine mouth wash on a regular basis. Next thing, you should have Betadine gargles with you. With the earliest symptoms of sore throat, you should start gargling four times a day which would prevent the progression to frank infection. If your diet is not good then you may consider having a course of multivitamins for two weeks, otherwise not necessary. I hope this helps. </s>

<s> [INST] I am having erection problem with reduced morning erections. Please help.Hello doctor, I am a 32-year-old male. I weigh about 80 kg with a height of 5'9". I am facing erection issues since last week though there is no change in my sex drive. Also, I feel reduced morning erections too. I feel aroused but the erection does not come as it used to before a week. Healthwise, I have sound health and have a moderately active lifestyle and pretty normal sleep pattern. Anxiety level is suboptimal due to COVID19 situation. I was using a semen volumizer herbal supplement intermittently. I am not sure if this plays any role in it too. I drink occasionally in limits and I am a vegetarian. My food habits are healthy and I avoid junk food as such. These erection problems started just a few days ago and now they are troubling me to a bigger extent. Please help.[/INST]Hi. I can understand your concern. According to your statement, you have been suffering from erectile dysfunction for the last few days. Erectile dysfunction is usually caused by low blood flow to the penis or problems of nerve of penis which control erections. Most common cause of erectile dysfunction is psychological reasons such as stress or depression. It may have resulted from the hardening of arteries, high blood pressure, high blood glucose, high cholesterol, medications, BPH, prostatitis, hormonal disturbances, etc. Usually, erectile dysfunction is common in everyone's life due to many causes. In most cases, it goes away over time and no treatment is needed. You can do some investments like CBC (complete blood count), urine R/M/E, RBS (random blood sugar), lipid profile, USG of W/A, PSA, etc and hormonal tests such as testosterone, LH, prolactin, thyroid function test, etc., to find out the underlying the causes which are responsible for your present sufferings and then treat them accordingly. </s>

<s> [INST] My husband has fever for 10 days and abdominal pain while passsing stools. What is his problem?Hello doctor, My 59-year-old husband has had a fever for about 10 days, the first two days it varied between 37.8 and 38.8 maximum and small diarrhea without any other symptoms. We thought it was the COVID at the beginning but it cannot be because he had no other symptoms and me and my children have been in contact with him and we have no symptoms (knowing that I have health problems and have asthma) so we went to a doctor who prescribed diarrhea medication. Since the fever has dropped and it does not exceed 37.7 (so he continues to take Paracetamol) but for the past week he has been suffering from abdominal pain more precisely below the navel. So we went back to see the same doctor two days ago, who gave him an ultrasound that showed nothing abnormal. He diagnosed a colopathy but I have the impression that this diagnosis is wrong. He started this treatment that same day but until today there is no improvement. He still suffers from abdominal pain especially after going to the bathroom and fever although low (maximum 37.7 °) got as high as 38.8 tonight, no more diarrhea but little constipation. What do you recommend that I do? Could it be something serious knowing that the ultrasound showed nothing abnormal? Please help.[/INST]Hello. I feel very sorry to hear about your husband, and very rightly understand your concern and temptation for his unresolving symptoms. You are perfectly right that if treatment were given rightly he should have shown some improvement but unfortunately he did until now. So considering all the information you provided to me, there are few possibilities. First of all, is typhoid fever which is a bacterial infection. The second is intestinal amebiasis which is a parasitic infection. Typhoid seems to be likely possibly given his almost 10 days of fever, and in second week, he started to develop abdominal pain which is suggestive of typhoid ulcers in small bowel. I would suggest him an antibiotic course for at least 10 days, and a maximum of 14 days which would cover both potential bugs. I also want that you get him some blood and stool tests before starting antibiotic course. The antibiotic course is relatively safe. I also want that you closely examine his chest for the development of rose spots. They are very small pinkish marks which develop among patient over the chest in the second week of the illness. Do not worry they are harmless, it is just a manifestation. I really hope his symptoms will improve like a fever would start settle, and abdominal pain should resolve in the next 48 to 72 hours of the start of the antibiotic regimen. I would also want to know the assessment/prescription of a previous doctor who said about colopathy. The colopathy is a very broad and vague term which means colon (large bowel) inflammation. It has a number of causes the one is painkillers (NSAIDs) and recently COVID 19 has shows some case reports with colopathy. But if your family and he himself does not have any contact history to COVID 19 positive or suspected case, then the possibility is very rare. Ultrasound is not a sensitive investigation for the disease which involves the bowel lumen such as in your husband's case. Ultrasound is more helpful in disease involving liver, spleen, or gall bladder. So it is not uncommon to have a normal ultrasound with conditions like typhoid fever or intestinal amebiasis. So I am writing him antibiotics for 10 days now if the improvement is shown we would increase up to 14 days. I really hope with this course his symptoms will start settling in the next 48 to 72 hours. And lastly, get some blood and stool tests as I suggest her and discuss the reports once they are available. Typhoid fever. Intestinal amebiasis. C. difficle infection. Colopathy. Complete blood count. Blood culture and sensitivity (before starting antibiotic course). IHA titer for E. Histolytica. Stool detail report and ova parasites. Stool for fecal calprotectin. Stool for C.difficle infection and stool for culture and Sensitivity (before starting antibiotic course). You can ask him to give sample today and start antibiotics just after giving the sample. Capsule Cefixime 400 mg twice daily for 10 days, tablet Flagyl 400 mg thrice daily for seven days (this antibiotic can cause metallic taste in mouth and or decreased appetite) for that you can give him tablet Levosulpiride 25 mg thrice daily half hour before meals for nausea, appetite. Take home cooked meals, take good amount of water, mineral water if possible (both infections are acquired after a contaminated food or water). See me after labs, and earlier if any further concern. </s>

<s> [INST] I have swelling and boil on my left leg where medication did not help. Is surgery necessary?Hello doctor, My brother has swelling on his left foot. He has a boil on his left inner leg 4 inches above his left ankle inner bone. The doctor he visited gave him medicines for his boil and said the boil will come out in some days. The swelling in his foot has increased and so he visited the same doctor the next day and was advised to see an orthopedic. The orthopedic doctor did not diagnose it but referred him to a general doctor who again did not diagnose it but said there is pus buildup inside the foot and it needs surgery. My father who accompanied my brother asked the doctor whether it will subside with medicines or if surgery is needed. The doctor simply said you can use the medicine or you can do the surgery. I am out of the country and feel the doctor may have not specified the situation correctly to my father and also may have not clearly explained why he suggested the surgery. I needed a second opinion, as I want my brother to receive proper treatment and identify if it is a serious condition and I need to know the best solution. I also want to know why the doctor mentioned surgery for a pus buildup and what is the diagnosis of the foot condition. I can provide pictures of my brother's foot if needed.[/INST]Hello. He is having diabetes? If yes, what is the sugar level? If yes, first you have to control the sugar level. He is having a deep infected ulcer with cellulitis. What medications he is on? Since it is a deep and swelling extended up to the foot better open the wound and drain pus and send it for pus culture and sensitivity. Meantime, start tablet Pan 40 (Pantoprazole) one-two times daily before food, tablet Ciprofloxacin 500 mg two times daily, tablet Combiflam (Ibuprofen) one tablet twice daily, and tablet Chymorol forte one tablet thrice times daily for five days after food, and wound dressing with T Bact ointment. </s>

<s> [INST] I have a 8 mm renal calculi in the upper ureter. Can it be cured by medication?Hello doctor, I have 8 mm renal calculi in the right upper ureter. Please help.[/INST]Hi. CT KUB (kidneys, ureter, and bladder) is 95% accurate to diagnose urinary stones. Usually, stones form in the kidney and drop down the ureter causing extreme pain due to stretch of the renal capsule. Since your right kidney is blocked, I need to check on your kidney functions by doing a blood test called creatinine level, especially if you have other medical problems like diabetes or hypertension. I also want to make sure you do not have urinary infections after this if kidney functions are normal and no infection then we can try medical therapy for 4-6 weeks with capsule Tamsulosin (Contiflo) 0.4 mg at night daily for six weeks the possibility of passing the stone is 25%. If you need more urgent treatment with a 70% stone clearance rate will be shock wave lithotripsy. If you got pain again in spite of medication or you got high creatinine level then endoscopic ureteroscopy DJ stent will be the best first-line option. On follow up after treatment you need needs calcium level, phosphate, and uric acid. I hope this helps. Creatinine, urine analysis, and culture. Hydration lemon and orange fresh juices. Needs calcium level, phosphate, and uric acid. </s>

<s> [INST] Is it possible to get upper abdominal pain due to peptic ulcer?Hello doctor, I am a 25-year-old male. I am 210 lbs and 5 ft 10 in. Lately I have been having really bad upper abdominal pain and tenderness. I get really sharp pains in the same area when I lift heavy things, it is so uncomfortable at all times. I have a history of peptic ulcers from the time I was 16, but this pain is different and constant.[/INST]Hello. Well the pain which comes in or worsen after doing physical movements is highly likely secondary to muscle and bone related. The pain of peptic ulcer however can be knawing and usually worsens after meals. But given the fact that you have been using Omeprazole which is a strong acid suppressant, is helpful in healing peptic ulcer; the presence of peptic ulcers in your stomach seems to be a rare possibility. 1. I suggest you to take tablet Orphanderine plus Paracetamol combination one tablet three times daily for a few days and avoid doing heavy lifting or any thing that you think will worsen the pain; and see how does it go. 2. If your pain does not solve then I suggest you to increase the Omeprazole dose to 40 mg twice daily half an hour before meals. This would certainly improve the pain if it secondary to peptic ulcer disease. Lastly there are other conditions which tend to cause pain which worsen with excercise and bearing weight and one such condition is called nerve entrapment pain. But I want you to start with step 1 and let me know how things go. Musculoskeletal pain, functional abdominal pain or nerve entrapment pain. Musculoskeletal pain. Follow in a few days and update if pain settles. If not, then I will recommend some testing. </s>

<s> [INST] Why do I have pain during intercourse, spotting after, and burning on urination?Pain during intercourse , spotting after, burning urine. Chronic pain, and it is getting worse. I am birth control pills. Went to the doctor about it they said I didn’t have any sti’s or std’s.[/INST]Hello, Welcome to Icliniq. If the infection are ruled out, then the chronic pain could be due to a condition called Endometriosis, where there can be severe pain during periods, and in worse cases it can be a while passing motion or while having sexual intercourse. Please get an ultrasound done to look out for any Endometriotic cysts. Also get an examination done with your Gynaecologist for looking up at your cervix to find out the cause for post coital spotting. As for the burning during urine, it could be due to urinary infection. Please get a urine culture sensitivity testing, and drink plenty of water. You need to start the appropriate Antibiotics after collecting the sensitivity test result. Hope this information help you. Please feel free to consult me anytime with any further queries or for any further information. would be happy to help you out. Have a nice day. - Ultrasound Abdomen and Pelvis - Urine routine and microscopy - Urine culture and sensitivity. ? UTI with ? Endometriosis After thorough evaluation and diagnosis of the condition - Drink plenty of water at least 3-4litres a day. </s>

<s> [INST] I have difficulty breathing along with a headache almost every day. Please help.hello good day, I've been having difficulty breathing almost everyday and i have a headache along with this problem.[/INST]Hi, I have gone through your medical history and your CBC report.. Your CBC report does not contain any significant abnormal values to be worried off.. Slight deviations which they have mentioned as L or H are insignificant.. So dont worry about your report.. Coming to your breathing difficulty, it being present for a very long time and at this younger age, it is most probably Bronchial Asthma.. Apart from this, we need to rule out any cardiac ailments.. I would suggest you to visit a Doctor to get yoursefl examined clinically for presence of Asthma signs in your chest of any.. Meanwhile also do the adviced investigations amd get back to me.. And answer me few questions, CXR PA VIEW ECHO Bronchial asthma / Congenital heart disease T. Deriphyllin retard 150mg 1tab twice daily to continue Avoid dust exposure </s>

<s> [INST] Please give me some advice or medication for fatty liver.Hi, a pleasant day..i have a problem with my liver,i just have an ultrasound last month, to found out i have a moderate fatty lever grade 2,,my problems is sometimes i feel some soreness in my stomach. if i to rate the pain 1-10,10 being the highest ,around 3-4..may i ask for sum advice..or medication for it[/INST]Hi, I went through your USG report and I see that you are worried about your Fatty Liver.. Need not worry about it.. Fatty Liver is something very common in most of the population in the current era all because of our present food habits and less physical work due to digitalization in every industry.. Fatty liver is nothing but excess cholesterol deposition in the Liver.. It is still correctable, you need have some diet modifications, reduce oily and high fatty and carbohydrate foods and increase your physical exercise.. Engage yourself in regular exercise.. That will do.. And do check your Serum cholesterol levels and revert back to me.. We may start medicines if levels are very high.. See you.. Take care.. Fasting Lipid Profile FBS, PPBS Fatty Liver Diet modification as adviced Regular exercise avoid alcohol </s>

<s> [INST] What are the ways to treat recurring UTI?Hello doctor, I have recurring UTI. Last time,a few months back, after taking medicines for the recurring UTI, results were normal. I took Cital syrup and antibiotics. After experiencing pain recently I again went for urine test, and it shows RBC, epithelial cells and bacteria. I have attached the reports. I was consulting a gynecologist prior to this, but she told me to consult a urologist. I have attached my last ultrasound and kidney function test along with today's urine test.[/INST]Hi. After reviewing your complains and your blood and urine test with ultrasound reports (attachment removed to protect patient identity), kidney functions are normal, your ultrasound is normal, your urine analysis showed pus cells and few red cells and white blood cells. My question is do you have symptoms like difficulty in passing urine? Or pain while passing urine? If not then did you have urine culture result before your antibiotics treatment? If you have documented UTI before and you got treated then you have pus cells and white cells in urine, your test might have been performed soon after antibiotics. The possibilities are incomplete treatment or chronic inflammation of the urinary bladder as sending infections are also common in postmenopausal period. You will need to follow up with urine culture test, if it is negative and you have no symptoms then no need to treat. If it is negative and you are still having symptoms (pain while passing urine), we need to do more tests. I hope to follow up you after urine culture results. As preventive measure, you need proper hydration, cranberry juice, yogurt and proper hygiene. Cystitis, incomplete treatment. Urine culture. Cystitis bacterial, TB. Cystitis. Observation and hydration. Hydration cranberry juice, yogurt. 4 days after urine culture. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] I get right-sided lower abdominal pain while passing stool. Is it appendicitis?Hi doctor, I am having abdominal pain on my lower right stomach since yesterday and my parents thought it is just the only bloated stomach. I cannot also urinate well and pass stools. Whenever I pass stools my lower right abdominal get hurt so badly. Is this appendicitis or other stomach disease?[/INST]Hello. I can imagine you must be very upset about your pain. Well the pain of appendicitis should be continues and not intermittent. Pain starts at the center of the abdomen around umbilicus and travel to the right lower part of the abdomen. Pain of appendicitis is often unbearable accompany with vomiting or severe constipation and sometimes diarrhea. Now I think you can better figure out what sort of pain is this. Gas bloating can cause pain but not often severe and usually occur when one have a meal not otherwise. The pain improves with fasting or taking a certain diet which does not produce excessive gases. Pain of gas often worsens after milk and dairy products intake. If you feel a strong suspicion for appendicitis an ultrasound abdomen targeted for appendicitis would be the first best investigation to do. I hope this helps. Abdominal pain. Complete blood count. Serum amylase. Liver function tests. Ultrasound abdomen for liver, gall bladder, and appendix. Functional gas and bloating. Capsule Tramadol 100 mg for pain until definite treatment is given. </s>

<s> [INST] I have chronic hepatitis B with viral load of 6 million IU/ml. Am I at danger?Hello doctor, I am currently diagnosed with chronic hepatitis B. Viral load is 6 million IU/ml, SGPT is 85 and others are in range, and HBeAg is 0.06. Should I start medication? Am I in danger? I am a 30-year-old male. I also have a loss of appetite, gastritis, and bloated stomach. Please help.[/INST]Hello. Yes, you should definitely start the treatment. But I want you to get a baseline renal function tests and fibroscan of the liver. If renal functions are normal then we can start and continue the treatment at the maximum dose. You can use tablet Tenofovir 300 mg once daily. If the renal function tests are normal. I would urge you to get a fibroscan and alpha-fetoprotein AFP. If you are married then please get your wife and children tested. I want to know about your rest or family like your sibling, mother, and father. Is any family history of hepatitis B? It is important because screening has to be performed in case there is suspicion of vertical transmission (from mother to fetus). You can get the tests and see me afteward to discuss the reports of tests and provide other information related to your family. I may then suggest testing for them. Lastly, I remember that hepatitis B cannot be completely cured but can be substantially controlled with antiviral medicines. It requires follow up and guidance. Chronic hepatitis B, HBeAg positive disease. AFP (alpha fetoprotein). Fibroscan of liver. Follow up to discuss the relevant family history and to discuss the lab reports. </s>

<s> [INST] My hair is thinning out with excess hairfall. How to fix my problem?Hi doctor, I am a 17-year-old male. Since I started to grow my hair, I began to realize how thin it is naturally. Is there any way to thicken it up? But the main concern is that since I have grown it, I started to experience excessive shedding. By only passing my hand on my head I would get on average 15 hairs. The pattern stopped for a while, but my hair is thinning a lot on the sides. I can see across my scalp easily by lifting the hairs on the side of my head, (lateral sides, on top of ears, and the regular pattern baldness zones). It has become excessively thin. Please help.[/INST]Hi. From the information given it seems you are experiencing the early signs of male pattern hair loss. This is a very common condition and there are many factors responsible, one of them being genetic. If you have other family members with similar patterned hair loss the chances for you to develop it increase too. Due to the effect of the male hormone on the hair cycle, over a period of time, the hair follicle starts shrinking and so the hair which comes out is thinner and more fragile and breaks easily. Also, the growing phase of the hair is shortened, so your hair does not grow as long it used to and becomes shorter and wispier. Being just 17 years old I am sure it must be worrying you a lot. But do not be disheartened. There are several treatment options available and the sooner we start the treatment the better the chances of reducing further hair loss, thinning, and increasing regrowth. A combination of oral supplements to boost hair growth along with application of lotions containing Minoxidil 5% to begin with will be the best course of action in my opinion. Oral Finasteride, which is the male hormone blocker, is used frequently. Applications with Finasteride are available too. This will be prescribed by your treating doctor after assessing the extent of thinning and discussing the side effects, etc. Several preparations of bio-peptides and other natural ingredients like saw palmetto extract, melatonin, etc are also available to boost the hair growth. PRP (platelet-rich plasma) is a popular procedure which is often used in combination with medical treatment to stimulate hair growth further. Usually, a combination of treatments is suggested after the clinical evaluation. But using the applications regularly is the key to good results. Hair regrowth takes a few months to show and you will have to be patient to see the benefit of the treatment. I hope this helps. </s>

<s> [INST] I recently noticed a small lump beneath my nipple. Is this normal for a 13-year-old boy?Hi im a 13 year old boy. I have recently noticed a small lump beneath my nipple and was wondering if this is normal? The lump is not too hard but not soft and the same time. Kind of rubbery. I haven’t noticed any other changes so far.[/INST]Good Day, I am Dr. David. Since when did you exactly notice the lump? Did it grow in size since then. Any change of color on the skin over the lump? Did you notice dimpling of the skin over it? And is it painful when you touch it? I would also like to know if you have relatives that also had this? If most of your answers are "yes" i suggest to say to your parents that you have to see a surgeon right away to be evaluated. If not i will still suggest you to see a surgeon, but you can take your time. Lumps should be evaluated properly and will be treated accordingly depending on the physical findings. Base on your findings it might be a lump of fat cells that formed. But still a good evaluation would tell us more. Thank you. If you have further questions you may message me here. Suggest to do a breast ultrasound Suggest to Suggest to undergo a sugery consult. </s>

<s> [INST] I am fat and facing difficulty in losing weight. Please suggest tips to reduce my weight.Hello doctor, I am tired of being fat and I am tired of diets. After a diet, I gain double and every time it is harder to lose. I am desperate, lonely, and depressed. I do not want to be fat for my entire life. I am only 26 and have always struggled with my weight. Please help.[/INST]Hello. I can imagine the level of your frustration regarding your weight. Yes, it is nearly impossible to keep reduce weight and maintain diet and exercise. I may not be able to give you a composite plan of action for your weight reduction since it is not basically a one day consultation task. In fact, it is a long term commitment towards yourself and towards a multidisciplinary team inclusive of a dietician, bariatric endoscopist (gastroenterologist), behavioral therapist, and lastly a bariatric surgeon. So I would give you facts and figures for the existing evidence of weight reduction therapies. Remember your current body mass index BMI is 34.3. The goal of any weight reduction treatment is to reduce weight to optimal ranges where the physical and psychological well being of a person is maintained. Now anybody whose body mass index (BMI) is more than 40 should straight away consider bariatric intervention in the form of endoscopic or surgical modality. And anybody whose BMI is 35 but having other conditions such as uncontrolled diabetes, coronary artery disease (heart disease) or lung dysfunction (lung hypertension and sleep disorders) should undergo interventions. But you see not all person fit into above category. Many have BMI less than 35 (such as in your case) and having very troubling symptoms, among such people individualized approach is employed whether medicinal use or endoscopic or surgical intervention. Diets and regular weight reduction exercises do help to reduce weight by 7 to 10%. All medicines which are currently in use help reduce weight by 10 to 20%. Certain endoscopic bariatric procedures such as balloon placement in stomach and sleeve gastrectomy does help reduce weight around 25% And lastly, surgical procedures such as metallic rings around the stomach via laparoscopy and surgical sleeve gastrectomy, and surgical Roux Y bypass, help to reduce weight by 30 to 35%. The figures are ranges, they vary significantly in individual cases. I also want you to understand, that these interventions should be accompanied with optimal dieting and exercise even after surgery or medicinal therapy. Otherwise, the weight can frequently recur to original ones. This above description is only to make you understand and figure out things. I can recommend you to start with dieting (keeping your calories well below 1500 Kcal daily), running, swimming, and weight lifting on a regular basis. I also suggest you to meet a dietician on icliniq or otherwise in person, to get a diet plan with respect to your calorie requirement. I can suggest you some medicinal treatment, but they are prescription medicine, may not be OTC, and the course has to be taken for at least six months to see the effect. Naltrexone/Bupropion (Contrave) is proven and FDA approved and can be started in your case. But I want you to provide more information about your health, as I can assess your condition first and treat aimfully rather adding more harm to your health. Because these medications have some side effects and they should be kept in mind before giving it therapeutically. I also want to know about family support, any occupational therapist available near your vicinity, your current job status, and medical health insurance, and also information whether the cost of these medicines is covered or not. Until that time you follow up, I want you to get the following blood tests to better know the impact of your obesity on bodily systems. I hope this helps. Obesity. Complete blood count. TSH (thyroid-stimulating hormone), FT3, FT4. Liver function test. Fasting lipid profile. Serum CRP (C-reactive protein). Albumin total protein and AG ratio. Arterial blood gases. Urine detail report, and urine for albumin. Will decide after further information is provided and after investigation thoroughly for any underlying metabolic complications. </s>

<s> [INST] Please suggest medicine for granular pharyngitis.I have Granular Pharyngitis problems 60 days Plz help me medicine name?[/INST]Hi! I had a look at the picture you have sent. This looks like more of a Chronic pharyngitis. The red spot you have pointed out is more of a lymphoid follicle which has slightly increased in size and is present in almost all of us. There is nothing that you need to worry about as this is a very common entity we come across and is treatable. You can consider following the advice mentioned below Drugs mentioned in point 1,2 and 3 can be taken only if there is an acute infection associated with pain while swallowing. If there is no pain or infection the medication mentioned in 1,2 and 3 are not required. Make sure you follow points in 4, 5 and 6 as long as possible as this prevents the possibility of developing a throat infection. There is absolutely nothing to worry about the red spot over there as it doesnt indicate any cancer or malignancy and is only a lymphoid follicle which has increased in size due to possible previous throat infections. I hope I have answered your query in detail. If there is anything more you want to know or enquire, please let us know and we will get back to you ASAP. Please take care Warm regards </s>

<s> [INST] I have clogged ears with pain from ear to throat with vertigo. Is it due to nasal drip or herpes infection?Hello doctor, I have clogged ears and pain from ears to the throat, vertigo, and always feeling confused. I had a sinus nasal drip which I thought that is why my ears where clogged it has been six weeks and it is still clogged, popping and painful. I saw an ENT and he said I had no fluid and there be any underline issues causing my ears to stay with pressure and fullness like HSV-1 and HSV-2 can cause me to lose my hearing. I am 40 years old and never experienced this before. My doctor prescribed me antibiotics and they are not working. I already took Acyclovir and he prescribed it again. I just need to know if herpes causes hearing loss?[/INST]Hi. I can understand your concern. According to your statement, you have been suffering from clogged earaches with painful jaw joints and sore throat with vertigo and all these sufferings may result from herpes infection according to your assumption. When herpes affects the nerve in the face that spreads to ear known as Herpes zoster oticus its clinical features are severe earaches, swelling of vestibular nerve, fluid-filled vesicles on outside of ear and inside ear canal, permanent or temporary paralysis of the face with hearing loss. Again herpes esophagitis can attack the mouth. Sores may develop in the mouth and make swelling difficult due to inflammation of the throat. This pain can radiate to mouth and jaws. Sudden hearing loss can result commonly from viral infections other than herpes are measles, mumps, rubella, viral meningitis, syphilis, AIDS, etc., which can cause sudden loss of hearing. Again bacterial meningitis, Lyme, any tumors in the ear can also be hearing loss. Any type of hearing loss, steroid should be applied immediately. It helps in reducing the inflammation and decrease the swelling and increasing hearing ability. So along with your current medications, you should use steroids immediately to prevent further hearing loss. In case of any other query knock me and I will try to help u further. </s>

<s> [INST] Why do I get swelling in the eyes predominantly in the morning?Hello doctor, My eyes are swollen especially in the morning. I find it hard to open my eyes after a nap or when I wake up in the morning. After that, I am fine during the day with watery eyes sometimes. No itching but it is little reddish when it is hot. Around the first week of March, I went to see an opthalmologist who told me I had a bacterial infection of both eyes. I was prescribed Vigamox and after seven days my eyes were fine. Due to quarantine, I was not able to go back to my doctor. Around the last week of April, I had the same symptoms and since I cannot go out I treated my eyes with Vigamox again and was healed after seven days. After that from time to time, I have swelling, not much but mostly in the morning. I am a 68-year-old female. I have allergies, seafood, pollen, and dust. I take Allerta or Claritin from time to time to relieve my allergies. I smoke but I am trying to quit, before 6 to 10 sticks, now reduced to four or five.[/INST]Hello. As you have described in your history it is looking like an infection in your eyes. Can you please send your eye image to me? So that I can get an exact idea about your condition and depend upon that we can plan further. It is better if I can see your eye condition and then prescribe you drops. So my advice is to please attach your eye image as soon as possible so that we can start your treatment as early as possible and you will feel better after treatment. </s>

<s> [INST] How will Melatonin interact with the effect of birth control pills?Hello doctor, I have read that Melatonin could possibly lessen the effectiveness of birth control pills. My understanding is that there is little to no peer-reviewed scientific studies to support this claim, but I am still worried, as I am sexually active and take 3 mg of Melatonin each night (and I am on the progestin-only pill). I am looking for a doctor to weigh in on this issue.[/INST]Hello. I understand your concern here and you are right that there are not many or in fact hardly any articles or peer-reviewed papers on Melatonin and birth control interactions. But I would like to keep it simple for you to understand. Melatonin is produced during the night to ease the sleep pattern in humans post-sunset with maximum levels at 9 PM and by morning 9 AM, the levels found are almost negligible. So, it is produced by the pineal gland in the dark cycle and metabolized at night by the liver. Now liver also is known to metabolize the birth control pills be it progesterone-only or combinations pills. Hence, if taken together then there is a likelihood of slower metabolism of either compound and thereby prolonged residual effect may be seen on concurrent use of pills and Melatonin together. The effects could be prolonged sleepiness and also Melatonin induced increased progesterone levels in the body causing bloating and noticeable progestogenic side effects. However, the efficacy or effectiveness of the pill is not compromised but metabolism is delayed as Melatonin competes with the pill with the liver. So ideally the better way would be to switch the POP in the morning hours and the Melatonin pill at night 12 hours apart. This would prevent any interference with either action on the body or cause any interaction. </s>

<s> [INST] I have pain in pelvic area during intercourse with a history of UTI. Please help.Hello doctor, I only have one sexual partner for almost a year. However, during intercourse, I feel that I am having a pain in my pelvic area and it is a sudden sharp pain. Sometimes it is random or happens during deeper penetration. It feels like pressure and almost seems like it is gas but I am not sure what it is that I am experiencing. A while back, I had a UTI and since then I have been experiencing this at times. Sometimes it does not bother me. I just want to make sure I am fine or see if this is a concern that I need to come in. Yesterday, I experienced the pressure pain on my left side more and it drew enough for concern. I do not know if it is gas or something else.[/INST]Hello. It is important in your case to rule out the possibility of pelvic inflammatory disease. Now points in favor are history of chlamydia and UTI in the past, pain on deep penetration and tenderness on the left side of abdomen. These are the sufficient point to evaluate for the possibility of PID (pelvic inflammatory disease). I guess you do not have any discharge per vaginum may be scanty. One more thing is, just try to see if you are having this pain from the beginning from the intercourse or started after some time. Because if it is from the beginning then this may be dyspareunia and not related to PID. But if it has developed later then it becomes important that you undergo evaluation for PID. You will need an ultrasound of pelvis, CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate), vaginal fluid smear. However, the vaginal examination will also be helpful to see whether there is any cervical motion tenderness, which would give a fair idea about the possibility. It is important to rule out PID because it can have consequences later like fertility issues. So if we get any clues regarding it then you will need a course of antibiotic treatment. I hope this helps. </s>

<s> [INST] What does abutment of the nerve root mean?Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?[/INST]Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist </s>

<s> [INST] Every time I eat spicy food, I poop blood. Why?Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached.[/INST]Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> https://icliniq.com./ask-a-doctor-online/general-surgeon </s>

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

<s> [INST] 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.[/INST]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. </s>

<s> [INST] I masturbate only by rubbing the tip of the penis. Is it a wrong way?Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help.[/INST]Hi. For further doubts consult a sexologist online -->https://www.icliniq.com/ask-a-doctor-online/sexologist </s>

<s> [INST] My diabetic father is refusing food for four days now. How to help him get his appetite back?hello my father who is 62yrs old has diabetes type 2.. Recently, he started not feeling well. He has stopped eating, basically doesn't want to eat or drink anything. He's been like this refusing food for about 4 days now. His blood sugar is anywhere around 250-380 even though he isn't eating anything.. We took him to the hospital and they said it was Neuropathy because he's also experiencing body aches.. My father is extremely fatigued, all he wants to do is lay down and sleep.. Any help on what could be happening? or what should we do to help him get his appetite back?[/INST]Hi, The mentioned sugar levels are too high. The medication dosage is not mentioned. Only Metformin doesn't work for such high levels. He might need insulin too initially to control the levels and then eventually can be on pills depending upon the condition and thorough follow up. Please don't ignore the condition, he must be going into diabetic ketoacidosis. Need to go through immediate blood sugar levels, blood pH, serum and urine ketone levels. I will recommend you to please immediately visit a doctor physically for through examination and complete detailed history. Untill then just follow some preventive measures. blood sugar levels including HbA1C blood pH serum and urine ketone levels SerUm bicarbonate Uncontrolled Diabetes ?Diabetic ketoacidosis ? Neuropathy Excess intake of water to stay hydrated Coconut water Less calorie diet </s>

<s> [INST] Why does my boyfriend have extreme pain in the upper right abdominal area on breathing?My boyfriend has extreme pain when he breathes in his upper right abdominal area. This is the third time this month and it started at around 7 pm last night and he went to the hospital last night at 1am. They told him they couldn’t find anything on the xrays or blood work. He woke up this morning and his pain is still extreme. Can you offer any insight please?[/INST]Hello Dear. I welcome you to icliniq. I feel very sorry for his pain. The causes of severe pain in upper part of the abdomen are gall bladder stones common bile duct stones-stones within the bile duct which drain bile (a yellow secretion) from gall bladder to small bowel peptic ulcers - ulcers within stomach and/or small bowel pancreatitis -inflammation of the pancreas a gland over the back of our abdomen. I think he already been advised some medications for that. But I just write here in case they are not given Cap Esomprazole 40 mg now and half hour before meals. Cap Tramodol 100 mg now. It may or may not be OTC. in case not available give him Cap celecoxib 100 mg now. Do not give any other painkillers because they may worsen pain of peptic ulcers if present. Syp Gaviscon 15 ml now and half hour after meals for 4 times in a day. If you want to provide more information about his pain I may suggest some investigations to rule out above possibilites. I hope the medicines will help him to control his pain. Take care and have a good day peptic ulcer disease gall stones cbd stones pancreatiris intusscception volvulus serum amylase ultrasound abdomen follow to discuss and provide more information </s>

<s> [INST] My dad saw blood in his urine after taking a walk. Is it due to kidney stones?My father is diabetic and have kidney stones. Recently he saw blood in his urine after walk(exercise) what's the reason behind it???[/INST]Hi thank you for consulting me Kidney stones can have different presentations it also can cause blood in urine after exercise and stones should be evaluated properly and treatment Your father have diabetes and might have other medical issues so proper evaluation before intervention is required I need more follow up with you to get more detailed history from you about your dad then I will order Ultrasound blood tests to check on his kidneys as for now then will proceed further Hematuria due to stones Fbc creat urine analysis and culture + ultrasound KUB Renal stones, urothelial / kidney tumor Urolithiasis To be decided after investigations Hydration and observation if persistent gross hematuria admission and evaluation as inpatient After 4 days with requested investigations </s>

<s> [INST] My inguinal hernia is causing pain suddenly. How can I reduce the pain for a month?Hi sir, I'm an 18 year old boy. I have an inborn inguinal hernia. But till now it hasn't given me that much pain as it is giving right now. If I lay down for more than 2 hours then it starts hurting and I can't sleep anymore. The pain extends from lower abdomen, pelvic region to some upper portion of fimer. I can't take surgery now as I have an entrance exam within a month and also there's corona outbreak outside so I have a fear to go to hospital. So Sir, can you please tell me how can I reduce my pain at least for this month?? And also, should I take surgery immediately or can I wait for this month??[/INST]Hello Your complaints of pain related to the hernia needs to be examined . If there is no complications within the herni In normal circumstances I would suggest all hernia should be operated but since you are having exams you can delay the surgery given that on physical examination and ultrasound you do not have any complications. For the time being as a temporary measure you can use what is called as a TRUS available in the market even online . But it is temporary and once you are free fork your exams I suggest you to get operated there after as TRUS or any other treatment is just temporary and has its own pro and cons. But if on ultrasound it shows you have any complication the you need immediate surgery. Avoid lifting heavy weights add fiber rich food to your diet and avoid constipation to prevent exacerbation of your hernia. Hope this helps </s>

<s> [INST] 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 :(((([/INST]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 </s>