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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] I have pain, redness and swelling in eyes for the past one week. Please help.Hello doctor, My eye is paining since Sunday. My eye is red now, it is paining while moving also when the light comes. I am felling a little swelling as well.[/INST]Hello. Thank you for sending the image (attachment removed to protect patient identity) so that I can get an idea about it. For me it is looking like an infection. I can prescribe you medicine so that you can get rid of these symptoms. But in the first image, there is something whitish area on your cornea. So I just want to know that it is really there or its reflection which is visible in the photo. Just answer me one question because treatment is different for both conditions. So I should confirm it from you and then I will give you a prescription of drops. That you have to use and you will be completely all right. </s>

<s> [INST] I feel itchy when I pull back foreskin with white substance on it. What could it be?Hello doctor, I had this problem for three to four months when I pull back my foreskin it feels strain and kind of ticklish and itchy. I have been to the doctor and they just gave me Pevisone and it did not work. There is also a little white substance on the penis head. I do not know if it is smegma or not but it is smelly and I cannot seem to clean it. May my foreskin be dry or something? I have also done STD and test for urine infection.[/INST]Hello. Are you a diabetic or hypertensive? Have you ever tried oral medications for this? If yes, then which one? Do you have any urinary complaints like frequency, urgency, poor stream, nocturia, dribbling, burning micturation? Do you have any history of unprotected sex with a new partner in the recent past? </s>

<s> [INST] I am 44 years old and trying to get pregnant for the first time. Do I need to take Folic acid?Hello doctor, I have just got married and I am planning to have a child. I am 44 years old have not had a child before and have no medical problems. I wish to check if I need to take any medical tablets like Folic acid, etc or shall I just go proceed naturally. As mentioned before, I have no health issues and neither do I smoke or drink.[/INST]Hello. Congratulations on your wedding. First thing you should do is to start Folic acid and try for timed intercourse. For that, if your periods are regular you can download an application of period tracking. It will tell you the most fertile days of your cycle. Since you are 44 where ovarian reserve may be on a lower side I will not advise you to waste much time. So while you try for a month or two for natural methods of conception I want you to also get tested in the meantime so that you are ready for any medical intervention for fertility enhancing if needed after two months. So please go for LH (leutinizing hormone), FSH (follicle stimulating hormone), AMH (anti-Mullerian hormone) and TSH (thyroid-stimulating hormone) blood levels. Also get an OGTT (oral glucose tolerance test) and ultrasound pelvis. Your partner can also go for semen analysis to see if the quality of his sperm is good enough. Eat healthily, sleep well and ask your partner also to avoid smoking and alcohol. </s>

<s> [INST] 82 years old lady is having swelling of foot with bluish discoloration. Is it due to blockage of blood vessel?Hello doctor, Patient is an 82-year-old female. She weighs only about 45 kg. No BP, no diabetes. She is having inflammation and swelling in the right foot. It seems to be a blockage somewhere in the right foot blood vessel and it appears bluish one month back. And now it subsided a bit but the swelling is there. She is on Neurowin injection, Ecospirin, and Zerodol SP. She is moving comfortably now but the swelling is there and the bluish color has reduced a bit.[/INST]Hello. Her foot appears to be in good condition now (attachment removed to protect patient identity). The likely cause for bluish discoloration is blockages only and is called peripheral arterial disease. So of she should be treated on the line of blockages itself. Now blockages in the foot raise the strong possibility of blockages elsewhere in the body like heart, brain, and its fortunate that she did not suffer any consequences due to that. So she should be evaluated with few investigations, like ECG (echocardiogram), Echo, Fasting lipid profile (sugar if not done recently). Also, to confirm the diagnosis, she should undergo CT (computed tomography) angiography of both the lower limbs. Now coming to the treatment part, obviously, the best would be to open it with stents. But as of now, she will need some more medications than what she is having. You may continue with Neurowin or better to have it in a tablet form once daily, and it is just a multivitamin supplement. She should also continue plain Ecospirin and dose should be 75 mg only at bedtime. Now in my opinion, she should additionally have tablet Rosuvastatin 10 mg bedtime once daily and tablet Cilostazol 50 mg twice daily after food. She should also have some antacids along with these medications like tablet Cyra 20 mg (Rabeprazole) once daily before breakfast. So these three medications should be added additionally until her evaluation is completed and probably will need to continue for the long term. Zerodol SP should be avoided as it may harm her by causing bleeding or raising blood pressure. Plain paracetamol is allowed. She should be encouraged to move and walk atleast 30 minutes a day as it would improve blood flow. I hope this helps. </s>

<s> [INST] My brother had an acute pancreatitis and CT shows pancreatic pseudocyst formation. Please help.Hello doctor, My brother is 43 years old. He had an episode of acute pancreatitis last year. Gas and indigestion persisted since then. A recent CT scan has shown a possibility of pancreatic pseudocyst formation. The doctor has advised to remove the same by the procedure. My query regarding this is whether the pseudocyst can be treated by medicines or a procedure is recommended. And if yes, whether a laparoscopic procedure can be opted. What are the advantages and disadvantages? If there is a chance of the pseudocyst being formed again after the procedure? I am currently on Atowa Aony, Prankeeatoflat, Sompray D, VSC 3#, and Telma AM.[/INST]Hello. When he had the first episode of pancreatitis? What is the size of the cyst by ultrasound? What is serum amylase or lipase levels? Is he a diabetic? Is he an alcoholic? Will you please answer to above questions if possible. If pseudocyst usually acute means we will wait for four to six weeks for recovery. If it is not recovering with medication or increasing the size in sequential CT scans or it causing any complications (adjoining vessel compression or size > 5 cm or infected or causing bowel obstruction or symptoms of decreased appetite or weight loss) need surgery. Yes, you may undergo laparoscopic pseudocyst gastrostomy or cysto jejunostomy. For this procedure need experienced hands and long term outcome not known. But less morbidity and success rate. Yes in 15-18% of causes recurrence. </s>

<s> [INST] I am 35 years old and NT scan shows risk of Down's syndrome. What is the accuracy of NT scan?Hi doctor, I am 35 years old. Right now I am14 weeks pregnant. My doctor found out that my baby has a risk of down syndrome. In NT scan at 11 weeks 5 days the CRL was 48 mm and NT was 1.32 mm the double marker test report is showing background risk T 21 1:369 and adjusted risk 1: 911. T 18 background risk is 1:4357 and adjusted risk is 1:238. T13 background risk is 1:10257 and adjusted risk is 1:3524. Doctor did NIPT after this report. Can you tell me how accurate the results are and why NIPT was done?[/INST]Hi. Your report in the link is not readable (attachment removed to protect patient identity). However, the values that you have written in the query seem to be all within range. For T21 cut off is 1 in 250 and NT 1.3 mm is also fine. May be you are 35 and doctor wants to be doubly sure for your safety. </s>

<s> [INST] My 6 months old grandson has developed red spots in body after eating egg yolk. Please help.Hello doctor, After introduction of solid foods to my 6 months old grandson, he was doing well. We introduced rice, dal, pumpkin, apple, and beans. Urine, stool, and the body temperature was normal and baby is also active. Next, we introduced egg yolk. Within 24 hours three rashes/red spot appeared on his left-hand palm. Within 48 hours another three red spots appeared in the mouth. Within 72 hours another two similar red spots appear on the left ear and it was there until today. Urine, stool, and body temperature is normal and the baby is a bit less active. We have stopped egg yolk but continue rice, dal, apple puree, banana. Baby is taking formula stage 2 at a normal rate. Please suggest what care we should take? Is there any suspected food allergy for him?[/INST]Hi. As you have mentioned, he is allergic to egg, you need to stop giving egg. Being allergic to one food, he might be allergic to other food or articles. Common food which are considered to be notorious are fish, peanuts, egg, and also take care of dust and pollen of flowers. Currently, just give those food which you have already introduced. Do not add any new food for at least two weeks. Introduce new food in a very small quantity one at a time and watch for any reaction. Presently as he is having rashes, give syrup Zyrtec (Cetirizine) 1.5 ml once daily for five days. </s>

<s> [INST] Please suggest tablets to prolong the duration of intercourse.Hello doctor, I want sex tablets that work for longer hours. Please suggest.[/INST]Hi. According to your statement, you want to increase sexual intercourse by sex tablets. You should provide detailed history of your sex-related problems, then it will be easy for us to solve the problems. You can take tablet Viagra half an hour before sexual activity. I want to add some medications that are given below. Emla cream apply a small amount to the head of the penis and wash off before starting sexual intercourse. Tablet Priligy 30 mg one tablet one hour before sexual activity. You can continue these medications along with tablet Viagra to improve your sexual performance. </s>

<s> [INST] How can parasitic infection of GIT be treated?Hello doctor, I have had GI issues which do not go away. There severity is cyclical. I have reason to believe that I may have a parasitic infection.[/INST]Hello. Yes, it looks like some parasite kind of thing but difficult to say from picture (attachment removed to protect patient identity). It is better to get proper stool test with special stains that will tell kind of parasite. Other thing I want to know is what kind of GI issues you have. Exact nature, duration and also pain is there or not, constipation or diarrhea? For parasite, I recommend tablet Nitazoxanide 500 mg two times a day for 5 days will elimate most of parasite from your body. GI issue related to parasite is not so common so I think it is better you describe your exact history of GI issue and what medications they had given to you. </s>

<s> [INST] I have vaginal dryness and itching at night. What should I do now?Hi doctor, I have PCOS and suddenly I am having vaginal dryness and a bit of itching especially at night. I have tried all homemade remedies for my periods but I did not get it. What should I do now? And this vaginal dryness is literally making me feel irritated. Please help.[/INST]Hello. First of all, I like to inform you that PCOS (polycystic ovary syndrome) could be an underlying cause for vaginal dryness due to hormonal imbalance caused by PCOS itself. Secondly, itching is probably the result of vaginal dryness rather than anything else. In case you are sexually active, we need to look for STI (sexually transmitted infection) as they can also present with similar symptoms. Practically speaking if the vaginal dryness causing significant impairment in your quality of life, it is time to see a doctor. She may run some tests and do some examination to find out the exact cause of the problem. However, for time being topical estrogen can be used for symptomatic relief. It is available in the form of gel, ring or cream. As per your convenience, you can use either cream or gel and the use of ring requires assistance of a doctor. The second thing is stress management. Stress is one of the common reasons for causing decreased vaginal lubrication. Thirdly, avoid soap-based formulations to clean the private area as it increases dryness. 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] I accidentally took double dose of Levothyroxine and facing some side effect. How to proceed further?Hi doctor, I have hypothyroid for many years and I am having daily 75 ug dose Levothyroxine medicine but last Friday I took 150 ug dose by mistake and after that, I started to have joint and bone pain and my heartbeat becomes higher and I am nervous about what to do now? Should I continue with 75 daily? Or any other help or recommendation to proceed?[/INST]Hello. I can understand your concern. According to your statement, you have been suffering from hypothyroidism for the last seven years and your current medication is Levothyroxine 75 micrograms daily, but last Friday you took double dose of Levothyroxine that was 150 micrograms and felt nervous with increased heart beat and joint pain. At first let me ensure you that taking an extra dose of Levothyroxine by accident is unlikely to harm you. You get side effects such as rapid heart beat, chest pain, sweating, nervousness, etc. They may not develop at once, it may be several days before they come on. These side effects that are resulted from over dose will be subside over time and basically no treatment is needed. Normal range for TSH level is 0.4-4 mU/L.so your recent TSH level is within normal limit. As your last year TSH level was 0.55 mU/L and recent result is 2.6 mU/L which is within the normal limit, so continue your current dose of Levothyroxine. No dose adjustment is needed. Now you are suffering from weight gain, puffy eyes, hair loss, etc., if these are resulted from the side effects of Levothyroxine then they will be subsided soon. Please monitor your blood pressure and do investigations like with CBC (complete blood count), RBS (random blood sugar), and S.creatinine level to exclude other causes. </s>

<s> [INST] I get movements in feet and tingling before I fall asleep. Is it Parkinson's disease?Hi doctor, About 10 months ago after a workout, I had pins and needles on the left side of my body. After months of MRIs and EMGs, I got a skin biopsy that showed you gave small fiber neuropathy. Before I knew this, I got a deep tissue massage and started getting fasciculations. They had calmed down much since October but I will notice them here and there. I always developed movements before I fall asleep. My feet may just move or even my chest, it gives me much anxiety to go to bed. Lately, I have been noticing a little tremor in my right hand and tingling in them when I tried to put in fake eyelashes or hold a pen for a little time. Last week, I have noticed my thumb moved twice. Also, I feel sometimes like my teeth are shaking. A lot or neuros have told me that I am 32 and not to worry about much but they overlooked SFN. I am worried all EMGs are normal. I am concerned now and I have early Parkinson's?[/INST]Hello. I have studied your data. 10 months ago, I have a sudden onset of tingling on the left side after workout but with normal MRI (magnetic resonance imaging) brain and spine which means the stroke is less likely. Later you noted random twisting of muscles (fasciculations) with right-hand action tremor occasional. Movements before sleep (hypnogogic periodic limb movements) work up showed SFN but the cause of it not known until now with normal NCV EMG. We need to find out the cause of SFN like autoimmune disorders etc. It is not Parkinson's syndrome as it is not fitting into it. So do not worry about it. It seems some benign tremor fasciculation syndrome. Please answer some of my questions. Any family history of similar tremors? Any painful or burning sensation in palm and soles? I want to know about your blood sugar status, thyroid profile, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), ANA (antinuclear antibody), APLA (antiphospholipid syndrome), ANCA (anti-neutrophil cytoplasmic antibody). </s>

<s> [INST] I was diagnosed with peptic ulcer for blood in stool but medication did not help. Why?Hello doctor, I was diagnosed with peptic ulcers because I was having blood (fresh) in my stool. I am on medication but the medication is not effective because my blood has not stopped for even one day. It keeps coming every time I go to pass stool and at times my stool has blood in it too. My stomach feels stretchy most of the times and I feel cramps too often. A few days back, I have started facing left side pain as well. I do not really know what is the reason for the blood not stopping and my pains. Just to add, I do not have constipation issues because I am having Ispaghol every night before sleeping. The medication I am taking are Sucralfate enema (once daily), Transamin 500 mg (twice daily), Mebever 200 mg (twice daily), Motilium 10 mg (twice daily), Caflam (twice daily), Ciproxin 500 mg (twice daily), and Ispaghol (before sleeping).[/INST]Hello. Well, the peptic ulcer disease often presents with upper abdominal pain. It does not present with per rectal bleeding unless some once has a brisk and huge amount of bleeding ulcers with the stomach or small bowel. And the color of stools often appears dark tarry black, if the source of bleeding in within the stomach or small bowel. I understand you have fresh red color bleeding in stools which comes every day you pass stools. Plus cramps and pain over the left lower side of the abdomen suggest few possibilities. 1. Infections with the parasites such as E. Histolytica. 2. Diverticulosis with diverticular bleeding. 3. Ulcerative colitis is an autoimmune inflammatory disease causing ulcers in the rectum and large bowel (colon). I want you to stop Caflam (Diclofenac) since this is a painkiller and can cause ulcers within the stomach, small bowel, and large bowel. It can also precipitate your peptic ulcer disease. I recommend you to use tablet Flagyl 400 mg thrice daily for five days, plus capsule Cefspan (Cefixime) 400 mg once daily for five days. I ask you to get the following tests and get back to me once they are done. I would further guide on you what to do next. You should also stop Mebever, Motilium, and Cirpoxcin, they would not be useful in your case. Rest of your medication can be continued. Plus take capsule Esomeprazole 40 mg half an hour before breakfast daily. This is for your peptic ulcer disease. I hope this helps. Infection colitis. Ulcerative colitis. Diverticulosis and diverticular bleeding. Solitary rectal ulcer syndrome, Anal fissure. Complete blood count, stool for detail report, stool for ova and parasites, stool for C.diffcile antigen, stool for fecal calprotectin, IHA titers for E histolytica, serum CRP (C-reactive protein) level. </s>

<s> [INST] What causes frequent abdominal pain?Hello doctor, I have a problem of abdomen pain since last 3 months which comes and goes away. I too have aches and pain in my body which comes and goes away. I recently got all my medical tests done but it is normal apart from my ultrasound which reflected strong light spot in my liver whose focus is calcified. Is there anything to worry?[/INST]Hello. I will help you regarding your problem. There are multiple reasons of abdominal pain out of which most common conditions are ulcers and indigestion in both of the condition every investigation will be normal. You may have problem of indigestion in which pain came and go away. To relieve from it you have to change your daily dietary habits. Avoid spicy and fatty diet. Regular walking and exercise is must. Drink plenty of water. You may go through upper GI endoscopy which will tell you about ulcer in stomach. Start medicines which I am prescribing here. They will help you in digestion and to heal ulcers. Please send me your USG report to comment on the finding in liver. Upper GI endoscopy. Syrup Gelusil 2 tsp TDS for 5 days. Tablet Drotin 80 mg BD for 3 days. </s>

<s> [INST] I have abscess at the back of the top molar undrained for the past 2 years. Will antibiotics help?Hello doctor, I have an abscess in my gum for almost two years because I lost my back top molar and it progressed from there. I do not have dental insurance, so I have never gotten it drained or my missing tooth closed. I have taken antibiotics for this abscess twice now when it flares up, but now it is having a flare-up again and I cannot afford to go to the dentist. I have a bottle of Amoxicillin from a different injury that I have never used. Are there any negative effects any antibiotics could have on this abscess if it is not the same antibiotic I have used before for it?[/INST]Hello. I went through your query. I am sorry for your inconvenience it is too hard to be in such condtions for a long time. But do not worry, as an expert I would recommend you to upload an image of the area. I strongly needed that to comment on any of it. Yes, there might be any root stump left behind from the missing molar tooth, leading to infection and abscess so just taking medications will not help. If the abscess is not drained, medicines can solidify the abscess to form antibioma what will be a complication as needed surgical assistance. You can take Betadine gargle in lukewarm water two or three times a day, capsule Amoxicillin 500 mg one capsule thrice daily for five days, tablet Metrogyl ER one tablet BD for five days, Zerodol SP (Aceclofenac, Paracetamol, and Serratiopeptidase) one tablet twice daily for five days, capsule Pan D (Pantoprazole) before meal for five days. Periapical abscess due to retained root. Drainage. </s>

<s> [INST] I have third degree burns in right hand with heaviness and pain while letting down. Please help.Hi doctor, I am a third-degree burns survivor. I was three weeks in the hospital before being discharged in the last week of November. My right arm is the one badly hit by the fire. It was a cooking gas explosion that splashed red oil over my body. It is over six months now after my discharge and I have a thick black painful scar from my right arm to my hand. I am also fighting contracture. My doctors think I should let the healing take its full course before anything can be done. The pain is much and the fight against contracture is intense. I am no medication, only apply honey and Dermazin cream on it. I have also stopped taking painkillers. I have serious itching also and it causes me sleepless nights sometimes. I feel slight heaviness when I let the hand down. I have to make a fist if the hand has to be downward.[/INST]Hello. As I saw in the history and clinical photograph (attachment removed to protect patient identiy) that you had suffered severe almost third or fourth-degree burn with a scar and you have a lot of difficulties owing to it. It is almost six months and I think within a few days once COVID infection comes to a standstill you can go ahead with the definite surgery of eschar excision and grafting which might decrease your pain and trouble. Since most of the cases owing to pain and immobility the limb gets into state of contracture so I recommend you to do some kind of physiotherapy and exercise to prevent it. You can definitely go and consult a plastic surgeon and go ahead but I recommend you to wait for some months since due to Coronavirus there are high chance of hospital-acquired infection. You may take painkillers like Tramadol when pain is intense. </s>

<s> [INST] I have sore throat for the past six months. Please help.Hello doctor, I have a sore throat since january, at first I thought it was COVID-19 and have been self-isolating for a month but no other symptoms have occured. It is nearly June and my sore throat still has not cleared.[/INST]Hello. Please mention the symptoms what you are feeling? Any throat pain? Any cough? Any sputum production? Any nose block? Any chest pain? Any acid reflux? Any fever? Are you diabetic? Any post nasal drip? Send me a photograph of the inner side of your mouth showing posterior part of pharynx in open position. Common causes for chronic pharyngitis is 1. Persistent infection in the nose or ear. In chronic rhinitis and sinusitis, purulent discharge constantly trickles down the pharynx and provides a constant source of infection. 2. Mouth breathing is seen in nasal polyps or adenoids. 3. Environmental pollution: smoky or dusty environment or irritant industrial fumes may also be responsible for chronic pharyngitis. 4. Faulty voice production: excessive use of voice or vigorous clearing of mouth throat in some professionals. 5. Acid reflux due to lower esophageal sphincter leads to acid reach the pharynx cause irritation and pharyngitis. Treatment depends upon the cause. Use salt water gargling thrice a day for five days. </s>

<s> [INST] My doctor prescribed Dogmatil 50 mg for IBS. Should I be taking it?Hi Dr. I have mild lower back abdominal pain, lower back pain , and pressure on the bladder area. My local dr. diagnosed me with IBS after doing CT Scan (ethnography oral and IV contrast) , urine, stool and blood test. The CT scan showed everything was normal and urine, stool and blood tests also normal. He said take these 2 medicines. 1 - duSPATALIN 200mg twice daily, and 2 - DOGMATIL 50mg twice daily. When I read the side affects of DOGMATIL 50mg, it has a lot of side affects for which I am a bit scared of. My question is should I be taking DOGMATIL 50mg?[/INST]Hello. I welcome you to icliniq. Well Dogmatil is not otherwise indicated in irritable bowel syndrome, it is better given and effective if someone who has upper gastrointestinal tract symptoms such as vomiting, nausea, or early stomach fullness, frequent belching. IBS is more a problem with small and large bowel, not stomach otherwise. So, since you do not have any symptoms suggestive of stomach involvement, I suggest you to refrain from use of Dogmatil. Duspatalin however can be used and very well tolerated among IBS patients. It is basically an anti spasmodic agent, it reduces pain, but can cause constipation. You should remember this while its use. I hope this serve the purpose. Take care and have a good day </s>

<s> [INST] I have pain in my second molar with redness in gingiva and it hurts on eating and drinking. Please help.Hello doctor, I had pain in my second molar. I felt the pain in my wisdom tooth last week then the pain fades away after 3-5 minutes. I thought it will not come back but then it happens recently then the gums in my second right molar teeth have the red lining and it always hurts when I eat or drink and even when I do toothbrush. Please help.[/INST]Hello. I went through your query. I am sorry for your inconvenience with the tooth. As an expert in this field, I know what is exactly wrong. Nothing to worry it is your third molar. What happens during erupting third molars or partially erupted third molars is the gum between the second and the third molars undergo swelling and pain due to infection. It also makes mouth opening difficult in some cases. But not to worry. Kindly upload an image if possible for more help. Follow these instructions: - Do warm saline gargle two to three times a day. - Take tablet Sporidex (Cephalexin) 500 mg one tablet BD for five days, Zerodol SP (Aceclofenac, Serratiopeptidase, and Paracetamol) one tablet BD for five days, capsule Pan D (Pantoprazole) one capsule BD before meals for five days. These medications will help you a lot. You will be fine. Erupting third molar. Pericoronitis. Avoid sticky or sweet or cold items, not even cold water. Follow up after seven days. </s>

<s> [INST] I have burning chest pain with acid reflux and hot flushes. What should I do?Hello doctor, I have been having chest pain on the left side since a long time. It feels like burning sometimes and at other times it feels like pressure. I feel really tired most of the time and sometimes I feel a little light-headed, nauseous, irritated, and feel like coughing but I cannot. I also get tired mostly after eating. Occasionaly I get acid reflux like the food does not digested and I wake up in the middle of the night feeling like I cannot breathe and having heat flashes. What should I do?[/INST]Hello. Welcome to icliniq.com. With history, I come to a diagnosis that you have an acid peptic disease (APD). It is a common problem, people face frequently. I would suggest you to take less spicy and peppery food and avoid oily and masala foods. Kindly take plenty of water, vegetables, and green leafy vegetables. I will give you tablets and take these tablets for 10 days and get back for follow up for further evaluation and management. Treatment: 1) Tablet Pan-D (Pantoprazole) 1-0-0 (before food). 2) Tablet Rantac 300 (Ranitidine) OD 0-0-1 (before food). 3) Syrup Sucrafil O (Suclralfate) 10 ml 1-1-1 (before food). 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] I have itchy bumps and pus-filled blisters in breast. Please help.Hello doctor, I have itchy bumps located on right breast with blisters filled with pus.[/INST]Hello. Could you attach picture of it? Are those painful? Are you sexually active or do have close contacts with other individuals or do you share any clothes? If those are multiple small vesicles aligned or grouped together, with clear fluid inside rather than pus, then those are likely a herpes infection. Then you would antiviral like Acyclovir or Valacyclovir. Now since it is less than 72 hours, it is better to get antiviral prescribed, which gives better result with early treatment. Herpes is usually painful to begin with or may get painful later. If there is single swollen area with clear pus demonstrable or there is drainage then it is a bacterial infection which would need antibiotics like Augmentin. This would be associated redness or tenderness. So, be it either ways, you will need medications. So get it prescribed after examination. </s>

<s> [INST] Is it possible to experience urine leakage due to anxiety?Hello doctor, I am a 36-year-old male. I have been having a problem with urine leakage for the past few months. After I urinate, several drops of urine oftentimes leak out. It has left a small spot on my jeans a couple of times. It happens even if I wait a minute and try to force all of the excess urine out. I have also noticed a drop in the tip of my penis occasionally when I am lying in bed. I am wondering if this could be caused from anxiety. I have had an extreme amount of stress over the past year, which I believe has caused me to have some muscle twitching. But I am also wondering if all of this could be caused by a pinched nerve. Also, because of the stress, I gained approximately 20 pounds a few months ago. At 5’-11” I am 182 lbs, which is just barely overweight. Could this cause this problem? Could this be caused by either stress, a pinched nerve, or weight gain? Also, do I need to be concerned about prostate cancer?[/INST]Hello. First thing first. You do not need to be concerned about prostate cancer at all. It does not occur at this age. Secondly, have you done any investigations yet like uroflowmetry or ultrasound abdomen with PVRU? Do you have any urinary complaints like frequency, urgency, poor stream, nocturia, dribbling, burning micturation? Are you diabetic or hypertensive or on any medications for this? Do you have taken any medication for your urinary problem (urine leakage)? Do you have urine leakage only after you go to pee or sometimes before going to pee you are not able to control and it leaks? And when you cough or sneeze do urine leakage occur? Married? Children? Any history of constipation? </s>

<s> [INST] Kindly explain about the usage of Lidocaine to numb the pressure due to retainers.Hello doctor, I am trying to use Lidocaine spray to numb the pressure sensation I get from wearing my retainer. Could you please tell me how to properly use Lidocaine spray without numbing my whole mouth and tongue? I just want to target the lower jaw.[/INST]Hello. I should recommend you revisit your Dentist to get it adjusted. The retainer might be too tight ,it should not be as tight to take a numbing spray (Lidocaine). For now if you are using a numbing spray there is no way you can stop numbing your tongue in as you cannot manage the aerosol of the spay, eventually it is going to spread and numb the entire mouth as you are saying. For the time being, I might suggest Rexidine M Forte gel (numbing gel). It contains Chlorhexidine + Metronidazole + Ligocaine. It will help you better but its action might be less than the spray but definately will help you with the issue of numbing the entire mouth. Dressin mouthwash (relieves a bit pain upon using). These two.things will help you a lot. Pressure from a tight retainer </s>

<s> [INST] Can I get pregnant naturally after tubectomy?Hello doctor, My age is 36 and I had tubectomy done 18 years back after second delivery cesarean like my first delivery. I do not know whether the fallopian tubes were tied, cut, clamped burnt, or banded. 1. Is there any scanning or some other method to identify the process of tubectomy done to me? 2. Is there any chance of getting pregnant naturally after tubectomy done by whichever method mentioned above? 3. To have a child now can we go for IVF, if so at the time of delivery will gynecologist come to know that I underwent IVF process for pregnancy? Because she has to do tubectomy again, she will go through with these tubes at delivery time.[/INST]Hi. The method of tubectecomy can be identified only after opening during caeserian section or through laparocsopy. If tubal ligation is done you cannot conceive naturally, if you try there are chances of ectopic pregnancy. You can go for IVF for another baby. Course of the pregnancy through IVF and natural pregnancy will be same. In case of delivery if normal delivery, you do not have to go through tubes. If going for caesaerean section you can identify it was previous surgery. </s>

<s> [INST] Is it possible for skin tags developed from healed fissures to recur after surgery?Hello doctor, I have two small anal skin tags developed from healed fissures. Physically they do not bother me much but mentally I do not like to have them. I consulted a doctor, he said he can only remove 90 % of skin tags as removing completely will affect the sphincter muscles. He also said skin tags might grow back in future as skin looses as you age. Is there any side effects of the surgery or should I go ahead with surgery? Do the skin tags reappear after surgery?[/INST]Hello. I will definitely help you regarding your query. Skin tags are formed in long standing anal fissure. These are nothing but accumulated skin due to fissure. Usually nothing to do that but if you do not like them, you can opt for surgery. It is a very minor surgery. No side effects or any problem after removing them by experienced hands. A raw area will form that will heal by its own. It can reappear if you have another formation of anal fissure. So avoid the conditions that will cause it again. So do not worry just go through the surgery if you do not want them. </s>

<s> [INST] I am suffering from anal fissure and warts with HIV. Please suggest solution.Hello doctor, I am 25 years old. I am suffering from fissure for the past one year but it is not healing properly. I am using Lox-2%, Osil and stool softener Softovac now regularly. Last time when I consulted a doctor he told me that I am having piles too with warts. Warts are now disappearing as I used Imiquimod for more than a month but it caused the skin around my anus red, little itchy, and inflamed. Please help. I am an HIV positive person. Can I use Candid around the anus?[/INST]Hello, Welcome to cliniq.com. I see you have taken all the necessary medications for the fissure in anus. What I would like to tell you is you need to do two more important things. Firstly, since you have fissure and piles I can guess you might have constipation quite commonly hence you must be straining to pass the stools so I suggest you stop straining while passing stools. Next, add fiber to your diet. Consuming one cucumber and carrot a day will help you a lot to avoid constipation. Also, drink plenty of water throughout the day. Secondly, how you use the medication is also important. I advise you to do a sitz bath twice a day (add Betadine 5 ml in lukewarm water in a tub and sit on it for 5 to 10 minutes). Next apply the Lox-2% (Lignocaine hydrochloride) cream (opaque) and not gel, as gel does not get absorbed and the cream crosses the skin. Apply it before passing stools and immediately after cleaning yourself after passing the stools. You can apply it whenever you have severe pain also. You can also take syrup Lactulose 15 ml at night time after food for 10 days. For the piles, if you have third or fourth-degree piles then surgery is the only choice. For first and second degrees you can treat by tablet Daflon 500 mg one tablet a day for 14 days. Apply Pilex ointment or Hemoproct ointment before sleep in the anal region. Avoid anal sex if any until the fissure heals. Lastly, all acute fissure can be treated by the methods I have mentioned here and more than any medication follow the dietary advice and you can keep the fissure occurrence under control. However, if the fissure is persistent for more than two to three months it is better to get operated. Suggested operations are lateral internal sphincterotomy for the fissure and hemorrhoidectomy for piles. Also, keep a check on your viral load and Cd4 counts. I hope this helps. </s>

<s> [INST] My bilirubin level is 1. 7 with no symptoms of jaundice. Please help.Hello doctor, My bilirubin level is 1.7, but I do not have any symptoms of jaundice. How can I bring the bilirubin level to normal?[/INST]Hello. Well, there are certain medications that can bring bilirubin down but your bilirubin is 1.7 which is within normal limits. It does not require any treatment. The possible cause of asymptomatic small raised bilirubin is Gilbert syndrome which is completely harmless. In case, you suppose that I should diagnose your problem then please share the complete report of liver function tests. Follow up with complete liver function tests. </s>

<s> [INST] I have a painful ball attached to the testicle. Please suggest medication.Hello doctor, I have a painful medium size ball that I think is attached to my left testicle. It hurts too much to check, but it will not move away from my testicle, so I assume it is attached. I am not on any medications.[/INST]Hi. Medium sized painful ball attached to your testis can be inflammatory and painful. I understand the situation and hope to work up towards the right diagnosis and treatment. The different masses can be inflammation of epididymis which is above the testis or spermatocele which is a cyst containing sperms and it can be painful if infected. Abscess also can be near the testis and can cause pain. Hematoma blood collection beside testis results from trauma or injury. Other thing like torsion of testis means twist of testis and blockage of its blood supply is considered an emergency and needs an immediate operation. Ultrasound is diagnostic to confirm the mass and its type then we can decide about the treatment. I prefer you to go to a clinic near you to check preferably if they have ultrasound there then can be diagnosed properly. You can take painkillers like Brufen tablets 400 mg thrice daily with Omeprazole 20 mg at night to prevent gastric ulcer and in addition Augmentin (Amoxicillin and Clavulanic acid) tablet 625 mg thrice daily for a week. Ultrasound scrotum. </s>

<s> [INST] I have heavy feeling in ankle and feet while at rest and it subsides on walking. Please help.Hello doctor, I am a 34-year-old woman. I am healthy and never had any serious medical problems before. Last ten days I have a weird heavy feeling in my ankles and sometimes it goes to the top of both feet. It started in my calves and a couple of nights it went to my thighs and it felt like both my legs are on fire. The feeling is more like tingly, sometimes burning sensation and sometimes cold. After this, I started to have a tinging in my fingers, face and the occasional feeling of something is crawling on the body (however, this is not major symptom). The most annoying thing is the heavy feeling in my feet which is there constantly. It is more annoying when I am still but as soon as I start walking it feels like the feeling is not there. I went to my GP and they did blood tests and Lyme disease and did not find anything. Please can you explain what may be causing this?[/INST]Hello. So there are two possibilities, one is peripheral neuropathy and the second is restless leg syndrome. Now do you have access to any of those tests or atleast knows what all tests were performed? Are you having any medications for that? I guess, you do not have any hormonal issues or did not receive any medications recently? There are certain causes we need to rule out besides diabetes like anemia or iron deficiency, thyroid problem, Vitamin B12 or Folic acid deficiency and liver or kidney disease, Vitamin D deficiency, and hypocalcemia. You may have some multivitamin supplements containing vitamin B12 like ME12OD or Neurobion forte etc, which may resolve this issue as vitamin deficiencies are quite common cause for the same. Meanwhile, try to have a diet rich in green leafy vegetables, fruits, and calcium. So you should discuss with your doctor regarding tests performed and request for remaining tests. I hope this helps. </s>

<s> [INST] My period has got delayed. Could it be due to unproteced sex before few months?Hello doctor, I am 20 years old. I had unprotected sex before six months and I got regular periods for two months and then for the next four months I got period four days period and now at the seventh month, I do not get period even after 39 days. Can you please tell me about this?[/INST]Hi, Welcome to icliniq.com. Have you been gaining weight also? </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 have small white bumps in my testicle. What are they?Hello doctor, I have small white bumps in my testicles skin like pimples, one or two looks nearly 1 cm size. I am worried about this issue, usually, it will appear and disappear but this time it is not going. Please help.[/INST]Hi, Welcome to icliniq.com. From the pictures I saw (attachment removed to protect patient identity), those are called sebaceous cysts the small ones can disappear with time. Keep in mind you should keep the area clean and dry in summer like you can use powder to keep it dry but the bigger ones need to be removed. Do not worry, removal does not need admission. You just need to undergo small operation will numb the area with injection and remove the cyst putting one stitch then you can go home same day with antibiotic and Paracetamol. Follow up after removal is recommended just to make sure there is no infection on the wound. I hope this helps. </s>

<s> [INST] Please suggest vegetarian diet plan for weight loss.Hello doctor, I want to lose weight. I do not eat much and I have been working out regularly. Still, I am not losing any weight. I want a good vegetarian diet plan and some tips. Please suggest.[/INST]Hi. As per your height, your weight should be 68 kg. Here is a meal plan which you can follow for a month and contact back for follow up. Early morning: one tablespoon apple cider vinegar in warm water. Then you can work out for 35 to 40 minutes. After half an hour you can do breakfast. Breakfast: one plate poha + one cup green tea, or one bowl oats porridge with fresh fruits or one multigrain paratha with curd raita. Mid morning: one fruit + five almonds or two whole walnuts. After one and a half an hour lunch: two whole wheat roti + vegetable gravy + fresh salad a bowl + a bowl of yogurt or thin dal. Afternoon: A bowl of sprout bhel, or corn chaat, or popcorn, or chana chaat. Late evening: a cup of green tea + a small fruit. Dinner: A bowl of soup + one roti + veg gravy + half plate rice + a bowl of thin dal + few slices of cucumber and tomato. Bedtime: A cup of low-fat milk. Tips: 1. Avoid fried foods and outside eating should be restricted to once a week. 2. Avoid pickles and papads. 3. Try to finish your last meal 40 minutes before sleep. I hope this helps. </s>

<s> [INST] Why do my 4-year-old daughter gets frequent nose bleeding only from her left nostril?Hi doctor, My daughter who is 4 years old had a frequent nosebleed in her left nose. First was last Thursday, then the second was three days later, and today also on her left nostril. I do not know if she pricked her nose, but when I asked her she said yes. I am a bit worried since it has been three times already, but she gets bleeding only on her left nostril. PIease advise me on whether I really need to have it check physically by an ENT because I am afraid of the COVID 19 situation.[/INST]Hi. The most common reason for nose bleeds in children of this age group is 1. Frequent nose picking: We need to ascertain the cause of the nasal bleeds as the most common cause is secondary to dry nose and crusting which in turn causes irritation. Dry nose can be treated by using saline nasal drops four drops six times a day to ensure that the child's nasal mucosa is kept moist and does not dry up. In addition, I would also recommend the child not to get directly exposed to AC / fan as it can also dry up the nasal mucosa often. 2. Adenoid hypertrophy: Usually the adenoids increase in size and they can also be a reason for recurrent nasal bleeds. The child can be put on Mometasone nasal spray two puffs two times a day for the next coming three weeks. 3. Infection in the nose: This can also be another cause of recurrent crusting and inflammation in the nose which results in nasal bleeds. You can give her syrup Augmentin (Amoxicillin and Clavulanic acid) 228.5 mg 4ml three times a day after food for the next one week. It is better to treat all three possibilities for long term relief from the symptoms. All three aspects are extremely common and there is nothing that you need to worry about as it is very common for children to present with such a problem. I hope this helps. </s>

<s> [INST] I am having lower abdominal pain and unable to expel gas for the past 3 days. Please help.Hello doctor, I am not feeling well in my large intestine for the past three days. I have abdominal pain in my lower part and it is effecting my bladder too. I feel a bunch of gas in my colon but I am unable to expel it. Please advise. I just used Entamizole tablet yesterday night and today morning but still, I am feeling discomfort.[/INST]Hello. Well, it seems that you have intestinal colic (spasm of intestine). The Entamizole (Diloxanide Furoate and Metronidazole) can work well if you have an infection otherwise not. It may be because of you had something unusual with food that probably has caused increased gas production and or pain. Sometime excessive spices in food can cause this pain. You should start taking syrup Gaviscon 15 ml thrice daily. I suggest you to use syrup Cremaffin if you have constiopation at the moment. Take plenty of water. You can use home remedy for now such as pippermint. This works very well for colic. I do not think that you should continue with Entamizole unless you have blood in stools. I hope this helps. Intestinal colic. Food poisoning. Infection colitis Follow up if symptoms do not improve in two days. </s>

<s> [INST] My 2-year-old kid is having high fever for the past 2 days. Can high WBC be the cause?Hello doctor, My baby is 2 years old. She is having a high fever for two days now. Last month when she had a fever we found out that her WBC is so high. We tested her twice and the second test shows lower results but it is still not normal. So her pediatrician advised me to have a third test but due to pandemic I did not do it and my baby was doing well. Now I think the problem is still with her WBC. What do you think? Please advise.[/INST]Hi. Whenever we suffer an infection, our body’s immune mechanism comes into action. Those immune cells are nothing but WBCs (white blood corpuscles). So if the WBCs are high, then either there is an infection or the body is trying to fight bad cells in the body. WBCs are not the cause of infection. But it can cause fever by its actions. So whenever someone has a fever, it is very likely that they also have a high WBC count. There are different types of WBCs which increase/decrease in different situations. So the aim of doing blood tests is to see if only one type of WBCs are involved or there are multiple increased cell lines. Our diagnosis depends heavily on which type of WBCs are increased. So please put up the baby’s blood sample reports. </s>

<s> [INST] Is it normal to get sharp shooting chest pain with increased heart rate in a patient with AR?Hi doctor, My history: I am a patient of aortic regurgitation (moderate-severe) with a bicuspid valve. SB III (as per my last checkup). My question is, many times I feel a sudden sharp shooting pain in the middle and slight left of the chest which shortens the breath and gets normal within a few seconds (drinking water helps in to be able to breathe at this time). Also, I wear a MI fit to track the heart rate while walking. Even when not walking too fast, my heart rate touches 165 bpm. Is this normal? I am suggested to take Amtas 2.5 but I have not too it so far. Please help.[/INST]Hello. Firstly it is a moderate to severe AR (aortic regurgitation) with normal heart function and normal LV dimension. So there is no significant damage to the heart. And also since you do not have symptoms of aortic regurgitation like palpitations or shortness of breath with exertion, serial monitoring with echo would be enough. Now regarding chest pain, it is unlikely to be cardiac. It is likely related to acid reflux which is diluted by drinking water. So you may have some antacid medications like Rabeprazole, Domperidone or Pantoprazole and Domperidone combination before breakfast for few days. You should also avoid spicy, oily, and hot foods as much as possible. Have light meals and walk for sometime after meals rather than resting immediately. Avoid too much tea or avoid caffeinated drinks. Now regarding heart rate, it is unusual for heart rate to go up this much with simple walking, however, with running it is expected. Also, one would certainly feel palpitations at this high heart rate. And arrhythmic tachycardia would have other associated symptoms like dizziness, shortness of breath, chest pain, etc. So it is probably an artefact, which is read as heartbeat by watch. It is better if you can wear a watch which also shows ECG tracings to confirm it or have 24-hour Holter monitoring to confirm it. Amtas is for blood pressure, not to control heartbeat so if your blood pressure is elevated then you may have it. So in a nutshell, it is probably artefactual rather true tachycardia, as it is unlikely for the heart rate to go above 150 with just walking. However, if one is too breathless during walking or has severe low hemoglobin or hyperthyroidism with baseline elevated heart rate of more than 100 bpm then it may or otherwise not. I hope this helps. </s>

<s> [INST] What can be done to treat stomach pain, gas, bloating with indigestion?Hello doctor, I have been suffering from stomach pain, gas, bloating, strange sounds in stomach, burping, indigestion, watery stools, always floating stools on the toilet commode since last year. Took several medications for it and of no use. Finally, I underwent endoscopy and colonoscopy last year and the doctor informed me that I have got fundal gastritis and LAX LESS. The doctor asked me to take 6 months of medication for it. For the first 3 months Motilium M 1-0-1before food, Pantodac 40 1-0-1 before food, Librax 0-0-1 after food 4k-Peg+ 3 hours after food. It is completed.[/INST]Hello. I can imagine the level of your frustration for your chronic unresolving symptoms. And I really feel sorry to hear that you been back and forth around doctors for solution of your symptoms. Well, I can very well understand your problem, I will explain to you point by point. 1. Lax LES (lower esophageal sphincter) is not a uncommon findings on endoscopy. It reflects that the valve which controls reflux from stomach to lower part of food pipe is little bit open. However, your endoscopy did not show any ulcer formation in the food pipe which suggest you do not have Gastroesophageal reflux (GERD). Again your symptoms are not related to GERD. It is something else. I tell in a moment. 2. So you see the fundal gastritis (inflammation of the fundus- a part of stomach). Usually inflammation of stomach confines to the other parts of stomach -like antrum and stomach body, but not to the fundus. The one cause of inflammation predominantly to the fundus suggest H pylori infection. This bug initially infect antrum of the stomach then it moves to fundus if chronic infection that has not been treated. I will suggest you investigation before I suggest you an antibiotic course of this H pylori. And remember this H pylori can cause stomach slowing leading to your symptoms of gas. The condition is called gastroparesis. Below I explain to you in more detail the reasons of your symptoms of gas. 3. To simplify the constellation of your symptoms, we doctors classify in to two- the predominant gaseous symptoms or predominantly pain symptoms. You have predominantly gaseous symptoms including bloating, sounds, burping, fullness, early satiety after meals, and some gas in stools as well. So it is important you should understand why these gases production is in excess in you. The one such reason is: i) Dysbiosis-which is alteration of human gut bacteria more gas producing species. These bacteria or harmlessly present in the human gut, however; at times the environmental factors, food, water, other dietary habits; change the composition of these bacteria and turn them in to gas producing bacteria. I will give you an antibiotic for a 3 week duration, this will correct your dysbiosis. ii) The other reason is excessive of food intake that produces gases. These foods are collectively called as FODMAPs. These foods to be avoided as possible as you can. I will share with you a link where you will find the list of such foods which should be avoided. iii) Less common mechanism is feeling of normal amount of gases-this condition is called hypersensitive gut. For this I would suggest you behavioral therapy called diaphragmatic breathing. I will share you the link how you can exercise it at your home. I really hope now you would the some idea of mechanism causing your chronic unresolving symptoms. I would just correct your above mentioned mechanism, and you would see the things get improved for you. Please find below treatment plan, and I want you should update me about your symptoms in coming 2 weeks time. Secondly, I also want to suggest you some investigations as we can exclude any other possibility and treat the things accordingly. Dysbiosis Functional bloating and gas H pylori infection Overweight Complete blood count TSH, FT3, FT4 Liver function tests Anti TTg IgA and IgG fasting sugar level fasting lipid profile Stool for H pylori antigen Stool for Giardiasis antigen Stool for Fecal calprotectin stool for ova and parasites Stool for Fat globules and reducing substance Capsule Rifaximin 200 mg thrice daily for 3 weeks. This is for dysbiosis Avoid FODMAPs Diet. Diaphragmatic breathing. Tab Digestine (Metoclopramide) 40 mg half hour before meals. You can stop the Motilitum. You can continue with Pantodac. You should stop PEG 4k. You can continue with Librax but increase the dose to one tablet twice daily after meals. Avoid FODMAPs. I really hope that your symptoms will improve in coming 2 weeks times, till then you get some tests and revert back to me. In the end of treatment course, I would consider giving you another class of medication that you take for life long. </s>

<s> [INST] Can Levetiracetam cause disturbance in sleeping?Hello doctor, Since after the holidays last year, I have had a hard time sleeping due to some external factors (light, noise, etc) as well as marital problems. Eventually, it got to the point where my hands started shaking again, I stated feeling numbness in my feet, my eyes move very fast sometimes--these are all symptoms I experienced when I was taking Phenobarbital and Phenytoin four years back, my neurologist changed the Phenobarbital with Levetiracetam, and together with Phenytoin, the combination worked very well until I started experiencing these symptoms due to the lack of sleep). Also, a weird sensation that I had, at one point I felt as if my brain was growing bigger and bigger inside the skull, and it got to the point where I was experiencing pressure and eventually headache. After almost six months of lacking sleep, I feel as when I was taking Phenobarbital and Phenytoin: I have problems getting an erection, I lack the energy, I feel sleepy throughout the day, and I experience all the symptoms which I only experienced with Phenobarbital. I really want to get back to how I felt when I started the treatment with Levetiracetam. Are there medications that could replace both Levetiracetam and Phenytoin--or maybe just the Phenytoin? Could the Phenytoin be taken out of the treatment completely? Please, help me.[/INST]Hello. I would like to know some details of your symptoms: 1. Since when you started to have epilepsy? 2. When you started to take anti-epileptic medicines? 3. Seizure details: What what happens during a seizure to you? Do you get aware of seizure just before it starts? How frequent are seizures (how many times in a month or year)? 1) Before starting anti-epileptics? 2) While taking Phenytoin + Phenytoin 3) While taking Phenytoin + levetiracetam? 4. Since when you started to feel lack of sleep/ weird sensations/ lack of energy? What other symptoms you feel these days? 5. How is your mood in day today activities/ appetite? 6. Do you have ever undergone MRI Brain and EEG and other blood tests? If yes, please send the reports and MRI films through DICOM software from MRI CD. 7. How many times in a day you taking Tablet Levetiracetam 500 mg 7 Phenytoin 100 mg? </s>

<s> [INST] What causes presence of HPV virus after complete treatment?Hi doctor, I was HPV 16 positivethree years back. Follow up Pap a year later showed positive for HPV 16 again. Last year Pap was normal but my Gyno doctor notes stated “pap normal but HPV still present”. I was told today that I had cleared the virus last year but why would he write HPV still present if I cleared it. Hysterectomy with removal of my cervix and uterus was done last year. Pathology of cervix and uterus were fine and normal. Last pap was 2 weeks ago. It showed abnormal cells in my vaginal cuff and HPV positive but it is not 16 or 18. The nurse told me it is a low risk type.[/INST]Hi. I understand your anxiety. The fortune thing is that even if last year HPV was present the treatment has been done in the form of hysterectomy. In fact it is over treated. I do not think it is a matter of concern. For your vaginal HPV, low risk types are rarely responsible for any cancer. Also If one is sexually active, HPV infection keeps coming and body deals with it by its own immunity. What should concern us is a persistent HPV infection in your vaginal smears. So right now just use barrier contraception like condoms and repeat vaginal smear at 6 months. That is all. Follow up is what is needed as you are a very low risk case. </s>

<s> [INST] Kindly explain about dry socket.Hello doctor, I got my back right wisdom tooth removed today. How often do people get dry socket? How long until I will know I have it? Is there any way to check if the blood clot is missing?[/INST]Hello. As a specialist in third molar extraction, I will guide you through. See what happens not only third molar, any tooth extraction carry the risk of a dry socket. It is nothing serious just unhealed extraction site. Upon extraction healing takes places by the blood clott that stays in the socket post extraction.That clott dislodges if rinsed vigorously by the patient , so as a precautionary measure I make sure to advice each of my patients not to rinse forcefully for atlest 24 hours and after that warm salinge gargle gently, just to remove if any food lodgement to the socket. Symptoms of dry socket is very painful area of extraction, pain similar to the day after it was done and no such relief upon medication. Bone is visible at the extraction socket with no signs of healing. This was all about the dry socket. It is not like it a sureshot or rare thing its totally based upon how a patient manages himself 1-2 days prior extraction. Now coming to the management it is simple too. Nothing to be worried about, You will have to visit your Dentist, he/she will clean the socket to remove if any food partice and then place a gauze mixed with medication and pack the area of the socket . Due to placement of the gauze the area gets secures from further food lodgement and heals itself in 1-2 weeks to be maximum. To ckeck, it is better you send me an image of the extraction site, I will have a look and let you know. It is better this way to avoid any confusion. I will be waiting for your response so kindly upload as soon as possible. Medications that you got Along with warm saline gargle 2-3 times a day to wash off if any food lodgement at the site but do it gently and not forcefully. </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 daughter has pinhole on nasal bridge with swelling and discharge at present. Please help.Hello doctor, My daughter has had a pin hole from birth on the bridge of her nose. We asked her pediatrician and she said with time it will fade away, but I have been researching because white stuff comes out from the tiny hole. Now she is 4 years and it starts to swell up and it is red and tender, her nose also sweats a lot. Is it a nasal dermoid cyst? Please help. Also, what can I do to bring the swelling down?[/INST]Hi. This is definitely a dermoid cyst sinus. This lesion typically presents as a small opening (sinus) at birth and as the child grows the wall lining in the cyst accumulates sebaceous material which can get secondarily infected, resulting in swelling and then a discharge. In very few cases, the sinus disappears as age progresses. The infection has to be treated with antibiotics and once the infection subsides this cyst along with the enter sinus tract has to be excised under general anesthesia. For now, you can give her an antibiotic containing Amoxicillin with Potassium clavulanate 475 mg 4 ml three times a day for one week. In addition syrup Ibugesic plus (or its equivalent) 4 ml two times a day for one week to reduce the inflammation and pain. I think, for now, this should be sufficient. Please do not go to puncture or do anything to the swelling as it can flare up the infection and inflammation. I hope this helps. </s>

<s> [INST] I have severe lower abdominal pain with an urge to urinate and diarrhea. Why do I get this?Hello doctor, I am a 31-year-old male. For the past four months, I have periodically experienced severe pain in my lower right abdomen and lower right back regions. The pain comes quickly and can last for a few hours, and is so severe that all I can do is lay down and writhe. I have never passed any stones that I am aware of. The pain is usually accompanied by the feeling of needing to urinate, as well as some diarrhea. When the pain begins to set in, I make a point to drink lots of water. I do not have health insurance, so I have not had any imaging done. I would greatly appreciate any input or recommendations.[/INST]Hello, Welcome to icliniq.com. Well, I understand you have pain with diarrhea and pain that lasts a few hours before it goes away. Listening to your history, it seems a few possibilities. The pain of intestinal loops affecting the cecum a part of large bowel or terminal ileum which is small bowel. The causes are many but given your age, there are possibilities of Crohn's, yersinia infection or Whipple, and lastly uncommon is intestinal tuberculosis. The other possibility is renal stones. It is not necessary to have stones in urine in person with renal stones. Thirdly, functional abdominal pain syndrome which is basically hypersensitivity of the intestine to food, stools, water, etc. This pain cannot cause weight loss however, the causes mentioned above can cause fever and weight loss. The third often overlooked cause of pain is nerve entrapment pain. This is because of the compression of the nerve in between the muscles. You see the list of differentials can be shrunken after a good history. I want you to tell me more about your symptoms in context to the above-mentioned conditions as we then target the one or two and investigate specifically and then can suggest treatment for the underlying cause. Do not get afraid. It is completely possible that you may not have any of those, but this has to be excluded from close questioning particular to these conditions. I hope this helps. Intestinal inflammation. Functional hypersensitivity. Nerve entrapment pain. Renal stones. Follow up to discuss in detail and formulate a plan of action for management of the problem. </s>

<s> [INST] I have decay in the front tooth with gingival recession and bleeding. Please help.Hello doctor, For the past one month, I am facing a frontal tooth decay with receding gum. Sometimes, I have bleeding gums. Please help.[/INST]Hello. I went through your query. As an endodontist, I would like to assure you there is no major issue with your gums and teeth. Just minor caries in upper left lateral incisor and bit of inflamed gums due to deposition of tartar and improper brushing techniques. First, try to brush in a proper technique that is in soft vertical strokes (from gums to teeth edge) and not a forceful horizontal motion. Improving these habits will solve your issue 30%. Rest you need scaling to remove the already accumulated tartar and also the issue of bleeding gums. Betadine mouthwash gargle in lukewarm water two to three times a day. You have a very minor caries, please do not call it a decay. It will need a small restoration and you are good to do. Gingivitis (gum bleeding and recession). Caries in upper left lateral incisor. Gingivitis and Irreversible pulpitis. Improve the brushing technique. Get a scaling. Avoid sticky or sweet or cold food items until then. Let me know if any further query. Just post it and I will take care of it. </s>

<s> [INST] I have difficulty to concentrate with excessive mood swings and voluntary leg shaking. Please help.Hello doctor, I have trouble concentrating. It feels like my mind is always in a thousand different places at once and it is hard to keep in it one place or thought. I have excessive moods and sway from one thing to next all the time. I also have a constant voluntary shaking of my leg. I need something to help concentrate.[/INST]Hello. How long have you been having trouble with concentration, mood swings, and restless legs? There are several different possible reasons that can cause these symptoms. For example, if these symptoms were present since childhood we may need to consider ADD/ADHD (attention deficit hyperactivity disorder). If these symptoms started only recently, mood disorder, anxiety may be a possibility. You will need a comprehensive assessment to determine the cause so that appropriate treatment can be suggested. You can either consult a specialist in your city or contact us online for an assessment. I hope this helps. </s>

<s> [INST] What is causing raised blood pressure on going to hospital?Hi doctor, I would like to consult regarding my situation, my blood pressure is normal but everytime I go to clinic or hospital I feel nervous so my blood pressure becomes high. Any recommendations or medication on this? Is it safe to go back to work while the COVID-19 pandemic is still on going?[/INST]Hello. I have gone through your query and can understand your concern. I would like to know some more details about your present problem. How many times have you checked your blood pressure in clinic and what was the range of BP? I mean how much it rises? Do you have any cardiac symtoms like chest pain, breathing difficulty on exertion or walking, palpitations, fatigue, giddiness? Family history of hypertension? I would suggest you to get a digital BP apparatus at home and monitor your BP at home. If it is high at home also then you may definitely have hypertension and will have to be treated. Decision to work in COVID 19 pandemic depends on the place you stay, the number of cases you have around, the safety environment of your office and so on. But definitely has to be very careful and follow all safety measures. Kindly get back with above details for further discussion and management. </s>

<s> [INST] My face looks old because of acne and acne scars. Please help.Hello, due to the pandemic I'm not allowed to visit a dermatologist in person. But my skin has changed for the worse drastically. Im a 16 year old student, but my face now looks old because of the following: So I had some dark spots cause from acne scaring and I decided to use the "AMBI skincare fade cream" which I thought would work wonders but it left a red, darker, larger spot on my forehead, chin, and sides of cheeks. So I let it be for a few days and it was still the same, so then I decided to look u some home remedies, and I found that garlic not only fights acne, which I have on top of the scaring (which looks horrible) but it also fights dark patches, so I applied that on my face and it burnt... A LOT, but I thought that the burning sensation must mean that its working its magic but, noo. the next day my skin was irritated, and red. Now fast forward to today ( almost a month and a half before the incident) my forehead is wrinkly (but it could also be thin forehead hairs) (oh also my forehead was affected the most, because I put the majority of garlic on that area of my face ). I have huge drak- yellowish, brownish patches all over my skin, plus some acne. Ive TRIED homemade recipes to lighten your face, but they haven't been working, then I tried boosting my melanin, and collagen, but still nothing, and now I'm using anti wrinkle cream, but from doing all of these things I don't see any results, heck I actually see it getting worse, My mom told me to give it time, but I'm not sure that would be the best approach. Please help me.[/INST]Hey Acne are common in teen ages in most if the people. They should not be much disturbed. They appear and slowly disappear with age. They are due to excessive sebum production from the oil gland in your face along with blockade of thise oil tract into the surface of skin aggravated by oily cosmetics and bactetia. The treatment depends upon the grade of acne. For mild ones we use simple creams and gels made up if vitamin a derivatives and few antibiotics whereas in highet grade you need otal meducation plus those topical ones. But in severe grade we use oral vitamin za derivative like isotretinoin. It seems you have dark spot diue to acne. Is it only pigmentation or you do have scars as well? Whatever it be, protect the skin from sunlight as much as possible , can use sunscreen gel spf 30+. The medicine you hzve been using contains alpha hydroxy acid which coul be anyacid. They must be spplied in low quantity. I prefer to use retenoic acid along with AHA at bedtime. You cab use kojic acid and glycolic avud combonation at night which vould ve available in cream. Please send me your photo and solve my prior query. </s>

<s> [INST] What causes reddish flap in the tonsil area?Hello doctor, I had been having slight trouble with left tonsil. I suffer with tonsil stones and started to get yellow/green semi-solid fluid forming bottom of tonsil. This was easy to get out with cotton bud. It smelt so knew it was tonsil fluid/stone. I have always had lots of bouts of tonsillitis and suffered more that side. The fluid stop but a reddish patch come where the fluid come out of flap. It goes up and down as blood vessels in that area. The tonsil same size, no pain all other issues with it. Just this little irritated patch that does look a little couple bumps but flat and hardly noticable. I suffer from lichen planus and geographic tongue. I have been to GP and he put me in ten days Penicillin but that did not make the patch go. It is reddish in morning and fades as day goes on but not disappear. I have been referred to ENT.[/INST]Hello. The picture you have attached does not show any lesion (attachment removed to protect patient identity). It is a normal looking tonsil showing tonsillar crypt (Crypta magna) which is normal. As of now the tonsils are normal looking. They are hypertrophied nor is there any membrane or pus filled clefts or crypts. There is nothing to worry. However it is at times possible that one may be able to express purulent discharge from tonsillar surface even if it is normal looking. Even then there is no need to worry. All you need is a course of antibiotics which you have completed. You only require topical antiseptic mouth gargles like betadine or chlorhexidine. They are not even that hypertrophic to merit tonsillectomy. However, if there are recurrent attacks of tonsillitis or peritonsillitis with bad breath or halitosis, tonsillectomy may be considered at a later date. </s>

<s> [INST] Why do I keep going to the toilet and fart so many times a day?Hey doctor how do you do? To be honest am not fine !! When we come to ma point i have a symptoms like going to toilet many times in a day and also farting much times in a day(over 100 times ). Am from poor family Once I tried in hospital but because of money I Can't continued .It tooks many years and influenced me for isolation of social lifes even if from school.now i am a 2nd year university student and i have many ideas what i want to do but I can't please help me !![/INST]Hello. I welcome you to icliniq. I am sorry to hear that you have been such distressful times. I really hope with the following advise your problem solve for rest of your life. Well you it is not uncommon to have fart and burping. Since these are the normal.process of body of emitting gases which are produced in the small bowel. However, excessive gases are produced in someone who have problem with two things. 1. carbohydrate maldigestion. The corbohydtates are the major compotent of our diet approx. 70% of diet we take it is corbohydrates. This corbohydrates are fermented by small bowel.bacteria and produces excessive gases..one such example is milk and wheat grains and barley rye etc. You have to cut them to half before excessive production of gases can be prevented. At least you should try avoiding milk and milk based dairy production such as coffee, tea, icecream, and sweets. You can learn more about the foods who are carbohydrated and who freqeuntly cause excessive gas production on the internet. 2. Dysbiosis. Excessive of gas producing bacteria and lack of lactobacillus which help digest corbohydrats. This altered composition of bacteria is due to many factors namely oast use of antibiotic use, enviormental influence, sorts of diet one take and water one take. The one way is to treat this dysbiosis with a 10 day antibiotic course -Tab Rifaximin 500 mg twice daily for 10 days. Followed by use of probiotic which are healthy bacteria reguraly for 6 months at least. With the above explanation and advise you would be in good position to treat your condition.. Lastly only food modification can improve your symptoms by 50%. So I suggest you to start with that. There are formal testing for Dysbiosis by giving stool sample for microbiota spectrum analysis. But this is not currently performed in many countries. you can check at your end. if it being done over there. I hope this will help.you good day corbohydtates malabsoption dysbiosis corbohydrates malabsoption lactose intolerance. follow up if want to discuss in more detail. </s>

<s> [INST] I have pins and needles sensation in heart with anxiety. Please interpret my ECG.Hello doctor, I am having a feeling pin and needles like sensations near my heart for the past two weeks. I do not know if my ECG is normal, I wanted to get it checked by you. I have no cholesterol issues, no blood pressure issues, no diabetes. I have low blood platelets count from years and recently my abdomen ultrasound showed mild spleen enlargement and prostate enlargement. I am 31 years old. I have anxiety issues for years. I also feel the warmth on my face after evenings until the time I sleep, but no fever. Weakness is there with pain in the left leg. Chest x-ray is normal.[/INST]Hello. I checked your ECG (electrocardiography) (attachment removed to protect patient identity). All is normal without no sign of any abnormality. The sensation you feel, does it come with shortness of breath? Or chest pain? Do you have a history of stomach ulcer or trauma to the chest region? Have you taken any medications so far? </s>

<s> [INST] Can ear drops cure an infection in the inner ear wall?Hi , MY query is i suffer from chronic ear infection. This time when ear infection started i started taking ear drops preemptively which worked for me. But the problem is infection is in the inner walls which keeps coming back after out walls are healed and i stop taking drops for 2 weeks. Now i want to ask can ear drops cure inner infection too if i keep taking my drops. Dexatob/Clotrim[/INST]Hi, There is a possibility that there is a chronic infection in the middle ear which is located beyond your ear drum. In such a situation plain ear drops will not treat the infection completely. You will require oral antibiotics to completely treat the infection failing which the ear discharge will keep recurring again. I recommend you to start the following treatment Make sure you keep you ear dry and don't let any water to enter. Place a sterile cotton in the ear entrance of the ear canal and change the cotton every 6 hrs. Make sure you don't clean the ear using ear buds or any foreign object as it can introduce infection into the ear. I hope I have answered your query. If there is anything you need to know or want to enquire, please do let us know and we will get back to you ASAP. Warm regards! </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 have a lump in the outer anal area that keeps increasing and decreasing in size. Please help.I am suffering from pain in outer anal area. There is also a lump with white top which keeps on increasing and decreasing . Also a sticky liquid comes and my anus is most of the times wet.Its about 3 months i am suffering from this. I am a 22 year male[/INST]Hello. I welcome you to icliniq. Well the symptom you mention suggest a possibility of peri anal sinus or abscess. This is pus collection around the anus. In your age, with history of problem for 3 months; one of few possible underlying causes are infection with secondary abscess (pus) formation. The other possibility is that you have underlying inflammation of the bowel in the form of inflammatory bowel disease (IBD). If it is simple infection the treatment is straightforward however, in the later, a longer and specialized treatment is provided to control the underlying disease. For now I suggest you to get following stools tests and some blood tests and take a picture of the area and upload it as I can see it and can be in better position to tell what to do now. And I also would like to hear in more detail about your problem like any change in bowel habits, weight loss, bleeding in stools, abdominal pain, history of smoking, or alcohol intake, any family history of similar illness, and personal history of exposure to TB patients. And lastly any travel history? This all above information would help us to diagnose your problem and then implement the treatment accordingly. Good day and take care your self Ischiorectal abscess perianal abscess crohns disease with perianal disease Complete blood count serum CRP stool for fecal calprotectin stool for ova and parasites stool detail report for now apply xylocain 2% gel at the perianal and anal area follow up to provide more information and discuss investigations </s>

<s> [INST] Inserting an earbud resulted in a tear and ringing sound in my ear. What should I do?In my left ear a thin hole in the membrane because of the putting ear bud in the ear it has been teared now, i am getting a ringing sound in my ear. what shall i do stop the sound in my ear[/INST]Hi! There is a high probability that you would have accidentally injured the ear drum while cleaning. This is a very common thing to happen and you don't have worry too much. The defect in the ear drum interferes with optimum sound transmission to the middle and inner ear and thereby you will have symptoms such as continuous ringing sensations, muffled sounds, echoing of your own voice or any loud sound, intolerance to high frequency sounds, decreased hearing etc. Usually over 4 to 6 weeks this traumatic perforation heals and you will be completely fine. However, you shouldn't let it get infected as it can interfere with the healing process and if proper hygiene is not maintained the perforation might never close. My advice for you would be to There is no medication required here as such unless your having an infection associated with copius amount of discharge. I hope I have answered your query in detail. If there is anything you want to enquire, please do let us know, and I will revert back to you ASAP. Take care and have a wonderful day! Warm Regards! </s>

<s> [INST] Is colposcopy used to diagnose HPV?About a month ago I had a Pap smear that came back abnormal, and was told I have hpv. My dr then did a colposcopy two weeks ago. I got a call today saying that it came back normal. What does this mean? Do I still have hpv? Do I just have low risk hpv? I have never experienced warts.[/INST]Hello, Welcome to Icliniq. There is a difference between all the tests you underwent. To make it clear for you I will explain one at a time. 1) Pap smear - it's a test used to screen if a women can be harbouring cancerous or precancerous cells over the mouth of the uterus ( i.e. CERVIX) , so basically a screening test for cervical cancer and it's pre cancerous changes. And as it is just a screening tests, it can not always diagnose if you have any foci of cancer over the cervix. it just give characteristics of the cells which were studied on the smears. So unless they are overtly cancerous looking, we always try to rule that out by doing other tests, So next comes the HPV ( Human Papilloma Virus) testing. 2) HPV testing - It's a test to detect the causative agent of the cervical cancer, that is human Papilloma Virus, it's spread through sexual contact. Based on their genomic sequence, they can be categorised into various types. So warts are caused by the low risk type that is 6 & 11. where as there some 12 high risk types which can cause cervical cancer, so these are detected in the HPV testing ( Depending on your test done - as various tests have different sensitivity & specificity). Of these high risk majority are caused by Type 16 & 18. So once a women starts her sexual activity, almost 70- 80% women may have HPV infection but it gets cleared over 1-2years, so that is why we do not test it for women less than 30yrs ( I see you haven't mentioned your age).So as the HPV is a virus and it coming positive indicates higher risk of having precancerous changes or may be risk of cervical cancer in future, we need to see if any changes have already happened to substantiate the previous tests. So then comes the role of colposcopy. 3) Colposcopy - it's basically a test to visualise the cervix under huge magnification and to see for any deviation from normal, and to look for any changes over the cervix which can hint on being abnormal or precancerous, so that from that particular abnormal sites biopsies canbe taken and subjected to histopathological examination ( where a pathologist sees the tissue under microscope to look for any cancerous cell). So as your colposcopy finding are normal, your gynaec may call you repeat testing after 6-12months for repeat cytology & HPV testing. If the Repeat screening are negative twice then you can just follow the screening protocols routinely as other women. Please share the reports of your HPV & Pap smear so that I can go through & guide you through in case you any further doubts. Hope the information helps you. Have a nice day. </s>

<s> [INST] My wife gets acute abdominal pain for the past three years. Please help.Hello doctor, For the last three years, my wife had an acute abdominal pain due to gastritis. All the blood reports, sonography reports, x-ray are normal. Please help.[/INST]Hi. If it is due to gastritis, you should go for endoscopy, until that time you can start tablet Pantakind DSR (Pantoprazole). </s>

<s> [INST] How can hip pain be managed in a diabetic and hypertensive patient?Hello doctor, My mother is having lower hip side pain for almost a week now. She is taking maintenance medicines for high blood pressure (Approvel) and 24 units of Insulin everyday. What could be causing the pain and can I give her pain reliever?[/INST]Hi. Looking into mother's problem, you have got both hypertension and diabetic under Insulin with hip pain. First of all we need to understand what is the association between the current problem and existing diseases. Once we understand why it is happening and try to find its link then it is easy to understand the diseases to diagnosis and help long term treatment preparation.Uncontrolled diabetes can affect the muscles and skeleton, leading to joint pain, nerve damage.There is a link between diabetes, arthritis, and joint pain. Both rheumatoid arthritis (RA) and type 1 diabetes are autoimmune disorders. In both cases, the immune system is attacking an otherwise healthy part of the body. According to Arthritis Foundation guidelines, losing 15 pounds can significantly improve the level of hip pain in a person with Osteoarthritis. So, I would recommend to do: 1. Radiography of hip joint Ap/Lateral view to assess OA changes. 2. RA Rheumatoid factor. 3. CRP-To assess condition of active joint inflammation and destruction. I will follow up with the report. </s>

<s> [INST] I get widespread muscle twitching with anxiety and OCD. Should I worry about ALS?Hi doctor, I am a 20-year-old male. For the past seven months, I have had widespread muscle twitching. The most annoying ones occur in my eyelids. I am diagnosed with anxiety and OCD, and I took Lexapro for 90 days. A couple of days ago, I was instructed by my doctor to stop the Lexapro due to the feeling of being off-balance and some minor changes to my vision. I am terrified of having ALS (amyotrophic lateral sclerosis). Within the past few days, I have had the urge to clear my throat every few minutes. I do suffer from health anxiety. Please help.[/INST]Hi. I would like to know how it started and progressed in detail. How it was with the said medicine? Please answer a few more questions. Is there any weakness of hands or leg or anywhere? Is there any abnormal sensation or loss of sensation? Is there any loss of muscle mass? Is there difficulty in swallowing, chewing? In which part of the body fasciculations started and then migrated to which part? Or it started all over the body simultaneously? Do you take any CNS stimulants such as coffee or any addiction or abuse of substance? What were the components of blood work? What is the content of medicine Lexapro? And how you were with Lexapro in terms of fasciculations? </s>

<s> [INST] I have a circular black patch on the back with severe itching. Please help.Hello doctor, I have a black patch on my back which is almost circular and is itching constantly. It has become quite big in the last three to four months. Can you please suggest what it could be and what I can do? It feels good when I put hot water on it. And it becomes very dry. It has a small line on its edges. The itching is happening continuously. It subsides a bit when I apply moisturizer. But the black patch seems to become darker.[/INST]Hi. Can you attach the picture of the lesion for an accurate diagnosis and treatment plan? Please attach a picture of it. </s>

<s> [INST] I am having cough for the past 3 months, with persistent mucus production. Please help.Hello doctor, For the past three months, I was having a dry cough. I consulted a doctor who advised me Augmentin 625 mg, Grilinctus, Betadine gargle, and steam for five days. That gave me a lot but not full relief. I continued gargle and steam for some more time. Since then, the cough is reducing. But, some amount of mucus remains in my throat. Nothing comes out but keeps giving me a feeling of something there.[/INST]Hello. The problem you are suffering is a viral illness that is temporary. You also need to check for any triggers that cause the mucus to increase. If you started with a dry cough, there should be no mucus build-up anymore. The feeling in your throat may possibly be due to dryness of your membranes. Please double your water intake and you should notice a considerable change. You can also take a tablet Neksium 40 (Esomeprazole) on empty stomach in the morning so that any gastric irritation can be prevented by this. </s>

<s> [INST] My 8-year-old son gets chest pain for the past six months. Please interpret his CT scan.Hello doctor, My 8-year-old son has been having chest pains since six months. He takes medication for acid reflux, anxiety, and asthma currently. We had a CT scan done but the doctor says it should nothing to be concerned about, however, some of the stuff in the report I feel is of concern and I am looking for clarification on some things. He is currently on Omeprazole, Levabuterol, Atomoxetine, Flovent, and Guanfacine.[/INST]Hello. I have gone through the CT report (attachment removed to protect patient identity). There are variations in the branching pattern, but this is fine to have. Many individuals have such a branching pattern without any consequences. Slight bulging was mentioned at ramification, but they also commented that it appears to be within normal limits. And such slight bulging would not cause pain or would not have any consequences unless there is any obstruction within it. Important is that there is no obstruction or abnormal course of left coronary artery. They have mentioned that the left coronary has a slightly high take off which is fine and unlikely to be responsible for symptoms or complications. So, as far as coronaries are concerned, they are unlikely to be responsible for his symptoms and unlikely to end up in any adverse consequences. Now I guess, he must have had an ECG and echo, which would give additional assurance to this. Now if according to symptoms, they are again not classical of heart. If they were cardiac then they would have certainly aggravated by activities. So unlikely to be a cardiac issue. Now considering his reflux issue, the first possibility should be considered of acid reflux and secondly of musculoskeletal even if there is no definitive demonstrable tenderness. Omeprazole may not be able to counteract reflux totally. So it is worthwhile to try locally acting agents like syrup Sucralfate and see if it helps. Light meals and some walking after meals. Locally acting agent Diclofenac gel may also be tried. I hope this helps. </s>

<s> [INST] My period delayed for 4 days this month with a history OCP before 3 months. What is the chance of pregnancy?Hello doctor, I had unprotected sex last March but took emergency contraceptive afterward. Six days after, I had the bleeding associated with the emergency contraceptive. Two weeks after that, in the first week of April, I had my period for six days (my usual period lasts five to seven days). In May, I had five days of the period although the last two days were only very light bleeding. Now I was due for my period four days ago, but I still have not got it. What are the chances that I am pregnant and if not should I be worried about my late period?[/INST]Hello. Firstly, as you had three episodes of menstrual bleed including the withdrawal bleed post-emergency contraceptive after you had intercourse in March, so it is unlikely that you would be pregnant due to your sexual encounter in March. As you have missed your menses now by four days and if you have been sexually active during this cycle as well, then you must rule out pregnancy first with a home urine pregnancy test kit. If negative, then the delay is most likely stress-induced and you should wait for at least five days to allow menses to start naturally. If not, then you would need an ultrasound pelvis to check for endometrial thickness which if more than 8 mm. You can be offered a withdrawal bleed with progesterones to resume your menses. </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] Is it possible to get anaphylaxis if stung by bee frequently?Hello doctor, Few months ago I got stung by a bee in arm. It is not the first time I was stung by a bee, but this time 30 minutes after it happened, I got swelling under my eyes, on my cheeks and it was getting bigger as time passed. I went to ER and they gave me Corticosteroids IV. Now, I was wondering if this means I am allergic to bee stings and if in future I get stung by a bee again does it mean anaphylacic attack can develop?[/INST]Hello. Yes, that is correct. It seems you are allergic to bee sting. For an allergic reaction to develop, initial exposure must occur in order for your body to create an immune response to it. This might have happened a few months ago when you were stung before. Since there was already an exposure and established immune response, subsequent exposure may result in allergic reaction. Severe allergic reaction resulting in anaphylaxis may occur but most of the time allergic reaction is mild and not life threatening. Symptoms such as excessive skin reactions, including hives and itching and flushed or pale skin, low blood pressure, constriction of your airways and a swollen tongue or throat, difficulty breathing, weak and rapid pulse, nausea, vomiting or diarrhea and dizziness or fainting warrants immediate consult. I hope I was able to answer your concern. Is there anything else I can help you with? </s>

<s> [INST] My side facial profile is more forward and thick. Is there any surgery to correct it?Hello doctor, From my late teens to now (I am thirty), I started becoming very insecure about my face, especially my side profile. It is heavy, thick and my mouth is more forward. I was prettier as a child. I want to inquire about surgeries that can be done to adjust my jaw. Also, I seem to have some degree of overbite. I do not know if it is more about the overbite or that either my maxilla or mandible are too big or forward. I hate taking pictures because I always look ugly and I also have had people make comments about my forward looking mouth. Please help.[/INST]Hello. I am sorry for your suffering. But the picture you sent me is not clear (attachment removed to protect patient identity). Please send close-up pictures of your front face and side face with the mouth in resting position. There is a surgical treatment for this problem. It is called orthognathic surgery. In this procedure, both the maxilla and mandible can be brought forward or pushed backward. But it is is important to decide which procedure is suitable for you. Please send me the pictures and let me help further. </s>

<s> [INST] Why am I having toothache after biting ice?Hello doctor,I crunched a hard piece of ice a week ago and those few teeth (left corner teeth) were a bit sore since but starting sunday the pain became increasingly intense (I put a solid clove in my teeth for about 30 minutes and it helped the pain but as soon as I took the clove out the pain returned). This has caused disturbance in my sleep for the past few days. Monday majority of the tooth pain went away (a few teeth still slightly hurt but not bad at all) but now my entire left side of the face is swollen and it became worse overnight (under the eye, nose, and top lip) something in my gum hurts but there is no pimple or bubble there. I have a slight fever (but it is not bad) and my left ear hurts sometimes. Sounds like an infection but I do not know why. I want to blame this on the ice but it is odd that the prominent pain started so long after the incident.How long will this continue and what is the best at home treatment? Should I see a dentist (I have been trying to avoid it because of COVID-19). Is this a serious issue or did crunching the hard ice just trigger an infection somehow?[/INST]Hello. Actually ice leads to transient sensitivity but actually has zero role upon your infection. It might be a gum propblem (periodontitis). Let me know if you notice visible stain and tartar on your tooth or it might be caries that leads to infection and sensitivity from the ice triggered the pain but infection was already there. Upload an image of the area for better perception. Applying clove is a good idea but chornic clove oil acts as irritant and lead to burning sensation (ulceration), it might add to the pain too if used for a long time. Please do not worry. Kindly answer my questions. Meanwhile, as we all are in a lockdown state, I can suggest you medication to ease your pain and manage the infection. So do not worry. Betadine mouthwash gargle in lukewarm water 2-3 times a day, capsule Sporidex 500 mg one capsule BD for 5 days, tablet Metrogyl 400 mg 1 tablet BD for 5 days, tablet Zerodol SP 1 tablet BD for 5 days, capsule Pan D 1 capsule BD before meal for 5 days. These medication are the safest and will work like miracle. But upload the image for confirming the diagnosis to prevent any future pain or discomfort. Caries or tartar depending upon the image. Periodontitis. Irreversible pulpitis (caries). Avoid sweet or sticky or cold food items. Stop the application of clove. Maintain oral hygiene. </s>

<s> [INST] What causes severe pain in the lower chest while coughing?Hello doctor, I recently fell off a roof. After ER visit w/ct scans and X-rays I received 7 staples in my head and was discharged. Prescribed Cephalexin and Percocet I went home for recovery. Two days ago while coughing I felt an excruciating pain what seemed to be under and behind my lowest rib on my right side. This pain continued only when I strain myself such as with a cough or sneeze, etc. Since beginning this pain has gotten more intense with each involuntary strain.[/INST]Hello. Have you undergone any chest X-ray? While coughing is there any sputum? Have you feeling any pain in the abdomen? Is there any blood in urine? Did you land on head or abdomen during fall? If possible, answer above questions please. </s>

<s> [INST] I am diagnosed with genital molluscum. Is it related to HIV?Hi doctor, I was diagnosed with genital molluscum contagiosum (about a month and a half ago). I am being treated now and there are few number of bumps left (less than 5) when it first appeared there were 8-9 bumps. I wanted to ask if this had anything to do with the HIV virus. I have almost never been in a relationship without protection. But that still made me worry for a while. Please let me know if I should panic.[/INST]Hello. Genital molluscum is a viral infection but not caused by HIV virus. It is a sexually transmitted diseases and therefore usually spread from sexual route. Genital molluscum is considered to be a marker of HIV infection. Therefore, it is usually advised to rule out HIV infection in patients of genital molluscum. As you are having genital molluscum does not mean that you are having HIV infection. If you are practicing safe sexual practices then chances of HIV infection is minimal at least not because of sexual route. But to be in safe side I will advise you to rule out HIV infection by doing HIV testing as it is considered in protocol to test for it incase of genital molluscum. </s>