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hello doctor I have a question with respect to doxypal do medicine and my question is whether the delayed release remains active when I would open a capsule to remove half of the pellets the capsules are 100 my and I would like to take 50 my but I need the delayed release to remain working because otherwise I get too many side effects with nausea the side effects are also the reason I would like to take 50 my two times a day instead of 100 my once a day I investigate and found that the delayed release mechanism can be in the capsule and if this is the case I cannot open it to remove half of the pellets because it will loose the delayed release mechanism but I read on the internet that the delayed release mechanism can also be in the pellets inside of the capsule if this is the case I could open it and remove half of the pellets and the delayed release mechanism would still be working I want to know is the delayed release mechanism of doxypal 100mg re contained in the pellets or is it due to the capsules

hello the delayed release capsule contains the active drug doxycycline and few other excipients that slowly release the active drug from it so the active drug is mixed with the excipients and put into the capsule so if you divide the capsule into equal half it still works still it is delayed release and you can make 50 my dosage you also see that whether the infection in acne is controlled with 50 my dose if so you can follow it if not controlled then 100 my must be taken the benefit and side effects should be weighed to choose the balanced dosage

hello doctor eight months ago I had severe rev lasting for 10 weeks I am years old athletic fit and in perfect health before rev I took no prescriptions whatsoever I got rev from my friend infant at church my husband is a double boarded physician and recognized the rev very quickly I had acute wheezing and coughing I was on five prescriptions the usuals for 10 weeks I was off all medicines and back on the treadmill daily and also at the gym the one very noticeable thing that has remained and is very troubling is that every time I climb stairs in my home about 18 stairs to the second floor I am quite out of breath this does not happen on the treadmill but just on the stairs I am convinced this is damage from rev the two rays six months apart are showing scarring from the rev I was recently at a high altitude after many visits to that same location and I was seriously struck with altitude problems I was extremely short of breath and had to get a prescription inhaler which helped enormously when I returned to my place of low altitude my breathing greatly improved my questions are can I improve my lung scarring in any way should I get pulmonary studies if I am not wheezing will an inhaler help shortness of breath upon exertion this is a problem for my fitness program and my very busy personal life

hi scarring is an irreversible process so it cannot be cured your breathlessness is due to less lung reserve because of scarring kindly share your ray chest image your lungs will not become normal but breathlessness problem will be corrected by medications and respiratory exercises pulmonary rehabilitation medications are simple bronchodilators like tablet doxophyllin 650 my od with inhaler combination of formeterol and budesonide respiratory exercises can be done in the form of pulmonary rehabilitation download edf form of pulmonary rehabilitation and do it slowly in increasing way I hope this helps rev respiratory syncytial virus hrct chest high resolution it scan bag arterial blood gas test treatment plan will be changed after investigation prevent infection and maintain hygiene follow up after one week

hello doctor I have a few problems with my body since last year I was under work pressure I could see my blood sugar gone up to 289 my do on post prandial up last month and reduced to 175 on up and 109 on fasting last week in the meantime for the past two weeks I suffer from fissure I am a case of vitiligo and epilepsy for 20 years and under medication with valproic acid 500 my reduced to 250 my for the last 10 months and clonazepam 5 my I have been noticing that my penis skin is shrinking for the last eight months and now narrowed down to my opening on the penis forehead skin for the last three months I am suffering from back muscle spasm after consulting my medicine I am taking a sit bath for fissure continuing valproic acid 500 my for epilepsy and back pain following a strict diet for blood sugar and no medication for vitiligo he suggests circumcision as the only option for penis skin problem I request your second opinion

hello I understand your concerns I have checked all the attached reports thoroughly attachments removed to protect patient identity and here are my notes repeated high post prandial sugar above 200 means that you are diabetic and need to start therapy do you have polyuria frequent urination do you drink water more than usual repeated cholesterol level above 200 along with fatty liver grade means dyslipidemia that requires management stress egg shows some changes that could mean some cardiac ischemia do you feel any chest pain especially with efforts if yes could you describe it all other investigations are within normal limits advice healthy life style that includes daily 30 minutes walk a healthy diet with low sugar starch and oily foods metformin 500 my after meals plus glimepiride amaryl my before breakfast for diabetes rosuvastatin 10 my once per day for high cholesterol a retinal fundoscopy and urine analysis for microproteinuria are required continue other medications you have follow up after one week regarding the penis problem I agree with circumcision I hope this helps

hi doctor I am feeling dizziness and vomiting sensation for over one week rest everything is fine periods are normal and just had periods ten days back I just had my blood test done kindly advise the possible medication and preventive health care I am attaching my complete blood report

hi based on your query and attached report my opinion is as follows most of the values are borderline normal early iron deficiency anemia manifestations through low mav and mchc are present however iron levels are normal and should get corrected within two months hemoglobin being the lower limit of normal it should not be the cause of the symptoms being experienced at present vomiting and dizziness sensation appears to be possibly local cause like gastritis or gastric reflux esophagitis proton pump inhibitors like pantoprazole with domperidone should be helpful in curbing vomiting irritation in the stomach or esophagus is known to cause dizziness I hope there is no tarry or black color stools if present it indicates bleeding in the stomach you need to reduce stress eat regularly and avoid spicy foods sleep should be regular and proper avoid lying down immediately after food at least for two hours also you need to concentrate on nutrition to improve borderline values take protein rich diet with green leafy vegetables two egg whites and vitamin rich fruits should help in improvement also maintain good hydration with at least five to six liters of water per day avoid coffee or tea if possible as it can cause gastritis and also reduce iron absorption for now pantoprazole with domperidone should be helpful along with lifestyle changes as indicated above I hope this helps

hello doctor my granddaughter is 17 months and one week old she was a term baby born out of a normal vaginal delivery she weighed keg during birth and was 8 keg when we were discharged from the hospital four days later she was exclusively breastfed for six months after which we introduced solid foods in addition to breast milk which is still continuing she is a very bad eater however we are managing to feed her protein rich food thrice daily using a lot of diversion tactics my questions are why her anterior fontanelle is still not closed still there is a little bit of space left she seems otherwise healthy and active and seems very intelligent in the way she grasps things through books remembering every single thing her weight also seems normal although she is not overweight or chubby is it normal for the fontanelle to still remain open a little bit I know it is supposed to close completely by 18 months but I am wondering if it will close in the remaining three weeks suppose it takes longer than 18 months to close is it fine please let me know

hi from what you mentioned your kid seems completely normal you do not have to worry you should add supplemental calcium and vitamin drops also by 17 months she should be able to walk warning signs that you should watch for are persistent vomiting fits or delayed motor development just follow up and the fontanelle will close within a few weeks I hope this helps

hello doctor I have been having back knee and foot pain and numbness for some time so I am wondering if I should see professional help it started about a year or more ago and then it was merely the lower left side of my back it would go numb for a brief time after riding for about thirty or more minutes however as time has progressed the pain has gotten worse and mostly the pain is in my left knee I own apartment buildings and I love working on the properties but it is beginning to wear on my body being a 53 year old male yesterday was especially hard because I was on a ladder a lot and it makes my lower back and left knee hurt when I use a ladder and I went up and down three flights of steps numerous times moving supplies from one apartment to another and it took its toll therefore today I am experiencing pain in my left knee on the side of my knee and in the back last night I woke up with a lot of pain in my left knee and it was a burning sensation but my back did not hurt as it usually does I had a baker cyst many years ago on this same knee and my doctor advised me to take it easy for a few days and take anvil once I did as he recommended the pain went away and until recently I have had no problems with my knee one more thing most of the time when I feel a sharp pain going through the left part of my lower back it makes my foot numb if I sit or lie down and pull my leg up to my chest it gives me a lot of relief most of the time if I am feeling this sensation in my lower back and it starts to go down to my left leg pulling my leg up to my chest for a couple of minutes will usually make the pain go away completely most of my time is spent about ten hours a day at my desk working and while my favorite thing to do is work on my properties I have to sometimes hire people because of spending so much time at my desk at one time about ten years ago I used to lift weights free weights and workout on a cross trainer for two to two and a half hours a day from monday to friday although as I got more responsibility for my work I started cutting back on the exercising and eventually gave it up altogether so I do not do anything outside of working on my properties for exercise and I hope to start lifting weights again and doing cardio because my waist has gotten up to a 34 and I want to stop it from expanding more however I am afraid to start any exercise routine before I find out what is going on with my left side the pain I am referring to is strictly from my waist down the leg and to my foot I have no problems with my right side and if a doctor recommends surgery it is not going to happen because I grew up with a dad that had perthes and I have seen how he has suffered his entire life and how many times doctors have replaced hips telling him this one is the last one only for him to have to go back over and over until he is finally in a wheelchair sorry there is one more thing my primary doctor has retired and I have not been sick in over seven years so I have no primary doctor to give me a referral but I have to do something about this pain thanks for any advice or ideas you can give me because I always worry it might be cancer because my grandmother died of osteogenic sarcoma I am currently taking vyvanse sawpametto vitamin magnesium and multivitamin

hello welcome to icliniiq com your symptoms back pain radiating in the knee and leg are suggestive of a bulging slipped intervertebral disc in the lumbar region which is causing irradiating radicular pain in the knee for this reason I would recommend consulting with a neurologist for a physical examination and a lumbar spine it computed tomography scan or mri magnetic resonance imaging study prolonged sitting position or weight lifting could be the cause of such clinical situation for this reason I would recommend having some rest avoiding prolonged standing up or sitting position and avoid weight lifting painkillers acetaminophen ibuprofen coupled with a muscle relaxant flexeril can help improve the pain local warm packs on the lower back and massage or physiotherapy can help improve your situation a nerve conduction study would help to determine the possible damage to your nerves you should discuss it with your doctor on the above tests I hope this helps bulging lumbar disc lumbar column it scan or mri scan nerve conduction study painkillers muscle relaxants and physiotherapy avoid weight lifting prolonged sitting or standing up position

hello doctor I think I have a counting disorder whenever I do certain work I do not know from where this feeling comes to me that I have to do that same thing several times until I get satisfied for example whenever I pick a book then I have to pick that book four or more times and sometimes 20 times another example is that whenever I wash my clothes then also I pull out the clothes from the bucket 20 times until I get satisfied is my case normal or serious please help

hi I am sorry to hear about your problem let me try to explain your problem in detail what you are describing is called obsessive compulsive disorder ocd a person suffering ocd has repetitive thoughts that are beyond control for example in your case it is this feeling of doing the same thing several times these are obsessions the act you do to feel better and get rid of these thoughts are called compulsions coming to the management the first thing you need to do is start cognitive behavioral therapy in which the therapist will help you recognize his thoughts and teach you techniques to control them and not get involved in this behavior the second thing is medication in severe cases medications are required this can be checked after complete evaluation medication and cognitive behavioral therapy combined are the gold standard treatment of ocd I hope this helps

hello doctor I have unprotected vaginal and oral sex with a sex worker three weeks ago I do not know her status of hiv although she said she is clean exactly after seven days of my exposure I feel something wrong with my body as it is feeling uncomfortable I had oral thrush loss of appetite swollen lymph nodes in neck body aches needles like pain all over my body night sweat although no fever but I can feel the temperature is high it is 98 9 degrees for the next couple of days so I suspected that I got infected with hiv due to anxiety I took the hiv antibody test on the ith day of my exposure which I know is a bit early come out negative but then on the 10th day exactly after days 10 hours I took hiv ran tea test on stdcheck com which they said 95 accurate in 1 days after exposure I got the result yesterday as negative no hiv ran detected now still I am in confusion because I am 100 sure I got infected with hiv I do not know if these tests are conclusive or not I do not have guts to do another test please help and also some of my symptoms are gone but I discovered some additional like pain in kidneys lower abdomen chest pain joint pain and extreme fatigue for two to three days

hi I have gone through the details and reports all the tests are negative is a good sign the chances of transmission of hiv by unprotected intercourse with an hiv positive person is too low if negative it is nil you can allay fears hiv ran per is negative and is a good sign it is almost conclusive the chances of tests coming positive later are nil but it is better to get tested for hiv and antibodies after three months to have conclusive results

hello doctor I have been experiencing a muscle spasm above my lip on the left side it is a rapid vibration that I can see when I look in the mirror and feel when I touch the affected area I do not experience any pain when the spasms are happening and I can still talk smile and otherwise move my face I first began noticing the issue last year the spasms seem to come and go for the past few days they have been occurring at night sometimes the spasm is still happening when I go to sleep but by the time I wake up the spasms have stopped last night I noticed the spasm started after a workout where my heart rate got up to 171 bum I have talked to a few doctors who have recommended magnesium and I have noticed that when I take 400 my per day dose the issue does not last as long that said the spasms are still happening I do not drink large amounts of caffeine never more than one cup a day so I do not think it is related to that a couple of weeks ago I noticed a similar spasm under my left eye but that only happened for a day and then disappeared completely last winter I noticed an eye spasm as well which lasted for a few weeks but then disappeared entirely my go did hba1c ash to free ok sedimentation rate magnesium basic metabolic panel and gor all results came back normal she provided me a referral for a neurologist and I am working on getting an appointment there are some long wait times so I am hoping to speak with a specialist in the meantime to get a little bit better of an understanding of what this might be

hi I can understand the issue it is basically the facial muscle spasm that you have in the classical pattern it involves larger areas of the face and not smaller area or single muscle the cause for it can be mild compression more of irritation than compression over the nerve which runs into the facial muscles the site of compression can be near its origin secondary to pressure from a neighboring blood vessel the less common cause can be viral involvement of the nerve in the ear for that you should be investigated with the torch panel viral screening test depending on results we can plan further management a short therapeutic course of steroids may help if it persists for a long time then botox injection into the muscle to inactivate it will help

hi doctor I am a 19 year old female doing mobs everything is really good in my life but I certainly do not understand the chit chat going on in my mind all the time I do not feel going when I meet people I do not like noise parties and going out but this was not the case earlier I like dressing up and going out for shopping now I do not feel like doing these things I just like studying and following my normal routine I do not want to be like this please help I am very anxious about my face as I have acne scars so I am always very conscious about them I just take medication for it I often have severe headache attacks probably migraine especially when I go out with my friends or hear a very loud noise

hello I am sorry to hear about your situation I can see that you are under a lot of stress what you are describing looks more like anxiety disorder it is possible that because you have been under a lot of stress for a long time mobs is a very tough field and even though you must be a good student it does take a toll on your mental health with chronic stress problems like severe headaches migraines social avoidance can occur I would suggest you to talk to a counselor and they will help you find out the negative thoughts which are causing this anxiety and this type of behavior and they will help you to cope up with them and be able to enjoy your life again either find a local counselor or you can opt for online counseling sessions with me via icliniq if these are severe you might require anti anxiety medications but as you have mentioned that you are able to function well I think they might not be required the counselor will evaluate you and take a detailed history and advise you accordingly I hope this helps

hello doctor I had a minor injury four weeks ago when my partner while on the bed accidentally hit my erected penis on the left side next to the frenulum under the head I had some minor pains here and there but I stopped all sexual activities I did notice a very sharp pain today after an erection only and the pain was at the same location of the injury as I wanted to feel if there is a lump I did feel something there at the same location I described above size of 2 millimeters please tell me if this will heal in a good way such as no scar tissue or bad way with scar tissue and peyearonie as my age is only 26 and I do not have any medical history or problems and the same for my family I do have varicoceles on my left nut sack grade I have attached a picture of the frenulum my questions are what will be the healing time and pain healing time what are the percentage of chances of developing or not developing scar tissue or peyearonie at this age will you recommend any medicines like pentoxifylline or anti inflammatory I am not taking anything now

hello I have seen the pictures if the trauma was at the level of frenulum then you can go for frenuloplasty so that frenulum will be freed from glans and there should not be any problem further peyearonie disease generally develops after trauma to the shaft of penis there is no recommendation to start medication for this prophylactically take some pain killers and anti inflammatory medicines so that pain and inflammation will subside early it may take three to five days

hi doctor I am a 30 year old male and I have been on cipralex 20 my for my depression for more than a year now when I started cipralex 10 my I was fine however when my depression worsened I was given mirtazapine 30 my and my weight increased like hell I gained 15 keg in three months mostly around my belly and hip I consulted you and my medicine was changed from mirtazapine 30 my to topomax 100 my I lost 10 keg in three months with topomax and stopped it eventually nevertheless my weight has started increasing drastically around the belly and hips I feel bulky and the tummy is growing out it is so embarrassing as I am a lean guy and with a belly protruding out I am going low on confidence I cannot leave my depression tablets but I cannot ignore my increasing weight either could you please let me know what should I do to lose this excess weight and get back to shape I cannot walk as I have a slipped disc problem I cannot go to the gym either as it is not recommended by doctors if on leaving topomax I am going to gain weight again then it is only a temporary solution further in spite of taking cipralex 20 my at night I am extremely sleepy and feeling tired all day I fall asleep unconsciously even while driving and working on the computer I have disturbed sleep at nite and the weight gain is another trouble I still feel I am depressed and cipralex is not doing all it can I need your help to tackle my depression sleepiness tiredness and my increasing weight please help

hello stopping topiramate is not the reason for weight gain in your case topiramate resulted in weight loss and the drug is also a good mood stabilizer drug this helps in stabilizing the mood and supplements the antidepressants so stopping topiramate probably result in worsening of depressive symptoms and thus altered food intake which consequently resulted in weight gain in my opinion you can start topirmate again and this will help in controlling the weight gain the drug will help in improving the depressive symptoms too so there is no harm in restarting the drug apart from this please change your dietary intake avoid any foods with refined sugars and high fat take high protein diets rich like meat and animal food avoid fried food totally lime juice in an empty stomach daily without sugar should be included in the diet please take at least a cup of green tea which will help to dissolve the belly fat this will help in making you fit again if you are feeling sleepy and tired then drugs like modafinil can be added to your prescription modafinil will help in improving alertness and will reduce your tiredness this will help in improving the depressive symptoms too so you can make these changes and you will definitely come out of depression

hi doctor I am 34 years old and I have facial droop in the lower half of the left side of my face it has been with me for years I would not call it a paralysis or bells palsy as I have full control of my forehead and eyebrows but the lower part when I talk it is noticeable that the lip from the left side is way lower and the nose as well seems lower from one side I was wondering what this could be all the searches online say stroke but I am young and never had any symptoms of stroke so what else could it be and what would you advise me to do

hello I would like to know some details about your symptoms when first time you noticed facial drop in left lower half face did it happen suddenly or it happened slowly and gradually did you had any weakness in left arm hand left leg along with had you any change in voice that time have you ever undergone some tests for its evaluation have you any symptom in left ear hearing difficulty ear discharge hearing abnormal sound have you any other significant medical history apart from this facial droop at what time this facial droop is most noticeable at normal forward face look while smiling while speaking while eating while laughing have you any difficulty in swallowing revert with above mentioned information and also I suggest to make a short video of your face in normal smiling speaking laughing and upload here as attachment mri brain ent ear examination serum ace level viral markers hiv hbsag anti hav antibodies nav bilateral facial nerve

hello doctor I had unprotected intercourse two days after my period the first time we used the condom the second time without and did the withdrawal method I took the action about one and a half an hour later I do not know when I was ovulating and did not think it could be my fertile week I started bleeding five days later and it was light and pink then has gotten heavier and turned red and moderate enough to soak a panty liner I have taken hit twice and both showed negative is this implantation bleeding or withdrawal bleeding

hello if it was your second day of your period and you take an emergency pill after intercourse that it is withdrawal bleeding and due to the tablet your period can be irregular this time and may take two to three cycles to get regularize and maybe the next cycle will be normal depends on your body own hormonal cycle if hit home pregnancy test is negative then no need to worry you are not pregnant and the second day of menses is counted as safe days of any cycle so you cannot be pregnant during that period because of no ovulation during menses drink more water and wait for your period and do not get much stress everything is fine and under control and if you get your period for three to four days and if you have intercourse two days after that also you had taken the precautions like condom withdrawal and at last emergency pill and it also comes in safe period so do not worry more chances that it is withdrawal bleeding and sometimes ovulation bleeding in both cases you do not have to worry because if it is ovulation bleeding then it is happening now and no need to worry about before I hope this helps

hi doctor I have a symptom of redness on my penis and with no pain and itchiness on it for the past one day can you please suggest me something I had unprotected sex due to condom break two weeks back with an unknown person for that I am taking tavin em and instgra medicine now for 28 days as prescribed by the doctor

hello I could not get the contents of the medication prescribed to you could you send the same with details I would be able to comment on the issue secondly get a forth generation elisa test done for hiv and six weeks and repeat the test at three months from the date of exposure along with hbsag and vdrl tests lastly is there any swelling in the groin region or any foul smelling or milky discharge from the penile tip

hello doctor I have multiple questions recently I might have been exposed to mercury vapor in a hotel room I was sleeping in for around 10 hours the room was small and the type of mercury was unknown I remember the one type of chemical was clear liquid watery substance and the other once was more clay grey with dissolved in water I left the room around 10 hours later and did not touch anything but I might have breathed in the vapors in this small room I also washed away the crystals that has landed on the carpet all of these substances I have no clue about what was except when I asked I was told mercury 5 months later I got a pins and needles feeling in arms and feet with has lasted a month but no other symptoms until now I feel like I have some kind of internal vibration in my feet and my knees are shaking when I stand up like I am freezing or have done a hard workout from time to time I went to the doctor in my area and told him about what had happened and showed him pictures of the various substances and I took a urine test and a blood test and this was made around 130 days after possible initial exposure and the test came back at normal levels but can it be that I had a toxic exposure and the mercury has already settled in organs and therefore do not show in blood or urine I am not sure about the half life times in these metals or can I settle down and accept the test results are final and that mercury levels do indeed declear that I have not had an exposure of toxic levels and that my symptoms might be of other cause if not number one is the cause then a few months before that I got an acute pins and needles feeling in hands and feet paresthesia which continued until today and it increased over the one month before it stabilized a little it went from pins and burning sensations different parts of the hands and pins feeling in the legs a few times I got shooting pain from a finger and up my arm but very rarely which has not returned after alcohol consumption one weekend it went from stabilized to worse and I also noticed my knees shakes a little when I stand still but not when I am walking the feeling can be compared to when you are freezing or after a hard workout on your feet it started with a sensation under my feet like I was standing on a vibrating phone and then moved up to my calves which felt like they were bubbling inside and now my knees which shake when I stand but the vibration under the feet is gone my hands also one week felt like they was shocked and they turned red and stiff the kind of feel like I put my hands down in hot water and then removed them red spots on my hands underneath the skin appeared and the closest thing I found resembling it was pura when I looked up causes online my hands are much better now but it still feels like some areas are sunburnt and my fingertips are peeling but I think that is because of winter and dry weather the red spots remains I have taken multiple blood test for vitamins deficiency and other things which turned out normal besides vitamin which was a little to low and neurological test like standing on one foot with eyes closed and finger pointing and sensation test of sharp cold hot which all was normal I am taking a mri next month to check for is and other conditions sorry for making this text so unclear and poorly written but I have no idea of what this might be so doctor do you have any ideas about what this can be

hello I read carefully your question and would explain that your symptoms are not typical of mercury intoxication anyway I would recommend performing nerve conduction to in order to examine your nerves and a brain mri in order to examine your brain as the neurological exam is normal I do not think it the brain mri will result abnormal a cervical spine mri may be necessary too in order to exclude possible spinal cord compression in this region due to a bulging disc

hello doctor I am a male 51 years old height feet inches balanitis problem an unpleasant smell redness around the glans inflammation soreness itchiness or irritation of the glans

hello if the symptoms have been present since a week did you take any medicines or cream for those did you start any antibiotic how is your personal hygiene can you take a picture of the affected area with retracted foreskin and send to me are you circumcised you need a course of ciprofloxacin tinidazole or ofloxacin ornidazole with some anti inflammatory medicines local application creams and lukewarm water rinses of the penis twice daily you may refrain from sexual activities till you get better please provide us more details so that we can help you better are you a diabetic is there any medical condition for which you take medicines regularly

hello doctor due to an accident I had unsafe sex I went to the pharmacy to get a epic or morning after pill however they said they were not being sold they prescribed althea cypriterone acetate ethinyl estradiol my 35mcg tablet from trust and said to take per day for the next 21 days however if I understand correctly is this a normal contraceptive I read some things about the yuzpe method how would this work with the contraception described and I already took one pill an hour ago what should I do I do not want to get pregnant especially since this is the 13th day since my menstruation I am getting worried

hi you should get emergency pills if they are selling normal contraceptive pills anyway in emergency pills the dose of hormones are more so you can take tablets two times a day for dose can also works same as emergency pills but at the same time you should understand that emergency pills are not 100 safe and there is up to 30 chance of failure but have only option after unprotected sex when you stop taking tablets than there can be withdrawal bleeding within days and your cycle can be irregular for or periods if you are not pregnant best way to confirm whether pills worked or not is to wait for 15 days atleast and do urine pregnancy test on kit and see if turns to be positive than you are pregnant and if negative than pills worked well do drink more water chance of failure is because pills worked by stopping ovulation but if ovulation already happened than it will not work so have to wait and watch after taking pills

hello doctor my dad has been on dialysis for years and has only recently been getting pounding headaches hour into dialysis he says they are pretty painful and it only occurs in his forehead and just to the right of the forehead it does not make him sensitive to light sound or any vision changes he was in the hospital a month ago for a left leg amputation and while in the rehab unit he had a seizure that we witnessed and it took him days to wake up from it the mri showed posterior reversible encepholopothy caused by very high blood pressure luckily he is almost 100 neurologically and memory regained I bring that up because only after the seizure and pers mri result is when the headaches started on dialysis he never had headaches before on dialysis prior to the seizure headache the doctors did not put him on any new medications after this and tylenol helps the headache greatly but it still bothers him and I do not like him taking tylenol almost every day he is on metoprolol 50mg extended release ex per day usually in the morning and his blood pressure is fairly controlled usually in the 130 70 however sometimes it gets high during dialysis I have an appointment with a neurologist in january as that was the first available any answers

hi having headache one hour into dialysis suggest either it could be related to transient increase in blood pressure or changes in electrolytes during this interval is his be monitored during dialysis and where do they stand one way to get around is by slowing the dialysis speed which will help in slower change in electrolytes and body fluid thus preventing fluctuation in be see if has be fluctuation during dialysis and his nephrologist should be able to help you metaprolol is also a migraine prophylactic medicine thus it should help with headaches there are other medications also but will discuss once we are sure its not related to be taking tynelol daily is not good it can cause rebound headache the day you dont take it limit its use to day or max 3 week and or max 10 month how is his mri brain now he had pres but has it completely resolved not just clinically but also radiologically is he on any anti seizure medication post seizure how was his eg is it normalized

hello doctor I get frustrated even for very small things I take too much stress before starting some work and thinking that it will not work and also my temper is becoming too high whenever I get angry I cannot control myself please help

hello I can understand it must be really hard for you to be in this situation what you are describing looks like an anxiety disorder there is nervousness in starting anything new because the mind has negative thoughts which overwhelm you and make you feel it might not work out and then the mind gets fixated on this pattern of negativity and you just cannot stop the overthinking which gives you stress and long term stress produces aggression what you need is to start psychotherapy via counseling psychotherapy cognitive behavioral therapy the therapist helps you find out where these thoughts are coming from and help you in changing these thoughts in and controlling them so that inside it is not produced in the first place second part is anger management where you learn some techniques to control your temper and also via therapy you will be able to find out the source of your anger I would need to talk to you in detail to be able to find out why you are having these thoughts after I take a detailed psychiatry history and evaluation you can find a local therapist or we can start therapy sessions online via video consultation if the problem is severe which we will be able to find out after evaluation we can decide whether or not you need medications I hope this helps

hi doctor about a month ago I had protected sex with a woman and unprotected oral sex with her as well then two days after that I had unprotected oral sex and fingered a different woman five days later I got a low fever of about degrees the following day I got chills night sweats joint pain and a bad fever about 102 degrees that broke that same night the next day I got a rash that covered my entire stomach chest arms and legs I went to the hospital and they told me they thought it was a viral rash the rash went away in about 24 hours I got an hiv ran and fourth generation test done ten days after the last incident and then I got another hiv ran and fourth generation test done again at 17 days from the last incident both came back negative I tested the woman that I had protected sex with using oraquick and she came back negative but I did not test the woman that I had unprotected oral sex with could this still be hiv I have never gotten a rash like that before in my life what are the chances that this could be hiv based on the two negative ran tests

hi see a rash does not confirm the diagnosis of hiv a rash is a very common finding in viral infection and you could have got the viral infection from your partners only luckily this time the virus was not hiv the fourth generation per tests are highly sensitive and hence you do not require any further evaluation I would hereby conclude based on the details that you do not have hiv I would also recommend you to avoid unprotected sexual exposures as well as to indulge with more than one partner every time you cannot be lucky like this time I hope this helps

hello doctor after a neck injury five years ago I get a headache every morning because of this I cannot sleep for more than five hours headache wakes me osteopath helps not more than one or two days please tell me what could it be experts whom I consulted do not know exactly what is the source of headache and treatment does not help

hi I feel really sorry for this painful situation you have to face after careful review of your detailed case I want to add that musculoskeletal insult is the main cause behind this pain and lifestyle modification is its main solution I will elaborate all of this in a very simple way so that you may come out of this pain and can sleep comfortably thanks for uploading all the supporting documents and I have thoroughly reviewed all of them fortunately your cervical spine and the surrounding structures bear no visible signs of major trauma that may have warranted immediate interventions by an orthopedist and neurosurgeons your cervical spine spinal ligaments and the muscles got extreme stress due to excess weight on them the spinal in cervical region is not made for weight bearing due to stress or strain caused by weight there had been a stretch and or compression causing a change in anatomical structures out there you need to change the sleeping posture and position your head so that there is a least possible strain on the cervical spine keep track of everything you are doing to modify sleep habits adopt the one that best suits you buy a mattress that is angle adjustable there are smart mattresses available in the market that makes sleeping a bit comfortable for the cervical spine patients and the general healthy population too at the same time they are temperature controlled too so if you need to provide heat to the body they help doing it with the click of a button first try sleeping without pillows underneath your head try sleeping straight supine position your whole body facing upwards then try sleeping on the right side then on the left side of the body it is only you who can tell which ever suits you best then you may try keeping a soft pillow under the head if it hurts again you need to try the angle adjustable mattress and try different angles every night keep track if raising the angle soothes you or decreasing the angle is a better option for you meanwhile physical therapy is my advice for you please consult a physical therapist for proper evaluation and management accordingly it will assist you in getting out of this pain very fast you may use heat wraps around the neck to soothe the deep neck structures it alleviates the pain and improves circulation keep a balanced and healthy diet and avoid stressing your spine out by spending a lot of time in front of to laptop smartphone etc these are bad for your cervical spine as they all make the neck stiff at a certain angle if required

hello doctor I am a 31 year old male I have been diagnosed with crohn disease before years and I have been on humira 40 my every two weeks I had unprotected sex with two different girls a year ago I have had done three hiv tests and one hiv comb elecsys at 10 months from the last possible exposure after a few days of the first possible exposure I had flu after a few weeks of the last possible exposure I started to have some skin condition sebopsoriasis around my mouth and under my armpit I am also losing some muscle weight all my hiv and elecsys test results came back negative my questions are my tests reliable does crohn disease affect hiv test results being on humira will it affect hiv tests does humira cause a false negative also I know that sebopsoriasis is associated with hiv is there any other tests I have to do I am under huge stress I need your help

hello going by your description it seems highly unlikely that you have contracted hiv infection the elisa enzyme linked immuno0sorbent assay detects antibodies to hiv antigens whereas the comb test detects both antibodies and antigen since you have done these tests much after the exposure I believe there is a little chance that you could be harboring hiv infection the rashes you have developed are more likely to be a part of crohn disease syndrome progression humira although may suppress the production of antibodies it does not affect the detection of hiv antigen crohn disease has various non intestinal manifestations that could crop up anytime I believe the new rashes are a part of crohn disease syndrome complex

hi doctor for about two years I have constant problems with my hand skin there are spots on my hand where my skin gets extremely dry to the point where it peels sometimes even cracks and bleeds it regenerates quite quickly even deeper wounds heal in three to five days I consulted several dermatologists here is what I was able to confirm so far it is not a fungal or bacterial infection it may be a blood vessel problem smoking tobacco seems to make symptoms more severe more peeling and cracking the problem occurs only in few places on my hands mainly index fingers and right thumb please see attached photo cream with urea content seems to give the best effects barrier creams did not help diet does not seem to have a noticeable impact on my condition silica q10 and collagen supplementation did not help sometimes when my condition gets a little better and there is no dried peeled of skin on my hands small red dots are visible just under the skin one of the doctors mentioned they look like burst blood vessels they are visible in one of the attached photos please suggest

hi from the pictures it is looking like hyperkeratotic eczema over palms it is a kind of dermatitis and not related with any blood vessels it can aggravate during winter seasons treatment includes judicious use of moisturizer and along with mild potent steroid in case of any erythema apply moisture cream on the whole palms twice to thrice daily apply halovate habbetasol propionate cream apply only on the erythematous or fissure areas if any daily night for one month

hello doctor I am a 25 year old female my mi is I am a non smoker with no ongoing conditions like diabetes I am not breastfeeding and have never been pregnant I developed mastitis very suddenly about three weeks ago by that evening I was in a and with a lump the size of an egg in one breast I was prescribed codamol and 500 my flucloxacillin a day after the first course which was 10 days I saw the doctor again as the lump had reduced to the size of a large grape but was still painful I often had fevers and I felt unwell doctor put me on another seven day course of flucloxacillin and booked a breast cancer screening I just finished my second course and I am still in pain with lump still the size of a small grape and still feel ill and feel like I am getting worse again breast is back to being red and swollen my only option to see a medical professional before my breast screening is to wait for several hours at an urgent care clinic after work should I try and get more antibiotics if so should I insist on getting a different kind also please be honest I know there is a chance it could be ibn but as a young healthy childless woman is it actually likely that I should prepare for bad news or not

hello let me assure you that there are no cancers which come suddenly and settles with antibiotics one breast cancer which progresses over a few period is inflammatory carcinoma of the breast but it does not come in days and settle with antibiotics you have a breast abscess that settled with antibiotics and some times a part of it gets walled with fibrous tissue were antibiotics do not reach it is called antibioma I would suggest you take linezolid 600 my twice a day as there are chances of resistance to flucloxacillin

hello doctor for someone suffering from anxiety ocd intrusive thoughts this person was on my of cipralex for quite a few years then about months began a change of medicines about 7 in this time finally this person was given 25 my fluvoxamine first days everything was fine then anxiety attacks started as of last night dose went up to 50 my result is the person is feeling calmer however they feel very disconnected and cannot do anything cannot concentrate cannot think or analyse things I forgot to say that when they started fuvloxamine they stopped the drops of cipralex we do not know what to do tonight whether to stop this fluvoxamine and go back to cipralex or whether to keep going and maybe these side effects will stop if so how long aproximately we are very confused and cannot get hold of the psychiatrist that prescribed this please if some doctor there is an expert on these meds and there side effects that could help us a lot of these medicines and maybe all give strange and serious side effects that are not listed by the pharma companies

hello I can understand your concern as you have mentioned that the patient is feeling better with this medication I would suggest you to continue 50 my fluvoxamine for atleast another to days and see if they feel okay fluvoxamine has a sedative effect and that is why the patient is feeling all these symptoms of not being able to concentrate or do anything etc I would suggest you to take the medicine before sleeping 50 my is actually a low dose so you should not be worried continue same dose for a few days and see if body adjusts sometimes if anxiety is under control with fluvoxamine some medicine can be added to prevent the side effects secondly you have not mentioned details of the patients age etc I would suggest you that if possible patient should start therapy as well medications and therapy when combined give faster results take care of yourself

hello doctor I always had a lower left brow causing the lid to appear more droopy than the right side however the skin on the left side has recently become thinner in the past year I would say causing less of my lid to appear and I feel a sensation now on that eye like something is sitting on my lid I am only 18 so I feel like I should not be having any issues with my eyes yet however I did have hashimoto and thyearoid cancer and got the thyearoid removed and all of my thyearoid levels have been stable since then however the skin on my left lid never went back to normal also I feel like I might have a little bit of ptosis in both of my eyes but it does not obstruct my vision when I look back at old pictures when I was a baby up until the age of 12 my eyelids appear much more open so is it normal for eyelids to droop as we age I am currently on synthroid

hi you have explained your history nicely you have not mentioned about photos both are recently taken or different in the photos attached first one which is showing your lower lids down seems to be taken in a slightly down gaze that is a normal thing when we look down lower lid goes down with the eye while in the second picture light reflex is central in both eyes and lower lids are in normal position your both upper lids are in a normal position normally upper lids cover 2 my cornea superiorly I would not say these as droopy lids while in cases of thyearoid disease skin changes occur like skin thinning and dryness so these sensations could be due to hypersensitive skin for dryness of the skin around the eye or dry eyes you can use artificial tears it seems you are thinking too much about it no significant changes are seen in your eyes or lids after seeing these photos just relax nothing to worry about and you are absolutely fine if these are older photos you can send the latest ones and do not take photos yourself selfies because it is not taken in primary gaze looking straight I hope this helps

hi doctor after shaving my face six days ago I saw a big red bump on the right side of my nose above the mustache at first I thought it might be a pimple last week I felt something wrong on my throat and visited a doctor said lymph node inflammation and prescribed me penicillin doctor did not ask me anything about that red bump in my mustache area at that time I have been suffering from mild fever as well after my lymph inflammation right now I am worried again since the red bump on my mustache becomes large and from two or three openings drains watery liquid when I tried to squeeze it is really painful and irritates a lot I am worried about hav since it is near my mouth I am having mild fever and lymph infection I am not in sexual contact for the last seven years what is your suggestion what might cause this problem

hello welcome to icliniq com two broad differential diagnoses are folliculitis or hav herpes simplex virus infection most likely I would want you to know that we all are exposed to hav and it could spread without sexual contact it stays in the ganglion nerve endings and pops up when your immunity goes down it is also known as fever blister my feeling is that since you were about to come down with the sore throat which seems like strep throat you had a reactivation of the hav and got these lesions as you feel better they will subside you may use acyclovir if you want but usually we treat the underlying cause and you are receiving the antibiotics for sore throat please do not squeeze it you can use any anti inflammatory agent for pain and fever like acetaminophen you can also try topical steroids like desonide I hope this helps

hi doctor I had unprotected intercourse but no ejaculation was done I have a fear of being exposed to hiv what necessary steps should be taken earliest

hi unprotected sexual intercourse is a risk factor for studs sexually transmitted disease including hiv however the risk is very low 03 there is no reason to panic at the moment if possible please get the partner tested first if she is a known case of hiv then it would be advisable to consult the nearest dermatologist for post exposure prophylaxis pep in case if this is not possible it would be advisable to weigh the risk benefit ratio for pep in your case high risk exposures such as homosexuality contact with blood during intercourse sex with a commercial sex worker may warrant a need for pep hiv by elisa at and months after exposure hbsag hepatitis virus antigen anti hav hepatitis virus vdrl veneral disease research laboratory if high risk exposure then consider pep

hello doctor I am 34 years old and diabetic my penis foreskin is not pulled back it is swelled and tears on the tip of foreskin are not healing and are very painful penile glans has white discharge

hello the diagnosis seems to be something called candidal balanitis or fungal infection of a part of the penis are you married and if so does your spouse experience any discomfort or white discharge this information will be helpful to plan the treatment for both of you simultaneously so that we can eliminate the chances of ping pong infection and recurrence

hello doctor I am a 32 year old male one month back I checked my be it was 120 90 mhg and today again I checked it was 140 90 mhg both were done in doctor clinic I did blood hemogram and cholesterol tests everything is normal two years back I did us of full abdomen it was normal in my family my mom is having a high be due to which she is a cod patient and on dialysis that is why I am a bit concerned whether this be figure indicates that should I start the be medication I have changed my food habits kindly suggest whether I should start the medication so that it does not affect me in my later life as my mom

hi blood pressure is different at the same time by different machine or the instrument used previously now regarding the value of blood pressure it is not mandatory that the value is fixed it is different for different people of the same age but it depends on weight height food habits regular work out etc take a low salt diet and avoid pickles family history did not count but you can prevent it by changing the lifestyle I regularity in food habits exercise etc avoid consuming alcohol stop smoking if you do avoid or decrease the non vegetarian diet as it may increase your cholesterol levels and leads to atherosclerosis heart disease kidney failure etc in nutshell all organs may be affected do not start blood pressure tablets as 120 90 and 140 90 mhg does not make any big difference the upper value is called systolic pressure which up to 150 160 is no worry and the lower value is called diastolic pressure in which 90 is the lower limit of high blood pressure I hope this helps

hello doctor every year during summer and winter I face problems with continuous cough irrespective of the type of food I consume I am having an allergy to both dust and smoke I got a lot of gas generation and irregular motion again irrespective of the food I take I am a 51 year old male with a family history of asthma I am not under any medication

hi such type of cough is called allergic cough which occurs in a particular time gas formation is due to irregular bowel habits advice hot saline gargle before breakfast lunch and dinner stop fried things it enhances the problem are you hypertensive check out your blood pressure also treatment tablet azithromycin 500 my once every day for three to six days nexpro red 200 my one before breakfast and dinner esmoprezole plus sustained released domperidon for three days one before breakfast for five days or whenever required for irregular bowel habits take one bowl of salad in the morning and evening add curd in lunch take buttermilk in the afternoon it is very good for health take husk isabgol three teaspoons full at night with milk it is a herbal remedy good for the intestine also it forms a slimy layer and protects the mucosa of the intestine you can take it in the morning also cough syearup again produces irregular bowel habit amrodil plus one teaspoon full at night is sufficient I hope this helps

hello doctor this is a request to analyze my mri report I would expect detailed guidance with what kind of treatment we have to proceed what is the prescription for the condition and how long to use the prescribed medication please reply with the prescription as soon as possible please let me know the cautions and care we have to take

hi I can understand your concern I have gone through the report you have attached you need urgent immobilization of knee by cast or slab along with painkiller and anti inflammatory drugs the next step is an arthroscopic correction surgery for all anterior cruciate ligament repair I hope this helps

hi doctor last week I and my partner had a romance I did everything expect for the penetration of my penis into her vagina at last I was masturbating outside with my hands when the sperm came out it spills out over her legs and also near to her vagina so we got scared that if sperm spill over was only outside her vagina incase if the spillage over her vagina was only outside means will it cause pregnancy if it causes pregnancy means what are all the symptoms immediately or with in a week if in case pregnancy means how to stop now please tell us if there is any solution for our safer side to keep us without fear when the period will stop incase of pregnancy please help

hi pregnancy can happen rarely in the scenario you described there will not be any immediate symptoms of pregnancy the earliest symptom is missing the next expected period you cannot do anything to stop the pregnancy right now if she misses her period she can confirm pregnancy at home by doing a urine pregnancy test if pregnancy is confirmed you can consult a gynecologist for abortion through medicines in case she becomes pregnant she will miss her next expected period remember one thing pregnancy is very rare most unlikely in the scenario you described so there is no need to fear just wait for her next period and things will become clear by then

hello doctor I have recently got married and moved abroad when I was in india last time we got the medical tests done and diagnosed with diabetes hba1c of 10 and fasting blood sugar as 235 doctor gave me cetapin or 100 my and asked me to use it for three months and get the medical test done I have got the tests done and now the hba1c is 4 and fbi is 124 my do with total cholesterol 173 103 is bad cholesterol 47 is good cholesterol and rest is vldl I have low vitamin of 18 doctor asked me to continue cetapin or 100 my for another three months and gave me medication for cholesterol lipitor 10 my every night and vitamin do 50 units once a week for three months I have attached the medical reports please look into it and let me know your feedback

hi I went through your reports and your hba1c glycated hemoglobin has improved really well I am happy about that as advised by the doctor continue taking cetapin the same dose but as of lipitor is concerned I think only my is sufficient in addition you have to reduce nonvegetarian food avoid alcohol butter cheese and potatoes eat more vegetables hope you are exercising every day continue vitamin supplement weekly once for three months repeat hba1c and lipid profile after three months and revert back with reports

hello doctor I wanted to know about my wife eye condition two doctors have said that she has keratoconus and another doctor says no it is not that

hello it is very difficult to comment without examining you kindly send me your topography reports so that I may study them and guide you

hi doctor my son is thalassemia major subject his age is months male boy his weight is he is suffering from headache and fever every now and then some times heart beet is fast his liver and spleen are enlarged he has been blood transfusion in one time in last week now he is taking folic acid 5mg flovita a tablet 2 per a day kindly suggest if he needs to take any other precaution can you please provide a diet chart for my child which can help him to grow up his body

hi he is suffering from thalassemia major here there is destruction of the blood cells due to which haemoglobin becomes low frequently hence he will need blood transfusions regularly he is prone for infections because of low haemoglobin which can also cause fast heartbeat and cardiolmegaly increase in size of heart and tiredness hence please consult a good pediatric hematologist who will make a monthly follow up plan for your baby and monitor his growth haemoglobin levels and start appropriate treatment based on his health condition and reports continue breast feeding the baby you can give the normal weaning food rest will discussed by the hematologist in detail his low weight gain is due to the low he mainly and not related to food if his haemoglobin is monitored and maintained at near normal levels his growth will improve

hello doctor I have a fracture of the bone joint on my right hand ring finger which was caused by a road traffic accident were I was hit by a van pulling out of a side road I was due surgery to repair the injury last month the surgeon decided not to operate as under the live ray he was able to manipulate the bone back into the joint therefore asked physio to splint the finger the issue is each time I take the splint of to clean the bone is back as fracture and am not able to bend my ring finger I am due to see my surgeon as the splitting is not working any advice of what I need to ask my surgeon to do is most appreciated

hi well there is intro articular fracture of base of middle phalanx of your ring finger if I would be the surgeon then I would have gone for operative treatment because intro articular fractures need perfect reduction if he has decided to treat it non operatively then he could have applied plaster or strapping which is not removable like your current splint

hello doctor continuous dizziness losing balance could not sit or stand for more than few minutes age 65 height 2 weight 20 lb

hi your mri spine reports osteophytes at multiple spinal levels along with bilateral neural foraminal stenosis at ca c7 level these cervical changes though can cause dizziness but persistent imbalance is not usually seen with these spondylotic changes if you would have presented to me as an outpatient I would have asked you the following questions to answer your query well do you have history of double vision do you have history of hearing loss or tinnitus please follow up with answers to these queries meanwhile please start taking tablet tryptomer 10 my once a day at bedtime tablet pregalin 75 my twice a day tablet calinept once a day please take medicines under a physician guidance only

hello doctor is kissing babies really deadly I am sure you have seen the story in the news today about the newborn baby who is in critical condition after contracting meningitis from someone kissing her according to her mother I am working on a follow up story on whether parents really do need to shield their babies from kisses contact with other people specific questions do new parents really need to worry about someone making their baby very sick by kissing it how common are occurrences like the ones in the news today what should parents allow not allow in terms of people having contact with newborn babies

hi I do not recommend kissing a new born baby firstly a newborn baby immune system is not fully developed and is prone for infections secondly contact with the baby can transmit many types of bacteria and viruses which can cause various infections hence hand washing before touching the baby handling only by mother and a couple of caretakers is ideal when a baby is kissed there can be transmission of various bacteria germs which are normally present in the mouth of people these generally do not cause any infection in healthy people who have a strong immune system but these can cause infection in people who have low immunity and newborn baby is one among them kissing cannot cause meningitis per se but can transmit few bacteria which can first cause a mild respiratory infection which can spread to brain especially in low immunity people like newborns kissing can transmit viral infection like herpes simplex and infectious mononucleosis hence it is better to avoid kissing the baby especially by friends and relatives etc even parents should avoid if possible

hello doctor I have a big scar in my right thigh that has led to a contracture with little flexure on my knew joint for over ten years I have recently underwent a corrective plasty release but with only little gains in flexure the doctor said the contracture had develop a fibrosis that needs to be removed is there any non surgical method of releasing fibrotic contracture

hi from what I can see in the pictures is that you have got a massive tissue loss over your thigh and that too over such a long period that it has gone for severe contracture only the plasty will definitely not give you enough results as your doctor has suggested you will have to go for complete removal of the scar and fibrotic tissue with reconstruction by a large free flap before that few investigations will be required which will give the idea about how much post op benefit you will be gaining non surgical methods are there for removing the fibrosis but definitely not for such a massive one ray of the knee and hip mri of thigh region vascular doppler of donor vessel for a free flap scar and fibrosis excision with reconstruction by free flap

hello doctor I took a banana shake and started feeling imbalance so I came back home because of restlessness imbalance and palpitations I vomited that night so the next day I went to the hospital there intensive care doctor said it is due to high acidity at that time my be was 150 90 mhg and pulse 10 bum that imbalance subsided in some time and then it occurred once in a week if there is a little bit of anxious environment it will come back since then I had been to cardiologist my psychologist and ent all of them brought it down to anxiety I had done all blood tests ray and mri of neck there was ca budge in mri and mild scoliosis in ray rest all tests were normal my symptoms are imbalance during sitting and walking feeling best in moving vehicle heavy head like a tight band at the back of head restlessness and have started physiotherapy with some relief physio is saying nerve compression due to spondylitis so he is giving ultrasound neck traction and neck exercise and said I do have bad posture too what is it exactly

hi I have gone through all your records symptoms like imbalance while sitting and walking with head heaviness restlessness and palpitations with stress precipitating them indicate a non organic or what we call as a functional problem I nothing wrong with hardware a little software issue nothing to worry at all I have my reservations for associating vomiting with your functional problems which I feel may be due to gastritis you do not have any issues with your neck please avoid traction to the neck even if you are feeling better with physiotherapy since there is no evidence of any root compression in mri magnetic resonance imaging I feel what you can start is amitriptyline 10 my every night for a month do regular yoga and mindfulness meditation these things will definitely help you do not be preoccupied with your illness you are absolutely fine if you have underlying stressors you can contact me

hello doctor we are four sisters and I am the first daughter to my parents I have taken treatment for depression before years I am now happy and my studies are going on my sister is studying 10th grade and she was also a black belt in karate now she is mentally disturbed and thinking about her self not concentrating on her studies and she wants to stay alone she is writing on papers on the wall or otherwise writing on notes like why I was born I want to die she is having this problem for the past six months please suggest solution to solve this problem

hello I read your query and understand your concerns first of all I feel your sister is suffering from the same depression for which you got treated in the past the possibility is very high as there was a similar problem in genetically related elder sister I mean you as the presence of family members with depression increases the risk of depression among other family members I must acknowledge that you do not need to feel anything wrong as the genes are at fault and not the family depression as a diagnosis is based on the fact that your sister have poor academic performance at a time when we expect better performance board exams in addition the social isolation and preference to stay alone indicate depression as people with depression lose interest in almost all activities especially the pleasurable ones the presence of expressed wish to die is another thing which indicates the possibility of severe depression in my opinion it is urgent to seek help from a psychiatrist you may argue that I am a psychiatrist and I must handle the case but the presence of suicidal ideas points toward need of urgent and personalized care and online help is not sufficient I hope this helps

hello doctor a few months before I felt burn and pain in the chest area when I swallow anything like my own saliva it lasted more than a week and again I felt normal again yesterday I started to feel this pain and I started to think about that and felt stress tonight when I swallow anything I feel this chest pain and burn and when I do not swallow also I feel pain in the chest area is it serious and should I worry about that when I searched on the internet it says big diseases like esophageal cancer the symptoms say difficulty in swallowing coughing and things and now I feel like I am feeling all those symptoms please help

hello the symptoms you have been experiencing such as difficulty in swallowing and burning pain warrant a more extensive study with barium studies in which you swallow a material composed of barium and then you will be radiographed the esophageal structural pathologies are going to be demonstrated by this way such as strictures and endoscopy to have a more clear view of esophagus and stomach gastroesophageal reflux which is the backflow of acid into the esophagus is the most common reason and it can be treated easily with medications gastritis or pyloric infection needs to be treated with specific medications ubt urea breath test is required to rule out pyloric infection the results of the aforementioned test are required to make a definite diagnosis however esophageal cancers are extremely unlikely given the duration of your symptoms and your age I can assure you in your age most common etiologies are esophageal spasm and strictures former can be treated with calcium channel blockers and antidepressants and in case of strictures endoscopic dilation can be done to relieve the pressure

hello doctor I broke my nose in kindergarten I am 26 right now and just now realized how my facial features are not symmetrical how much does a broken nose affect that as you can tell my right side of my face is more laid back and natural looking even my mustache above my lip and my left side looks more tight and my mustache and lip does not match the right side what causes this

hi definitely there is a whole lot of asymmetry as you suggested because of the old broken nose I can also see that the base of the nose is a bit too broad and gives a feeling of oddly joined fractured segments this can be confirmed by few rays further correction if this is as well simple we call it osteotomy and splitting that will give you more symmetrical looking sleeper nasal dorsum it better if you can get yourself examined by a board certified plastic surgeon

hello doctor after sex with my partner I am feeling pain in my penis and my tes are also too small I am feeling weak after sex

hi I read your query and understand your concerns first of all I like to inform you that your question have a lack of details and this will limit my response to generic one rather than specific applicable to your problem the pain in penis after sex is indicative of infection if it occurs up to 24 hours or more if the pain was immediately after sex most probably it was due to vigorous sex in there former condition you need to get blood investigations and urine examinations such as abc complete blood count urine microscope urine culture and sensitivity if the later condition applies to you a simple rest for a few days will resolve the condition on most occasions regarding smaller tes I will suggest semen analysis this will reveal the amount of sperm produced and thus the measure is tests capacity weakness after sex is non specific and indicates your poor health the abc test advised above will assist us in this I will request you to eat healthily and do regular exercise I hope this helps

hello doctor I have had a clear wart looking things pop up on my genitals for a few years now never many I just burn them off and all is fine however a few months ago I had three darker color things popped up and I burned one off but it did not heal fully it actually got bigger and redder and more painful I have attached a picture can you tell me what I am dealing with here please

hi I have seen the picture this does not seem to be herpes genitals in case of herpes you would have got vehicles that would burst to leave erythematous erosion these can be verruca plan variety of wart the second one looks inflamed use antibacterial cream for it between I hope to burn them of means getting them treated medically

hello doctor I have had an sad for 30 years but it occurs only on the surfaces for every four or five years and only under much stress I was able to photograph it this time but still cannot see a doctor for a couple of days I am afraid it will vanish again before I see a doctor the bumps are in clusters of three on my shaft it lasts for two or three days and then goes away

hi I have seen the photo attachment removed to protect patient identity it is herpes genitals is it associated with itching or burning sensation does your partner suffer from a similar problem how many episodes per year if you have recurrent episodes you should consider oral antiviral medication standard treatment for herpes genitals is tablet acyclovir 400 my three times a day for seven days after meal rantac 150 my before meal twice a day fusidic acid cream twice a day can be applied partner treatment is a must avoid sexual contact in case of recurrent episodes patient is given suppressive therapy for more than seven days with a low dose you said you have sad for 30 years means have you done sad profile before if not you should get it done in herpes genitals vehicles appear on the genital area commonly on the glans or shaft of the penis which burst even without touching leaving small clean looking ulcers which usually heal within seven days it is associated sometimes with itching or burning sensation

hi doctor I had some vocal fatigue for a while and I have been resting my voice for pretty much one month now I was not so sure if I should start speaking again or not I am a bit afraid if it is going to affect my singing voice either way the first time I consult an ent they said I had hemorrhagic patches on my anterior one third of both of the vocal cords I have been drinking a lot of water and also I took some proton pump inhibitors I also have a phonatory gap but I do not think that is the problem here really anyway I was just wondering how much time do you think I still have to keep resting

hello I assume that these videos are one month prior to today condition I see some amount of inter arytenoid pachydermia suggestive of acid reflux and associated changes in the posterior part of vocal apparatus and anterior phonatory gap although I cannot see the anterior one third of the vocal cords that clearly I understand that your ent has found that those portions had some hemorrhages he was right in advising you voice rest and proton pump inhibitors ideally a week of absolute voice rest is sufficient followed by voice restriction vocal hygiene antiallergic treatment nasal sprays based on nasal symptoms increased hydration etc now considering you have taken a month of voice rest I think it is sufficient but do you have any symptoms whatsoever now any nasal symptoms or allergic symptoms any history of substance abuse do you suffer from diabetes or hypertension in my practice in addition to antireflux pi tablets antiallergics antihistaminics like fexofenadine allegra deslor etc hydration voice rest dietary and lifestyle changes I add some voice therapy probably you should explore some vocal hygiene tips from a speech language pathologist or voice therapist

hello doctor I have some pain due to injury last week I was at a construction site and marine plywood that is used for construction fell and hit me on the back of my head my head is fine but my upper back is still in pain and chest also I did not fall down when I was hit but the impact pushed my upper body down and forward I think beyond normal that is why I am getting back and chest pain I did not go to the hospital because I do not feel the need I am sure they will just tell me to give time and take pain killer can I get your advice is it possible I fractured my spine what should I do I am just taking ibuprofen pain is not very bad I am still doing things normally and I can move I am just wondering why I am still in pain after one week can this be a fracture please advise

hello it seems that you have suffered whiplash injuries this is common following high energy impacts on the upper body from the mechanism you described it seems unlikely to sustain a fracture however it is very difficult to be certain without clinical examination and rays how is your pain is it tender at any particular spot is the tenderness is on the midline of your spine or on the sides pain directly in the midline with a particular spot of tenderness is something I would recommend that you get an ray the fact that you are otherwise moving and carrying on with life normally is reassuring however unfortunately whiplash injuries can take many weeks to settle with regard to the chest pain it is possible that the injury might have caused a crack in your ribs rays are not very good at showing this the treatment in any case is rest and painkillers I hope this helps

hello doctor I try to help a mentally limited woman of 36 with as complaint from which the egg is not clear I have a photo of her egg it seems inferior wall ischemia or nstemi I try to get her examined but difficult to explain to her please can you help in reading the egg

hi I have gone through the attachment yes definitely there are ischemic changes in the inferior wall as well as lateral wall suggestive of ischemia if possible do give her an antiplatelet agent like aspirin and clopidogrel after consulting the local physician better still take her to a cardiologist

hello doctor I am having knee pain how will I manage it

hi your knee pain could be due to many reasons but common ones are chondromalacia pain due to knee instability inflammation due to an underlying pathology or just degenerative joint disease etc what was the cause of onset of pain in your knees and what has been the total duration of your symptoms apart from pain do you also have any associated swelling skin redness or any other local inflammation like skin warmth etc as well what management and investigations have been done until now by you for the existing problem if there is no history of any injury and no inflammation or infection like swelling skin redness or local warmth on touching then I will like to advise you for conservative management initially in form of intensive physical therapy with a focus on strengthening of quadriceps and stretching of other groups of muscles gentle anti inflammatory medications like etoshine or paracetamol for five to seven days usually helps in such cases take according to your body suitability adequate calcium and vitamin supplementation as per requirement ice packs at home three to four times a day and see how it goes for around two weeks time if your condition does not improve then we will have to get certain investigations done

hi doctor I am 29 years old I never had intercourse before I was dating and my partner did oral sex and fingering for a few minutes I am not too sure if he had semen on his hand or his hands were clean I am really worried if this will lead to pregnancy I am feeling stomach cramps on and off after that please advise

hi welcome to icliniq com please tell me when was your last period pattern and cycle length so that I can tell you about the chances of getting pregnant if you had the act before a week it is too early to detect pregnancy please share the period details for further guidance

hello doctor I have a abdominal pain in my left side it is not acute and continuous but when I sit or stand for a long the pain arises my doctor prescribed banocide and ultracet tablets

hi there could be many reasons for the problems you are stating so to know exactly what is the cause of pain many more questions need to be asked I would like to know exactly where on the left side does the pain occurs is it below the ribs or lower than that do you have any change in taste or acidity does the pain also go to the back what is the color of your urine any other problems like loose motion or vomit do you have a fever these questions will help me come near to the diagnosis and then with relevant tests we could come to a confirmed diagnosis as far as the medication that are prescribed to you I would like to say that both of them are strong pain killer which are given for problems like kidney stones but they will not cure the problem so the diagnosis is a must to find out what is the problem with you in order to give you the correct drugs

hi doctor I have got a skin problem in both armpits due to scratching the skin was torn the images are attached please help

hi I have seen your query and concern with your descriptions and given pictures it seems initially you have tina corporis of this area due to the application of steroid containing creams like quadriderm or salim lotion or foderm now you developed eczematization this is my assumption since you have not sent detailed treatment history or it may be irritant contact dermatitis due to duo now I can make severe eczematization so I would advise you not to apply any such thing if you have applied in the past start applying mometasone plus sertaconazole twice daily over the affected area for seven days then stop mometasone and continue sertaconazole also take terbinafine 250 my once daily for 21 days and cetirizine once daily for five days get review after five days with detailed history

hi doctor I am suffering from neck pain for over three weeks now I got an mri done two days back but must wait for my results for a couple of weeks I have the images of the mri and would like to know is there is any disc herniation or anything else wrong with my cervical spine would you be able to have a look at it and let me know if everything is fine I am in a great deal of pain and just want to know what is wrong with my neck

hi I received your neck mri images and saw it now there is a loss of cervical lordosis straightening of your cervical spine there is squaring of the vertebral bodies signal changes in the bodies suggestive of marrow edema more at levels ca c5 ca and c7 the discs are hyperintense on both to and to suggestive of calcification early syndesmophyte formation at c4 c5 levels the height of the disc spaces are maintained there is no disc herniation there is no cord or root compression well this was the scientific description of the set of images you have sent me the message for you is stated below the good news is that there is no disc herniation or budge and pressure on the cord but there are changes suggestive of the inflammatory changes in the spine at multiple levels and that is the reason for your pain in the neck regarding inflammation my first impression would be an autoimmune disorder called ankylosing spondylitis we need to do several lab tests to catch the diagnosis the most important being ha b27 assay the others would include the ear erythrocyte sedimentation rate cop reactive protein ra factor rheumatoid factor and anti cop anti cyclic citrullinated peptide antibodies the results of these tests would find the cause of the inflammation regarding treatment the primary or first line treatment of all the inflammatory disorder is common nsaids like ibuprofen thrice daily after food along with this you should take pantoprazole 40 my one tablet before 20 minutes of your breakfast if ibuprofen causes uncontrollable heartburn you can go for other options in said group going through the tests is required to establish the cause of inflammation in case the nsaids does not work further treatment depends on the cause also the ear and cop levels help in monitoring the response to the treatment with nsaids I hope this helps

hello doctor I would like to know the substitute for melacare cream as I got the look after using the cream and want to stop it

hi why was it prescribed to you wat was the complaint how long did you apply because it also contains steroid and should not be used for long time you should use sunscreen daily safer option like kojiglo cream can be used

hello doctor I and my partner are sexually active although we take precautions using two condoms at a time there is always a sense of fear when it comes to her each time she gets her period it is delayed by two weeks or 10 days at least and less discharge in terms of flow last time she had a normal flow days according to her but had a little abdominal pain with watering mouth and a bit of headache may I know the cause for why her periods get delayed and a reduced discharge because it creates an impression as if it is of implantation bleeding and leading to pregnancy request your understanding of how things work as it creates daily confusion and stress also does she require to seek a personal doctor inspection she is 25 years old

hi no there is no need for inspection you can go for pregnancy tests with home testing kits this change in periods duration and flow is normal for her as she is active sexually and there are emotional and hormonal changes that cause all of this if there are no flow excess flow missing periods unbearable and sustained pain in her abdomen back and thighs then there is a need for a gynecologist visit for checkup

hello doctor I am a married woman with two kids and a regular cycle my first day of last period was on the ith of last month on 26th I had intercourse and took mensovit plus on 30th and est and yet to get periods please advise I have not done any family planning post my second delivery but we are having our intercourse safely this time I am a little worried as I have no plan for a kid now

hello this seems you have sex on the 19th day of your cycle this could turn you pregnant and as such why do not you opt for a pregnancy testing now mensovit plus is a hormonal nonspecific medicine but not protective of pregnancy so do a test first and let me know the result

hello doctor I am a year old male I played soccer throughout my teens competitively five years ago I injured the muscle in my thigh what I presume was a tear of which I sat out from sports for a week or two however was rushed back into playing by my mother who thought I was faking the injury I injured the muscle again and these proceeded to happen again once more leading me to quit sports and focus on going to studies the following year currently now whenever I stretch my thigh muscle by pulling my leg up behind me I get a slight uncomfortable feel in my thigh muscle which I know is not normal however it is not painful enough to tell me to stop doing it furthermore I have been in the gym and jogging where my muscle seems to be fine but when I decide to sprint there is a 50 percent chance that I will get into discomfort again however it does not feel like a tear but it will become numb for a few days and finally if I go to kick a ball it is almost certain that the same result from sprinting will happen I have recently started to stretch the muscle to try and see if I can regain its strength to allow me to do these few things again without worrying about hurting my muscles again I am not sure what other things I can do to help this such as different types of stretches etc

hello I read your concern in my opinion you had a tear of your quadriceps muscle which has not healed properly and got reinjured again within less time so there is a possibility that a scar formed on the tear area of the muscle leading to stiffness and numbness is due to any neural stiffness around the scar area possibly there will be nerve entrapment do not worry all you have to do is get a deep friction massage to relieve the tension in the muscle slowly release the scar by massaging the scar frequently gently stretch the muscle and hold it keep icing that area frequently before attempting any running or any strenuous activity I advise you to properly activate and then strengthen that muscle progressively increase the load on the muscle I hope this helps

hello doctor I hit my head twice this week and wondering if I should see a doctor I am a 29 year old female the first hit was four days ago on the top right of my head when standing up underneath something metal it was a pretty hard hit it hurt on and off for a day just the spot itself on my scalp I did not have a headache or nausea or any other symptoms today I leaned forward quickly and bashed the front top of my head onto a wooden dresser it hurt pretty badly and I felt my teeth chatter I do not have a headache now other than the spot itself hurting I am not nauseous nor do I have any other symptoms of concussion I have read that if you hit your head twice two concussions within days you should go to a doctor but I am not even sure these are concussions I am not sure when a simple bump actually is a concussion or really how to tell do you have any advice

hi I have carefully and thoroughly reviewed all the details related to your case and feel sorry for the health issues you have there is no major harm to the brain when hitting like this even twice in quick succession your concerns are notable but that worrisome situation is when someone gets an impact harder enough to cause some signs of real concussion like nausea vomiting getting unconscious severe headache vertigo etc you did not have that large impact in both cases and there is no need to go for immediate medical care you need to handle it at home take ibuprofen for pain and apply local painkiller and anesthetic ointment on the scalp if needed these are available over the counter at any pharmacy apply heat to the site of impact and take care of yourself remain vigilant on your moves and be safe

hello doctor I have been using fluvoxin 100 my oxetol 450 my and quetiapine 100 my for depression and ocd for five years my problem is I am not regular to work as I do not feel to go to work I feel like this only in the morning I want to be in the bed I do not feel it is because only of sleepiness I do not understand the reason as well I have lost 12 jobs in the last five years all because of the irregularity please find the reason for my problem I am extremely upset with my behavior as my family depends only on my salary I am facing extreme financial problems because of frequent job loss please help

hi it seems that your depressive symptoms are bothering you it may be helpful to increase the dose of fluvoxin fluvoxamine and reduce the dose of quetiapine so discuss with your psychiatrist for increasing the doses of antidepressant fluvoxin do regular exercise or go for a morning walk at least five times a week

hi doctor my wife is 26 weeks pregnant and she is suffering from cold and cough for the past two days also she is having a chronic nose block from her 12th week and using nasal spray for relief she is finding it very hard to sleep for the past two days because of continuous cough her cough is without phlegm please suggest some safe medicines she is taking calcium and iron tablets along with eltroxin 50 mug for thyearoid

hi any infection is not good for pregnant women please confirm if your wife has any fever meanwhile you can take the following measures to help her feel comfortable dabur honitus cough syearup two teaspoons thrice a day honitus ginger cough lozenges once in two hours give ginger slices soaked in honey or raw to suppress the cough also please provide the following information any fever any sputum while coughing if yes what is the color any breathing difficulties any lower backache spotting or leaking of fluid I would suggest visiting an ent specialist for examination as well

hi doctor I am looking for a specialist in pulmonology my wife has been diagnosed with pulmonary fibrosis she is having a small rim of pneumothoraces bilaterally with subcutaneous disease and mediastinal emphysema I am attaching here her medical test reports for review by a specialist who can suggest a treatment to manage this condition

hello I have gone through all it scan reports and images it looks like this is a long standing problem and it is progressing as well but unfortunately there is no mention of the chief complaints of the patient and no previous treatment details are available before we plan any treatment it is very important to review previous medicines and see if there was an improvement or not as per it scan it looks like to be sip nonspecific interstitial pneumonia a chronic type of interstitial lung disease also it is complicating as leakage of air surrounding the lungs and heart it is very important to see what is the oxygenation status of the patient and other comorbidities the treatment of sip mainly consists of steroids as per the weight if oxygen saturation is not maintained above 92 on room air oxygen supplementation either by cylinder concentrator or ni non invasive ventilation must be considered so it is advisable to see a specialist pulmonologist near to you and take medicines and other required treatment under his observation as it has to be reviewed frequently according to the condition of the patient if the patient is suffering from any other comorbid autoimmune disease it should be treated simultaneously then only the lung pathology will be under control I hope I have elaborated the treatment plan in detail for you autoimmune old interstitial lung disease idiopathic pulmonary fibrosis sip nonspecific interstitial pneumonia steroids like tablet medrol methylprednisolone as per the weight of the patient supportive treatment as required oxygen supplementation

hello doctor I am 24 years old since last few days I have observed thick jelly like clear whitish mucus coming out from my vagina it is very thick and dry it is not like the regular stretchy moist discharge there is no irritation or pain I am not sexually active there is no odor also since last five months I am having scanty bleeding my period that would normally last five days now lasts only for three days I will visit a gynecologist in person in some days but I just wanted to know whether this is of anything serious otherwise I am very healthy thank you

hi revert back after the test to an obstetrician and gynaecologist online

hi doctor my father had chest pain three months back but he took it lightly in the last two months the pain has increased now I took him to a doctor after all the tests and angiography he suggested to do bypass surgery as we are not much aware of these types of diseases in family we are looking for a second opinion I request you to kindly look at the report and suggest your opinion

hi for further doubts consult an internal medicine physician online

hi doctor I had unprotected sex two months back and developed streptococcal infection within a day I took amoxicillin to get rid of it within five days developed yeast infection and got treatment for that now I have reactive arthritis I got two painless red bumps on the back of my hand and I do not know whether it is related to reactive arthritis my urine sample was negative for chlamydia but doctor found gram positive staphylococcus and said it was normal he suggested loxonin which is a said is staphylococcus infection dangerous I had abc and got the result as monocytes and cop were elevated in a gap of two weeks time repeated abc again and everything was normal now the urine test came out as gram positive I am suffering from multiple joint inflammation lightheaded fatigue upper respiratory difficulties papeles conjunctivitis and gram positive staphylococcus what is the solution

hi for further information consult a rheumatologist online

hi doctor first let me clarify that I have been to a doctor for this problem already but the clinic is closed right now and I will not be able to get the diagnosis for a couple of days but waiting without knowing the cause is troubling me so I am asking for my peace of mind and also to have a second opinion I lifted some heavy boxes of floor tiles a little over a week ago since then I got a swelling to my left side between the hip and ribs and to my abdominal area my doctor noted that those areas felt hard and said it might be fluid buildup I am done with my rays now but do not know the results of it the swelling has not gone up or down since then there is no pain but sometimes there is a pressure as if I am wearing a belt too tight the swelling is most obvious when I stand when lying down or wearing pants it looks almost normal bodily functions have been normal I do not have any diarrhea unusual stool vomiting and so on what do you think it could be thank you for your time

hello abdominal muscle sprain or muscle strain or inflammation less likely but ventral hernia is a possibility cold compressions ibuprofen 600 my three times a day with food available over the counter in 200 my pills avoid excessive exertion that requires the use of abdominal muscles for further information consult an internal medicine physician online

hello doctor I have a friend suffering from identity confusion she resorts to create several characters to identify what she is feeling each character has its one likes and dislikes and people it trusts she usually has a smooth change in between characters but this time the change is not going smoothly I read what did is but I found the symptoms too extreme in describing her case she does not have a memory problem in remembering what each character did I have tried to advise her to seek professional help but due to personal reasons she cannot seek this help I wanted to ask if you can give me a clearer image of her case and how I can help her through the change and make it smoother she has been living through her characters for a long time and does not know who she is now this is one of the main reasons of her confusion and frustration she is disgusted by herself and feels this as not normal please help

hello for further doubts consult a psychiatrist online

hello doctor I am getting itching in the area where I wear my undergarments I tried many medicines for fungal infection but it does not go away it has been there for more than a year it keeps recurring currently I am applying miconazole cream and clotrimazole powder please help

hi with your given description it looks like resistant tina cruris infections or may be erythrasma skin condition affecting the folds in the body you have not mentioned the duration of individual drugs you have taken itraconazole is a good drug for this but you have to take 100 my daily for around 28 days along with this you can try sertaconazole cream with fusidic acid cream to cover erythrasma twice daily for minimum of three months follow certain general measures such as may be not taken full duration of the course of medicines for fungal infection blood sugar skin scraping for oh potassium hydroxide tina cruris erythrasma candidal dermatitis recalcitrant tina cruris revert back after the tests to a dermatologist online

hi doctor I am facing problem whenever there is a season change I tend to lose my appetite and I cannot eat much if I try to eat then I feel like vomiting my weakness also increases during that time why

hello for further information consult an internal medicine physician online

hi doctor I am a 42 years old male I had low mood with anxiety problem around two years back I was on desvenlafaxine 50 my er tablet prescribed by go I took it for around eight months and felt better then I consulted my psychiatrist and told that I have only anxiety so he prescribed clonazepam my and alprazolam 5 my in the morning and nitrazepam 10 my and clonazepam my in the night and stopped desvenlafaxine 50 my er tablet I slowly tapered from first month itself to finally in around one year I was on 25 my clonazepam in the morning and 5 my nitrazepam in the night which I felt has same effect as I started later I tried to come out of it without any medication but I was feeling anxious actually I felt better with desvenlafaxine 50 my er tablet compared to other anti anxiety medicines so I asked my psychiatrist and he said start taking desvenlafaxine 50 my er tablet but I do not have the same effect as I felt earlier now it is almost seven weeks I am taking 5 my nitrazepam in the night and occasionally clonazepam 5 my or alprazolam 25 my or 50 my when I feel more anxious so I want to be only on desvenlafaxine 50 my er tablet as earlier should I wait for some more time or should I increase dose to 75 my or 100 my I really appreciate your help by the way I feel more anxious only at traffic signal or sometimes waiting in line at grocery store or sometime anticipatory fear in going far from my home thank you very much for your help

hi I can understand your concern desvenlafaxine is a good antidepressant and anti anxiety drug the drug should be continued for long time to see its full effects drugs like benzodiazepine clonazepam alprazolam or nitrazepam can help to control anxiety symptoms immediately but these drugs are not the definite treatment of anxiety high risk of tolerance and increased abuse potential are the main reasons that these drugs should not be taken regularly for more than four weeks it is good that you have started taking desvenlafaxine again and the drug will help you to come out of the symptoms currently you are on 50 my dose and in my opinion the dose should be increased to 100 my per day to see more effects and to get better control of symptoms so you can increase the dose of the drug without worries keep other drugs like clonazepam and alprazolam for use on sos basis only as and when necessary you continue nitrazepam for some days and then gradually reduce the dose and stop the drug completely wait for at least four more weeks to see the effect for further information consult a psychiatrist online

hello doctor I had ringworm problem for the past three to four months I used absorb clotrimazole powder and betnovate go cream it did not stop but increased spreading to other areas then I went to a doctor and he diagnosed it as tina incognito he prescribed terbinafine 250 levocetirizine dihydrochloride daily at night after dinner upcan 150 twice a week in the evening ketoconazole cream and veto plus soap after two weeks there was very less improvement and he added itraconazole twice a day along with same cream and soap it has been a week and improvement is very slow and at times it itches very much in between two days I missed itraconazole during the morning can it cause itching

hi if you are having ringworm infection then you are going on right track you have applied betnovate cream betamethasone which is a topical steroid it usually suppresses or hides your lesion that is why it gets converted into tina incognito fungal infection masked due to application of a topical steroid now you are using two oral antifungal simultaneously one terbinafine 250 my which usually requires three weeks and itraconazole 100 my once daily for 28 days or twice daily for at least two weeks use certain general measures for fastest recovery like use of topical steroids betnovate skin scraping for oh potassium hydroxide follow up till lesions completely regress to a dermatologist online

hello doctor I am a 23 year old female I am bulimic for the past nine years and also suffering from anxiety and depression for the past five years I like to drink alcohol a lot I recently had a checkup and I have attached my test reports for your reference I am just taking vitamin supplements I have looked up all of these online my doctor wants me to come back in and get an ultrasound of my liver I need to know my possible diagnosis please guide

hi alcohol induced hepatitis viral hepatitis versus fatty liver disease nash nonalcoholic steatohepatitis hepatitis serological panel hepatitis virus antibody hav ab fibrosure non invasive test to check liver status ultrasound of abdomen hiv test avoid sharing razors with family and friends unless the viral hepatitis has been ruled out please taper down your alcohol dose and try to quit do not abruptly discontinue it otherwise you can go into withdrawal safe sex is encouraged revert back after the tests to an internal medicine physician online

hi doctor I am weeks pregnant now I had slight fever and muscle aches recently I am scared about listeria while pregnant could you please tell me the symptoms of listeria also if it is listeria how long will it take to affect the baby I need some advice about listeria please

hi for further information consult an obstetrician and gynaecologist online

hello doctor recently I had acute pancreatitis which resulted in gallbladder surgery two weeks post operation I have noticed tiny black dots appearing on my body now it has spread some are raised and some are flat should I be concerned what are they I have attached the picture of my stomach area currently I am taking ondansetron hydrocodone singular and dulera

hello revert back with the asked details to a dermatologist online

hello doctor my skin hurts and itches during the workout and also it gets hurt when I am out in the sun when my body temperature is high my skin starts to hurt and itch after my body cools and heart rate gets stable the itching and hurt stops especially in my face chest and back but I do not feel it in my legs I have acne on my face chest and back I had acne like two years ago but I did not have these problems with my skin nowadays especially this year in spring this problem appeared I should point that I had been consumed doxycycline and trichopol but I have already stopped consuming them I have been using acne cleanser and I stopped consuming it also as my problem is not solved I have stopped consuming these things a month ago what do you think about it what is that how to cure that I cannot go out for it because these symptoms start when I am out in sun what do I need to do how to treat it

hi you can use certain general measures to reduce the above two conditions for further doubts consult a dermatologist online

hi doctor a couple of months ago I took out my lower wisdom tooth there were complications and my inferior alveolar nerve was compressed during the extraction I dealt with lip and chin numbness for over a month and I still have swelling below my chin in the jaw and neck area it looks like a double chin and I did not have it before the extraction I was wondering if it was fluid buildup is there any way to get rid of it because it is not going away by itself I had taken antibiotics but the swelling did not reduce please help

hello revert back after the test scans to an internal medicine physician online

hi doctor I am a 38 year old woman and have been losing my hair for about six years all tests came back negative my go prescribed a shampoo as she thought I had dandruff but I have never had dandruff I am taking fexofenadine for urticaria and naproxen for costochondritis also I have a irena coil due to very heavy periods I do have thyearoid diabetes and vitamin issue any help would be great thank you

hello with your descriptions it seems that you are suffering from female pattern hair loss if you can send picture of your scalp it will be better to diagnose you did not comment on test reports are you a diabetic are you suffering from hypothyearoidism since you are having heavy periods you should go for serum ferritin level and hemoglobin level if you have diffuse hair loss you can start minoxidil my local application daily and tablet biotin vitamin or vitamin be supplement once daily to see visible response it will take two to three months female pattern hair loss chronic telogen effluvium female pattern hair loss follow up monthly to a dermatologist online

hello doctor I am writing on behalf of my wife she is facing continuous bleeding from vagina since seven days after post pregnancy bleeding here is the complete scenario we blessed with a baby 38 days ago and it was a section delivery 16 days back the bleeding had stopped completely everything was normal 10 days back my wife started to have vaginal bleeding again and bleeding till today we thought that this is her monthly period after pregnancy the bleeding is heavy so she needs to change to 10 pads a day she is feeling tired and her be was low due to excessive bleeding we have also visited doctor nearby yesterday she has given two tablets to eat twice and day pause of and methergine were the tablets given after having these tablets bleeding is happening at same flow be and tiredness has disappeared there is no other complication like fever stomach pain etc except bleeding she needs to feed one month baby as well also note that there is no sex done post delivery please help us I am attaching her abc it in ptt reports for your reference

hello your wife is having bleeding per vagina following one month of cesarean section this is termed postpartum hemorrhage and often creates an emergency this could be caused by an infection of section wound commonly but as per your report she is having some form of blood clotting disorders raised prothrombin time it and international normalized ratio in now definitely she needs hospitalization she might have another bout of bleeding and in that case you will not be able to control the situation pause of combination of tranexamic acid and mefenamic acid and methergine methylergometrine can subside the bleeding temporarily but she needs intravenous antibiotics and may need clotting factor transfusion fresh frozen plasma as well as blood transfusion as her hemoglobin is 10 it is substantially low to combat another episode of massive bleeding I know the baby will be deprived but do not take the breastfeeding as a priority in contrast to your wife impending danger if any blood coagulation disorder routine blood liver function tests let urea creatinine platelet count bleeding time bt clotting time it prothrombin time it and activated partial thromboplastin apt us ultrasonography whole abdomen postpartum hemorrhage admission along with iv antibiotic as well as fop transfusion and blood reserve required revert back after the investigations to an obstetrician and gynaecologist online

dear doctor here is my lab report bilirubin total bilirubin direct 5 sept 4548 got 4153 I have taken drip and injection for nausea now nausea has been cured I have only abdomen pain now and my fever has been cured before three days color of urine is yellow and color of stools is white also my constipation is still remaining what shall I do now please give your opinion

hi for further queries consult a gastroenterologist online

hello doctor my marriage is ahead in 13 days we are planning for honeymoon after four days of our marriage but my fiance monthly cycle date is on the fifth day following our marriage we need help in postponing her period as well as about birth control please guide

hi for further doubts consult an obstetrician and gynaecologist online

hello doctor I recently had my blood test and the results came back that I had mild neutropenia it has got me a little concerned since this has been present on my last two blood tests with the lymphocyte count being significantly higher but still within the normal upper limits I have had no infections fever night sweats aches no splenomegaly and no history of anything I currently take propecia 25 my for hair loss my first blood test five months back was this way neutrophils 42 and absolute neutrophils 1 lymphocytes 45 and absolute lymphocytes my newest blood test as of this week reads neutrophils 30 and absolute neutrophils 2 lymphocytes 59 and absolute lymphocytes 3 I will upload my most recent laboratory work if more information is needed then I can get the previous one thank you

hi based on your query my opinion is as follows low grade viral infections increasing lymphocytes the normal lymphocyte count is 20 to 40 and here is 59 improve nutrition to fight the low grade infections maintain good hydration repeat test after three months and get back to a hematologist online

hi doctor it started with a burning sensation on my neck and then I have noticed red dots in the inner side of my arms then it spread to my stomach and back they itch sometimes I have previous history of psoriasis on my knees but this is different I also had shingles when I was years old

hi I have seen your picture and read your given history your case looks like a guttate psoriasis this type of psoriasis occurs in individual who had plaque psoriasis and developed sudden appearance of an outbreak of red drop like lesions all over body trigger of the disease is often streptococcal bacterial sore throat followed within two to three weeks by the eruption or chicken pox usually this type of psoriasis goes away in a few weeks without treatment simply moisturizing the skin may be sufficient if throat culture comes positive for sore throat then starting antibiotics for the infection will be helpful for further information consult a dermatologist online

hi doctor my friend is getting married in another six months and it is love marriage when his fiance was in her second relationship she fell in love with my friend after few months only he came to know that she does not seriously love him she started loving him so seriously when he lost his conscious and fainted on the floor one day from then onwards she realized his love and they decided to get married my friend requested her many times to share her past but she denied now he came to know she had been in a long term relationship with two guys before also he came to know that she used to text many guys with keep it simple stupid symbols etc now my friend is unable to forget her past and psychologically he is not well he has not been into any kind of relationships with anyone why he has got a girl like this day by day he is becoming psychologically tired please suggest something your valuable replies will be the tonic for my friend it will be really more helpful thank you

hi for further information consult a psychologist counsellor online

hi doctor I had meniscus surgery before two and a half weeks still there is a kind of swelling around my knee I feel little pain outside the knee and also there is still a crack noise when I bend why

hi for further information consult an orthopaedician and traumatologist online

hi doctor yesterday I was diagnosed to have chlamydia I am freaking out because I want to get it cured as soon as possible to prevent damage to my ability to have children later in life unfortunately I am not able to get treatment from the nearby hospital for a couple of weeks I was wondering if there is another way to get the treatment sooner if possible the clinic offered free treatment but my peace of mind and less damage done is worth me paying for the prescription as long as I can afford it I just do not know where to go or if the clinic could fax the results somewhere thanks for the help

hi I can understand your concern chlamydia trachomatis is a sad sexually transmitted disease you have got the infection from your partner so you both should be treated ideally a vaginal swab test should be done to confirm the diagnosis you have not mentioned whether you have taken the test to confirm chlamydia infection first line agent for uncomplicated infection in non pregnant patient is ceftriaxone with azithromycin orally for one dose or doxycycline 100 my orally twice daily for seven days if you can share your vaginal swab test with cultural and sensitivity then I can suggest you the right treatment do not panic it will be cured once you take proper treatment revert back with the swab test report to an general practitioner online

hi doctor my son is years old and has been diagnosed with add odd and sensory integration disorder he had adderall or my for a while and recently was changed to strattera 27 my son has been experiencing major insomnia high aggressive behaviors which involved throwing objects at people hitting punching people kicking and biting especially adults as his mother I do not believe that he has add although he has odd it is a normal thing in a year old however the behavior is not becoming better and it has actually become worst to the point where he is on the verge of being kicked out of everything I want to take him away from all medications because I do not want my year old on them to begin with however I am out of ideas and it scares me because my son could be really wonderful but currently he is not at all can you help me with any suggestions

hello revert back with the answers to an internal medicine physician online

hi doctor my 10 month old daughter had a fall from bed she had little blood in her nose blood is just little and not dripping is it something to worry about

hi revert back with the reports to a paediatrician online

hi doctor I am 25 years old and a virgin I used to watch too much porn movies two to three years back because of issues in personal life I had watched it before that also but once or twice a week after my breakup I was totally depressed and shattered a friend of mine deliberately forced me to watch porn movies to come out of depression after that I got addicted to it now the problem is I have a small penis and whenever I masturbate I ejaculate very soon say four minutes and pain rises in my back tailbone as if the inner nerves are stretched too much it seems like I cannot be in the field of encounter for a long time what should I do please help

hi you are contributing porn watching and masturbation to your back pain masturbation is a healthy way of satisfying your sexual desires and you can masturbate weekly twice or thrice anything in excess is not good it will not affect your sex life or general health by watching porn continuously and masturbating daily is common in your age it will not cause any serious damage except early ejaculation that is because you have trained yourself and your penis to ejaculate early lot of constructive time was wasted in this you can divert your mind by concentrating in your studies or professional career also learn yoga and meditation which will help your back ache and assist you to concentrate on useful activities you can watch porn for five to ten minutes and masturbate weekly twice or thrice but train yourself to ejaculate late by delaying stroking for your back pain consult an ortho doctor

hello doctor I am 30 years old I am having a problem of restlessness in legs fatigue tiredness irritation confusion lack of sleep or disturbed sleep I am currently taking calcium tablets

hi welcome to icliniq com you seem to be suffering from restless leg syndrome res this however needs exclusion of other issues like thyearoid disorder iron and calcium deficiency as well if all these investigations are normal my recommendations for your treatment would be pregabalin along with lifestyle modifications like yoga meditation I hope this helps

hello doctor last night I fell from my bike on my right side as it got slipped while driving my right hand and right shoulder directly hit the road and cause severe pain on the right side of the abdomen a local doctor prescribed some medicine and I got relieved from my side pain I went for an ray of the right chest it was normal but after 36 hours I am having pain in the right shoulder scapula and while sitting or arising out of bed or moving hand on the upper side the pain increases a lot is it normal or need better medical assistance

hello you should get yourself examined by an orthopedic surgeon and ray of the shoulder region is required any pain in the shoulder after trauma requires evaluation and any pain cannot be considered as normal there are chances of soft tissue alone with no bony injury but I would recommend a re evaluation till then you can apply ice to the affected area and take analgesic for pain relief kindly follow up with your ray and feel free to discuss further

hello doctor I had bell palsy before few months and it resolved within two months I was treated by a neurologist then but now I feel that my taste buds are blunt and I cannot taste very well within the past day or so I have no other symptoms of bell palsy yet but this is how it started back it was on my left side I am worried that I am getting bell palsy again is it possible to get it so soon again and if I feel it is what shall I do shall I start my steroids and acyclovir again

hello welcome to icliniq com I can understand your concern try finding any other cause of taste loss like consumption of any drug like metronidazole if you are sure that no other cause explains it then I will suggest to get nav nerve conduction velocity egg electromyography test because it can pick up delay in nerve conduction earlier than the symptoms results are available by the same evening bell palsy prophylaxis is not recommended anywhere however if I imagine myself in your position I would start the medication by the time all these investigations are done you can also get a detailed neurological examination many a time clinical signs can be seen when a patient cannot appreciate symptoms if it proves to be bell then we will have a discussion for further causes of recurrent bell s

hello doctor I have silicone mentor gel smooth round moderate profile breast implants that were placed befor years I have reason to believe I have what the community is calling breast implant illness I am curious if the integrity of the implant is intact and if there are any lesions that could be free floating silicone the right breast is a 350 ca implant and the left is 400 ca

hi breast implant illness is a term associated with symptoms of health concerns in women having breast implant surgery done it includes a wide spectrum of physical symptoms and commonly involves fatigue chest pain headaches anxiety vision problems nerve and hormone problems this is not officially a confirmed medical term in use and is a more general expression of symptoms however one should not ignore if there is a likely possibility of implant rupture mri magnetic resonance imaging scan is useful to search for any areas of rupture in silicone implants if there is a clinical indication you can get an mri breast scan done and it will confirm the integrity of the implant

hello doctor I was diagnosed with a candid albicans I used emergency contraceptives as and then but I treated it with ciprofloxacin antibiotic I also started using cotton pants took care of my vagina too then last month I went to the clinic and retook the test hoping it would come out clean then they said I have a staphylococcus infection it was moderate and I took the same antibiotics they prescribed I did not have any symptoms but I treated it anyway then earlier this month I had catarrh which I also treated with an antibiotic now I am four days late from seeing my period I am very scared I do not think I am pregnant because I check with a strip two days ago and it tested negative I am just very scared because I feel it was the infection that is delaying my period and it is messing with my system inside how dangerous are staphylococcus infections and why have I not seen my period

hi welcome to ciliiq com you do not need to be scared vaginal infection should be taken care of but these infections are not uncommon in sexually active females so do not worry if there are no symptoms taking antibiotics every time may not be the right thing to do just maintain hygiene staphylococcus infection is also not an uncommon vaginal infection sometimes even contamination from the surrounding areas while taking swab may show such a picture period delay due to this seems unlikely wait another week and recheck in the urine if still negative see a gynecologist who can examine you and find out the reason for it could be hormonal imbalance or a uterine or ovarian pathology I hope this helps

hello doctor a few months before I developed a gastric issue that required treatment with pips soon into using the drugs I developed headaches dizziness and nausea I changed the type of pi three times but the symptoms persisted the symptoms included a feeling of pressure above my right ear and behind my right eye later I came off the pips and after using over the counter headache painkillers for three days the severity of the headaches eased but the feeling of pressure remains to this day on the right side of the face I often feel heavy head or even light headed with a slight dizziness often as if I am hung over the symptoms come and go but are there every day for differing periods of time and the constant is this feeling of slight pressure on the right side of my head above the ear and extending sometimes down to the cheek and behind the right eye

hello I read carefully your question and would explain that the dizziness does not seem to be related to pi adverse effects as it would have disappeared now for this reason I would recommend consulting first with an ent specialist in order to exclude a possible inner ear disorder which could trigger this clinical situation it is also necessary to perform a sinus ray study inflammation tests complete blood count per ear and thyearoid hormone levels in order to exclude a possible thyearoid gland dysfunction if all the above tests result are normal I would recommend consulting a neurologist for a physical exam a brain mri may be necessary I hope this helps

hello doctor I was diagnosed with mugs ga when I was seeing a neurologist for some burning in my palms of my hands and soles of my feet which is awful at night and prohibits me from sleeping this has been going on for six months but has gotten worse so I went back to the neurologist ordered an mri for next week to see if the six white matter brain lesions I had were changed since the mugs I followed up with hematologist three times and he said my numbers are so low they do not show up on spike all other labs were normal I saw a dermatologist to see if burning was skin related she said no maybe vascular so I saw a cardiovascular doctor who is also running tests I also saw a rheumatologist so does not believe it is rheumatology based on blood work my question is if my numbers at hematology were so low they do not show spike could they be causing the random burning in the palms of my hands and soles of my feet just want answers and as of right now I get the neuro saying it is mugs and hematologist saying it neuro I am scared and exhausted please help my primary complaint is burning red palms of my hands and red soles of my feet not fire engine red just slightly red my hands tend to get a little swollen on the top and my veins are swollen and then it goes away and my hands are looking normal and are cold sometimes well it happens all day regardless of what I am doing with the activity is it randomly pops up definitely when I am moving around or running the vacuum or doing something like that but it is really bad at night so far I have done myeloma profile abc ana and cop tests

hi welcome to ciliniq com I am sorry to hear with regards to your complaints and how much you are going through I have seen your hand pictures to be frank it is really a tough case there can be a few things that can be looked for chronic inflammatory demyelinating disorder rarely mugs monoclonal gammopathy of undefined significance can be associated with neuropathy it can be raynaud phenomenon any heavy metal related I have a few suggestions which you can ask your neurologists or hematologist if they have thought about them did anyone think of getting a nerve conduction study later on can a nerve biopsy give an answer if we are thinking cid chronic inflammatory demyelinating neuropathy sometimes can any heavy metal can cause this kind of symptoms lab work for raynaud phenomenon if your symptoms fit into that criteria looks less likely though any remote chance of amyloidosis there is a test for that as well known as fat pad biopsy please ask the doctors to consider these points to your question mugs has been shown to have an association with neuropathy related pain though less likely I am here always if you need further guidance I hope this helps

hello doctor this is pertaining to my period and my birth control I had my daughter a little over two months ago and started my birth control last month I was still having on and off bleeding but it stopped about a week or so after taking my birth control I started my period on the ord of this month and it stopped completely yesterday until I had sex last night when I went to the bathroom after the fact I was bleeding as if I were on my period and my vagina hurt and burned a little not when I urinate just in general is this normal am I still on period next is my birth control as I stated in the first question I started my birth control last month well I still have one more pill to take out of it and I had unprotected sex last night I take it at am every day never missed one but we are late taking a couple especially yesterday I was late by an hour taking the pill am I able to get pregnant immediately due to the fact it is still my first month on it and I only have one pill out of the pack

hi what I could gather from the information you gave was that you are on birth control since last month what I would want to know is what was the mode of your delivery vaginal or operative it has a bearing on the answer also what kind of pills are you on are they continuous pills without a break or like three weeks on one week off pills were you still taking pills when you had your periods on the ord if it was a vaginal delivery sudden bleeding could be due to vaginal laceration if the bleeding was while on pills it could be a breakthrough bleeding if only one pill is left and you have been taking it for more than two weeks regularly pregnancy seems unlikely being late for pill by one hour does not decrease its efficacy if you are breastfeeding your child chances of pregnancy are even lesser I would suggest you to see your doctor and understand clearly how and when to take pills to avoid such problems in the future I hope this helps

hi doctor I have hypertension and diabetes for 25 years I am taking 250 units of insulin for six years gor 20 creatinine is 1 should I take cremaffin to reduce the creatinine I am taking ten 100 telmisartan 80 benina 8mg I had edema in legs and started lasik 120 my and pyloric 500 my weight had gone up suddenly by 10 keg I weigh about 100 keg I had a kidney stone of 15 my six years back and now it is my suddenly my weight increased and so the be I was taking amlodipine but now changed to benina my

hello I have seen the reports sent by you your creatinine is 1 which is not very high also your other blood reports are fairly fine but your hba1c glycated hemoglobin is high it should be below your diabetes is not under adequate control other parameters like calcium sodium and potassium are fine you are presently suffering from diabetes and hypertension related chronic kidney disease your treatment should include adequate control of diabetes and hypertension proper exercise and lifestyle changes no smoking and alcohol fluid intake should be 500 my more than the total urine output diabetic renal diet is very important can consult a dietician for proper diabetic renal diet other antihypertensives lasik and insulin to be continued as it is cremaffin will not help in reducing creatinine as it is chronic kidney disease it is irreversible and your goal should be only to prevent progression by strict diet and medicines

hi I am a 32 year old male my mri report says posterocentral protrusion of la disc is abutting the la nerve root bilaterally in mri it is black between la and kind of poking the nerve my back pains occasionally and I think it is the nerve which is hurting because the pain is like a sting currently I am taking rest and doctor said that he will check if physiotherapy can be started after a couple of weeks I am afraid of the pain especially when it is near the neck or shoulders I am able to walk and work I am being treated by a spine specialist please let me know if I have to go to another doctor like a neurosurgeon and can I lead a normal life in future

hi I am not sure of your neck symptoms as the neck has nothing to do with your lower back and from your description it is not clear if you have any leg symptoms or bladder symptoms however I need to see your mri scan to be able to make a judgment on the further management revert back with the reports to a spine health specialist online for further follow up