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hello doctor I experienced a sudden and severe pain in my stomach lower part and anus which caused me to shake become dizzy and really pale and I have difficulty breathing I did not faint but if I were standing up then I probably would have it happened to me once before and I was on my period then I had consulted a doctor then as well and was told that perhaps my body was just shocked because I had skipped a few months of my period I am also diagnosed with iron deficiency anemia but I am currently not taking my iron tablets this time around however I had my period last month and was not on my period at all I am not sure what it is but wanted to let you know should you have come across a similar situation with one of your patients please reply

hello well most of our patients initially complain to us about very vague symptoms at onset just like yours but we explore the possibility based on some more information and yes of course investigating them thoroughly the pain you mention which made you still and shaky can be arising from the gut as in abdominal colic a sudden wave of spasm in muscles within the gut or can be arising from endometriosis which is anther problem of the female genital tract whereby there is excessive growth of normal uterus tissues in the lower part of the belly thirdly it can simply be due to perimenstrual syndrome which is pain occurring at the time of menses for now I suggest you to do some test and ultrasound abdomen and pelvis later we can discuss the findings of your result functional abdominal colic perimenstrual syndrome endometriosis complete blood count ash thyearoid stimulating hormone ft3 liver function tests stool detail report urine detail report us ultrasound abdomen and pelvis follow up after investigation to discuss the results

hello doctor I have a tiny hard spot on the head of my penis it does not bother me unless I mess with it has been there for many years but just recently I have noticed a bit of pain when I am just sitting around it is probably the size of a pinhead and it is dark in color I have not had a sexual partner in a very long time years it does not seem like a boil or a pimple the very top of the spot is black please suggest

hello I can understand your concern according to your statement you have been suffering from a tiny hard spot on the head of the penis this type of tiny spot can result from various reasons such as mole produced from over secretion of melanin by skin cells they are harmless and nothing to be worried penile papule appears around the penis head which does not itch or produce any fluid they may disappear as time passes angiokeratoma is a tiny red bump that appears when blood vessels near your penile skin become dilated they are rough in nature and may become thicker over time lymphocele has resulted from blockage in the lymph channel near your penile head it does not need any treatment and dissolves over time peyearonie disease is resulted from scar tissue which is found on the top of the penis that tends to harden due to calcium deposition treatment is needed when it makes erection of the penis difficult again your penile tiny hard spot may be resulted from a pimple cyst or sad sexually transmitted disease as your penile spot does not create any difficulty in your regular performance so it is nothing to be worried and needs no treatment I think it will disappear over time you can undergo fac fine needle aspiration cytology or biopsy from a tiny hard spot on the top of your penile head

hello doctor is there any chance of hepatitis spread through eating food contaminated with infected blood

hello well the whole blood and serum white fluid within blood contains large amount of virus and virus can live on blood spots outside the human body for the duration of one week so actually it depends upon how much blood and how much time it has been on the stain that can determine the chances of acquiring infection if contaminated with food so I guess my answer can be partially answering your query if you tell me the exact event I may be in a better position to tell you the figures otherwise as a general rule hepatitis does not spread via food having said that it can still spread if blood contaminated food has been ingested since virus invades the human body when comes in close to mucosa lining of our mouth and then spread to blood within human this happens in the same way as one infected person can transmit infection via kissing hugging sharing of a towel spoon plates and so on if you are puzzled with all that information I want you to simply get a blood test for hepatitis infection it is a simple blood test that can give us a clue I hope this helps post exposure risk stratification hepatitis surface antigen hepatitis core total follow up after testing

hello doctor my left foot is swollen with purple color and pain I am currently on diamicron 60 my and xelevia 100 my

hello with history I feel you have left foot cellulitis it is the infection on the foot you might need heavy antibiotics for the infection is warmth present on the wound any pus discharge from the area kindly update these details and also the picture of the purple color and also I would like to know what is your sugars levels in present condition

hello doctor my upper stomach area is pulsing suddenly from yesterday after eating what does that mean

hello welcome to icliniq com I want to know when did you last have albuterol it is used in asthma for air pipe spasm it has common side effects such as tachycardia increased heart rate more than 90 minutes when the person is at rest where people feel there heartbeat I also notice your heart rate is 90 which seems to be secondary to albuterol pounding of stomach however is an unusual phenomenon but can occur due to certain drugs and sometimes without any cause the condition is called tachygastria you can simply decrease the dose of albuterol to see if it works in your case I hope this helps tachycardia gi motility disorder drug side effects and tachycardia reduce the dose of albuterol

hi doctor I have been using high quality highly rated penis extended for two days for hours a day and no for the past three weeks now do these things really work is it possible to experience penis shortening instead of enlarging a month ago I was but now I am almost at

hello I want to know the reason for which you are using a penile extender do you have a very decent size why you want to increase it further it is like your height is feet but you want it to be 3 everything you do has got side effects if not done properly can lead to trauma and hence shortening are you diabetic or hypertensive any other chronic illness

hello doctor I am a 26 year old male my height is 9 and weight is 54 keg I do not look healthy I take a regular diet and meals thrice a day I do not have any health problems like cough fever and pain actually I want to put on my weight and develop my muscles because I look very thin could you suggest me any medicines or supplements for my better body growth

hi good to know that you are eating well what about family history are your both parents or anyone parent is underweight if it is familial it is difficult to gain weight you can try with any protein powders ensure is good for a supplement take it as mentioned in the bottle try to include some evening snacks you can eat milk based sweets like rasagollas milkshake etc prepared at home exercise every day to increase your metabolic rate simplest is brisk walking gradually increase your intake of food do the above said things and get back to me after 10 days ensure two teaspoons daily with milk follow up after 10 days

hello doctor I am a 54 year old hypertension patient and in control with medicines ramipril 10 my natrilix 5 suspense release and rosuvastatin 10 my ramipril was causing dry cough and was managing until recently but now cough becomes very sensitive due to current couid 19 situation and so visited another clinic for an opinion and the doctor changed to connor 5mg and amaasc my at least for three months until the current situation improves as constant cough due to ramipril concerns me and others as well doctor asked to reduce the dose of rosuvastatin or to take on alternate days my question are the prescribed medicines safe I read connor does affect the sexual drive to some extent although with my age not so active but with ramipril there was no issue on this ground even otherwise will the combination prescribe now benefit

hi I read and understand that your concern is about the side effects of the newly prescribed drugs reduction of sexual drive is one of the side effects of beta blocker group of drugs connor contains bisoprolol which is a cardioselective beta blocker the systemic side effects of cardioselective beta blockers are less compared to the general beta blockers so the effect of connor on the sexual drive would not be that significant to affect your usual life and the combination prescribed is safe to take there are no significant drug interactions between these group of drugs

hi doctor I was lying on my stomach for about 20 minutes when I moved to a seated position I get the most intense painful headache of my life it was in both my temples and lasted about a minute should I worry it is a brain aneurysm

hi this pain seems to be due to vasospasm unlikely to be aneurysmal bleed pain if it was aneurysm it should have continued for a long duration I have another set of questions please answer them is this first ever headache of this kind was there nausea vomiting and dizziness was there any blurring of vision are the temples painful on touching is there any weakness in limbs or double vision

hi doctor I have pimples on my penis I do not feel any pain when I touch I just want them to dissappear I am having this for the past many months I was feeling shame to consult but now I do not want to take risk please help

hi I can understand your concern according to your statement you have been suffering from pimples on your penis for the past few months pimples can develop on the penis as they are common elsewhere on the body pimples are resulted from blockage of the sebaceous gland of the skin due to excess serum or debris or dead skin sebaceous glands excess secretion of oil serum can develop pimples for the prevention of pimples you should avoid excess sweat producing activities wear loose clothes for preventing them from friction take bath regularly and do not rub your affected area you can use topical retiniods salicylic acid benzoyl peroxide etc without any medications they are also disappeared with passing of time by keeping personal hygiene strictly

hello doctor I am a 59 year old male I have dark spots on my cheeks close to eyes on both sides identical I would like to have medical advice on this problem which I am having for more than three years I am currently taking obimet so 500 glimisave m1 pivasta my pinot 40 my and clopilet 75 my

hello please send two to three clear pictures of the affected area for better evaluation and guidance do you have any symptoms itching burning over this area

hello doctor I have pilonidal sinus I had two surgeries one with the endoscopic method and the second one six months before by incision and drainage method after recovering from this I had a small pimple on the wound doctor said it is normal and it is because of surgery but now I am having redness around that I am using alcohol swap to clean the opening areas of pilonidal sinus and they are closed kindly tell me is this recurrence of pilonidal sinus or boil or what it is it is causing pain while sitting as well

hello do not worry I will help you with your problem as you said you underwent surgery for pilonidal sinus two times and now you have one boil at the same site as I can see in the image attachment removed toprotect patient identity it can be boil or recurrence of pilonidal sinus that may be due to infection of that local area I will prescribe you some medicine please maintain local hygiene shave your hair in that area get back to me after five days I will add some more medicine and local remedies sit bath in luke water with betadine twice a day tablet augmenting amoxicillin and clavulanic acid 625 my ads for five days tablet chymoral forte ads for five days tablet serradic be for three days capsule a to od for 10 days

hello doctor I am 17 years old and have a little bit of white nipple discharge in both breasts but one has it a little worse and the skin on my nipple appears to be white and has little blisters on it does not really itch or anything but it is sore to the touch

hi I see that you are worried about discharge from both your breasts and you are telling it has blister like appearance white discharge with blister like appearance and sore to touch generally points towards an infection but an infection occurring simultaneously in both breasts at the same time is very rare another possibility is that milk secretion from both breasts which you might think as white discharge do not doubt there are certain conditions where there can be milk secretion even without pregnancy and birth which occurs due to hormone disturbances need some more information too do you have a fever how are your menstrual cycles is it regular is the flow high do you feel any small lump behind the nipples do you take medicines for any other problem do not mistake me but your problem needs a direct clinical examination to visualize the breast discharge and to see if there are any lumps behind the nipples you would not be comfortable to post pictures of your discharge and blisters so I would recommend you to visit a doctor in person and have yourself examined meanwhile do the investigations I have advised and try the medicines given below hypothyearoidism hyperprolactinemia breast infection galactorrhea tablet amoxicillin clavulanic acid 625 my twice daily after food for five days tablet aceclofenac serratiopeptidase two tablets twice daily after food for three days avoid wearing tight vests and too much sweating

hello doctor my child is one year old on routine examination his eye has a power of minus 5 and minus 5 refractive error what is the normal refractive error at this age as refraction continues to change doctor said to follow up after six months as glasses may be needed if power increases please help

hello first of all let me tell you that visual development takes until the age of puberty as your child grows his vision parameters will change because his eyeball grows with him as he ages so visual stability will continue to change until the age of 18 20 years old normally the child is born with a plus refractive error unlike the case here your child has a condition called myopia which is a refractive error with a minus as you said but that is completely fixable as the child grows whether by glasses contact lenses or lasik surgery if it continues and he needs to take glasses off later the most important examination in his age is something called a red reflex you should ask your doctor if he has done it to him also I would ask about the funds examination too if both were normal I would not have any concerns I want to reassure you that your child eyes are in good health he just needs to be examined precisely every follow up every six months as your doctor suggested just to make sure everything is going right and to treat anything if something happens early the glasses will not be tolerated by a child as his age is too small as soon as he can tolerate glasses put them on that could happen in two years if you need further assistance do not hesitate to contact me

hello doctor my wife is 50 years and I am 54 years old last night we had sex with a condom but I have doubt it may be unsafe her period occurs once in one and a half months other than this she does not have any gynecological problem can she take any contraceptive pill like unwanted 72

hello welcome to icliniq com though your wife is in the late part of her reproductive age and might be approaching her menopause yet if she continues to have her menstrual cycles regularly there is a chance that she might be still ovulating and if intercourse happens in her fertile period she might conceive it is better she takes unwanted 72 this time unwanted 72 is safe for her from a medical point of view but it is not 100 percent effective in avoiding pregnancy and cannot substitute a routine contraceptive so please do a pregnancy test also if she does not have her periods at the scheduled time after her next periods follow up for an effective contraceptive with additional benefits for hormone replacement appropriate for her age

hello doctor I may have a liver problem and would like to get advice I had done some medical tests recently and the liver turned out to be a bit problematic for me hence thought of consulting a specialist I am currently blood pressure blood thinner cholesterol reducing drugs and medicine for thyearoid

hello I have gone through your query your be and cholesterol levels seem to be fairly well under control of treatment kindly share all your available reports liver function tests and details of the symptoms and problem that you are facing at present kindly get back with the above details and any other questions if you have further discussion and management

hello doctor I had protected sex with a woman after a few days I had an itch at the bottom of one of my ears after 12 days I done an hiv ran per test and it was negative after a few days I had a wart like bump in the shaft of my penis and body itching then after 60 days I have done hiv duo combo test and it was negative in these days I had intense itching with rash similar at the bottom of both of my ears after 90 days I have done the elisa test for hepatitis a and herpes syphilis chlamydia and they were negatives after a few days I had small itchy red bumps in the body after 25 days I done hiv tridot test and it was negative but the itching in the body with bumps continues now I am 314th day after sex what should I do should I go for another hiv test or other sad tests

hi welcome to icliniq com I have gone through the case in my opinion if you have no contact history for almost a year then there is no need to repeat all the tests but first you need detailed physical examination because there are different types of itchy red bumps and some of these are linked to sex and some are not so do not go for all tests at once

hello doctor my eye has become red and is watering I think a foreign object has entered but I am not able to find it what should I do it happened yesterday and icing did not help currently I am under medication for high blood pressure

hi first this to rule out is a foreign body in the eye for that ask someone to examine your eye with a torchlight and also check the upper lid by exerting it because that is the common site for foreign body sometimes a very small foreign body cannot be seen with the naked eye and need an eye exam by a doctor wash your eye with clean water if there is no foreign body seen then it is most probably conjunctivitis that presents with the same symptoms usually viral conjunctivitis it usually takes 10 days to complete recovery but during this period protect your other eye and other family members because it spreads from one person to another through contact for symptomatic relief keep washing your eyes with cold water and do icepacks that helps to relieve discomfort start antibiotic moxifloxacin 5 eye drops four times a day to avoid secondary infection if pain and discomfort are severe consult your nearby eye doctor for a complete eye exam

hello doctor taking ctd 6 25 for hypertension and amaryl my for diabetes for more than five years my fasting sugar level is always above 200 on average besides this I have vertigo syndrome rbb severe constipation and for the last three years itching in lower legs right leg in winter and left leg in summer most of the time I am sitting for my job my height is 181 am and weight 10 keg no change for the last five years

hello after going through short the medical history I want to address some points for you first important aspect of management of diabetes is diet that will remain the primary objective for the management of type diabetes across the globe please elaborate a little about your basic diet pattern second important aspect of management of diabetes is exercise as you have mentioned your are an accountant and that will make you a less active person during a major time of the day while on the job and presently in lockdown at home take small 10 minutes of time and walk across the corridor start with little things then on the third part comes the medicines you have not mentioned how many times a day you are taking amaryl my please do mention that your weight is also more compared to your height amaryl can cause a little weight gain also you should opt for tablets that will not gain weight there are certain medicines available now which controls blood sugars and also help in weight loss apart from this I would like to know about your family history of diabetes and the stress levels you are facing on the scale of 10 are you getting enough sleep how many times you have to go for urine at night any pain or burning sensation in legs obesity uncontrolled sugar levels fbi fasting blood sugar pubs post prandial blood sugar hba1c glycated hemoglobin lipid profile serum creatinine type do continue the same medicines until we work on detailed diabetic history take six to seven small frequent meals a day more leafy vegetables fruits pulses take less grains maid and processed food once detailed history available and reports done

hello doctor I am 51 years old I am having sweaty palms and feet every morning I also feel nausea and headaches what is the cause of this

hello as per your presenting complaint the diagnosis is migraine headaches are a common cause of combined headache and nausea migraines can cause a variety of symptoms including nausea dizziness sensitivity to light and severe headache you can make small changes to your lifestyle so that you prevent future migraine attacks here are a few steps to take to relieve migraine pain you should drink a lot of water throughout the day so that you stay hydrated at all times you should avoid eating less and should eat enough so you are getting all the nutrition that your body needs eating proper and healthy food is key to ensure your body is healthy you should try and eat at the same time daily sleeping deficiency can trigger migraines which is why adequate sleep eight hours is important you should maintain a steady sleep cycle by sleeping at the same time every night and wake up at the same time I hope this helps

i have pain while passing stool and also blood with it sum time spots and some time much more and I have physical exam to a doctor who said it is not piles it is anal fissure then I ask what is this he said in simple words its a cut he suggest me gun 2 and brixin tab if there is no relief in 10 days there will be need of operate please suggest me

hello I will definitely help you regarding your problem anal fissure is a cut in the anal message due to hard stools it may present with pain and bleeding in percent cases surgery not required but proper medicines and prevention is necessary here I will advise you complete treatment only one gel and tablet will not help follow my treatment you will get better in days follow me after days so I will modify your treatment anal fissure sit bath with betadine times for 15 minutes spy duphalac top is ointment diltigesic locally times ointment south locally times tab enzoflam times daily tab panto der od plenty of water avoid spicy and fatty foods high fibre diet days

hello I am looking and would like to discuss my treatment options for my conditions I have bipolar disorder I social and generalized anxiety disorders panic attacks and agoraphobia due to it in past I used escitalopram venlafaxine fluoxetine sertraline lithium depakote quetiapine risperidone anxiolytics venlafaxine was effective but had to discontinue it due to high blood pressure it caused other treatments mentioned did not work for me anxiolytics worked but now I do not have such options to continue this treatment because I am getting used to tranxene currently I am taking lamictal 200 my and 10 my olanzapine I am afraid to go out from my flat I am constantly alarmed nervous anxious cannot eat because of constant lump in my throat anxiety is debilitating I cannot work outside my home at work I get so anxious that I have to take some free days from work if I do not do that I vomit from this anxiety can duloxetine be effective is it common that it can increase pulse and blood pressure as venlafaxine did how long does it take for escitalopram to take effect can prozac decrease anxiety is paroxetine an good option for me

thank you for taking help from psychiatrist you should continue medications on which you are stable at present duloxetine may be good option for you it does not increases blood pressure tablet escitalopram takes around weeks for full effect after starting medications yup prozac can decrease anxiety but it belongs to same group as tablet escitalopram yup paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine you should follow below advice which can help your anxiety hope you get your answer thank you

hi I am a male aged 52years weight 80kg diabetic my doctor has recently advised me gabapentin it 400 for neuropathy earlier I was on pregab150 so while checking about the reviews from the patients on net I found that were against gabapentin which confused me and thought to have a and opinion kindly advise

hi welcome to icliniq I am do anshul varshney for your help it an excellent drug infact it is an elder sister of pregabalin only gabapentin is little more potent then pregabalin only possible side effect of that drug is dizziness but since your mother has been on pregabalin 150 my then gabapentin should suit her gabapin it also contains nortryptilline which helps further in neuropathic pain dear if you will check side effects reviews of any drugs you would get for all if in doubt discuss with your doctor once again being empathetic I use this drug very often and most of the diabetologists use it so I would suggest you to start it and see if she gets any adverse effects we can go for other options though to be very honest we do not have much options other then pregabalin or gabapentin in diabetic neuropathy I hope it helps you if you have any further questions please ask me

i have blood in my stool but no pain I suffering from externally piles but there is no itching and pain in that almost from a week blood is regularly going through out stool

hello I welcome you to icliniq the external hemorrhoids can cause bleeding and pain when they are enlarged or secondary to constipation which produces an abnormal pressure over anus causing swelling of piles the definite therapy is surgery however if certain lifestyle modification are employed the anal hemorrhoids can reasonably be controlled these life style modifications are I hope this will solve your problem anal hemorrhoids as above can follow up after days of treatment

hello doctor I have history of thyearoid and cos I am taking 50mg of eltroxin my period is delayed by days when I tested preganacy test after days of period days two lines are showing but not clearly please suggest me can I go to doctor for a checkup or wait for week for clear result or what type of precaution I should take during pregnancy

hello welcome to icliniq I see than you have not mentioned the date of your last menstrual period ideally if you have had a regular 28days cycles the urine pregnancy test is usually positive by the time you skip your periods delayed ovulation can be common in cos so I would suggest you to recheck your home pregnancy test with an early morning urine sample tomorrow and exactly at the time interval at which the result has to be read as mentioned on the kit sometimes if seen very late the evaporation line also may seem as faintly positive which is actually a false positive early morning urine sample is supposed to be having concentrated levels of the beta hug hormone which is detected on the pregnancy kit so recheck again tomorrow with a morning sample of urine if you donot have any pain or spotting you can visit your gynaecologist at ease may be in a week and get an ultrasound done for pregnancy viability and localization meanwhile continue taking folic acid eltroxin medications recheck your thyearoid levels as during the pregnancy the dose may have to be changed due to increased requirements in pregnancy hope this helps please feel free to revert back anytime for any further queries or information continue tablet folic acid 5mg daily once till 14weeks continue tablet eltroxin 50mcg daily once avoid sexual intercourse in the first months of pregnancy

hello doctor it has been weeks since I have been feeling acid reflux with symptoms of heartburn and back pain I have been taking kremil and omeprazole lately I am experiencing diarrhea I hope you can help me

hello I have reviewed your history as well as the medication profile you just shared so the part of the problem is secondary to the medicine you are taking such as diarrhea which tends to occur secondary to kremil since this medicine contains aluminum and magnesium both could cause diarrhea I want you to stop it now in addition senokot also causes diarrhea I am afraid that your initial physician has given you both these medicines for constipation or for stomach pain you should stop it as well until your diarrhea gets better omepron omeprazole is a generic medication but there are many which are now available with good effect I recommend you to switch to capsule esomeprazole 40 my take similarly as you were taking omepron before breakfast in the morning if this dose does not help increase the dose to twice daily before the meals let me know in a few days if symptoms persist I may consider adding other medicines for you if it does not work in your case gastroesophageal reflux disease dyspepsia follow up in three to five days

hello doctor I am weeks pregnant in my previous pregnancy I had a section at weeks as my water broke presently I am taking aspirin tablets daily my doctor prescribed it but I have a doubt that will it cause excessive bleeding in my delivery as I am near to delivery is it safe to take these tablets I am currently taking ecospirin 150 my diamet metformin 500 my rotate ad folsafe wysolone my and iron tablets

hello I totally understand your concern but please do not be stressed all you need right now is to relax keep calm and take some rest yes ecosporin is totally safe during pregnancy and mostly your gynecologist will continue it until 36 weeks at least but I would like to know the reason for starting ecosporin and also the steroids wysolone because you have not mentioned it could be related to previous pregnancy events which need to be known in detail and also if you go into labor you can stop it then the effect usually does not last more than a day and the dose that is given in pregnancy is very low so definitely there is not much risk of bleeding I hope this helps

hello doctor I am a year old male I have been getting hips legs knees and back pain issues when masturbating I usually masturbate four to five times a week sometimes I can go two to three days without masturbating I have cracking noises in my hips and knees and my quad muscles feel over stretched and tight this problem has affected me and I am very limited in performing any activities such as sports I am not physically active anymore I used to play sports regularly but since I started having so many problems from the waist down I stopped also I get pain even when I am standing sitting or driving and get pain in the morning after waking up I live abroad and to get any medical attention requires months of waiting I currently have an mri booked in five months but my symptoms are getting worse day by day and I do not have the patience to wait until then is masturbation the reason for my problems how can I fix these issues and get my life back to normal is mri necessary if not what do I need instead please help

hello sorry about your health condition masturbation usually may not cause weakness or muscle problems so do not worry the possible causes for your problem is panic attacks or anxiety which lead to increased tension in muscles hypocalcemia fibromyalgia hypothyearoidism vitamin deficiency rheumatoid arthritis myositis still many possibilities are there so use vitamin capsule like evian 400 my twice a day for two weeks use tablet aceclofenac 100 thiocolchicoside my twice a day for five days avoid excessive masturbation as it may lead to penile mucosal injuries lack of sex drive etc eat more green leafy vegetables and fruits do yoga and meditation regularly to release your muscle tension get done hemoglobin level thyearoid profile serum calcium and vitamin levels also do ra rheumatoid factor ana antinuclear antibody aso antistreptolysin are also useful if symptoms are not improved please consult with your physician or rheumatologist he will examine and treat you accordingly

hi doctor my last period was on 25th february 20 I have done urine test twice at home and it is positive and I do have other symptoms of pregnancy I am sure that I am pregnant due to corona situation I am afraid to get out and do other tests and see the doctor I do have a dry cough for the last one month and some time with white mucus mostly when I eat rice and spicy food my cough starts I have called a gynecologist and she told me to have adovas after lunch and duvet rupatadine 10 my after dinner for seven days after seven days I called her and told her that I feel a little better but not stopped coughing and she advise me to take adovas only three times a day I did and it did not help me at all I called her again and she advises montelukast 10 my after dinner and its also not working it has been four days since I took montelukast and I feel like I need to deep breath when I take it I have only cough no fever no pain no breathing problem no headaches and no running nose as you know in this corona situation I cannot go out with a cough to get other tests or see a doctor for my pregnancy advice and lab test would you please help me advising good medicine so my cough stops other than the above I am taking folic acid my two times morning and evening as she told me do I need to take anything else for my pregnancy at this moment please help

hi congratulations on your pregnancy let me tell you in the first three months of pregnancy vomiting sensation gaseous state mood swings breast and back pain are common I understand it is not possible to have a consultation now for cough do stream inhalation three times a day tablet azithromycin 500 my twice daily for five days syearup dextromethorphan guaiphenesin combination my twice daily for five days we get it as syearup ascoril in india you will be fine folic acid is a must once a day till your pregnancy and tablet dominate doxylamine twice daily before food will prevent nausea and vomiting

having pain in anus as well as difficulty while passing stools huge amount of blood loss

hello I welcome you to icliniq first of all try to reduce your weight at most times it is the obesity which has been causing problems the bleeding while passing stools can be secondary to anal fissure hemorrhoids rectal ulcer due to difficult defecation for better clarification and confirming the diagnosis I need to know more about your symptoms such as how exactly the amount of blood it is does blood form a streak over the sides of poop how painful it is while passing stools and does it causes pain or burning even after hour of opening your bowel and do you have constipation no of stools in a week if you could answer me for above question I would be in better position to tell you what it is exactly considering a possibility of anal fissure I recommend you to apply diltiazem gel over the bottom with a finger times daily and start taking ispagol husk table spoon full in glass of water daily irrespective of constipation or not take at least to liters of water fluid daily reduce weight by brisk walking 150 min week and reduce caloric intake as mentioned above mentioned above as mentioned above

hello doctor I am 24 years old female my height is 156cm and I weigh 91kg I had two abortions and still no baby yesterday night I had some blood on my stool and earlier for few months I had gas problems usually gas comes for many times in a day also I feel like gas is stored in my abdominal area and feels like to visit toilet often feeling heavy in my lower abdominal area for me it feels like gas yesterday one time I got some blood on my stool and today I did not get any blood but my abdomen feels heavy and it creates discomfort what is my problem and what I need to do to get relief from this doctor will you please suggest me some opinion please doctor

hello I welcome you to icliniq actually the chronic problem of gas you mention is common in some one with overweight to obese as in your case may be since your weight appears to be way beyond normal and this has definitely health consequences if not controlled the blood in stool you mention is somewhat alarming and requires a thorough in person examination of the bottom and looking for the causes such as anal fissure hemorrhoids to some serious disorders like inflammatory bowel disease to summarize I want you to go and meet a gastroenterologist in your local area and get yourself examined to determine the cause for your and foresee physician ease just discuss above mentioned causes with him or her so to finalize the gas problem is benign non alarming but the blood you mention is alarming and need to be investigated I hope this will help small intestinal bacterial overgrowth follow up after getting examined by physician in person

hello doctor I have had ed for several years now I am able to get an erection but I am unable to maintain it I have been going to a men clinic for seven months now and they have done the gainswave treatment and implanted a testosterone pellet last week after all this there has been no improvement I have been using the ici injections and that maintains the erection sildenafil is effective sometimes but not consistently I have also improved my diet and exercise I also have delayed ejaculation during this but in the last 10 days I am unable to ejaculate at all either through sexual intercourse or masturbation I have been on saris selective serotonin reuptake inhibitors in the past but stopped taking them six days ago at this point I am at a loss and would like to get another opinion and some direction

hello your lipid values and blood sugar values are absolutely normal I would like to say a few points here lisinopril hctz hydrochlorothiazide is a combo of two drugs in which hctz has erectile dysfunction as one of its side effects hydrochlorothiazide need to be replaced with a different drug or removed you are on three antihypertensives lisinopril hctz and amlodipine is your hypertension that severe testosterone implant may improve your libido but may not benefit ed erectile dysfunction always unless there is a gross hormonal dysfunction sari group of medicines are prescribed to delay ejaculation I do not know why were you prescribed one that is the culprit which has stopped your ejaculation totally better to discontinue it instead of sildenafil for erection you can try tablet tadalafil 10 my cialis after consulting your andrologist the erectile effects of sildenafil are short lasting whereas tadalafil has prolonged effects and one pill on friday will make you have a wholesome weekend it may even stop the need to have intracavernosal injections one investigation which I would suggest you is a penile doppler which gives an idea of blood flow to the penis gainswave is an addons to cure you fast penile doppler study ed

hello doctor I had a medical abortion a month ago my period came 29 days after the abortion after the period I did an hug test and it was positive 37 days after abortion my hug level is 18 21 after three days the test showed 17 56 I also did an ultrasound and the doctor said I have my endometrial thickness on one spot he prescribed me duphaston to take from day 15th day to 25th day of my cycle I am scared to take it and also I am scared that maybe I have some retained products but the doctor said I am fine what should I do is it safe to take duphaston in my condition

hello first of all there is no harm in taking duphaston in your condition it is just a progesterone hormonal analog the same hormone is secreted from the ovaries once the egg is released after ovulation so there is nothing to worry about taking it I would like to know what was the indication for checking beta hug human chorionic gonadotropin value at 37th day post abortion when everything was fine you even got your periods pretty much on time regarding your beta hug value I would like to tell you that beta hug may be detected in maternal blood up to 6 weeks post first trimester miscarriage or medical abortion did you had a missed miscarriage or was it an unwanted pregnancy that was terminated medically and at how many weeks of gestation this is important because sometimes missed miscarriage may harbor partial molar pregnancy which goes unnoticed as biopsy or histopathological examination is not done for such cases but yes any persistence beyond weeks of abortions should be monitored carefully as these may be a hint of development of gestational trophoblastic neoplasia gun as your scan is normal and also endometrial thickness of my is also a normal finding so there is no chance of having any retained products it would be helpful if you could share the ultrasound reports pre and post abortion and the dates of the events along with the date of doing beta hug levels to have a better idea of your situation I would advise you to recheck your beta hug value again after a week please revert back to me with the necessary details I requested you so that I can guide you further serum beta hug value after a week

hi firstly I would like to thank for this wonderful and a very helpful service of online consultation my query is I have been using inhaler cipla serflo 250 from almost years as I am an asthma patient as its a hereditary thing that I have but as I am in a foreign country at the moment and my inhaler is about to get over and due to this pandemic time I cannot get it imported to my place but I have a friend who has given me maxiflow 250 from cipla as well so I wanted to know if I can use that as an alternative inhaler as I do not have my serflow 250 inhaler in stock your assistance would be highly appreciated and much obliged thank you

hello doctor my son is 19 months old he is grinding teeth most of the time not eating at all only one spoon after that he has feel of vomiting so am giving food with a long interval between every bite also we giving only mashed foods previously he was taking idlies now even half idle is difficult for him to finish one of my friends suggested me to give albendazole syearup ad his symptoms suggestive of worm infestation can I give albendazole syearup if yes how many my and his weight before two months was 9kgs because of lockdown we did not check his recent weight if no what medication can we give please reply am really worried about his eating habits he became very thin comparing to before thank you in advance

hello hope you are safe thank you for the elaborate history I appreciate your concern regarding your child I would like to first tell you that grinding is a common phenomenal in children till years most children outgrow it by years however at this age if he is grinding you can give him plenty of water positive feedback helps and for more discussion regarding reward and positive feedback you can consult me on phone as it is difficult to explain those things verbally as for albendazole you can give 400 my once stat dose only repeat at months interval regards

age 62 years my mother has severe heart problem she had high blood pressure from long time but didn't get any medication now her feet and ankles are swollen a doctor recommended triforge 160 12 loprin 75mg her be is managed now but she feels high heart rate palpitations and cold sweating please help me I cant afford hospital expenditures waiting for your kind and helpful response s she is also taking epival from last years

at the ends of my lips I see it is little dark in color so I applied honey and sugar mix on the dark area it now became even more darker so I started applying neutrogena fine fairness cream for lightening the dark color after applying the cream my entire skin started becoming red and I also have little burning sensation so I started rubbing with ice cubes and I also applied aloevera gel and also boroplus antiseptic cream but still I could see my skin red and little burning sensation is still present could you please tell me any home remedy for this or any ointment which could reduce burning sensation and lighten the darkness around my lips

hello doctor I have a positive up and my lap is 31st march I have an irregular period at 13th may and I found some blood spots after that I go for a to ultrasound that shows no definite gestational sac endometrial echo is central and normal in thickness and measures 6 am before to ultrasound on ith may I checked my beta hug and it is 178 and after 48 hours it is 247 is this miscarriage or should I go for another ultrasound because after that I do not have bleeding or cramps or anything please guide

hello I have gone through the description you mentioned and understand your concern totally but the details are a little confusing it would have been good if you could give details with dates when beta hug human chorionic gonadotropin was checked I understand that scans were performed and the beta hug test on ith may is 178 and on 10th may it was 247 on 13th may you got the scan as you had a spotting right see as your previous cycles have been irregular it is difficult to predict when you would have ovulate exactly so we cannot go by your dates to calculate the duration of the pregnancy may I know when did the urine pregnancy test turn positive for the first time it would be advisable to recheck your urine pregnancy test now again as you had spotting if the levels are falling then it would be suggestive of a miscarriage and mostly this could be like a biochemical pregnancy where pregnancy is detected only in the blood tests but on the scan I cannot find the gestational sac development which has ultimately got aborted as levels you mentioned last were pretty low another possibility to be ruled out more importantly is ectopic pregnancy or pregnancy at some unknown location to rule out all these doing a serum beta hug will clear your doubts serum beta hug level repeat ultrasound after checking the beta hug value report to your gynecologist if you have any sharp pain

hello doctor I have fever and leg pain since last night I had preauricular sinus infection pus drainage three weeks back I was on different antibiotics for the last 45 days taxi centil augmenting and lizobact 600 I stopped taking them two days back

hello I have gone through your query as per your query you have taken multiple antibiotics for a long time which is not good I need to know whether you have done a culture sensitivity test for the pus draining out of the sinus or not because if you take antibiotics according to the culture then chances of recurrent sinus infection and fever are very less can you send me the photos of your infected area preauricular sinus mostly pus discharging sinuses are caused by tuberculosis infection in most of the cases in my opinion you should go for a detailed physical and systemic examination along with some blood tests and chest ray also if discharging sinuses is still persisting then you need to do a pus culture sensitivity test both for bacterial culture and acid fast bacilli aft culture and other advanced tests for tuberculosis now you can take tablet paracetamol 650 my whenever you develop a fever please do not ignore your problem as it can lead to deterioration of your health I suggest you to consult a physician and get a detailed physical and systemic examination done and detailed evaluation along with the above tests

hello doctor I have white patch on my face it was very pale but when I apply fluticasone it appears as white even my cheeks are rough and slightly depigmented

hello how long it has been there what are the symptoms of it any other area affected any other family members affected any history of hypertension diabetes mellitus thyearoid disorder any known drug reaction looking forward to your response in order to help you

hello doctor how accurate are early ultrasounds at determining gestational age and conception based on my ith week scan I am 23 weeks today means I conceived around december 25th is it possible that I actually conceived around december ith and baby is measuring small I have had six ultrasounds and the baby has never measured more than days off from the date given at my week scan even though my last period last came on november 28th she has never measured on track for that

hello welcome to icliniq com the first trimester ultrasound scans done before 12 weeks are the most accurate ones in the assessment of gestational age with an error of only to days in the assessment of gestational age so they are used for obstetric dating and determination of expected date of delivery moreover if you have done ultrasounds and the date calculated from each of them corroborates and does not lag behind then probably your baby is growing well and it is not small as you apprehend the date we calculate from the first day of last periods is accurate only if the periods were regular for the last months and there was no history of miscarriage or ovulatory disorder like cos polycystic ovary syndrome or contraceptive pill intake in case of any discrepancy the date from dating scan at weeks are accurate and to be considered it is a probability that you actually conceived in later part of the cycle which leads to this discrepancy between the date and us

hello doctor I am a 36 year old male I previously had a chlamydia infection and was successfully treated will such previous infection interfere or affect my fertility I recently had a scrotal examination and the results were normal

hello chlamydia infection persistence or recurrence can definitely cause an apparent increase in the pus cell and abc count in the seminal fluid which can easily decrease the total sperm count and its quality if you have been treated it is good but again it takes 90 days for new spermatids to form adults and become functionally mature for fertilization it is always best to get a repeat semen analysis and culture done to be sure that there is no repeat or recurrence of chlamydia infection if you have been sexually active post your previous examination or if your partner was not treated along with you

i have a small pimple or swelling in anal area where stools are passing from last one week which is not painful and there is no problem with bowel movement its having an itching sometimes it is piles or any related disease it just had a small itching sensation and had small pain while washing after bowel movement and no pain while passing stool

hello dear I welcome you to icliniq this seem to be a perianal boil the boil is a pus containing hair follicle hair are the stalk and follicles are the trunk of the hair the follicle can get infected and cause enlarged painful swelling called as boil it is not communicating to your bowel thats why you dont have problem with your bowel the best thing you can do is to keep this bottom are clean and hygienic wash it thoroughly with each bath and remove hairs timely you can apply fusidic cream three times daily over it shall heal in few days of application of this cream I hope you will be fine good day perianal boil folliculitis none fusidin cream for local application follow up if symptom persist

please I will like to know what I can do about it dark underarm

i have always had trouble with my tonsils I get tonsil stones frequently and snore for the past month I have had a mild sore scratchy throat I can tell my left tonsil is swollen and it is causing some pain sometimes the pain reaches my ear but not often my doctor did a swab to check for infections but it came back clean could this be allergies I have never had allergies before except for asthma as a child I have no other symptoms

hi I understand that you are worried about your long term tonsil problem tonsil enlargement could be due to infection or as a part of some other disease if your swab is negative we need to investigate for other possibilities also I would suggest you some investigations for the same meanwhile also take the tablets as prescribed abc ear peripheral smear it neck chest xray tonsillar enlargement under evaluation cefuroxime 500mg stab twice daily for week after food aceclofenac serratiopeptidase stab twice daily after food for day betadine throat gargle thrice daily review with investigations

hello doctor today I had an asthma attack at work and they treated me and did a chest ray I am an ray technician and I just do not think my chest ray looks right please suggest I am currently on concerta omeprazole cetirizine montelukast symbicort pro air emergency pump and albuterol

hi the chest rays pa and lateral views are showing mildly prominent bronchovascular markings in the bilateral perihilar and lower zones and might be of concern for hyperactive airways after the asthma attack there are no focal lung lesions there is no pleural effusion the cardiac size is normal the retrosternal space is normal the domes of diaphragm are normal please discuss this in detail with your doctor

hello doctor I feel rather extremely angry than at the same time very sad I always have this very gory thoughts that I wanted to kidnap and torture the person I hate and again at the same time I want to hurt myself because I am so incompetent and I always feel like all the people think the same way to me that I am incompetent and that if I die everyone will be happy I also started gripping things strongly and I always try to stop when I notice am I really unstable does this mean I cannot do my work properly

hello how long have you been experiencing these symptoms like extreme anger sadness and other difficult emotions has there been anything ongoing stressors in your life that affects you negatively from the information you have provided it appears that you are stressed experiencing depressive thoughts and need support to cope with the emotional difficulties speak to a trusted family member friend about your difficulties so that they can understand and support you do not keep things to yourself as it will add to your stress having fantasy thoughts of wanting to hurt the person you hate and self harming thoughts can happen if you are overwhelmed by your situation and not having positive coping strategies you need to consult a psychiatrist near your place for a comprehensive assessment to clarify the nature and severity of symptoms based on which counseling or therapy can be provided with the right treatment you will feel more in control of yourself and will be able to function normally I hope this helps

hello doctor I would like to get a third opinion in regard to categorizing which uterine abnormality I possess the initial doctor said it is arcuate my current doctor thinks it is bicornuate but I am going to do a ad ultrasound in the middle of my next cycle to get a better idea I have mri and hysteroscopy photos to provide I have had two missed miscarriages the last one hemorrhaged two days before going septic and sent me to the er for five days I have also been diagnosed with a placental site nodule on my right side where both pregnancies have been could my problem be surgically corrected currently we are going through genetic blood clotting disorder and menstrual cycle hormone monitoring genetic counselor said low risk for any genetic causes but is still waiting to complete the blood tests which should be done in four weeks same for the blood clotting tests

hello having gone through the mri pelvis and hysteroscopy pictures it is evident that you have a bicornuate uterus with a single cervical opening and it is not a septate uterus or an arcuate uterus two different horns of uterus are evident on mri magnetic resonance imaging indicating the bicornuate abnormality the option which you have is called straussman operation where both the horns can be cut in the centre and joined to make a single uterine cavity you may discuss the option with your gynecologist and make a decision

hello doctor my mother has paranoia schizophrenia for the past 16 years the delusions have become very absurd and in her story her immediate family is the culprit she has very vid auditory hallucinations and sometimes visual hallucinations she has refused to see a doctor as she believes they are in on it her stage of psychosis is very violent in which she screams and shouts and also turns violent this has been going on for 16 years but now the episodes of psychosis are becoming more intense please advise on how to talk to her or at the very least medicate her because it is taking a toll on our mental health my sister suffers from depression and I suffer from anger management how our father holds it together I have no clue please advise

hi it is quite difficult to manage such issues when patient refuses to take the drug however nowadays depot injections are available and their effect lasts up to four weeks so talk to your psychiatrist regarding the injection once she is put on a monthly injection then it will be easier for you to give her a monthly dose this will ensure drug compliance and a better outcome I hope this helps

hello doctor I am running an it firm for the past four years currently I am having two health issues related to my work lower back pain it started two years back and now it has become worst now I cannot ride a motorbike cannot sit in a normal chair and cannot even sleep on my sides I also cannot walk or stand continuously for more than half an hour currently I am using a belt and it is helping a lot pain in both the shoulders if they are not in action like if I am sitting in the chair for more than an hour without regularly using my hands the shoulders start paining this just started a few months back and getting worst I have not consulted a doctor yet for both of these issues I wish to book an appointment and it would be appreciated if the doctor knows malayalam as my english is not up to mark

hi well you have a typical problem with people working in an it firm tell me first how much physical activity you have in your daily routine

hello doctor my wife has been having itching on her body for the past one year itching subsides with allegra 120 she is taking this medicine for the last one year mostly she gets itching on the area which is not covered by clothes skin becomes red when she scratches it I am attaching the picture

hello she is allergic the allergy can be due to food sunlight pollen soap moisturizer or powder so she can be allergic to anything as you mentioned that only areas that are not covered by clothes are affected which points to photosensitivity which is an allergy to sunlight it can be an allergy to something else as well it is very difficult to say only on the basis of history I would suggest to look for any particular food if she develops itching after eating something change soap moisturizer and powder cover the whole body while going out which will protect if she is allergic to sunlight you can also go for skin allergy testing which will confirm the diagnosis take tablet montair la montelukast and levocetirizine whenever she has itching stop allegra it is basically prevention from allergens she is allergic to you can find it by yourself by closely watching or go for skin allergy testing

hello doctor I am 24 years old I have always been very anxious about health especially my sexual health but when I was about or 10 a spot came up on my penis where the glans and shaft meet it was flesh colored painless and round there was no dimple in it I was never sexually abused or sexually active at this age I did not even masturbate the first time until I was 12 or 13 my mom took me to the doctor and they said like just come back if it gets bigger she had likened it to a wart but it was not very hard or dry anyway it stayed for a couple of years after that it shrinks down it no longer appears as if it is above the skin but appears as a small pin sized bump underneath a skin bridge I am curious if it cannot be an sad and I have never found anything similar online so what could it be I would not think a wart would stick around that long and it really does not look like that at all that was there over 12 years so I would not think it is anything fatal to be even more specific it is on the top side to the right as I said it looks like a skin bridge with a little bump underneath but it really has no sort of texture and the only problem it really causes is some skin rubbing when that extra skin rubs my underwear

hello this was likely a wart only warts can have very varied morphology and most plausible explanation is for wart only because considering it was a single lesion was not painful or itchy flesh colored and it persisted for a long time and resolved on its own so all these factors favor it morphology can be variable the negative factor was not sexually active although most common causes are sexual contacts but significant number of individuals may have it with non sexual contacts as well it can be transmitted vertically during childbirth and remain dormant for a long time activating later in life it can be transmitted with usual contacts and can be transmitted through clothing like underwear if came in direct or indirect contact with infected individual clothing sharing toilets etc can also transmit it so being not sexually active is not a strong factor against it rest all causes like skin tags which would persist without treatment or fall off suddenly up pearly penile papeles would be numerous papeles other infectious causes would be short lived and multiple lesions and symptomatic like painful tender or red malignancies are unlikely at this age and would progress so the probability is high for wart only I hope this helps

the bottom part of my abdomen hurts and I cannot poop

hello I welcome you to icliniq I can understand you must be very upset about your problem it seems that you have a defecation disorder which is difficulty in passing stools it can occur to any body but common among individuals who have difficult learning the art of passing stools for this you have to relax remove your anxiety and start learning the art of pooping here are some tips for that if all above fail then there is computerized therapy called biofeedback therapy I want you to follow above tips first and let me know if improvement if required I will suggest when to go for biofeedback therapy the pain is a secondary phenomenon once your stools became normal the pain will go away do not use painkillers because they may slow your bowel and can cause more constipation defecatory disorder slow transit constipation defecatory disorder as above follow up in week and update me about your problem

hi doctor I am 21 years old I was diagnosed years back with obsessive compulsive disorder I followed treatment with the help of a psychiatrist who included cognitive behavioral therapy and medication of medication as many times as I tried to stop paroxetine seroxat in collaboration with my psychiatrist of course my body reacted with nausea dizziness and other similar symptoms so I take a seroxat 20 my one day and in the next day half alternatively on my own initiative this has been going on for the last few months as I was getting one and a half at first and then one I have been taking them for two years now I cant stop taking the medicine because I am afraid of the symptoms what can I do to deal with the symptoms of the drug cut after I have completed the treatment thank you in advance for your response

hello sir after finishing pack of combination pill 21 tablets I forgot to start another pack on ith day so I started new pack from 10th day we had intercourse in 10th day and I took ecp unwanted 72 after 42 hours of intercourse is the any chance of getting pregnent

doctors are switching between whether I have crowns or ulcerative colitis based off response to treatment and medicine started humira last month but it has come in for my and round and it is already a month late wont know if that worked or not since I am off schedule this past week the area around my rectum with is very raw has swelled up its around where I have the sexton in from a fistula past week my bowels have nothing but liquids every time I go to the bathroom is expands that area where the sexton is causing excruciating pain I am currently on imodium and flagil I have taken anvil and tylenol nothing has reduced the pain

hello I welcome you to icliniq I know you must be very upset about your ongoing condition you symptoms suggest that you have crowns disease not ulcerative colitis humira and biologic medications like this work for a while before losing effect till the time of next dose so yes if the interval between two doses is extended the patient can develop flare in interval period the symptoms you mention may be of a mild to moderate intensity flare but can be secondary to infections the clostridium difficile infection which is common you did not mention that the pain in area of where you have sexton is new or occurring before as well and when did you have sexton for fistula the swelling you mention can be an evolving perianal abscess due to active lumnial disease the abscess formation is the first step in the formation of fistula which is a end result due to rupture of abscess from both side lumen on one side and skin on other side so I am afraid you me have this flagyl is good if taken for long time to treat perianal disease but you did not mention for how long you been using this for now you can continue this and get yourself examined by your physician to look for evolving abscess adalimumab humira works well for perianal disease but make sure you need to increase the frequency and do not disturb the schedule I hope this will help take care crowns disease with perianl disease stool for difficile antigen and stool for calprotectin stool detail report stool culture

hello doctor I need a multivitamin supplement and digestive enzymes to regain bone ligaments and tendons weakened by digestive issues malabsorption of essential nutrients due to digestive conditions like chronic atomic gastritis resulted in bone loss osteoporosis low stomach acid and joint weakness like ligaments of knee etc I need supplements that do not depend on stomach acid

hello after going through your query and detailed report I suggest to calm your gut first which in turn helps to increase absorption of vitamin and calcium and start with glutamine supplement og capsule daily preferably before going to bed or at least an hour before meals later you can opt for multivitamin supplements with good food intake along with that follow these tips increase high protein diet including almonds vegetables fish chicken and eggs do muscle strength exercises if allowed by ortho increase fluid intake do rest for 9 hours of sleep manage stress with meditation do breathing exercises manage to follow small frequent meals do take 2500 cal diet if required you need to add supplement whey protein glutamine

hello doctor I have acne and oily skin with very bad acne scars and dark spots all over the face please help

hi if possible provide me photographs of the affected areas which will help me for better understanding of your skin problem and proper treatment plan photographs are required for diagnosis purpose because the treatment given without proper diagnosis can be less helpful or can also harmful for you

hi doctor the imaging of the neck region was done and some lesions were detected the operation of lower jaw and neck region was done followed by chemotherapy and radiotherapy and it was stated that things will settle to normal during routine checkup some swelling in neck region was detected and fac was done which shows metastatic poorly differentiated squamous cell carcinoma and after that full body scan was performed the reports are attached kindly look into it as the second opinion is required

hello I am sorry to know the recurrence of cancer you got diagnosed with squamous cell carcinoma in buccal mucosa of the left oral cavity in december 2019 which was operated then you received chemotherapy and radiation therapy and now on routine evaluation there are some new lesions coming up in the thyearoid and neck so basically there are two sites of new lesions now in parotid and around it one more lymph node so please undergo a biopsy of this lesion from parotid to see if it is same cancer as before or a new second primary cancer if it is confirmed as same cancer as before it will be operated and taken out and also few more lymph nodes on the same side of the neck followed by chemotherapy if a second primary cancer then treatment can be different depending upon what type of cancer it is on biopsy so your first step is biopsy

hello doctor red itchy patches on groin area all the way spread around anus and thigh tried treating with camphor mixed with conut oil first then used cosvate go ketoclean and veto soap it has worsened

hello you have tina corporis cruris which is also known as ringworm fungal infection kindly stop using the earlier medicines you should take capsule itraconazole 100 my twice a day for weeks also take tablet cetirizine 10 my at night for the itching also apply luliconazole sertaconazole eberconazole cream twice a day kindly take bath twice a day this will help in cleaning the sweat on the body which helps fungus to grow also as you are a diabetic you have to maintain your sugar levels in uncontrolled diabetes fungal infection is very common take care and stay healthy tina corporis cruris as explained above avoid wearing wet undergarments

hi doctor my niece who is year and months old got choked today when she drank her milk she got cough because of the choke but the cough keeps coming back the whole day I thought it was just a simple choke as it is just milk why does it last for the whole day

hello for further information consult a paediatrician online

hi doctor my son is years old his doctor told that he has a cylindrical power of and 25 he also said that his muscle power is weak is it a must to wear eyeglasses

hello I can understand your concern regarding your child revert back with the prescription to an eye care ophthalmologist online

hi doctor I am losing my hair day by day can I use finasteride I have hydrocele is it related to my testosterone

hi please do not go to finasteride straight away first the cause and the pattern of your hair loss have to be assessed it could vary from seborrheic dermatitis to androgenic alopecia to any other skin disorders too then treatment can be planned have a consultation with a dermatologist for physical evaluation and get your problem assessed hydrocele is not related to testosterone it is just a fluid collection in the sac so please do not get confused for further information consult a dermatologist online

hi doctor four days ago when I was away from home for some work I felt sick and my hands and feet were numb for several hours then I had fever for three nights with soaking sweats followed by continuous diarrhea for the last four days I am going nearly to 12 times a day I read the symptoms on campylobacter and it seems pretty similar do I need antibiotics does it go away by itself I assume that I should not take medicine to stop the diarrhea I did have chicken before all of this started not sure if that is connected thank you

hi for further information consult a general medicine physician online

hi doctor I am having irregular periods my cycle is usually on the 10th of every month but I had heavy spotting on the 19th of last month then I had my normal periods on the 10th of this month but I had my periods today which is 10 days earlier than the normal cycle during mid of last month I had some iron tablets for around three to four days please help me with this irregular period issue thank you

hi I have gone through your query and can understand your health concern for further information consult an internal medicine physician online

hello doctor over the last two days I have had a bad sore throat it also accompanies with a slight cough trouble in sleeping occasional uncommon sweating body soreness or fatigue slight vomiting and voice loss it is not really getting better it originally appeared to be just a bad cold but today there is blood in my sputum it started about 15 minutes ago and it is only when I spit it out every few minutes should I be concerned my mom thinks that it may be due to a laryngoscope I got at the ent yesterday but no bleeding occurred until now thank you

hi for further information consult an ent otolaryngologist online

hi doctor I am 24 years old I am not on any sort of birth control pills I had a normal menstruation in the starting of this month and normal bleeding after six to seven days I started bleeding again the bleeding was not very heavy but lasted on and off for about six days now after a gap of four days I have got heavy bleeding again it is not brown blood as I normally see during my period it is dark red much thinner and flows readily like a liquid I feel pain in the lower abdomen whenever I get this bleeding I also feel weak there is no pain on urination or sex I do not have a history of any infections also I am not on any other regular medication I am pretty sure that I am not pregnant I have got a go appointment in a week but it is really worrying and painful sometimes what could this be

hello for further information consult an obstetrician and gynaecologist online

hi doctor I struggle to focus and I cannot concentrate on my studies I just think about other things not always bad things but sometimes I think about throwing myself out the window when I am asked a question or if there are some people around I used to get panic and struggle to answer my voice will be too low and can hear my heart racing I have been self harming myself for over a year now I have got cuts and scars on my arm I do not get along with my family and I barely do anything anymore either I sleep or think simply lying in bed I sometimes hear voices of people who are not present I feel like tight chest and my breathing is difficult I want to do well at college but I am not happy my mood changes within a few seconds I am too shy to visit a doctor please help

hi personality issues psychotherapy dbt dialectical behavior therapy for further information consult a psychiatrist online

hi doctor I am having a tough time with my skin infection it is being around two months since I got affected by that I am having the hives of dark reddish in color in specific areas like on the penis point and on the buttock it is so itchy and the whole body is getting so itchy like on hands and legs too there developed some red spots can you provide me the best cure till now some dermatologist suggested he mite ointment and I forgot the name of the other tablet he said to apply that ointment for the whole body from neck to legs I did but no improvement please help

hi revert back with the photographs to a dermatologist online

hi doctor for controlling my hypertension I was prescribed benicar 40 12 my once in the morning amlodipine my twice a day and clonidine once in the evening these were prescribed after egg and blood work even after taking the medication my be is usually 160 85 mhg what to do further please advise

hello I want to highlight a few important points here amlodipine should be used once daily instead of taking my twice daily you should take 10 my once daily which is the maximum dose clonidine on the other side can actually cause rebound hypertension which can explain your high blood pressure it should be the last resort of the treatment of hypertension it would be nice to know the dose that you are taking these days I would like to know when did you take your blood pressure and if you follow a low salt diet benicar olmesartan is a good medication please consult your specialist doctor and discuss my opinion I would like to know if you have any other medical conditions like diabetes stroke high cholesterol or a heart attack to determine your blood pressure goal according to the latest guidelines revert back with the answers to the above questions to an internal medicine physician online

hi doctor I am a 27 year old male doctor prescribed me azithral and fepanil for fever but the fever is on and off for the past seven days my blood test showed normal no malaria or dengue or typhoid first I took azithral and fepanil and then the next day doctor added cefuroxime axetil along with it as the fever continues I have got amikacin intravenous and now I have stopped all the medicines and still have a fever what fever is it I had four fepanil capsules per day for every six hours for the past seven days my blood report is normal and there is no pathogen for malaria dengue or typhoid but the value of abc is high with ear of 50mm showing microcytic anemia with neutrophilia

hello the possibilities for fever in your case are as follows for further information consult a general medicine physician online

hello doctor I am a 28 year old male for the past five years I have few swellings on both underarms recently my mother was diagnosed with breast cancer while browsing on the internet for her condition I found out that my swelling may be of lymph nodes and may be cancerous this urged me to get consulted my swellings are a bit painful while touching it at times gets sore and brings out smelly pus which is yellow in color I am anxious and would like to know what the best way to proceed here many thanks

hi revert back with the answers to the medical oncologist online

hi doctor I had unprotected sex with my girlfriend she took unwanted 72 and vomited within one hour she was late in her period by six days now so we had a pregnancy test and it showed negative it has been eight days and she still did not get her period what may be the reason

hi we are here to help you for further information consult an internal medicine physician online

hi doctor I have recently noticed a lot of wrinkling of my skin on both my thecar muscles of the thumb I just noticed it a month ago I also have a dent or atrophy on the back of my right hand between the little and middle finger I am not sure whether this is new as it seems to appear in a video of myself taken before three months I am a 35 year old male my grip strength seems good I recently did a personal best hang test of minute 20 seconds two years ago my neurologist told me that I had cramp fasciculation syndrome as I had a lot of calf and feet twitchings I am concerned now that I may have mnd please help

hi for further information consult a neurologist online

hi doctor last week I was bitten by red ant within minutes I was collapsed and immediately rushed to the hospital my be was low at 80 60 mhg it was detected as anaphylaxis I hereby attaching the treatment sheet for your reference six months ago my year old son expired due to unknown insect bite we did not know about anaphylaxis at that time what type of treatment should I get further for anaphylaxis

hello for further information consult an internal medicine physician online

hi doctor my wife is having swelling over the collarbone and back our doctor diagnosed rheumatism after blood test now she has pain in ribs when she carries our year old son or any weight our doctor had prescribed bon dk bon ke etc how long will it take to recover is this a serious problem will this get cured please explain

hi anti cop ana and serum uric acid rheumatoid arthritis soft tissue rheumatism seronegative arthritis for further information consult an orthopaedician and traumatologist online

hi could you please review the attached photos and ray taken before treatment post root canal and post temporary filing please let me know whether a post is required or is core filling with crown sufficient

hi for further information consult a dentist online

hi doctor my friend is going to adopt a months old female child certain routine tests were performed on the child I have attached the reports for your reference the he electrophoresis for thalassemia screening is showing an abnormal hemoglobin pattern the treating pediatrician is not sure about the prognosis that is whether the child will be symptomatic and transfusion dependent presently the child is asymptomatic except for mild splenomegaly please suggest about the future prognosis of the child to facilitate the further course of action

hi based on your query and attached report my opinion is as follows for further information consult a hematologist online

hi doctor my voice is very low I am not able to scold or intimidate anyone when my friends abuse me I am not able to reply them they take advantage of me they never heed my words sometimes I feel much worried about it I also hesitate and vibrate while talking people keep me down with their voice I am not able to cope with them my friends suggest me to increase my pitch sometimes I am not audible to my friends also I have this problem since my childhood I am having some fear to speak to people and even my friends give me some tips to improve my speech and articulation skills

hello for further doubts consult a speech therapist online

hi doctor I am a 46 year old male my weight is 74 keg and I am having an excellent physical shape I think I have some sleep issue I did not get proper sleep for any days and hence I feel tired and irritable at times I am very active professionally and leading very engaging life I am not suffering from any depression or mental issues I get a little bit of anxiety at times but nothing serious that I can feel what could be the reason for this what are the remedies please suggest me

hi I have gone through your query and can understand your health concern for further information consult an internal medicine physician online

hi doctor I am suffering from peripheral vision for the past one year I cannot control my peripheral vision by ignoring the people just beside my main vision it is much wider than foveal vision and it seems like I am staring the person please help me to resolve this

hi revert back with the report and answers to the above question to an eye care ophthalmologist online

hi doctor my brother is suffering from back pain his doctor recommended some painkiller for one month now he also got pain on the right side of his back his doctor recommended laboratory test for kidney and liver along with mri of back the result showed some kidney related problem I want to know whether it is a sign of something serious can it get cured easily

hi we are here to help you for further information consult a nephrologist online

hi doctor my mother had an ankle injury and she cannot walk she fell down inside the house while walking and her leg is twisted we have subsequently taken an ray and I have attached the ray for your reference please help me

hello for further information consult an orthopaedician and traumatologist online

hi doctor I have dry skin I do not have any health problems but my skin got tanned and black as I spent most of my time in the sun my appearance looks more than my age I want to make my skin fair and glow with the ayurveda products I have read a lot of natural beauty products on the internet like turmeric sandalwood multani mitti paya and milk powder but it is confusing as which suits me well to make my skin fair and glow please suggest me the best one for my skin also advise when and how to use that also I read on the internet about kumadi tailam eladi oil and anti vardhaka are these good to use if it is so then how to use it is there any oil and cream in ayurveda to make my skin glow please suggest

hello yes what you have heard about ayurveda skin products are very good but the product will not be suitable for everyone for further information consult an ayurveda specialist online

hi doctor I am a 26 year old female I have checked my pregnancy test on the ith of this month and my last lap was on the ith of last month I have consulted the doctor he confirmed my pregnancy and prescribed me capsule gestafine 200 progesterone soft gelatin 200 one capsule per day for 15 days and folvite my one tablet per day for 15 days after a week I found some brown discharge then my doctor did a scan and said that the baby growth is not well for the one month of pregnancy she said that there is a 50 chance of miscarriage so she prescribed aspirin gastro resistant tablet ip 50 my one tablet per day for 15 days and tranlok two tablets per day for three days as my brown discharge did not stop again I went to the doctor she has done an ultrasonic scan and told me that the baby has started to grow now she prescribed im hucog 500 one injection im austen 200 one injection tranlok three tablets per day for days duphastone 10 my three tablets per day for 10 days austen 200 one tablet per day for 10 days folvite my one tablet per day for 10 days and aspirin gastro resistant ip 50 my one tablet per day for 10 days as of now my brown discharge has stopped I tried to approach you this time because on the internet I found that tranlok is prescribed to stop uncontrolled bleeding in menstrual periods and it is not mentioned for pregnant women since I am pregnant I just want to confirm whether there is any side effect in the above mentioned tablets shall I continue those medicines please help me

hello I understand your query completely here for further information consult an obstetrician and gynaecologist online

what is the worst thing that can happen if a small ant crawl in human body through nose or ear

i am 29 years old a mother of a 17months toddler two years ago I was suspected to have fibroadenoma on the right breast by a doctor who is only done the ultrasound because I have not accept to do the biopsy on the report it is written by the doctor ultrasonographic bilaterally dense glandular parenchyma on the left side there are no signs of pathological echogenicity on the right side is seen lobule hypohehogenic focus of 16mm suspected of fibroadenoma since then I have not done any ultrasound at all and have not used any kind of medication because the doctor havent prescribed me anything and recently I feel pain before the period and then after having the period I dont feel pain but now that I am on the fertile days I feel pain a lot when touching it and I can feel that there is a thick lump near the nipple moreover now I can feel I have lumps also on the left side when I touch it and it is painful but the right side is more painful and this did not happen to me before just to add that I am still breastfeeding I want to do another ultrasound but until then I need your answer about these questions I do not have family history with breast cancer except the aunt of my mother who had breast cancer is it possible this is cancer and not fibroadenoma what kind of a diet should I have to cure this disease I am afraid of biopsy I have heard that it is dangerous because when you get a part of the lump removed and if that is cancer the rest of it will be shared all over the body is it true should I stop breastfeeding and can I plan for another baby after some months or I should better do a surgery before then is it possible that I feel this pain these days because of the fertile days I am going through thank you a lot

hi I have gone through your narration of symptoms with the history of pain occurring around the periods time it is more likely to be fibroadenosis rather than fibriadenoma I would like to assure you not worry about either of this conditions as both of them are only benign conditions and not cancerous it wont cause any dangerous harm there is nothing much specific help we could get drastically from diet modification for this condition just maintain your ideal body weight but still you need to confirm it by a biopsy need not fear about biopsy as you described it is not removal of part of the lump it is just a pinch of the lump a small bit from it with a small injection sometimes your surgeon might decide to excise it as a whole and send for biopsy in which case it is called excision biopsy but that will serve you dally for diagnosis and also completion of treatment by total removal and it is only a minor surgery not a major one so just throw away your fears on that you can continue breastfeeding and plan for pregnancy but I think the lump may increase in size during pregnancy which I am not sure about you need to consult with a gynaecologist regarding this do the investigations as advice below and review back abc ribs serum lipid profile free to ash us both breasts

i am a 21 year old male and take no medications years ago I started having vasovagal syncope episodes that have increased in frequency over the years and I have now passed out from it around 10 times my triggers for it are blood needles and damage to the wrists my clinic reccomended that I wear a heart monitor for 30 days and when I passed out it showed that my heart stopped for seconds and I was told to visit the r I went to the nearest one and the cardiologist there informed me that my heart stopping that long was dangerous so they wanted to put a pacemaker in my the following morning I refused and went to another hospital and they did a cardio ultrasound told me my heart was fine and then their cardiologist said that my heart stopping for that long was normal with vasovagal syncope and that I would be fine and let me go home those are very different opinions and I wanted another should I be worried about my heart stopping for that long and is there any risk in it

suffering for anal ulcers for months now diagnosed with silo last year which was treated with antibiotics and now experiencing ulcers in the rectum which are very painful been tested for ulcerative colitis and chronos disease which came back negative I have had sti checks so can rule this out also I am so uncomfortable and a bit miserable now as it recurs every few weeks and very painful other symptoms include night sweats itching soreness and ulcers in the nose and mouth

goodevening I am having headache which got severe nowadays and so I just checked my blood and saw my platelets are increasing in a series of tests in the last test platelets abc and rec are slightly increased body has itching problems usually at night eyes are blurry nowadays and more than am so much tired feels like sleeping always I lost my appetite but he not lost my weight or gained weight my face is full of pimple like marks which fades in between and again comes I have severe periods pain and my periods blood are clotted thick nowadays my joint are aching and having leg and hand pain would like to what it

hi I see you are worried by many symptoms your platelet levels are not soo high to worry about it is only slightly elevated doesn't cause any significant harm need not worry about that most of your symptoms relate towards hypothyearoidism and your ash level is also high but only mildly elevated ash subclinical hypothyearoidism doesn't satisfy to start on thyearoid supplements unless its value is more than 10 overt hypothyearoidism though we can start when a person is presenting with the symptoms so I need you to retest with free to levels instead of total to and review to see the baseline free to levels and decide better on starting the supplements and I dont see any report showing the cholesterol levels kindly upload the picture of the same if you have not checked your sugars please check that also before next review ribs subclinical hypothyearoidism

hello doctor my mother is 57 years old and she is a cardiac patient she is having skin infection around his face neck and ear area for the past two days she is taking the following medicines for this infection surfaz in ointment clotrimazole beclomethasone dipropionate and neomycin sulfate cream zenflox oz ofloxacin and ornidazole allegra 120 my please suggest

hello I have seen the picture this is herpes foster the following medicines are required for this condition tablet valcivir thrice daily for seven days fusidic acid cream twice daily and tablet doll 650 my as required for pain is there any hearing loss or ringing voices inside that side of ear any face palsy for this you can send front facing a picture of your face with both eyes wide open

hello doctor I have been taking steroids on and off for the past three years I got martial fibrillation a year ago never again since then my blood pressure was quite high 152 90 at the doctor la is normal and lvedd is 53 my normal systolic function no regional wall movement abnormalities lvy 14 my and beginning diastolic dysfunction a e 15 la 21 am I already lost 24 keg and now I am weighing 10 keg at 194 am my goal is 93 keg I also stopped steroids and now my blood pressure is 123 75 will my diastolic function recover once I managed to reverse the lvy

hello I have gone through your query can I know why were you on steroids was there any particular disease that was diagnosed and started you with steroids as there are many determinants causing diastolic dysfunction one of the common cause is hypertension and yes diastolic dysfunction is reversible in the majority of the cases over a period of time if you properly control your be obesity and start doing regular exercise consume a healthy diet and lifestyle modification you should also stop any addictions like smoking or alcohol if any also get your blood sugar levels and thyearoid profile checked get back with details about your disease and indication for steroids for further discussion and management

hi doctor I am a 29 year old female lifestyle is healthy with exercise and good food mostly since last year on both sides of my cheeks especially on the right cheek there are three to four pimples they produce the white head dries off leaves a red scar and again another erupts I have slightly oily skin and stops applying all the serums please help

hello thank you for providing the information if possible provide me photographs of the affected areas which will help me for a better understanding of your skin problem and proper treatment plan

hello doctor I have suspected abortion at 10 weeks and days with heavy bleeding yesterday I have my tis ultrasound today and it shows heterogeneous endometrium is it fine

hello I have seen the report attachments based on your dates if your gestational age is 10 6weeks and if you had heavy bleeding most likely it indicates an abortion wherein the product of conception have been expelled already the heterogeneous endometrium just indicated the thickened uterine lining which develops in pregnancy to support the embryo which will take some time to become normal I am assuming your bleeding would have stopped by now and your gynecologist would have advised you some antibiotics to prevent any infections if not then please consider taking them I hope this helps repeat the scan after two weeks avoid pregnancy for the next two to three months evaluate and then plan a pregnancy evaluate yourself prior to planning a pregnancy in the view of recurrent miscarriages

hello doctor I am 5 months pregnant now and I have developed gestational diabetes and consulted with a gynecologist in the nearby polyclinic and made hba1c blood sugar monitoring test and the result is 4 reference range normal up to before pregnancy diabetes range used to be always in normal range nowadays blood sugar while fasting is 130 do I need to start insulin I need your advice I am 24 years old my height is 2 feet and weighs around 105 keg

hello welcome to icliniq com I just read your query and from what you have mentioned it appears that your blood sugar is not very high as to start insulin treatment as of now but you need to be closely monitored as regards to blood sugar ultrasound fetal monitoring by an obstetrician and a dietician for low carbohydrate diet consumption try to eat more vegetables like green leafy vegetables and not potatoes which contain high carbohydrates you need to check 50 go oral glucose tolerance test fasting and after hour and hours if still high we need to assess the results and do further tests for the same and then decide whether to start insulin or not maintain blood sugar chart by checking it fasting hour post meal and before bedtime be in touch with a physician avoid rice sweets and sugary drinks take folic acid my once daily I hope this helps

hello doctor I was diagnosed with fatty liver grade before two years prior to that I had a cough for almost two years and felt nauseated I felt like vomiting for four months that is when I got worried and consulted a doctor I also suffer from severe anxiety and that has led to binge eating disorder and that is one of the reasons for the fatty liver too I followed the doctor advice sincerely and lost weight in a few months and improved my diet I sincerely followed it for a year but then gradually again my diet started going haywire and now again I am at the same stage where I was before I was given pantocid 40 my twice a day lesuride once daily and ulgel during the second consultation after a month I was given pantocid dsr vitamin oil and asked to walk an hour a day with low calorie diet I feel like vomiting and cough after drinking a glass water or eating a meal

hello I have calculated your ideal body weight which is 5 keg however your weight at the moment is not way beyond limits if you just do what you were doing already such as low caloric intake and regular exercise that is more than anything your doctor gave you vitamin oil that seems to be good since up to now fda food and drug administration has not approved any medication for fatty liver except weight reduction so taking vitamin 400 my twice daily for six months would control your liver function tests but I want you to check for other causes for deranged liver function tests such as chronic hepatitis do you take alcohol if not then fine if yes how much and how frequently the blood tests are within normal limits except your vitamin you just take one dose of injection indrop lac units by mouth just break the vial and take it by mouth and try to take milk almost every day the rest of your symptoms like nausea and vomiting seems to be secondary to anxiety the anxiety and stress have to do a lot with someone is gastrointestinal tract there are certain medication which can control your gi gastrointestinal upset as well as anxiety but they are frequently adherent with side effects I want you to take the following medication for now and let me know if symptom persists I may consider you giving some medication for that for now take the following medications and get these blood tests I can understand it might be upsetting for you to have a lot many blood tests but I really want to help you fatty liver disease functional gi problem hbsag hepatitis surface antigen anti he core total anti hav hepatitis virus antinuclear antibody profile including ana asma and ama overlapping hepatitis fatty liver disease functional gi problem one dose of injection indrop lac units by mouth tablet rifxamin 200 my thrice daily for three weeks this is a safe antibiotic it will balance your gas production within gut abnormal gas production is a process in play in your case tablet digestive 40 my daily before meals to promote your gut motility you may continue pantoacid for now and syearup gaviscon 15 my four times daily after meals instead of antacid syearup ulgel let me know in two weeks how you respond

hello doctor having severe pain in rightside back lower body with rashes I will attach photos

hi you have got herpes foster it is caused by varicella foster virus very painful blisters will be there must be started on antivirals at earliest tablet acyclovir 800 my times a day or other equivalent for pain paracetamol apply calamine lotion to the spots if not available ot please meet your doctor take care do not break the blisters

hello doctor heartburn and indigestion all day frequent belching gurgling in throat esophagus throat or esophagus is making a funny noise off and on for years sporadically diagnosed with herd and larapharyngeal reflex clean endoscopy in years back but esophagus is slightly twisted had dilation during procedure other endoscopies were fine is this classic signs of herd saw ent recently for other issues throat looked good just never had the gurgling as much taking gas and protonic and tums here and there also deal with allergies and post nasal drip no vomiting or fever just uncomfortable

hello most of the symptoms such as burping gurgling within esophagus and funny noise all can be encompassed in to one diagnosis that is herd but thing which make concerned are you have endoscopies and all showing normal without signs of ulceration which is not usually a case in herd patient unless they are on maximal acid suppressant medications and symptom free at the time of undergoing endoscopy so endoscopy result has to be correlated with the timings and weather use of acid suppressant medication before making a diagnosis given some more interesting findings like dilated esophagus and no ulceration at the time of endoscopy with presence of persistent symptoms suggest some other additional problem bystanding with herd such as motility disorder some time herd is just a manifestation of motility disorders because two disorders almost cause similar symptoms secondly for herd one must have oh imepdence monitoring to confirm the diagnosis and in case you have already gone through this then you come in category of refractory herd not responding to usual acid suppressant medications for refractory herd the only single test that can confirm symptoms correlation index acid reflux causing the symptoms or non acid reflux causing symptoms or no acid reflux at all is oh impedence test while person on acid suppressant medications I can understand it must be very exhaustive and confusing for you to understand above things but it can be very easy while investigation all these possibilities I urge you to upload your previous reports and keep in touch with me as I can suggest you how it is further be approached refractory herd oh impedence monitoring motility disorder functional heartburn refractory herd suggest investigation you can follow up with me to discuss about how to approach this

hello doctor when I touch the tip of my middle finger I feel pain there as well as on the left side of my chest it just started yesterday is this a sign of a heart problem

hello I am sorry to hear about your pain please do not be worried you will be fine it is not a definite sign of heart disease there are arthritis angina etc do you have a history of heart diseases in your family do you experience shortness of breath have you experienced dizziness or has the pain radiating to other parts of your body what medications are you currently taking

hi doctor I have been diagnosed with cos for more than years recently I have been doing yoga and doing intermittent fasting for the past months now I got my period twice in april and for may month it is spotting for the last days please help me

hi treatment of women with cos should begin with lifestyle measures for those who are obese a combination of weight loss and exercise may stimulate ovulation intermittent fasting is wonderful lifestyle what is your mode of intermittent fasting are you doing 16 or fast and feast have you tried 36 hours fasting please let me know also low carbohydrates diet with no sugary juices and no added sugar is very beneficial if the woman is not overweight or weight loss is ineffective then taking into account potential adverse effects ease and mode of use the woman mi and monitoring needed clomifene citrate or metformin or a combination of the above for women who are taking clomifene citrate I offer ultrasound monitoring during at least the first cycle of treatment to ensure that they are taking a dose that minimise the risk of multiple pregnancy women prescribed metformin may know side effects such as nausea vomiting and other gastrointestinal disturbances if woman known to be resistant to clomifene citrate we can go for laparoscopic ovarian drilling or combined treatment with clomifene citrate and metformin if not already offered as first line treatment or gonadotrophins so there are plenty of options available and you are not alone we can together make a plan for management please give me more details if you have done investigations ultrasound and harmony tests