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I have a stable spinous process fracture of C-7 and have been prescribed a hard neck brace for 4-6 weeks. My neck does not hurt, I have no tingling anywhere except the neck brace is causing serious back problems in the middle of my back. Wearing it also gives my headaches. I can take it off to shower and once it is off my back and head feel better. what should I do? | non-urgent |
HI I WAS DIAGNOSED WITH RESTLESS LEG SYNDROME ABAUT 10 YRS BACK, IM 45 , AND ABAUT 5 YRS AGO I WAS RX,ED TRAMADOL 50 FOR PAIN AND FOR RLS, BUT THE DOSE KEPT INCREASING, UNTIL I WAS UP TO 600 MG EVERY 4 HRS, I HAVE BEEN RX,ED SUBUTEX TO STOP TAKING TRAMADOL AND I STOPPED TAKING TRAMADOL COMPLETLY 1 1/2 MOS AGO, AND 6 DAYS AGO I RAN OUT OF SUBUTEX, NOW I HAVENT BEEN ABLE TO SLEEP KICKING, ANXIETY, I FEEL SOOO WEAK, TIRED, CAN,T EAT, ANXIOUS, AND JUST BLAH, WHAT DO I DO, ASK FOR MORE SUBUTEX, OR START TRAMADOL AGAIN, OR GET A DRIRENT MED FOR THE RESTLESS LEG SYNDROME, HELP PLEASE, IM NOT GOING TO LAST TO LONG AT THIS RATE. THANK YOU, IM A 45 YR OLD HEALTHY OTHERWISE WOMAN. | urgent |
Alkali and alkaline earth metal adducts of a branched glycan, XXXG, were analyzed with helium charge transfer dissociation (He-CTD) and low-energy collision-induced dissociation (LE-CID) to investigate if metalation would impact the type of fragments generated and the structural characterization of the analyte. The studied adducts included 1+ and 2+ precursors involving one or more of the cations: H+ , Na+ , K+ , Ca2+ , and Mg2+ . Regardless of the metal adduct, He-CTD generated abundant and numerous glycosidic and cross-ring cleavages that were structurally informative and able to identify the 1,4-linkage and 1,6-branching patterns. In contrast, the LE-CID spectra mainly contained glycosidic cleavages, consecutive fragments, and numerous neutral losses, which complicated spectral interpretation. LE-CID of [M + K + H]2+ and [M + Na]+ precursors generated a few cross-ring cleavages, but they were not sufficient to identify the 1,4-linkage and 1,6-branching pattern of the XXXG xyloglucan. He-CTD predominantly generated 1+ fragments from 1+ precursors and 2+ product ions from 2+ precursors, although both LE-CID and He-CTD were able to generate 1+ product ions from 2+ adducts of magnesium and calcium. The singly charged fragments derive from the loss of H+ from the metalated product ions and the formation of a protonated complementary product ion; such observations are similar to previous reports for magnesium and calcium salts undergoing electron capture dissociation (ECD) activation. However, during He-CTD, the [M + Mg]2+ precursor generated more singly charged product ions than [M + Ca]2+ , either because Mg has a higher second ionization potential than Ca or because of conformational differences and the locations of the charging adducts during fragmentation. He-CTD of the [M + 2Na]2+ and the [M + 2 K]2+ precursors generated singly charged product ions from the loss of a sodium ion and potassium ion, respectively. In summary, although the metal ions influence the mass and charge state of the observed product ions, the metal ions had a negligible effect on the types of cross-ring cleavages observed. | non-urgent |
Hi, In the past several months I ve noticed a dark red ovalish spot inside my lower lip . It appears to be merely discoloration and is not raised. It doesn t hurt. My dentist noticed it too, last week and recommended a biopsy by an oral surgeon. I don t have great dental insurance so I m waiting instead to see my general physician--in three weeks after her vacation! so she can refer me to a specialist covered by my insurance. The dentist referred to it as a lesion. I m a 52-year-old female in generally good health. What could this be? Thank you. | non-urgent |
I took a line drive in softball right on my shin bone, it hurt really bad but it didnt even bruise hardly at all, but it hurt really bad, anyways its been like a month and there is a bump on my leg where the ball hit that hasnt gone away! The bump is hard and right on the bone, it doesnt really hurt at all, its just a hard bump. I was wondering if you know what that is caused by and if will eventually go away or if there is a way I can make it go away?? thanks for your help!! | non-urgent |
Q:An 82-year-old male with a history of congestive heart failure presented with new-onset atrial fibrillation. He was initially started on carvedilol, but he now requires an additional agent for rate control. He is started on a medicine and is warned by his physician of the following potential side effects associated with this therapy: nausea, vomiting, confusion, blurry yellow vision, electrolyte abnormalities, and potentially fatal arrhythmia. Which of the following is most likely to increase this patient's susceptibility to the toxic effects associated with this medication??
{'A': 'Hyponatremia', 'B': 'Elevated AST and ALT', 'C': 'Hypokalemia', 'D': 'Increased GFR with normal creatinine', 'E': 'Hyperkalemia'}, | non-urgent |
I have a 2 yr old with down syndrome. He had surgery at 2 mos. for hirshsprung disease. He has been bleeding and has bumps in and around his anus on and off for 6 months. I ve used mirolax, 6 types of diaper rash ointments and even a bacterial prescription. What am I dealing with? Please help | non-urgent |
What happens to Chlamydia spp. when the host cell undergoes lysis? | non-urgent |
my wife at beef at McDonalds and woke up with a horrible rash, jpont stiffness and some joint weakness in her left hand. Her PCP{ said it is a food allergic reaction. My concern is e-coli. But she does not have abdominal pain or diahrea. He put her on a dose medrol pack. Should she be tested for e-coli? | non-urgent |
At the moment I cant sleep, if I do its not for long and I often wake up from having nightmares and feeling scared. I am also crying all the time and I am never like this and dont no how to make it stop. | non-urgent |
query l have been diagnosed with mvp two months back.the bp was high with high pulse rate n severe palpitations, the medication given earlier did not suit me. i was put on ciplar 40 half tablet twice a day which resulted in murmur.now the medication given is:carca-3.125 twice a dayvalance od 500- once at nightpari cr- once at nightetirest - sos please suggest if the course of treatment is correct | non-urgent |
What can I take in place of Naproxen or Ibuprofen for my knee pain? I had arthroscopic surgery in August and was taking Naproxen. Caused issues with my hearing. Now I can hear but sitting or walking for long periods of time make it painful to move afterward. | non-urgent |
i am a 58 year old male, 170 lbs, physically fit, eating healthy. All recent physicals normal, colonoscopy 2yrs ago normal. Recent blood work shows I am anemic! These values test low: Hemoglobin is 12.9, hematocrit is 39, mcv 80, mch 26.7, rdw 16.9 (high). What kind of doctor should I begin with, an internist or a hematologist? | non-urgent |
ANXIETY IN LAST FEW MONTHS, FEAR LEVEL IN MY MIND HAS BEEN INCREASED. FEAR ABOUT FUTURE, SUCCESS, FALIURE ETC. I HAVE RECENTLY LEFT JOB ALSO AND STARTED MY OWN BUSINESS. WHAT SHOULD I DO TO REMOVE FEAR AND ANXIETY FROM MY MIND? HOW CAN I INCREASE MY DECISION MAKING ABILITY AS MY MIND ALWAYS HAND BETWEEN OPTIONS.REGARDSVINEET | urgent |
My 3 month old son has had a rash for more than 1 week. I am proactive with keep n his diapers changed applying cream Perth him air out n it doesn t go away. It looks like it s going to improve then gets redder again. Red ring around his anus especially. His stools are muccussy n runny. Only feedback him formula | non-urgent |
hi doctor about three years ago I had scans on my kidneys and I was told I had poly on my kidneys which I was told at the time were benign or harmless and I was discharged suddenly this week I am getting a strong itchy feeling under my rib cage both front and back do you think I should see my doctor or do you think it will eventually go away | non-urgent |
Hi, we are trying to get pregnant again. We have a 17 month old little boy, and my wife was pregnant in the beginning of the year but sadly miscarried in March. We were told that the first four months after the miscarriage is a time when she would be the most fertile. After three months of trying and miscalculating the days of ovulation I'm beginning to wonder. I use Cipralex and recently had my gallbladder removed. I also excercise ( I run twice a day 30 minutes). Is that possibly the reason? | non-urgent |
Hi, i had a laparoscopy 10 days ago now and 3 days post surgery i attended my gp as the belly button wound was very sore and weeping. they took a swab results not back yet but started me on antibiotics for a week as had a chest infection as well - Am finished antibiotic now but wound still really sore and weeping and there is a smell from it - should i go back to my gp or should i go straight back to the surgeon - also when the procedure was being carried out i had a broncho spasm and have been coughing and quite chesty since | non-urgent |
Hello Doctor, My baby is 5 months old. FOr him stool is getting tight like stone nad he is suffering a lot. He is drinking Nan pro-3 times, Breast feed - 2 times and cerelac 2 times and jucic - 1 time a day. what is the reason for tight stool.. Sometimes blood coming with it | urgent |
What are some complications that can arise from pneumonia caused by Staphylococcus aureus, and how do they affect the body? | non-urgent |
Hi I m a 24 year old male. My girlfriend And I have had a long distance relationship the past few months and we would do a a lot of Sexting. I feel like I ve masturbated more often then I used to. Recently my penis has become sore on the inside, mainly when first reaching erection and then it subsides as I become fully aroused but it is a little sore if I squeeze on the sides to hard. It s definitely an internal penis pain and it feels like its just on the siides. It s not a terrible pain but alarming because I ve never had penis pain before. In hoping it could just be from over use and I should just take it easy? All the other info says Peyronies disease but I feel like I m to young for that plus theirs no hard lumps or bands or a huge bend or anything. Any ideas? | non-urgent |
Which muscle is isolated during an eye exam by having the patient abduct and elevate their eye? | non-urgent |
hello I have been having lower abd pain x 4 days. feels like gas because sometimes it moves. comes and goes finished period 6 days ago. pain is sharp at times and feel dull after. woke up this morning feeling good drank water and chicken soup now its lunch im in pain and nausous | urgent |
my blood pressure has been going up continuously over the past month. i have began a regular cardio routine, and yet it goes up. at what point should i go to the hospital. today it is 152/100. i have been to my dr this week who put me on exercise diet, and to the cardiologist for stress test which i did well on. what are they missing? | urgent |
Hi. I recently had cervical spine surgery--6 months ago. While I healed from that, I was still in significant pain in both my right and left legs. An MRI revealed I have severe stenosis in lower lumbar region. I went back to the surgeon who did my cervical spine, and he said that surgery for this issue would only have a 50 percent success rate and could cause further pain, and possibly more problems. At the same time, I could be damaging my nerves. This is a no-win situation. When I asked my surgeon what he would do if he were me, he said he would shoot himself in the head. Are there no options for me? | urgent |
Methylene blue (MB), as the first fully man-made medicine, has a wide range of clinical applications. Apart from its well-known applications in surgical staining, malaria, and methemoglobinemia, the anti-oxidative properties of MB recently brought new attention to this century-old drug. Mitochondrial dysfunction has been observed in systematic aging that affects many different tissues, including the brain and skin. This leads to increaseding oxidative stress and results in downstream phenotypes under age-related conditions. MB can bypass Complex I/III activity in mitochondria and diminish oxidative stress to some degree. This review summarizes the recent studies on the applications of MB in treating age-related conditions, including neurodegeneration, memory loss, skin aging, and a premature aging disease, progeria. | non-urgent |
To forecast the time dynamics of an epidemic, we propose a discrete stochastic model that unifies and generalizes previous approaches to the subject. Viewing a given population of individuals or groups of individuals with given health state attributes as living in and moving between the nodes of a graph, we use Monte-Carlo Markov Chain techniques to simulate the movements and health state changes of the individuals according to given probabilities of stay that have been preassigned to each of the nodes. We utilize this model to either capture and predict the future geographic evolution of an epidemic in time, or the evolution of an epidemic inside a heterogeneous population which is divided into homogeneous sub-populations, or, more generally, its evolution in a combination or superposition of the previous two contexts. We also prove that when the size of the population increases and a natural hypothesis is satisfied, the stochastic process associated to our model converges to a deterministic process. Indeed, when the length of the time step used in the discrete model converges to zero, in the limit this deterministic process is driven by a differential equation yielding the evolution of the expectation value of the number of infected as a function of time. In the second part of the paper, we apply our model to study the evolution of the Covid-19 epidemic. We deduce a decomposition of the function yielding the number of infectious individuals into"wavelets", which allows to trace in time the expectation value for the number of infections inside each sub-population. Within this framework, we also discuss possible causes for the occurrence of multiple epidemiological waves. | non-urgent |
The COVID-19 lockdown has significantly disrupted the higher education environment within the Netherlands and led to changes in available study-related resources and study demands of students These changes in study resources and study demands, the uncertainty and confusion about educational activities, the developing fear and anxiety about the disease, and the implementation of the COVID-19 lockdown measures may have a significant impact on the mental health of students As such, this study aimed to investigate the trajectory patterns, rate of change, and longitudinal associations between study resources-demands and mental health of 141 university students from the Netherlands before and during the COVID-19 lockdown The present study employed a longitudinal design and a piecewise latent growth modeling strategy to investigate the changes in study resources and mental health over a 3 month period The results showed that moderate levels of student resources significantly decreased before, followed by a substantial rate of increase during, lockdown In contrast, study demands and mental health were reported to be moderate and stable throughout the study Finally, the growth trajectories of study resources-demands and mental health were only associated before the lockdown procedures were implemented Despite growing concerns relating to the negative psychological impact of COVID-19 on students, our study shows that the mental health during the initial COVID-19 lockdown remained relatively unchanged | non-urgent |
The Internet and social media are crucial platforms for health information. Factors such as the efficiency of online health information, the outcomes of seeking online health information and the awareness of reliable sources have become increasingly important for the elderly during the COVID-19 pandemic. This study aimed to examine differences between elderly individuals’ income above and below the average monthly wage in relation to their online health information efficiency and the outcomes of seeking online health information; to evaluate types of online information sources with online health information efficiency and the outcomes of seeking online health information; and to explore online health information efficiency as a mediator between health status and awareness of online sources. A cross-sectional study design was conducted with 336 elderly participants age 65 or older. The participants volunteered to complete a questionnaire. No differences were found between the two groups regarding efficiency in retrieving health information from official online health sites and Google. Perceived efficiency mediated health status and awareness of online sources. In these challenging times, it is important to provide a tailor-made education strategy plan for reliable sources of online health information for the elderly, in order to enhance their technology safety skills. It is also important to explore other mediating variables between health status and awareness of online sources. | non-urgent |
What condition is suggested by the presence of high anion gap metabolic acidosis in a patient with hypoperfusion? | non-urgent |
my daughter who is a university student in France was diagnosed with pericarditis today. She has chest pain , pulse over 100, fever and some shortness of breath when walking. She wants to come home (there is a week's break next week). She will be travelling by plane but my husband feels it would be better for us to drive down to the South of France (Montpellier) and bring her home by car. She is taking aspirin 1000 mg daily. she is seeing a cariologist tomorrow and will ask for a letter giving permission to travel but I think it will be too tiring is car travel (a long drive) the preferable option? | non-urgent |
Small injury 10 days ago in back of mouth in soft tissue caused by jamming a drinking straw into back of mouth has developed into a white sore approximately the size of 1 1/2 pencil eraser. Injury has developed into small appetite loss fever and chills 48 hours ago. 24 hours ago experienced severe muscle ache especially through the neck area, which has since subsided. Oral thermometer shows body temperature at 101.6°, with no document of previous temperatures due to unavailability of thermometer. No diarrhea at this point and today am constipated. Please advise | urgent |
Hi, i have a small white lump just smaller than the size of a pea on the inside of my cheek? Its not painful and i dont really know its there until i run my tongue over it. Its quite hard and sometimes gets in the way of things, and ive never noticed it before, any ideas on what it is? | urgent |
Hi there I would like to know, i've done the dettol test a few times now, and it shows positive than i went for a blood test but that shows negative. My friend also did the dettol test and her result did have the same look as mine and she was pregnant, is it that my hormone counting is to low on the blood test that's why it's not showing. Ani | non-urgent |
I complained of low mood, low enthusiasm towards work. Doctor prescribed ABSOLUT 3G. I have just started taking it OD doze. What would you suggest . Shall this medicine relieve me from above mentioned issues. I am 38+, 5'11", no illness whatsoever, BP normal. | non-urgent |
I know someone who has excruciating upper/middle back pain. It is very stressful for them and I think it is just giving them more back pain. They take Tylenol but I don t think that really helps. They use cupping therapy at home. I don t know if this pain is serious or the person should be taken into the doctor. I know my friend very well and I can tell it s really hurting them. Sometimes they say that their arms hurt too. Please tell me your take on the matter. Thank you. | non-urgent |
I have non-healing round and oval shaped lesions/ulcerations on my neck for almost a year now. A couple of them went away, but then new ones appeared; the tissue feels lumpy underneath. They get covered by scabs, but do not heal. Antibiotics and topical clindamycin seemed to help a little, but not much improvement had been observed. When a skin sample was attempted to be cultured, no single specific bacteria was found. What can it be?? Please help! | urgent |
My son 12 years old has diarrhea yesterday morning. High grade fever after. No normal food intake as he moved right after eating porridge and egg after lunch yesterday. Water and crackers the entire day yesterday and he vomitted 9pm. Fever wont go down with paracetamol. I just gave him Erceflora now but moved again. Pls help | urgent |
Background: Obesity is a modifiable risk factor for coronavirus(COVID-19)-related mortality. We estimated excess mortality in obesity, both 'direct', through infection, and 'indirect', through changes in healthcare, and also due to potential increasing obesity during lockdown. Methods: In population-based electronic health records for 1 958 638 individuals in England, we estimated 1-year mortality risk('direct' and 'indirect' effects) for obese individuals, incorporating: (i)pre-COVID-19 risk by age, sex and comorbidities, (ii)population infection rate, and (iii)relative impact on mortality(relative risk, RR: 1.2, 1.5, 2.0 and 3.0). Using causal inference models, we estimated impact of change in body-mass index(BMI) and physical activity during 3-month lockdown on 1-year incidence for high-risk conditions(cardiovascular diseases, CVD; diabetes; chronic obstructive pulmonary disease, COPD and chronic kidney disease, CKD), accounting for confounders. Findings: For severely obese individuals (3.5% at baseline), at 10% population infection rate, we estimated direct impact of 240 and 479 excess deaths in England at RR 1.5 and 2.0 respectively, and indirect effect of 383 to 767 excess deaths, assuming 40% and 80% will be affected at RR=1.2. Due to BMI change during the lockdown, we estimated that 97 755 (5.4%: normal weight to overweight, 5.0%: overweight to obese and 1.3%: obese to severely obese) to 434 104 individuals (15%: normal weight to overweight, 15%: overweight to obese and 6%: obese to severely obese) individuals would be at higher risk for COVID-19 over one year. Interpretation: Prevention of obesity and physical activity are at least as important as physical isolation of severely obese individuals during the pandemic. | non-urgent |
My dentist put in a bridge in 2012 and told me to keep it clean using a Water Pik. Then at my last cleaning, the hygienist gave me a threader to use with floss for it. Didn't know that was recommended. She said to use it "occasionally". When I used it yesterday for the first time, the dental floss came out red: blood. Very concerned that there is decay under the bridge, which was so costly! Can this be repaired without having to get another bridge? | non-urgent |
In 2020, the COVID-19 pandemic led to an unprecedented destabilization of the world's health and economic systems. The rapid spread and life-threatening consequences of COVID-19 have imposed testing of repurposed drugs, by investigating interventions already used in other indications, including anticancer drugs. The contours of anticancer drug repurposing have been shaped by similarities between the pathogenesis of COVID-19 and malignancies, including abnormal inflammatory and immunologic responses. In this review, we discuss the salient positive and negative points of repurposing anticancer drugs to advance treatments for COVID-19. SIGNIFICANCE: Targeting anti-inflammatory pathways with JAK/STAT inhibitors or anticytokine therapies aiming to curb COVID-19-related cytokine storm, using antiangiogenic drugs to reduce vascular abnormalities or immune-checkpoint inhibitors to improve antiviral defenses, could be of value in COVID-19. However, conflicting data on drug efficacy point to the need for better patient selection and biomarker studies. | non-urgent |
I had surgery last Wed. Surgeon put in a hemicap on my shoulder and took pin out of elbow. Had general anesth and a block on right arm. Since surgery my hand and fingers are numb. Working on that in PT. My hand and fingers are just always cold now. I wear a mitten when up and am putting a hot pad on it when in bed to warm it up. Just wanting to make sure that is ok. See my surgeon in the morning. Thanks | non-urgent |
BackgroundHomologous and heterologous SARS-CoV-2-vaccinations yield different spike protein-directed humoral and cellular immune responses. However, their interdependencies remain elusive. MethodsCOV-ADAPT is a prospective, observational cohort study of 417 healthcare workers who received homologous vaccination with Astra (ChAdOx1-S; AstraZeneca) or BNT (BNT162b2; Biontech/Pfizer) or heterologous vaccination with Astra/BNT. We assessed the humoral (anti-spike-RBD-IgG, neutralizing antibodies, antibody avidity) and cellular (spike-induced T cell interferon-{gamma} release) immune response in blood samples up to 2 weeks before (T1) and 2 to 12 weeks following secondary immunization (T2). FindingsInitial vaccination with Astra resulted in lower anti-spike-RBD-IgG responses compared to BNT (70{+/-}114 vs. 226{+/-}279 BAU/ml, p<0.01) at T1, whereas T cell activation did not differ significantly. Booster vaccination with BNT proved superior to Astra at T2 (anti-spike-RBD-IgG: Astra/BNT 2387{+/-}1627 and BNT/BNT 3202{+/-}2184 vs. Astra/Astra 413{+/-}461 BAU/ml, both p<0.001; spike-induced T cell interferon-{gamma} release: Astra/BNT 5069{+/-}6733 and BNT/BNT 4880{+/-}7570 vs. Astra/Astra 1152{+/-}2243 mIU/ml, both p<0.001). No significant differences were detected between BNT-boostered groups at T2. For Astra, we observed no booster effect on T cell activation. We found associations between anti-spike-RBD-IgG levels (Astra/BNT and BNT/BNT) and T cell responses (Astra/Astra and Astra/BNT) from T1 to T2. There were also links between levels of anti-spike-RBD-IgG and T cell at both time points (all groups combined). All regimes yielded neutralizing antibodies and increased antibody avidity at T2. InterpretationInterdependencies between humoral and cellular immune responses differ between common SARS-CoV-2 vaccination regimes. T cell activation is unlikely to compensate for poor humoral responses. FundingDeutsche Forschungsgemeinschaft (DFG), ER723/3-1 Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched Pubmed for papers published between 01/01/2019 and 14/05/2021 with the search terms "covid-19" combined with "vaccination" and "heterologous", excluding "BCG". Of the 41 papers found, none addressed the combination of ChAdOx1-S by AstraZeneca (Astra) and BNT162b2 by Biontech/Pfizer (BNT). After our study was initiated, the CombiVacS trial reported a significant booster effect when BNT was given after initial vaccination with Astra.1 The investigators of the CoCo trial subsequently published data on heterologous immunization in comparison to homologous Astra in a small population (n=87), with the heterologous immunization scheme showing a superior humoral and cellular immune response.2 Further studies investigated heterologous vaccinations with Astra and BNT as well as homologous Astra and BNT regimes and also found superior humoral and cellular immune responses in the heterologous regimes compared to homologous Astra, and comparable or slightly superior immune responses when compared to homologous BNT vaccination.3-6 The body of research covering the effects of heterologous immunization regimes has recently been aggregated in a systematic review.7 Added value of this studyTo our knowledge, this is the first study that evaluates the interdependencies of cellular and humoral immune responses following heterologous vaccination with Astra/BNT in a large group of individuals. Our data show strong correlations between humoral and cellular immune responses with the prime-boost combination Astra/BNT. The findings suggest that individuals with a robust initial response developed strong humoral and cellular immune responses after booster immunization. Implications of all the available evidenceOur study and the available data suggest that due to its superior capacity to elicit a humoral and cellular immune response, mRNA-based vaccines such as BNT should be chosen for booster vaccination rather than Astra. This seems to be particularly important in individuals whose immune response was poor after initial vaccination with Astra. We demonstrate here an association between humoral and cellular immune responses following vaccination. Our findings suggest that distinct differences between common COVID-19 vaccination regimes should be taken into account in population-based vaccine programs. The present data indicate that a poor humoral immune response is unlikely to be mitigated by a strong cellular immune response. | non-urgent |
I have a broken finger kinda got crushed and busted most of the way around.. Has been stitched and stitches removed. I just discoverer a bone fragment just under the skin where cut is not quite healed.. What happens to bone fragments ? Do they desolve? | non-urgent |
Recently I have been having pain in my mouth, like aching teeth, but it is not my teeth. My mouth feels hot and my tongue seems quite blistered. I have taken antibiotics for the last few days, and warm salt walter rinses, but in the night I wake up with a feeling of a hot mouth and inflamed tongue. could this be shingles of the mouth? | non-urgent |
In 08 and 09 I had knee replacement surgery. I have top of foot and above my ankle numbness since 08 rehab on my right side. The left side surgery 09 not as bad, but still, numbness above my ankle and top of my foot. It drives me crazy 24 - 7. I can walk, but I have a hard time finding shoes. I am 73 yrs old and I am not diabetic. I am ver uncomfortable. | non-urgent |
Q:A 29-year-old woman is recovering on the obstetrics floor after vaginal delivery of 8 pound twin boys born at 42 weeks gestation. The patient is very fatigued but states that she is doing well. Currently she is complaining that her vagina hurts. The next morning, the patient experiences chills and a light red voluminous discharge from her vagina. She states that she feels pain and cramps in her abdomen. The patient's past medical history is notable for diabetes which was managed during her pregnancy with insulin. Her temperature is 99.5°F (37.5°C), blood pressure is 107/68 mmHg, pulse is 97/min, respirations are 16/min, and oxygen saturation is 98% on room air. Laboratory values are obtained and shown below.
Hemoglobin: 12 g/dL
Hematocrit: 36%
Leukocyte count: 9,750/mm^3 with normal differential
Platelet count: 197,000/mm^3
Serum:
Na+: 139 mEq/L
Cl-: 101 mEq/L
K+: 4.2 mEq/L
HCO3-: 23 mEq/L
BUN: 20 mg/dL
Glucose: 111 mg/dL
Creatinine: 1.1 mg/dL
Ca2+: 10.2 mg/dL
AST: 12 U/L
ALT: 10 U/L
Which of the following interventions is associated with the best outcome for this patient??
{'A': 'Vancomycin and gentamicin', 'B': 'Vancomycin and clindamycin', 'C': 'Clindamycin and gentamicin', 'D': 'Cefoxitin and doxycycline', 'E': 'Supportive therapy only'}, | non-urgent |
What is the connection between dermatofibroma and an electrocardiogram (ECG)? | non-urgent |
Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. | non-urgent |
my daughter went to the pediatrician last week with bumps on her body. He told us that it is a classic case of the chickenpox. However, 2 days later, in addition to the chickenpox, she started getting small, very very tiny bumps all over her body.Now she not only has the chickenpox, she also has about a million small bumps all over her chest, stomach, back and thighs....we don't have very reliable medical service in our neck of the woods. can you tell me what this could possibly be? | non-urgent |
I'm 23 and have been experiencing tachycardia, often with shortness of breath, in the evenings and at night. There is no trigger with attacks occurring at rest. I initially put it down to anxiety but I've been 100% stress-free for weeks and yet the attacks have been consistent. My resting heart rate is about 68, and over 100 during attacks. I have no health problems, take no meds and avoid caffiene. What could possibly be the cause? | urgent |
Hello,I have had lower abdomen pain off and on for about two weeks. I have not felt sick to my stomach. The last two nights I awoke and had to vomit. I have a history of UTIs and took a home test today and the leukocytes were positive but negative for nitrates. I do not have a fever but I am very tired. I am a 48 year old female and had my gallbladder removed ten months ago. I weigh 150 lbs and am 5ft 3in. Thank you. Jen. | urgent |
I had a partial root canal roughly 36 hours ago on my lower left rear molar (wisdom teeth extracted years ago). The doctor drilled out the pulp (noting that it was mostly dead) and put on a temporary filling until the root canal specialist could see me. Now, about 36 hours later, I'm in quite a bit of pain again, both on the tooth that was operated on and in a molar on the top of my jaw and in the back jaw muscle. My neck is rather swollen too and is tender to the touch. I have plans to travel tomorrow by plane to see some family and go diving. Is my condition something that requires immediate attention? Should I not be flying or diving? | urgent |
I have been having upper left abdominal pain for the past week or so. It isn't severe or sharp pain, more like a dull and uncomfortable pain. I know that this can be something related to my spleen so I am worried. Would you recommend going to an emergency room right away or should I just go to a regular doctor tomorrow? | non-urgent |
Small lump has appeared on surface the tip, just off to the side of right nipple, Not on breast or areola on the actual nipple. There is no head like a pimple, have tried to squeeze it in case it is, but nothing. It can be uncomfortable at times but not often. It is basically the same colour as the rest of my nipple but is paler and more white on the top of the bump. | urgent |
BACKGROUND: Identifying county-level characteristics associated with high coronavirus 2019 (COVID-19) burden can help allow for data-driven, equitable allocation of public health intervention resources and reduce burdens on health care systems. METHODS: Synthesizing data from various government and nonprofit institutions for all 3142 United States (US) counties, we studied county-level characteristics that were associated with cumulative and weekly case and death rates through 12/21/2020. We used generalized linear mixed models to model cumulative and weekly (40 repeated measures per county) cases and deaths. Cumulative and weekly models included state fixed effects and county-specific random effects. Weekly models additionally allowed covariate effects to vary by season and included US Census region-specific B-splines to adjust for temporal trends. RESULTS: Rural counties, counties with more minorities and white/non-white segregation, and counties with more people with no high school diploma and with medical comorbidities were associated with higher cumulative COVID-19 case and death rates. In the spring, urban counties and counties with more minorities and white/non-white segregation were associated with increased weekly case and death rates. In the fall, rural counties were associated with larger weekly case and death rates. In the spring, summer, and fall, counties with more residents with socioeconomic disadvantage and medical comorbidities were associated greater weekly case and death rates. CONCLUSIONS: These county-level associations are based off complete data from the entire country, come from a single modeling framework that longitudinally analyzes the US COVID-19 pandemic at the county-level, and are applicable to guiding government resource allocation policies to different US counties. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11060-9. | non-urgent |
Hi | non-urgent |
Hi doctor, I am male, 28 years old. I work with lots of work stress. Sometimes I feel a bit headache. There is also after automatically masturbations or supposed masturbations I feel less energy and headache and hair loss. Could you please suggest to me any ayurvedic medicine for my healthy life and after masturbations headache, hair loss and how can I recover energy? | non-urgent |
hello. i am 31 year old. i had posterior wall fibroids (4 cms x 4.2 cms) in my uterus and had a myomectomy during dec 2011. i am now planning to try for an IUI . my doctor advised me on a GMH on my 8th day and Fertigyn 5000 on my 11th day. on scanning, i have good number of follicles. my question to you is 1) what is the success rate in IUI. 2) do i have to take any other supplementary medicines? 3) Is there any side effects of the above injections | non-urgent |
Can you suggest me which is the right time for intercourse from period cycle to get pregnent ? | non-urgent |
Hi i fell really hard on my hip about two weeks ago. the bruise was really bad, i had a goose egg bruise on the side of my hip/thigh. the lump and some coloring from hip to my knee is still there. what is the lump its kinda hard like there is fluid or tissue under the skin | non-urgent |
I wake up, and my stomach feels like its cramping, and somewhat bloated. If i get up and move around more, it does not seem to bother. I suffer most of the day with burping and feels like gas buildup and somewhat bloating of the stomach. I got my gallbladder out a few years ago, and ever since then i have had issues with bloating feeling. Every morning my stomach feels like its burning etc. PLease let me know. I tried most medicines, and does not work. Some like acid reducers seem to cause weight gain? Not really sure. Just looking for better opinionsS | non-urgent |
My husband gets very agitated at other drivers of cars that are rude or get in his way, and starts using profanity and yelling at them, road rage. I try and calm him down, but he just tells me to shut the f---k up, and other profanity at times. Then he tells me I just ruined the day and our outing. He never apologizes, and the next day he acts like nothing ever happened, and wonders why I m quiet or withdrawn. Am I wrong to say anything at all to him? | non-urgent |
The Coronavirus Disease 2019 (COVID-19) highlights the importance of understanding and controlling the spread of the coronavirus between persons We experimentally and numerically investigated an advanced engineering and environmental method on controlling the transmission of airborne SARS-CoV-2-laden aerosols in the breathing microenvironment between two persons during interactive breathing process by combining the limited space air stability and a ventilation method Experiments were carried out in a full-scale ventilated room with different limited space air stability conditions, i e , stable condition, neutral condition and unstable condition Two real humans were involved to conducted normal breathing process in the room and the exhaled carbon dioxide was used as the surrogate of infectious airborne SARS-CoV-2-laden aerosols from respiratory activities A correspondent numerical model was established to visualize the temperature field and contaminated field in the test room Results show that the performance of a ventilation system on removing infectious airborne SARS-CoV-2-laden aerosols from the interpersonal breathing microenvironment is dependent on the limited space air stability conditions Appropriate ventilation method should be implemented based on an evaluation of the air condition It is recommended that total volume ventilation methods are suitable for unstable and neutral conditions and local ventilation methods are preferable for stable conditions This study provides an insight into the transmission of airborne SARS-CoV-2-laden aerosols between persons in ventilated rooms with different limited space air stability conditions Useful guidance has been provided to cope with COVID-19 in limited spaces | non-urgent |
Hi, I am hoping you could help me. A month ago I saw a Gynecologist , as my husband and I have been trying to fall pregnant for 6 years with no luck, I am overweight and recently by blood test found out that I am a Type two diabetic, my Gynea put me on Metformin for that. I also have not had a period for 4 months and after an internal examination she aslo mentioned that I had PCOS and that is why I could not or having trouble falling preg. she then perscribed Duphaston to take 1 10mg pill 1x a day for 10 days, I completed this course. I have been intimate with my husband since, but have not had a period yet. Instead after intercourse on day 7 of taking duphaston I had a pale pink discharge asif a warning my period was due, but 5 days later still no period. is this supposed to happen?? I hopw you can help me or atleast give me some tips on conceiving, am growing desperate. Many many thanx Karushah | non-urgent |
Hi for over 2 years now my husband occasionally gets symptoms of fever, chills, body aches that are always followed by a rash on his buttocks. When the symptoms come he gets so very ill and cannot get out of bed but it will only last overnight or for a day. He has seen his doctor for this but has not been diagnosed. | non-urgent |
Hi iam 30 yrs.iwant best sex capsule without side effect .i want more power during sex with my wife.when i enter the pennis in her vagina only 1-2 minute later iam discharge and that time my wife want more sex.so please suggest me any oil or pill for more sexual power. | non-urgent |
My sister is experiencing occasional episodes of dizziness, extreme fatigue, sweating, shortness of breath, and nausea. The onset has been sudden and lasts from several minutes to hours, though she says she has been feeling unwell in general for several months. In the episode I witnessed 2 months ago, we took her to the hospital. Her BP was very high (150 s over high 90 s) and she listed to one side when walking. She commented that she didn t feel right in her head and that it took effort for her to speak. There was no blurred vision, or noticeable speech difficulty. The ECG, MRI , and all lab work were normal. Her family physician has been unable to identify the cause and she is not being treated. Her BP is usually normal at the doctor s office, but she did a self check (at pharmacy) when last episode occurred and it was again in the 150 s to high 90 s. I m concerned something is seriously wrong. Suggestions? | urgent |
Q:A 65-year-old man presents with low-grade fever and malaise for the last 4 months. He also says he has lost 9 kg (20 lb) during this period and suffers from extreme fatigue. Past medical history is significant for a mitral valve replacement 5 years ago. His temperature is 38.1°C (100.6°F), respirations are 22/min, pulse is 102/min, and blood pressure is 138/78 mm Hg. On physical examination, there is a new onset 2/6 holosystolic murmur loudest in the apical area of the precordium. Which of the following organisms is the most likely cause of this patient’s condition??
{'A': 'Candida albicans', 'B': 'Coagulase-negative Staphylococcus spp.', 'C': 'Pseudomonas aeruginosa', 'D': 'Enterococcus', 'E': 'Escherichia coli'}, | non-urgent |
What is the risk of disease or infection from a hypodermic needle stick? I was going through a box of my parents' things and was stuck. (Dad is a hoarder) wrapped around the syringe was a label from a hotel in Budapest. They had traveled there in the mid-1990s. I'm sure the syringe and needle have been in the box ever since. | non-urgent |
The objective of the present study was to evaluate the protective effect of humoral and cellular immunities on turkeys infected with turkey coronavirus (TCV). Two trials were conducted with two separate hatches of turkey poults. Turkeys were experimentally immunosuppressed with cyclosporin A (CsA) or cyclophosphamide (CY) and infected with TCV. Prior to infection, treatment with CsA selectively suppressed T cell activity as revealed by 2–3 fold decreased (p<0.1) lymphocyte proliferation responses to a T cell mitogen, concanavalin A (Con A). Treatment with CY mainly induced B cell deficiency as indicated by significant reductions (p<0.05) in antibody responses to sheep erythrocytes 7 days after injection. Body weight gain of turkeys treated with CY was significantly lower (p<0.05) than that of untreated turkeys at 9 days post-infection (PI). Turkeys treated with CY had 1–2 fold higher immunofluorescent antibody assay (IFA) scores for TCV antigens (p<0.05) in the intestine than untreated turkeys at 9 or 14 days PI. These results suggested that humoral immunity against TCV infection may be important in turkeys. | non-urgent |
I have almost uncontrollable strong shaking with chills in the late afternoon and early evening. Accompanying this is a headache (moderate, 1 to 3 hours), nasal congestion, Chest congestion, coughing and sore throat. When I get into bed fully clothed, under 2 or 3 blankets the shaking eventually stops and I begin to feel very hot and must get out of the bed. This has been going on for two days. This has happened before with cold symptoms, but not this strongly. I am a diabetic fairly controlled and I have an Aortic valve problem. Unless I am sitting and have my arms tightly wrapped around my chest. The shacking can leave me panying for air. I am 66. | urgent |
I have noticed two bald patches on my head. One is about two inches in diameter. They are both on the left side of my head. I have also been experiencing pain in my neck when I turn my head suddenly in either direction. I have had severe migraines that usually end up with me vomiting. I am normally healthy, 48 and female. I had one episode of a black out when I came to I was on the floor on my back. I am seeing my family doctor tomorrow what should I be asking him? | non-urgent |
Doctor my son Aditya Saraswat is suffering severe back ache in his spine and finds difficulty in sitting straight as for the last i year he use to sit for long hours to study for preparing for his competitive exams but for the last one month he is suffering from pain in his back and shoulders and now he is unable to undertake journey by bus even for 15 Kms bus jopurney in Kolkata. My family Doctor dvised for an X_Ray (L.S.Spine (AP+LAT)) and his x_Ray report indicates L5 ias sacralised - Disc soaces are normal - Both sacro - iliac joints are normal . Please advice what treatment or exercise my son should do. | non-urgent |
BACKGROUND: In an effort to prevent infants being infected with SARS-CoV-2, some governments, professional organisations, and health facilities are instituting policies that isolate newborns from their mothers and otherwise prevent or impede breastfeeding. WEIGHING OF RISKS IS NECESSARY IN POLICY DEVELOPMENT: Such policies are risky as was shown in the early response to the HIV pandemic where efforts to prevent mother to child transmission by replacing breastfeeding with infant formula feeding ultimately resulted in more infant deaths. In the COVID-19 pandemic, the risk of maternal SARS-CoV-2 transmission needs to be weighed against the protection skin-to-skin contact, maternal proximity, and breastfeeding affords infants. CONCLUSION: Policy makers and practitioners need to learn from the mistakes of the HIV pandemic and not undermine breastfeeding in the COVID-19 pandemic. It is clear that in order to maximise infant health and wellbeing, COVID-19 policies should support skin-to-skin contact, maternal proximity, and breastfeeding. | non-urgent |
What are the natural history, possible complications, and anticipated outcome of syncope? | non-urgent |
i got married 20 months back.trying to conceive having only one tube patent and husband s sperm count is 40%.will i be pregnant? my age is 27 yrs. and my husband is 32 yr old. | non-urgent |
The past 20 years have seen major public health emergencies and natural disasters, including the Severe Acute Respiratory Syndrome outbreak caused by the SARS-associated coronavirus (SARS-CoV) in 2003; the Wenchuan earthquake in 2008; and the novel coronavirus pandemic (COVID-19) of 2019, which caused mass casualties, infections, and panic. These also resulted in complex demands for medical resources and information, and a shortage of human resources for emergency responses. To address the shortage of human resources required for these emergency responses, Chinese dental professionals made useful contributions. From this work, deficiencies in emergency response training and opportunities for the expansion of rescue capabilities were identified, and relevant recommendations made. | non-urgent |
My daughter is 39 years old with 3 children 7, 5 and 2. She works as a speech pathologist 3 days a week. She has been taking different anxiety meds since she was in college. She recently switched to Trintellic (sp?). She has been seen by a psychiatrict s assistant and was given this med. She stopped it because she is having muscle spasms in legs and arms at different times and she says it is painful. Also, she has perioidic chest pains which has been checked out at a hospital in the past year. She has started to have headaches also. She just had blood work done by her own insistence) for lupus. She is most worried about possibly having ALS. She is currently freaking out waiting for these results. Would you have any idea if ALS is a possibility for her pains? Sorry for the explanation being so long. Thanks. | non-urgent |
Hi earlier today i took a fall and ever since i have a serve pain on the left side of my upper back , its slightly swollen , tender to touch , and i get a sharpe stabbing pain if i twist, cough or breath deeply. there is no visible bruising so im a little confused and concerened. surely if i had done some damage there would be some discolouration ??? | urgent |
What are the treatment options for a glucagonoma? | non-urgent |
Hi, may I answer your health queries right now ? Please type your query here... hi my name is Jorge and i just want to know the risk of a new born baby loosing one of her kidney cause she have some problems and right after she is out she have to go to a surgery to take one of her kidney so i want to know the risk in all this and how will be her life after this thank you | non-urgent |
Could you please explain what endogenous endophthalmitis is? | urgent |
Hi, I have a small loose white piece of skin, like a skin flap, on my frenulum. It's been there for a while but haven't thought much of it as it doesn't hurt, it's not red and it hasn't seemed to grow, though it may have done slightly, I just couldn't say. It doesn't hurt in the slightest during sex or when I pull my foreskin back. I have regular sex with my girlfriend, and havent had multiple partners. I just know its there. Is this just quite normal? Can if be removed, or will it just heal itself in time? Thank you. | non-urgent |
my brother is suffered with typhoid fever he takes medicines usually antibiotics heavy dose of 8 injection he recover to normally but he become week after 25 days of vaccination he felt pain at back of solder and swelling he day time his temperature rise up to 100 to 101 f and at night he felt no pain but temperature up to 99 to 100 f is this due to his pain he felt in his solder | urgent |
March 13th i had anal sex. when he came inside after about ten seconds i got up. i felt a gooey liquid all over. he said it was from my vagina and my butt. i couldnt tell what it was so i immediately wiped my butt and vagina. if it be that his cum did touch my vagina, how likely is it that im pregnant. also, my period is supposed to start sometime around March 26th. | non-urgent |
Background The COVID-19 pandemic has had a significant influence on the main epidemiological indicators of emergency trauma, as well as on the pediatric population Aim This study aimed to analyze the incidence of compression fractures of vertebral bodies in children between January and July 2020 (the first months of COVID-19 pandemic) Materials and methods A comprehensive examination and treatment of 82 children and adolescents aged 3–17 years, who received compression fractures of the vertebral bodies in the period from January 1 to July 31, 2020, was carried out A group of 96 children of the same age who sustained a similar type of injury at the same time in 2019 was studied as a control To make a clinical diagnosis, we used methods of traditional research examination for emergency traumatology The severity of vertebrogenic fractures was determined according to the AO/ASIF classification Results The total number of patients diagnosed with vertebral fractures during the COVID-19 pandemic was 14 58% less than that in the same period in 2019 Patients in the comparison groups were comparable in sex, average age of injury, and age group in which the spine was most often injured The most frequent mechanism of spinal injuries in patients of the comparison groups was a fall from a height More often than others, ThVI and ThVII vertebral bodies were broken The severity of vertebral fractures in all cases corresponded to type A, subtypes A1 and A2 For treatment, conservative methods were used in most cases During the period of strict self-isolation, in April 2020, no children of the main group had vertebral fracture because they were forbidden to leave their apartments unnecessarily In May 2020, the number of children with vertebral fractures was half the number in the same month in 2019 In June 2020, the incidence of vertebral fractures was in line with the pre-crisis average Conclusion Strictly following restrictive anti-epidemic measures during a pandemic is an effective method of reducing the number of cases requiring emergency treatment for compression fractures of the vertebral bodies in children © 2020, Eco-Vector LLC All rights reserved | non-urgent |
Hi, may I answer your health queries right now ? Please type your query here... Hi, I had fever and cough for 4 days and doctor says its viral. How come you guys always says its viral what if a bacteria is residing in kidneys and causing the fever. | non-urgent |
Q:An investigator is studying the incidence of the common cold among medical students at various time points during the school year. Results show an increased incidence of upper respiratory tract infections among these students during finals week. It is hypothesized that the stress of studying for examinations adversely affects the immune system, making the students more susceptible to infection. Which of the following laboratory findings in these students during examination week is most likely to support this hypothesis??
A:Decreased AM serum cortisol concentration;B:Decreased macrophage activity;C:Increased basophil count;D:Increased lymphocyte count | non-urgent |
My wife has a previous neck injury, incurred in an auto accident, and now, at age 54, and post-menopausal, she has recurring and movement-dependent searing upper back pain and bouts of what she describes as severe itching, unrelieved by anti- histamine lotions, cortisone lotions etc. I am assuming this is all related to some degree of cervical spine degeneration, stenosis , etc. and have told her that she needs to have her neck X-rayed, or an MRI, but she is adverse to health care. Also, she is a migraineur and I wonder if the two are in someway related. What would you recommend? | non-urgent |
I have lower abdomen pain? Consulted a doctor and did colonoscopy? It says as multiple ulceration in the colon buy my biopsy report shows as non specific proctitis. Prescribed tabs are mesacol, folic acid , vsl#3 and pantocid? I am not able to discuss briefly to the doctor. Why my colonoscopy and biopsy reports are different? But all these tablets are making me frighten. Is these tabs safe? Any side effects? Can i have it for a month without any confusion? PLEASE ANY DOCTOR SUGGEST ME? | non-urgent |
Hi! My 18 month old had hand, foot and mouth disease last week and passed it along to my husband. Little blisters began to form on his hands, feet and mouth on Friday but is still not feeling any better. He has a cough (he s had over two weeks), low fever, mild headache and feels light headed. My impression of the diseases was that he should be feeling better after the blisters appeared but that does not seem to be the case. He feels worse now than he did Friday. Should he see a doctor tomorrow? | non-urgent |
hi Doc,Apparently I dribble whilst sleeping, really icky, I wish I knew how to stop that but even more troubling and very embarrassing is the presence of blood on my pillow or t-shirt sleeve every morning! During the day I don't taste blood in my mouth but have seen discoloured saliva when i spit in the sink. the blood on the pillow ranges in color from light pink to deep red sometimes. Im 38, my wisdom teeth are not out but are not paining or anything. gums are healthy looking. Im think it's because of the wisdoms but my question is, can it be something else? | urgent |
hi im 16 and my girlfriend is 14 and we had sex for the first time about a month ago few days after her period ended and we had sex 2 more times after that and we used condoms in all of the time and yesterday she told me that she didnt got her period yet and that she is late 5 or 6 days can you give a answer for that please we are freaking out! | non-urgent |
My father aged 67 years is diagnosed with NON HODGKIN LYMPHOMA and would like to know the chances of survival and the possible positive treatment for the same in India. I request you to kindly spare your valuable time and advice me regarding the information ( a request from bottom heart) on treatment, and total cost of complete treatment | urgent |
I have a SGOT/SGPT blood test as well as a CBC W/DIFF test tomorrow. This is in regards to testing related to whether my MS drug Aubagio is having any negative affects on my liver etc. Do I need to fast for this test including not drinking any water? | non-urgent |
What are the causes of Beriberi ? | non-urgent |
INTRODUCTION: By late 2019, China notified a new disease rising, and with the agent's identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil. OBJECTIVE: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021. METHODS: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first "wave" (March to November 2020) and a second "wave" (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat. RESULTS: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p<0,001). The mortality and incidence showed an increasing trend (DPC=1,13, p<0,001; DPC=1,58, p<0,001, respectively. CONCLUSION: The level and variability of transmission during this first year of pandemic suggest that the disease in the State of Paraná was never under control. | non-urgent |
Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. | non-urgent |
Less than 24 hours ago, I fell violently off of my bicycle. I landed directly down on the back of my left hand with my arm in a vertical angle. I have mild soreness in my wrist but I have intense pain in my elbow and upper forearm. I have no swelling and no bruising. My question is, do I likely have a broken bone or is it simply and bad sprain with nerve damage? | urgent |