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### Human:\nhow to get relief from dandruff?\n\n### Assistant: the causes of dandruff are any of the following. not enough hair brushing and shampooing dry skin seborrheic dermatitis diet without proper nutrition mental stress and allergic reaction to any hair or skin care products. the dandruff treatment includes taking care of the above things to not happen. medical agents such as pyrithione zinc (fungistatic and bacteriostatic property) salicylic acid and sulfur plain salicylic acid selenium sulfide and ketoconazole are used to dandruff. proper water intake and healthy routine to bed prevent generation of extra heat in the body and dryness of the scalp. for further information consult a dermatologist online --> <link> |
### Human:\ni have developed hair dye allergy. please help.\n\n### Assistant: as per the details given it seems that you have hair dye allergy. most of the hair dye products contain a chemical called ppd (para phenylenediamine) which is responsible for allergic reactions. in such cases i advice my patients to strictly avoid application of hair dye. you may use herbal henna for dyeing hair. i advice my patients to apply topical steroid like hydrocortisone on the affected area. antihistaminics like levocetirizine also help. you need clinical examination. so you should visit your doctor so that he can examine you and give you prescription accordingly. you can share my opinion with him. stay healthy. consult a dermatologist online for further follow up --> <link> |
### Human:\nwhile treating a patient for depression when can we add in celexa?\n\n### Assistant: you seem to be dealing with a patient with treatment-resistant depression. what is the thyroid status of the patient? since you have tried ssris (selective serotonin reuptake inhibitor) and the patient seems to be a non-responder to these i feel that celexa (citalopram) will not benefit this patient. i suggest a mood stabiliser lamotrigine 25 mg to the existing venlafaxine. i would also consider a low dose of olanzapine 5 mg at night as augmentation. you can also prescribe bupropion 150 mg once daily to the existing combination. let us wait for one month and look for at least 25 percent reduction in hamilton depression rating scale scores. if still non-responsive then you can add 25 mcg of thyroxine to the current regimen and admit the patient for a course of electroconvulsive therapy. for further doubts consult a psychiatrist online --> <link> |
### Human:\ni have twin baby girls. one of them is not gaining weight. please help.\n\n### Assistant: keep trying to give breast feeds as much as possible till 6 months completion. different brands of milk powder have different tastes. so you can change what they like (as advised). do not dilute more or give more concentrated milk. usually dilution mentioned on the package can be followed i. e 30 ml for 1 scoop for most of the brands. but check with the manufractures' note. do not use feeding bottle. use bowl and spoon. you can use undiluted dairy milk (pasteurized ones). check with your local paediatrician for supplements if needed. check if there is adequate weight gain. maintain proper hygiene while feeding when using formula feed or top milk. do not compromise on hygiene. i would like to know the following: what supplement do you use now? how do you prepare it? how do you feed the babies? how much (quantity) do you feed them? how do you measure the quantity? how about the acceptability from both of them? do you maintain a chart regarding the weight gain? if so please attach it in the follow up query. do they have any other medical issues? finally breast feeding is the best for the babies. revert back with the details to a paediatrician online for further follow up --> <link> |
### Human:\nmy 4 month baby has not passed stools. please help.\n\n### Assistant: it is common to have decrease in stool frequency or constipation after switching from breast milk (breastfeeding) to formula feed. as long as your child is feeding well passing gas from below has no vomiting and has a soft belly there is nothing to worry about. it is normal to pass stool once every 2-3 days. also you may note change in stool color (green) after switching to formula feed. in this scenario you can try using a cotton q-tip (cotton swab). apply some lubrication on it and stimulate the rectal area to see if your child passes stool. if this does not help then try seeing your local pediatrician who can help with rectal stimulation and passage of his stool. for further queries consult a paediatrician online --> <link> |
### Human:\nhow to remove pimples and the scars on my face?\n\n### Assistant: pimple is somewhat hormonal and due to oily skin. remember the following measures to control pimples. do not use hair oil and avoid oily foods chocolates and milk products. do not use any steroid creams. face wash and soaps are not the treatment and they do not help. do not touch the acne and avoid pressing it. regarding treatment of pimple i suggest clindamycin (clintop faceclin or clear gel). this is more of preventive and curative so i tell patients to use it all over face in the morning and use adapalene gel (adapalene or differin) over acne in the night. i also suggest you to take tablet doxy (doxycycline) 100 mg once in a day. consult your doctor discuss with him/her and take the medicine with consent. if you have acne marks avoid direct sunlight exposure as much as you can. wear sunglass cap and cover exposed part of your body all the time use sunscreen thrice in a day such as 10 am 12 pm and 3 pm. it has to be applied all over the face. sunscreen spf (sun protection factor) should be around 50. use anti-pigmentation cream over pigmented parts like kojic acid hydroquinone depiwhite cream etc. in the night. ideal treatment is glycolic acid peels. sittings of six to eight peels must be required. post acne scars are three types. box scar ice-pick (pinpoint scars) and rolling scars. pinpoint scars are difficult to treat while box scars are easy. no cream or tablet can help you out in scars. best technique is co2 fractional laser and subscision. it takes five to six sitting but results are better than any other procedure. dermaroller and subscision are also other methods but less effective than the above. fillers do have hiding effect. it fills the pits and gives impression of fullness and it is not permanent. if scars are not much prominent then peels also could be effective. these are technique you can go through. all procedures take four to five sitting and five to six months for better results. for further information consult a dermatologist online --> <link> |
### Human:\ni brush my teeth twice daily. even then my teeth are yellow. what to do?\n\n### Assistant: even after brushing twice daily if your teeth remain yellow then there are chances of calculus deposits on your teeth. brushing alone does not remove calculi. a painless dental procedure called scaling has to be done immediately. scaling is a must for you at this stage because calculi left untreated will cause gum problems. consult a dentist online to know more about scaling --> <link> |
### Human:\nhow to confirm my pregnancy?\n\n### Assistant: the history typically suggests an implantation bleed but as your dark brown bleed coincides with the menstrual due date. it may have been scanty menses as well. now as you have done the urine pregnancy test after 7 days post missed periods and it was negative it does rule out pregnancy. as you feel that you may still be pregnant the best way is the blood serum beta hcg test (human chorionic gonadotropin) which can be done to allay your doubt. if the beta hcg levels are more than 1 then the pregnancy is confirmed. else if it is less than 1 then it is ruled out completely. the symptoms you are experiencing can be safe attributed to premenstrual syndrome if the test is negative. premenstrual syndrome mimics early pregnancy symptoms like headache nausea sore breasts mild cramps and increased frequency of urination. this may indicate that you may resume your menses in a few days if the beta hcg is negative as well. for further doubts consult an obstetrician and gynaecologist online --> <link> |
### Human:\ndoes lexapro take a long time to start working?\n\n### Assistant: if lexapro (escitalopram) caused insomnia then it is better to take the drug in the morning after breakfast. this drug is an ssri drug (selective serotonin reuptake inhibitor) and helps to reduce depressive symptoms when taken regularly. buspirone is an anti-anxiety drug that helps to reduce the symptoms. in my opinion lexapro is the better choice for mixed anxiety and depressive symptoms. for further doubts consult a psychiatrist online --> <link> |
### Human:\nmy period has been late by 4 days. i am trying to conceive. please help.\n\n### Assistant: i understand your concern completely here with regards to inability to conceive. the fact that you have just missed your menses by four days usually the urine pregnancy test is not conclusive till eight days post missed periods. go for a serum beta-hcg test. if it has been done and it show low level of hcg then you are not pregnant. i presume you are talking about serum beta-hcg test here which is negative. i am not sure if your husband has been investigated for his semen analysis and quality as this is the first thing which should be done. secondly it is important to know about your own fertile period which is the best time for the woman to conceive. thirdly it is important to learn whether your menses have been regular hormonal profile is normal and you are ovulating regularly. so if you have undergone any tests already then please send them across for a review. revert back with the test results to an obstetrician and gynaecologist online --> <link> |
### Human:\nhow to get rid of bad breath? i floss brush every morning and night but still suffer from bad breath.\n\n### Assistant: do not worry. after following these tips you will feel better and get rid of bad breath by 2 weeks. start using chlorhexidine mouthwash thrice a day for 4 weeks. do saline water mouth rinses (take lukewarm water in a small cup and add 1/4th teaspoon salt in it) thrice a day for 2 weeks. avoid soda drinks and food that may cause acidity watch your diet carefully. if you are already having complaints of acidity or heart burning or stomach ulcer problem then visit gastroenterologist because stomach problems can be one of the major causes of bad breath. check in mirror if you have yellow plaque or calculus deposits around the teeth and gum margins then first visit your dentist and get scaling done and then use mouthwash and do saline rinses. the results will be quickly evident. check if you are a mouth breather and try to control the habit. read dentist advice to get rid of bad breath. follow up after 2 weeks. stay happy. |
### Human:\nshall i use mtp kit as my last period was before 43 days?\n\n### Assistant: first you have to check urine for pregnancy. the pregnancy test will be positive from the next day after the missed periods. so you should get two lines if pregnant now. once confirmed have a scan to confirm the location of pregnancy. mtp (medical termination of pregnancy) kit will dislodge the pregnancy if it is intrauterine. so its location has to be confirmed whether inside uterus or not. unfortunately if it is in the tube then management is different. once intrauterine pregnancy is confirmed then you can use mtp kit any day sequentially. it is most effective up to 12 weeks of pregnancy earlier lesser the bleeding. you have a lot of time so do not be in a hurry. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nmy teeth are yellow. is scaling only a temporary process to clean the teeth?\n\n### Assistant: yellowing of teeth is mainly due to one of the following or a combination of these: 1) tartar or plaque deposits (soft yellowish deposits) on the teeth. 2) calculus deposits (calcified hard deposits) on the teeth. 3) fluorosis - internal discoloration of the teeth due to altered fluorine content in the drinking water. you have given an excellent description of the clinical condition of your oral cavity. from your history it is very clear that the yellowness of your teeth is due to plaque and calculus deposits. plaque as you have mentioned is yellowish and creamy. this gets partially removed with brushing. calculi are hard deposits either yellowish greenish or sometimes blackish in color. they are firmly attached to the teeth and do not go off with brushing or tooth powder. even the abrasiveness of the tooth powder cannot remove the calculi. during childhood due to improper brushing there are chances of plaque and calculus formation over the teeth. because children at this age tend to be playful and do not concentrate on oral hygiene. "tooth worms" as people say are nothing but bacteria that affect the teeth. these bacteria act on the teeth and cause demineralization of the teeth and lead to tooth decay and cavities. the lower incisors and canines are more prone to plaque and calculus deposition (v shaped deposition in accordance with the tooth morphology) due to inability of us to reach the inner sides of these teeth while brushing. at this age of yours these deposits may be due to: 1) improper brushing technique. 2) brushing only once a day. 3) malalignment of your teeth. 4) crowding of your teeth (due to inadequate spacing in between the teeth). 5) if you are having any prosthetic teeth (crown bridge removable appliances). 6) if you are undergoing orthodontic treatment (wire braces). dental scaling is the procedure that removes plaque and calculi. but it does not mean that these deposits will not come back again. continuous oral hygiene maintenance after scaling is mandatory to prevent recurrence of plaque and calculi. hence scaling is not a wastage of money it is an investment to prevent one's teeth and gums from infections and thereby increase the life of the teeth. so a permanent solution for your problem is to follow these steps to maintain oral hygiene: 1) brush with toothpaste and brush twice daily. the head of the toothbrush should be angulated in such a way that it reaches all the teeth and all the interior and hidden parts of the teeth. 2) use an antibacterial mouthwash only for the time period for which the dentist has prescribed. because long term use of mouthwash itself will cause staining of teeth. 3) rinse your mouth thoroughly soon after every meal. 4) in case you are wearing wire braces or prosthesis use the specific tooth brushes (orthodontic toothbrushes) to clean the teeth thoroughly well. 5) use interdental toothbrushes to clean the minute spaces in between the teeth. 6) visit a dentist once in every 6 months and get a scaling done if necessary. as your doctor has told regular use of colgate toothpaste is sufficient. sensodyne toothpaste is not needed for you since it is used for hypersensitive teeth. glodent toothpaste helps in stain removal and it can be used if extrinsic stains are present on the teeth. it does cause teeth whitening. regular use of mouthwash is not essential. you can use hexidine mouthwash for about two weeks and then stop it. bleaching is the procedure used to remove internal or intrinsic staining of the teeth which is not required for you. and finally pearl white color of the teeth indicate that they are unhealthy. teeth which are slightly yellow without any deposits on them are said to be healthy. hope this answer helps you. take care. consult a dentist online for further follow up --> <link> |
### Human:\nmy mouth stinks very badly. what shall i do?\n\n### Assistant: get a full mouth scaling done from a dentist. start using antibacterial mouthwash (example: listerine) twice daily for two weeks. this is the best for stinking mouth (bad breath/ halitosis). another method for cure of bad breath is saline mouth rinse. take a small cup of lukewarm water and add 1/4th teaspoon of salt in it and rinse thrice daily for 10 days. you must get the cause identified. treating the root cause will give a permanent solution for bad breath. if the halitosis remains evenafter the use of mouthwash for two weeks consult a dentist online for further treatment. |
### Human:\ntook urine pregnancy test on the 1st day of missed periods. is that right?\n\n### Assistant: you tested too early with a urine pregnancy test. please wait for three to four days and then retest if period does not start by then. urine pregnancy test though theoretically can give correct result on the day of a missed period practically it is not that sensitive and you need to wait for three or four days extra for beta hcg (human chorionic gonadotropin) to rise enough to be detected by a urine test. another possibility is a genuine negative pregnancy and impending period causing cramps. the second possibility is that of threatened miscarriage or ectopic pregnancy in which case the rise of beta hcg is slow and cannot be detected in urine test so early. it is too early to draw any conclusion and you need to wait for the situation to become clear. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nhow to prevent bleeding on brushing?\n\n### Assistant: you should use betadine gargle as mouthwash twice daily for 15 days to reduce the swelling of gums and bleeding and also to keep your teeth clean. it would be better if you could go to a dentist for physical evaluation. ask your dentist to do cleaning of your whole mouth (dental scaling) to remove calculus and plaque from your teeth and gums. cleaning will reduce the bleeding and helps to maintain good oral hygiene. try to get your mouth clean routinely every six months to get healthy gums. for further information consult a dentist online --> <link> |
### Human:\nthere is a tooth decay started in my all tooths on lower backsides\n\n### Assistant: if you think it is a decay that has started in your teeth i would like you to go to your nearby dentist and get it confirmed. if it is decay then your dentist might suggest you to get some dental fillings done. if it is just stains that you are noticing then the stains could be removed by dental scaling that is cleaning. decay can be formed due to lots of food impaction in the back tooth regions which is a very common complaint. sometimes even though we are good in brushing there are areas where the brush cannot reach. for further information consult a dentist online --> <link> |
### Human:\nis it fine to use mifepristone for abortion after c-section?\n\n### Assistant: first please confirm the pregnancy with a serum beta-hcg test (human chorionic gonadotropin) as urine pregnancy test is not reliable till eight days post missed periods. if the hcg levels are more than 5 ng/dl then she is pregnant. in that case as she has been a post c-section case medical abortion is not to be undertaken with either mifepristone or misoprostol simply. because the c-section scar would still be weak by one year and there are often chances of uterus rupture. the best option in that case would be an ultrasound guided dilation and curettage procedure for surgical abortion. please meet your gynecologist and get the needful. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nis it normal to miss periods after taking i-pill?\n\n### Assistant: amenorrhea is not a disease. amenorrhea is simply absence of the menstrual cycle. a lot of females have missed periods for one or two cycles after taking i-pill and this is normal. in most cases cycle resumes after one or two missed periods. so no need to worry. within one to two months her periods will resume. so no need to do anything. as she bled three to six days after taking i-pill there is no risk of pregnancy. the amenorrhea is the side effect of i-pill only. it is not a matter of fear. no need to do anything. just remain relaxed and wait for her periods to resume. for further information consult a sexologist online --><link> |
### Human:\nwhy have i missed my periods?\n\n### Assistant: this type of missed period could be due to ovarian cyst which can also cause painful cramps with brownish spotting. polyp can also cause pain with brownish spotting. if your hormonal profile is normal then yes you will get periods. please get lh (luteinizing hormone) and fsh (follicle stimulation hormone) done to understand about delayed period if it reoccurs. please share images of ultrasound to guide you further. revert back with the images to an obstetrician and gynaecologist online --><link> |
### Human:\ni bled after i-pill but missed period on due date. am i pregnant?\n\n### Assistant: first of all relax. you are not pregnant. your periods came early because of i-pill medicine (emergency contraceptive pill). sometimes it can make periods come early and sometimes it can delay. in your case it made your periods early. but i want to caution you that you should not use i-pill medicine in daily routine as it is a very strong medicine and have side effects also. in your case you did not even need to take i-pill because your periods finished on 12th and you had sex on 15th. you cannot become pregnant if you do sex in the first 10 days of your periods. for further information consult an internal medicine physician online --> <link> |
### Human:\ni am suffering from depression and not getting well with ssri. please help.\n\n### Assistant: you are currently on ssri (selective serotonin reuptake inhibitor). have you consulted a psychiatrist or your cardiologist regarding medicines for depression? several medications are available for treating depression but each drug takes on an average of two weeks to exert the effect. one point i would like to mention is that you are on clonotril (clonazepam) and ativan (lorazepam). both should be tapered off. besides medicines meditate daily for at least half an hour in the morning. it will help a lot. maintain a stress diary and log your thoughts daily. in some cases certain drugs do not help but still depression can be cured. for further information consult a psychiatrist online --> <link> |
### Human:\ni am doing better with my anti-anxiety drug. do i need counseling?\n\n### Assistant: from your detailed information i feel that you have responded to medication. all ssri (selective serotonin reuptake inhibitor) medications tend to over time make the person who takes them more relaxed. this could be attributed to the main task of reducing anxiety. thus maybe a lower dose for a few months may benefit. importantly absence of anxiety or motivation is more troublesome. also i do not think that any counseling will help you. as you are already aware and attend to the problem of not pursuing tasks to completion cbt (cognitive behavioral therapy) or nlp (neuro-linguistic programming) or coach may help. for further information consult a psychiatrist online --> <link> |
### Human:\nis laser treatment safe for acne scars?\n\n### Assistant: for acne in your age group it is always important to rule out pcos (polycystic ovarian syndrome). to find that out you need to tell me whether you have irregular periods. how many days does your period date shift from the expected date? do you get any hair growth in facial areas like upper lips or chin? although your weight is correct for your height pcos can be present in thin individuals as well. we can start the treatment for acne depending on your hormonal profile results. fillers are of different types depending on the area to be treated such as tear trough (under eyes) lips cheeks etc. nowadays all doctors prefer to use semi-permanent fillers because of their advantages. these typically last for a year on an average. revert back with the answers to the questions to a dermatologist online --> <link> |
### Human:\ncan fluoxetine cause disturbed sleep?\n\n### Assistant: fluoxetine is known to cause significant insomnia in many patients as it is an activating drug. being an selective serotonin reuptake inhibitor (ssri) fluoxetine causes sexual dysfunction. both these side effects can be treated by taking tablet trazodone (brand name trazaril) 25 mg at night time. it antagonizes the side effects of fluoxetine. after two weeks if needed the dose can be increased to 50 mg. the probable causes:fluoxetine induced sexual dysfunction or insomnia. probable diagnosis:ssri induced sexual dysfunction. treatment plan:tablet trazodone 25 mg at night time. regarding follow up:for further queries consult a psychiatrist online. ---> <link> |
### Human:\nseven days since i missed my period. pregnancy tests negative. why?\n\n### Assistant: if you have taken the urine pregnancy test after seven days of missed periods then the results are usually conclusive. you may repeat the test after 48 hours and if it is still negative then you are not pregnant. the delay can possibly be due to stress induced hormonal imbalance especially during this cycle due to stressors which can easily delay your menses. if your menses do not arrive naturally in next one week then you may opt for a withdrawal bleed with progesterone. a single delayed period is not an indication for infertility workup. repeat the tests and consult an obstetrician and gynaecologist online --> <link> |
### Human:\ni am not sure if i have rosacea. please help.\n\n### Assistant: rosacea is a skin disorder that affects people above 30 years. other than acne like lesions people with rosacea have redness of face and dry skin associated with burning sensation. they also have redness and irritation in the eyes. the redness of the face is aggravated by triggering factors such as weather changes stress alcohol consumption exercise and spicy food. yours clinical condition is not rosacea since your history is contradicting with the above said information. you seem to have acne. the cysts are a part of acne. acne varies in severity from individual to individual. some may have mild acne which may come off and on. others may have almost incessant eruption of acne which may leave behind post acne hyperpigmentation and acne scars. for acne you need to be constantly taking care care of your skin until the tendency for new acne formation dies down. topical treatment of acne mainly revolves around topical antibacterials (clindamycin gel or nadifloxacin gel) benzoyl peroxide and topical retinoids. topical retinoids are comedolytic thereby preventing new acne. for inflammatory acne (papules and pustules) i advise to start with one of the oral antibiotics either azithromycin doxycycline or minocycline. cystic acne is an indication for starting oral retinoids. they are the most effective drugs for acne and are usually first choice in severe acne or cystic acne or moderately severe acne or acne not responding adequately to traditional anti-acne medications or acne significantly affecting the quality of life of patients regardless of severity. you could also take a few peeling sessions like salicylic acid peels from a dermatologist. salicylic acid peels are specific for acne. acne is a recurrent condition and once your acne is brought under good control with oral and topical anti-acne medicines you should still continue to use a cream/gel (topical retinoid) for maintenance of improvement. topical retinoids are ideal for maintenance of improvement because they are comedolytic as well as anti-inflammatory thereby preventing the formation of new acne. for further follow up consult a dermatologist online --> <link> |
### Human:\nshall i get chemical stress test to know the reason for tachycardia?\n\n### Assistant: episodic tachycardia in the setting of pac and pvc (premature atrial and ventricular contractions) is suggestive of arrhythmia may be atrial fibrillation or flutter. we should try to find the cause for it. do you smoke or have alcohol or any other stimulant drugs? do you suffer from snoring interrupted and unrefreshed sleep daytime sleepiness headaches etc? is there any history of exertional chest pain? since your holter has not picked anything the next step is the stress test. there is no harm in undergoing it and it will help us to rule out ischemic heart disease as well. do you have had any episodes when you were on holter? if not and you are having those episodes more frequently now then you can consider wearing holter again. otherwise undergo the stress test. the next option is electrophysiological studies and it is an invasive test but will diagnose and treat the arrhythmia in the same setting. i guess echo must be normal before starting flecainide. regarding treatment i would suggest beta blockers like metoprolol 25 mg to 50 mg according to heart rate and flecainide should be pill in pocket approach that is as and when needed. for further information consult a cardiologist online --> <link> |
### Human:\nmy overall sexual desire has gone down after taking tablet flunil. should i stop taking this drug?\n\n### Assistant: fluoxetine (tablet flunil 20) belongs to the ssri (selective serotonin reuptake inhibitors) class of antidepressants. fluoxetine is one of the notorious antidepressants in relation to sexual side effects. the available data indicate that about 30-40% of those taking fluoxetine develop some sexual side effects. in regard to reversal of side effects it is said that once you stop the drug the side effects recover almost completely. there is no need to worry if you are recovering from the ailment for which flunil was prescribed. but if you do not see any improvement even after four weeks of treatment then it is advisable to stop flunil and use some better alternative. you can consult a psychiatrist online for safer alternatives. ---> <link> |
### Human:\nwhat will be the reason for headache chest pain and dizziness?\n\n### Assistant: there are two possibilities. one is anxiety episodes and the other one is cardiac arrhythmia like psvt (paroxysmal supraventricular tachycardia) or atrial fibrillation in which heart rate suddenly goes up and also suddenly decreases. do you have any palpitations or increased heart rate? if yes then it can be cardiac arrhythmia. how long does it persist? blood pressure falls during these episodes and one has dizziness fainting blackouts and sometimes syncope. usually ecg is normal as it is generally done in between the episodes. ecg done during the episodes will show abnormality. you will need 24-hour holter monitoring. so you should visit a nearby cardiologist for these investigations. also hemoglobin and thyroid test should be done. ln order to abort such episodes you should try to cough hard. until the time your evaluation is complete you can ask your local doctor for tablet ciplar la (propranolol) 20 mg once a day which will cover for both the things. for further information consult a general medicine physician online --> <link> |
### Human:\nis surgery necessary for heartbeat irregularities?\n\n### Assistant: your heart condition is a cardiac arrhythmia which is called psvt (paroxysmal supraventricular tachycardia) in which heart rate suddenly goes up and also suddenly decreases. the blood pressure falls during these episodes and one has dizziness fainting blackouts and sometimes syncope. ln order to abort such episodes you should try to cough hard or do neck massage as advised. there are two options for this as follows. if it is well controlled on medicine and you are not willing for electrophysiological studies then you can continue with medicine. but you need to take this medicine lifelong. electrophysiological studies which is an invasive test and it is a minor procedure which can treat the arrhythmia permanently in most of the cases. during this procedure the doctor approaches your heart through an artery with needle and wire. for more information consult a cardiologist online --> <link> |
### Human:\ni have lot of acne scars on my face that make me look ugly. please suggest me treatment for the same.\n\n### Assistant: contractubex gel is topically applied to reduce scars. it is very effective on various types of scars. other modes of treating scars include: fractional laser treatment - a non-invasive technique to remove scars. it is the best option but is slightly expensive. microdermabrasion - a non-surgical mechanical method of removing the outermost dead skin cells layer. subcision - a surgical method to remove acne scars. dermaroller therapy - generates new cells. but the procedure is decided depending upon the type of scar. consult a dermatologist online to find out the best treatment option for your acne scars. ---> <link> |
### Human:\ncan implantable cardioverter defibrillator cause afib?\n\n### Assistant: implantable defibrillators are implanted to terminate an episode of atrial arrhythmia. afib (atrial fibrillation) is also a type of atrial arrhythmia. the icd not only provides treatment for atrial arrhythmias but also provides treatment for ventricular arrhythmias as well as rate-responsive dual chamber pacing for the treatment of bradycardia. the pacing attempts to gain control over the arrhythmia by interrupting the pathway of the atrial arrhythmia and uses low energy pacing which is usually goes unnoticed by the patient. in cases when atp (antitachycardia pacing) is successful the patient may not even be aware that they have had an arrhythmia until their device follow-up. so the answer for your question is icd cannot cause atrial fibrillation until and unless it is implanted incorrectly; rather it will terminate an episode of atrial fibrillation automatically. for further information consult a cardiologist online --> <link> |
### Human:\nwhat causes dull cramping discontinuous chest pain?\n\n### Assistant: we are here to help you. from the way you are describing it seems either you had an arrhythmia that time or you had angina pain. since your blood pressure and heart rate are in normal ranges without medicines you should avoid any medicines at this time. i would recommend for you a treadmill test that is a stress test to rule out any angina on exertion. if that comes out to be normal then you would need to go for holter monitoring. take antacid drug like omeprazole for this purpose as this would help you in fighting with acidity as a cause of chest pain. however acidity is very unlikely to be a cause for that. i hope it helps you. revert back after the tests to a cardiologist online --> <link> |
### Human:\nwhat are the ways to remove acne scars?\n\n### Assistant: for acne take a course of tablet azithromycin 500 mg daily on three consecutive days in a week for four to six weeks and continue with benzoyl peroxide 2. 5 percent gel on the pimples in the morning and adapalene gel at night on the pimples. as far as scars are concerned you can try using tretinoin 0. 05 percent cream on the scars at night. it will not have significant benefit but you can give it a try. otherwise you can consider going for laser treatment microneedling sessions or surgical correction for the scars. besides this avoid oiling of scalp keep your face dry avoid using creams and moisturizers and reduce the intake of sugary foods. for breast changes and lump i would recommend you to consult a surgeon as he will be able to guide you better regarding these symptoms. for dandruff use a ketoconazole shampoo every alternate day to start with and then taper slowly once improvement is seen. along with this use a good quality conditioner after hair wash and start with tablet keraglo eva (gamma lenolenic acid) once daily for hair fall. this needs to be continued for a minimum of three to four months. for back pain consult an orthopedician and for allergy consult an ent specialist. baking soda and lemon juice will not have any effect on acne scars. so you can stop using them. dairy products are known to aggravate acne so reduce their intake. i do not think the burning sensation is due to acne scars. you should go for la shield sunscreen gel over your entire face at intervals of three to four hours during the daytime. for further information consult a dermatologist online --> <link> |
### Human:\nkindly advise regarding my chest pain as the test results are normal.\n\n### Assistant: cardiac origin of chest pain is highly unlikely in a 29 year old female. female has a cardioprotective hormone called estrogen which usually delays the onset of coronary artery disease till 65 years. the pain you get is most likely because of high levels of your anxiety or overthinking. once shunt reversal in pfo (patent foramen ovale) is ruled out then you can ask your cardiologist to start you with a low dose of ssri (selective serotonin reuptake inhibitor) like paroxetine along with low doses of anti-anxiety medicine benzodiazepine like clonazepam for two to three months. as echo and blood profile is normal it is not cardiac. however you have not mentioned if you are a smoker or alcoholic. is there any family history of early cardiac death? what is the shunt direction in pfo in 2d echo? what are the symptoms of lung congestion? how long does the pain last? what is the frequency of your pain and is it associated with sweating? a thorough history is a must before giving a cardiac clearance. please answer the above. for further information consult a cardiologist online --> <link> |
### Human:\nmy mother does not complain of chest pain but her ecg is abnormal. how?\n\n### Assistant: your mother's test results show abnormalities. that is why the doctor has recommended cag (coronary angiography). the ecg shows st segment flattening at v which indicates ischemia (reduced blood supply) and can lead to a heart attack. it can occur in patients without chest pain. the choice for the type of angiography should be made by the attending physician. he or she will be in the correct position to decide the best for her based on his experience. there is nothing much to panic. it is mostly due to the long-term effects of diabetes. for further information consult a cardiologist online --> <link> |
### Human:\ndespite taking medicine for the past four years i am facing depression and anxiety. why?\n\n### Assistant: depression and anxiety treatment should be given for long duration for best results. even with medicine your symptoms are persistent so this is not the time to stop the medicines. but the prescription should be evaluated. do not think of reducing the doses by own and talk to your doctor before making any change in the prescription. cognitive therapy with a good psychologist can help you to come out of depression. the therapy runs in sessions and a proper therapeutic relationship is made between the patient and psychologist. this can reduce the need to drugs. supplements containing omega fatty acids vitamin b12 etc. can be used in diet and will naturally potentiate the actions of antidepressants. for further information consult a psychiatrist online --> <link> |
### Human:\nhow to cope with exam failure?\n\n### Assistant: success and failure are part of life but we should keep trying. when we are down only way is up. i know it is easier said than done but you have to keep trying and persistence is the only key to success. here are a few steps that can help you. do meditation daily for at least half an hour in the morning. follow a routine exercise regularly and take a balanced diet rich in antioxidants and omega fatty acids. you study in small shifts of half an hour followed by 5 minutes rest. also give at least one hour daily for your hobbies. share your feelings with family or close friends as sharing helps a lot. remember every problem has a solution you just need to try solving it and help is just a step away. for further information consult a psychiatrist online --> <link> |
### Human:\nis cabg the only solution for coronary artery disease?\n\n### Assistant: i have carefully reviewed your health query and feel sorry for your father's health issues. it is a concerning disease process. i never recommend to leave it as such and do nothing much for an advanced coronary artery disease. he has got triple vessel involvement and in such circumstances the best next step is to go for cabg surgery (coronary bypass graft) especially if there is no obvious contraindication. no partial angioplasty is not a solution to the problem. although he has no obvious signs or symptoms but you should know well that the disease inside has progressed much and anytime with or without strenuous physical activity he may get a severe heart attack that can be really dangerous and lethal. i would go with the suggestion of cabg right away. for further information consult a cardiologist online --> <link> |
### Human:\neither mr angio or ct angio which will show brain aneurysm clearly?\n\n### Assistant: ct angiography has sensitivities of 77% to 97% and specificities of 87% to 100% for picking up an aneurysm. mr angio sensitivity and specificities are way less than ct angio. so when ct angio is negative for an aneurysm it is good news. even more important to know is that with level 1 evidence the 1 or 2 mm aneurysm does not require intervention when they are unruptured and patient is under 36 non-smoker not hypertensive or with negative family history of aneurysms. i assume that you are not a smoker or hypertensive as you have not mentioned anything about that. take care. for further information consult a neurologist online --> <link> |
### Human:\nwhat should i do to concentrate in my studies?\n\n### Assistant: i can understand your concern. the recurrent distractibility could be occurring due to anxiety and should be evaluated. intrusive thoughts during studying result in distraction. if remembering the things related to the past and imagining things are causing distress then that is most probably due to anxiety and need treatment. please consult a psychiatrist for evaluation of this problem and for treatment. if there are no intrusive thoughts then supplements containing omega fatty acids vitamin b12 and e can be used to improve the concentration. it will help in improving focus in your case. for further doubts consult a psychiatrist online --> <link> |
### Human:\nwhy do i keep getting a lot of negative thoughts about my health?\n\n### Assistant: these kind of ruminations are quite common especially in premenstrual period. the things that will help you are as follows. meditate daily for at least half an hour in the morning. daily write down whatever that comes to your mind uncensored and never read it again. avoid caffeinated drinks and add foods rich in antioxidants and omega fatty acids in your diet. if these things do not help even after two weeks then consult a psychiatrist. for further queries consult a psychiatrist online --> <link> |
### Human:\ni want to know whether my liver is in bad condition.\n\n### Assistant: the liver is a workhouse for metabolism of protein and fat (lipids). when there is an excess of lipid in your blood than the capacity to metabolize by the liver the excessive lipids start to accumulate in hepatic cells known as fatty liver. this is an ongoing process if not taken proper steps to prevent it. i am sure that your liver is not in bad condition at all and it can be reverted to normal metabolism by regular exercise intermittent fasting use of omega fatty acids containing oils in diet reducing fat content in diet and by avoiding alcohol. the probable causes:diet and alcohol. investigations to be done:lft (liver function tests) and ultrasonography abdomen. probable diagnosis:fatty liver. treatment plan:conservative treatment. preventive measures:1. regular exercise. 2. intermittent fasting. 3. use of omega fatty acids containing oils in the diet. 4. reducing fat content in diet. 5. avoiding alcohol. regarding follow up:for further information consult a medical gastroenterologist online. ---> <link> |
### Human:\nwhich is the best peel for rosacea?\n\n### Assistant: rosacea is a condition which may get aggravates during season change temperature change exercise alcohol and stress. in rosacea skin becomes very sensitive and you cannot apply for any other medicines. as you said treatment prescribed by the previous doctor worked for you you can continue those medicines. we use salicylic acid (20% to 30%) or azelaic acid peels. rosacea makes skin very sensitive so we defer using peels at home as peels contain acid which may also harm if not applied under supervision. patient friendly peels are not easily available. you can go to your local dermatologist and ask for these peels. meanwhile i suggest you topical salicylic acid 2% gel or azelaic acid 20% gel. why do not you like to take oral medicines if you have pimples like lesions in rosacea? they also work very well. for further information consult a dermatologist online --> <link> |
### Human:\nis my dht level causing mild hair fall and flaky scalp?\n\n### Assistant: flaky scalp not responding to noskurf (combination of climbazole piroctone olamine aminodermine and almond oil) lotion may be scalp psoriasis and need steroid plus salicylic acid 6 % combination lotion. the pain is due to hair root inflammation which is commonly seen in male pattern baldness. i would suggest you get the following test done. serum dht (dihydrotestosterone) level. thyroid profile. cbc (complete blood count). if dht is high then we have a specific treatment for that. both psoriasis and hair fall may increase due to stress. it is good that you are taking preventive steps. revert with more information to a dermatologist online --> <link> |
### Human:\ni am just fed up with my dark complexion. please prescribe me some skin whitening product.\n\n### Assistant: natural complexion is the best. cosmetics do more harm than good. you can avoid them. melanin pigment in the skin protects against cancers. presence of more melanin in the skin gives the dark complexion. you can use sunscreen lotions which help in preventing tan due to sun. there are mild peeling agents with salicylic acid used in skin peel treatment. to discuss regarding the skin peel treatment consult a dermatologist online --> <link> |
### Human:\ncan cotaryl cream be used to cure dry and flaky skin (ichthyosis)?\n\n### Assistant: ichthyosis as you rightly mentioned is a genetic condition leading to excessively dry and flaky skin. there is no cure for this condition but it can be controlled by using right medications and thus bringing the normal texture back. for the same follow these suggestions: use a mild soap like cetaphil soap. use lukewarm water to bathe and add liquid paraffin (2 caps full) in the water. after having the bath use a cotton wash cloth to slightly rub off the scales. this will dislodge the scales. always pat your skin to make it dry. use a thick emollient after bathing like cetaphil dam. mix cetaphil dam cream and cotaryl cream in equal amounts and apply all over the body. apply cotaryl cream over the affected area at night. and whenever you feel the need of moisturiser just use plain cetaphil dam. take diet rich in omega fatty acids such as fish nuts flax seeds and etc. once in a week use an oat meal scrub. mix powdered oats cream and milk and apply it over body and scrub it off. follow all these above steps regularly and you will be sure notice a positive change. consult a dermatologist online for further help --> <link> |
### Human:\ni am unable to sleep at night because of stress. please help.\n\n### Assistant: i feel sorry for your loss. your problems are stress unable to sleep at night and body pain. so basically it is your stress that is leading to other problems. stress can be managed both by medication as well as by lifestyle modifications (behavior therapy). first try lifestyle modifications which include: drink plenty of water. whenever you sit idle make it a practice to take deep breaths. include one tomato in your diet daily. add omega 3 fatty acid supplements. exercise outdoor regularly. exercise will help to release endorphins which will lift the mood and activity levels. breathing for relaxation - inhaling and exhaling exercise or yoga. take diets rich in protein carbohydrates and low in fats. increase the intake of walnuts hazelnut flax seeds in diet. these diets are known to be a rich source of omega fatty acids. also proper sleep hygiene needs to be practiced daily so as to help you to maintain good sleep in the long run. sleep hygiene entails following important points. adhering to a fixed sleep in and wake up time. wearing loose cotton clothes at night for sleeping. keeping the room dimly lit and well ventilated. changing room or bed temporarily. avoiding stimulant substances in the late evening or night such as coffee tea etc. and also avoid watching television or listening to music late at night. avoid eating heavy oil rich fried meals late in the evening and at night. take small frequent meals at regular intervals and dinner at 8 pm with good time interval between dinner and sleeping. a warm cup of hot milk15 minutes before going to bed can help in good sleep. these lifestyle modifications will help in improvement of symptoms and you will feel better. if symptoms persist even after lifestyle changes then visit a psychiatrist. drugs like modafinil or armodafinil will help to maintain daytime alertness and will reduce fatigue. visit a psychiatrist for proper prescription of this drug. for further information consult an internal medicine physician online --> <link> |
### Human:\ncan we use glycerin suppository twice a week for my 2 month old daughter?\n\n### Assistant: this must probably be your first child that is why this query. please note that children under the age of six months may pass stools either 10 to 15 times a month or once in 2 to 3 days. and it is absolutely normal. you should be worried only if the child has not passed stools is vomiting and has abdominal distention. otherwise it is fine. also you can give neopeptine (combination of simethicone amylase and papain) and decolic (combination of diazepam and dicyclomine) when required. no harm would be done. for further queries consult a paediatrician online --> <link> |
### Human:\nthough my baby is exclusively breastfed why does he fail to thrive?\n\n### Assistant: please note that the weight gain of your baby is fine. normally birth weight doubles by the age of 6 months which i think it has. as for 7-1/2 months of age the weight is only a very little bit lesser probably because of reflux issues. also babies pass stools either 10 to 15 times a day or once in two to three days so i do not think there is constipation. i feel that if the baby had any major problems then the child will not be able to become double of birth weight by 7 months of age. according to me the child is having a fair amount of weight gain which is slightly on the lower side probably due to the reflux which will go away eventually with age. also you can give multivitamins and calcium supplements to help the baby. also give mashed foods along with breast milk to the baby. for further information consult a paediatrician online --> <link> |
### Human:\ni do not have oily foods but still have pimples. why?\n\n### Assistant: i can understand your concern. you need to take proper medicine for the treatment of pimples so that dark spots will not appear. use a salicylic acid face wash twice daily and apply benzoyl peroxide 2. 5 percent gel on the pimples twice daily. along with this take a course of tablet azithromycin 500 mg daily for three consecutive days in a week for six weeks. for the dark spots apply tretinoin cream 0. 05 percent on the dark spots at night in minute amounts. sometimes dandruff is also associated with pimples. if you have dandruff use ketoconazole shampoo twice weekly along with tablet fluconazole 200 mg twice weekly. besides this keep your face dry avoid applying oily creams and moisturizers. you can use cosmetics labeled as noncomedogenic reduce the intake of sugary foods and avoid direct sunlight. the probable causes:seborrhea or hormonal imbalance. probable diagnosis:acne vulgaris with post inflammatory hyperpigmentation. regarding follow up:revert back after six weeks to a dermatologist online. ---> <link> |
### Human:\nmy baby is fussy while passing stool. is it due to anal fissure?\n\n### Assistant: yes it can be anal fissures. also you can look for a skin tag around perianal area which occurs in anal fissure. does the child have constipation or tight stools? because if it is an anal fissure then we will have to see the cause of hard stools as the difficulty to pass stool can cause fissures. he should also be checked for hypothyroidism. is there any blood in stools? most likely it is anal fissure. the rest all can be said on examination for which you should see a pediatrician. for further doubts consult a paediatrician online --><link> |
### Human:\nplease suggest some good shampoo for dandruff.\n\n### Assistant: i have gone through your complaints. you should start with shampoo containing salicylic acid and ketoconazole. use it every alternate day in the beginning. once you notice improvement gradually taper it to twice weekly and then once weekly. along with this apply clotrimazole and betamethasone combination lotion on the affected areas of the scalp twice daily. i also recommend you to take tablet ketoconazole 200 mg once daily in the morning and tablet levocetirizine 5 mg at bedtime. continue this treatment for two weeks and revert back. the probable causes:1. immune factors 2. hormonal factors 3. fungal infectionprobable diagnosis:seborrheic dermatitis. preventive measures:avoid oiling of scalp as it will increase your dandruff. regarding follow up:revert back after two weeks for follow up to a dermatologist online. ---> <link> |
### Human:\nwould zantac make allergy skin test false positive?\n\n### Assistant: at present you are suffering from allergic rhinitis converting to allergic asthma. get your absolute eosinophilic count done and you need to go for spirometry only at the time of the attack to pinpoint the diagnosis. the differential diagnosis includes allergic bronchiolitis. i suggest you fexofenadine 180 mg at night and pantoprazole 40 mg half an hour before breakfast. if eosinophils are raised then i suggest you diethylcarbamazine. consult your specialist doctor discuss with him or her and take treatment. for further information consult an allergy specialist online --> <link> |
### Human:\nkindly suggest a good brand of infant formula for baby constipation?\n\n### Assistant: i can understand your concerns. if child is constipated on dexolac premium then you can switch to nan pro 1 lactogen 1 or similar advance. all are equally good. nan pro 1 is more preferred. for further queries consult a paediatrician online --> <link> |
### Human:\nbaby passes stool only after two days. is it normal?\n\n### Assistant: if your baby is breastfed it is perfectly normal to pass stool less often. on the other hand it does not seem normal for such a young kid. if it continues for more than 2 weeks get him checked by a paediatrician. consult a paediatrician online to know the management of constipation in children --> <link> |
### Human:\ndoes peanut butter pose any allergy threat?\n\n### Assistant: you have asked an interesting question. peanut allergy is one of the most severe food allergies. it can cause itchiness urticaria swelling eczema sneezing asthma abdominal pain drop in blood pressure and cardiac arrest. it may even result in anaphylactic death if not controlled in the right time. the routes of exposure of the allergen are mostly the accidental ingestion of peanuts or pb by the concerned person (who is hypersensitive to peanuts). air-borne particles in a farm or factory or crushing environment may cause respiratory symptoms in allergic individuals. however the odor of peanut butter or its mere proximity have not produced any allergic symptoms in various studies conducted. hence answering your questions. it is safe to carry peanut butter in plane. if you are carrying it as part of hand baggage (cabin baggage) make sure it is packed properly in a colored container. this is just to prevent any psychogenic allergic symptoms in those susceptible individuals who may see the butter and develop allergy (however such psychogenic reactions are very rare but still documented in studies). since the pb as such is not an allergen by sight/proximity/odor a susceptible person need not take extra precautions to avoid allergy when someone else is carrying pb. however since psychogenic reactions can occur it may be advised that such a susceptible person may change his seat to another seat away from person who is carrying peanut butter. for further information consult an allergic specialist online --> <link> |
### Human:\nmy child struggles and tenses up so hard to pass stools. is there something she can be given to overcome this?\n\n### Assistant: your child has constipation. the common causes for constipation are anal fissure and dietary factors. if it has been for less than one month duration start lactulose 7ml twice a day for 15 days and revert back. give her high fibre diet and plenty of fluids. make your child sit in warm water for about 15 minutes daily such that her hips and buttocks are inside the water (sitz bath). if the constipation has been there for more than a month get these blood tests done: cbc (complete blood count) ttga (tissue transglutaminase antibody) iga thyroid function test and revert back to a paediatrician online --> <link> to know more about constipation in children read this article --> <link> |
### Human:\ni have chronic allergies which become worse in winter. please suggest ayurvedic medicine.\n\n### Assistant: the allergic symptoms usually aggravate during winter season. it continues from november till february based on the climate in your place. you have not mentioned about the allergic site (nose or lung or skin). if it is nose or lung the dryness due to winter can trigger the allergic response in nose. in this situation you need to maintain moisture by just applying a drop of coconut oil in each nostril before going to bed. on the other hand you can apply a drop of anu thailam (an ayurvedic nasal drops for allergy) in each nostril before going to bed. during evenings and nights when it is too cold you need to protect your ears (by keeping cotton plug) nose (by applying oil drops) head (by covering head with a woolen cap) and hands and feet (by wearing gloves and socks). the external cold stimulus triggers the allergic response. so prevent yourself from the cold stimulus to avoid allergy. if you have allergic asthma then it is better to practice pranayama and yoga. breathing exercises will help you. if you have allergic skin disorder then you can use vaseline or vegetable oils to gently apply on the skin. this helps in overcoming the dryness due to the cold climate. the skin manifestation should also be examined by a physician to decide the proper medication. revert back to an ayurveda specialist online for further follow up --> <link> |
### Human:\nhow to cure eye allergy?\n\n### Assistant: your doctor is right in saying that your son has allergic conjunctivitis. eye allergies called allergic conjunctivitis are a common condition that occurs when the eyes react to something that irritates them called an allergen. the most common allergens are dust and pollens. the eyes produce a substance called histamine to fight off the allergen. as a result the eyelids and conjunctiva (the thin filmy membrane that covers the inside of your eyelids) become red swollen and itchy with tearing and burning. the key to treating eye allergies are avoid or limit contact with the substance causing the problem. avoid rubbing eyes instead do cold compresses. use antiallergic eye drop like olopatadine along with lubricating eye drop. we prescribe mild steroid in pulse dose in case allergy is severe. in longstanding allergy we also prescribe tacrolimus (talimus ointment) with very good results. some doctors also prescribe cyclosporine instead of tacrolimus and that is also effective in longstanding cases. this will help you and i am very sorry to say that there is no medicine to cure allergy. only way is to stay away from all those things that you are allergic to. also this allergy will trouble him every year and usually after puberty it decreases. for further information consult an eye care ophthalmologist online --> <link> |
### Human:\nhaving allergy problems for many years. i always have running nose or sore throat or excessive sneezing and coughing and cannot breathe normally. please help.\n\n### Assistant: i totally understand your concern regarding cure of allergies. unfortunately allergy of the nose cannot be totally cured but definitely can be prevented. i would recommend the following:1. get an allergy skin test done; so as to identify the allergen. avoiding the allergen is half the solution to the problem. the allergen source could be dust sources like carpets/bedding/mattresses. avoid indoor plants/pollens. pet fur/hair is also a common cause. 2. get a ct scan of your sinuses. you could be having polyps in your sinuses; which may be contributing to your nose block. if so; your ent doctor may advise you to undergo a surgery to open up your sinuses; to enable you to breathe better. 3. taking a steroid spray regularly will give relief of your symptoms. you do need to take it for 2-3 months during the season. taking an antihistamine like allegra with steroid sprays is beneficial in moderate allergic rhinitis. 4. the latest treatment is immunotherapy; offered in some allergy centres. you can contact your local specialist for the same. it is a permanent cure; but it takes a long time for the immunity to develop. hope the above helps. if you do have a scan do share it with me and i can guide you further. keep your allergies under control; as a neglected sneeze can lead to aggravation of your wheeze. consult an ent otolaryngologist online for further help --> <link> |
### Human:\nwhy does my friend have numbness after hemilaminectomy surgery?\n\n### Assistant: it sounds like your friend is bothered by the persistent tingling and numbness in his left foot. i understand these sensations can be quite irritating especially if your work involves standing for long periods. did he have these tingling sensations in the same areas before the surgery? if so have these worsened after the surgery or remained the same? i assume his symptoms before the surgery were also on the left side and his hemilaminectomy was also performed on the left side. it will be nice if i could see the preoperative mri images to see what the hemilaminectomy was done for. often if the surgery involves removal of a large herniated disc or the space available for the nerve is very less (stenosis) then the nerve may get bruised during surgery due to retraction. this means that in order to decompress the nerve the surgeon has to retract the nerve to go around the nerve and remove the compressing elements. if the compression is severe the nerve gets bruised easily and there may be persistent numbness and tingling in the areas of the leg and foot that are geographically supplied by that nerve. since the surgeon has advised him to wait it out i assume this is likely the case. swelling of the foot is common if the nerve supplying that area is not fully functional. the weak muscles in the leg and foot are not able to push the blood back up towards the heart and gravity causes this dependent area to swell up. this is often seen at the end of the day and gets better at night when he sleeps. it is difficult to predict how long the tingling will last. it could be a few months. the fact that there is tingling and not pure numbness is actually encouraging although it is more irritating to the patient. if it were a complete nerve injury then only numbness would be experienced. the presence of tingling means that the nerve is just irritated inflamed and swollen due to the bruising. if the tingling is very bothersome he may try some neuralgic pain medications like gabapentin or pregabalin. nonsteroidal anti-inflammatory medications (nsaids) may also help in this situation. there is a very rare possibility of other complications like recurrent disc herniation other post-surgical changes irritating the nerve etc. these are difficult to diagnose and usually need a new mri with contrast. however it is advisable to delay such investigation for at least for two to three months after surgery since the mri images at this stage will be obscured by the post surgical changes. if the symptoms of tingling and numbness are progressively worsening and if he develops back pain a new mri may be needed irrespective of the time since surgery to rule out infection or instability. the probable causes:surgical retraction of nerve that may have caused it to bruise. investigations to be done:none if symptoms are not progressively worsening. differential diagnosis:recurrent disc herniation. treatment plan:gabapentin or pregabalin and nsaids. regarding follow up:for further doubts consult a spine surgeon online. ---> <link> |
### Human:\nis it normal to have palpitations during pregnancy?\n\n### Assistant: the palpitations you are experiencing are mostly a normal phenomenon during pregnancy. it is known as sinus tachycardia. nevertheless it is better to get an ecg done to reaffirm my suspicion. the hives and skin issues are also could be due to the hormonal changes in pregnancy. treatment plan:ecg if sinus tachycardia and then no need of any active intervention. regarding follow up:for further information consult a cardiologist online. ---> <link> |
### Human:\ni have episodes of dull pain over my left eye. what could be causing this?\n\n### Assistant: i read your query and understood your concerns. from the available description it is clear that you are having frontal sinusitis which can explain all of your symptoms except tingling sensation in groin. presence of pain on touch (tenderness) pain while in reclining position and coincidence of pain with post-nasal drip favors the clear cut diagnosis. one thing is that the episodic nature of pain which is not common with frontal sinusitis but can occur in few cases. i feel that pain over left eye and tingling sensation is not casually related as there is no condition which can explain both these symptoms on basis of single disease. the one possibility is anxiety associated with recurrent pain can be cause of tingling over the groin area although constant nature of tingling on same location points against anxiety. we can expect that complete neurological examination will reveal the true nature of association. at this moment i must assure you that this is not something serious and get yourself treated for sinusitis to break the event of chains. for further information consult a neurologist online --> <link> |
### Human:\nmy partner bled heavily after 3 years of menopause. what to do?\n\n### Assistant: postmenopausal bleeding is the vaginal bleeding which occurs 1 year after attaining menopause. it should be evaluated particularly in whom with a family history of carcinoma. pmp bleeding patients are at high risk of endometrial cancer. the causes of pmp bleeding include vaginal atrophy (the most common) hormonal replacement therapy for menopause like tamoxifen endometritis or endometrial infection endometrial hyperplasia endometrial carcinoma cervical polyps cervical carcinoma and any other gynecological carcinoma. better to go for tvus (transvaginal ultrasound scan) pap smear and then endometrial biopsy based on the wall thickness. for further information consult an internal medicine physician online --> <link> |
### Human:\nwhat is the possible cause for increased heart rate?\n\n### Assistant: it can be a sinus tachycardia. a sinus tachycardia is a sinus rhythm with an elevated rate of impulses defined as a rate greater than 100 beats per minute in an average adult. the normal resting heart rate in an average adult ranges from 60 to 100 beats per minute. there are a number of causes for a sinus tachycardia. the most common causes include anemia smoking (increased nicotine acts a stimulant) or elevated anxiety level. drugs like propranolol and clonazepam will be given to you initially for 21 days depending on your anxiety levels sleep cycle and habits (smoking or alcohol use). for further information consult a cardiologist online --> <link> |
### Human:\nswelling and hard bumps on elbow sore stiff hands in the morning. should i go to a rheumatologist?\n\n### Assistant: on icliniq. from your history it seems that you are suffering with rheumatoid arthritis. this is more in females having morning stiffness of the joint and improve during the day and presence of nodules over bony prominences. yes you need to go to a rheumatologist for proper evaluation and regular follow up. it is an autoimmune disorder which will affect various organs of the body at various stages. if delayed to start with the treatment it can cause restriction of movements of the joints and involvement of other organs also. investigation to be done are: cbc lft rft x-ray rh factor ana hiv hbsag anti hcv tft. management is with nsaids and other dmard's that can be decided after proper evaluation. you can follow up with a rheumatologist online --> <link> |
### Human:\ni have bad faeces smell coming from my nose when i breathe. what could be the possible causes?\n\n### Assistant: bad smell during breathing could be due to various reasons. let us see those one by one. malignancy: an intranasal (inside the nose) or intraoral (inside the mouth) malignancy can produce foul smell that can be perceived as faeces smell by the nose. malignancy can be painless and without any symptoms. malignancies of paranasal air sinuses also produce foul odor. dental infection: a tooth decay can produce bad smell. dental infection usually produces significant pain. food particles get collected inside the decayed tooth and hence cause the bad smell. sinusitis: chronic sinusitis can cause constant post nasal drip and purulent discharge (pus discharge). this results in foul odor. maxillary sinusitis commonly produces foul odor. sinusitis will have other symptoms like headache facial pain nasal blockage post nasal drip etc. foreign body inside nose: a foreign body which has got stuck inside nose without being removed for many days will produce purulent discharge and smell. the discharge will be from one side of the nose. it is common among kids. foreign body produces nasal block. atrophic rhinitis: it is a disease where the normal space inside the nose gets increased due to destruction of the anatomy. also the condition causes merciless anosmia (loss of sensation of smell). the sufferer cannot perceive any smell but the people around him can get the extreme foul odor emanating from the patients nose. atrophic rhinitis also presents with crusting inside nose and nose block. maggots in nose: maggots are larval stage of fly (chrysomia). maggots usually occur in association with atrophic rhinitis. fly lays its eggs inside nose leading to maggots inside nose. they are attracted to the foul odor and they themselves aggravate the odor. tonsillitis: pus accumulated over the tonsil can cause bad smell. tonsillar enlargement with infection and consequent foul breath is common in many children. other symptoms of tonsillitis include fever throat pain enlarged lymph nodes of neck difficulty and pain while swallowing. nasal diphtheria can produce foul odor. diphtheria produces a membrane over the affected mucosa. rhinitis caseosa: it is a destructive disease producing foul odor. it was thought to be a fungal disease exact etiology is still not clear. tuberculosis: tb of nasal mucosa produces granulomatous inflammation and caseating necrosis consequent death of tissues and foul smell. hope i have cleared your query. further evaluation and clinical examination is required. regarding follow up:for further follow up consult an ent otolaryngologist online. ---> <link> |
### Human:\nwhat could be the reason for blurred vision following a hit on the eye?\n\n### Assistant: after trauma with the ball there could be many things that can cause blurring. it could be a simple eyelid swelling or small abrasion on the cornea the front transparent surface of the eye. other causes may be inflammation in the eye or blood inside the eye called hyphema. sometimes after trauma pupil dilated due to sphincter muscle damage and that also produces blurring. lens subluxation or small vitreous hemorrhage can also cause blurring. after trauma with the ball there may be swelling in the back of the eye (retina) called commotio retinae - berlin's edema. so you need a complete eye examination from an eye specialist so that the exact cause of blurring could be established and treated if needed. after trauma with the ball there may be orbital bone fracture and double vision. also there is a risk of retinal detachment in life time and this may manifest as flashes floaters or a sudden decreased vision or a curtain in the field. so my advice is to go to your eye specialist and get your eyes checked. he will treat you accordingly. for further information consult an eye care ophthalmologist online --> <link> |
### Human:\nis morning phlegm with blood related to allergy?\n\n### Assistant: yes it is related to your allergy. sometimes with excessive sneezing you may have this capillary bleeding. nothing to worry as it is coming only in the morning associated with sneezing. try to avoid contact with pollen. i suggest you to use antihistamines and leukotriene inhibitors tablet allegra 180 mg (fexofenadine) once a day and tablet montelukast once a day. sometimes you may need to use steroids if symptoms are severe to evaluate. consult your specialist doctor discuss with him or her and take the medicine with their consent. do you have any cough or throat pain? get a chest x-ray posteroanterior (pa). check blood for bleeding and clotting time. get a detailed check of your nose and throat by your medical practitioner to see any nasal polyp and other things. revert back with the answer to the above question to an internal medicine physician online --> <link> |
### Human:\ncan i take antihistamines (an otc drug) when pregnant?\n\n### Assistant: antihistamines are used to treat allergy symptoms. we have two generations of antihistamines: first generation antihistamines like chlorpheniramine dimenhydrinate diphenhydramine doxylamine are considered safe to use during pregnancy. these medications have sedative effect (cause sleepiness). the newer non-sedating antihistamines like cetirizine desloratadine fexofenadine and loratadine are best avoided in pregnancy as we have no strong evidence confirming its safety in pregnancy. hope this helps. consult a general medicine physician online for further queries --> <link> |
### Human:\nwhy cpvt is not evident on ekgs?\n\n### Assistant: we are here to help you. cpvt - catecholaminergic polymorphic ventricular tachycardia is a devastating condition and is usually found and detected on holter monitor or on stress test if asymptomatic. in case of acute attack if a person has severe chest pain or syncope then at that time it can be documented in ecg. if your panic attack is due to cpvt then definitely it would have appeared in your ecg. it is very unlikely that you have cpvt. your sinus tachycardia is suggestive of anxiety. however i would recommend you to get your thyroid profile done if not done yet. for further information consult a cardiologist online --> <link> |
### Human:\ni took tablet metronidazole 5 hours after i had taken 20 ml of red wine. what can i do now?\n\n### Assistant: hi metronidazole and alcohol interaction causes disulfiram-like reaction. this leads to nausea vomiting tachycardia (increased heartbeat) shortness of breath etc. if you had consumed red wine 5 hours before the drug intake then it is all right. there is nothing much to fear. you may have nausea and vomiting but that would be minimal and temporary. 5 hours is ample time for the wine to be metabolized in the body. for further follow up consult a family physician online --> <link> |
### Human:\ni am getting swelling over my face followed by toothache. why?\n\n### Assistant: the swelling that you have seems to be an abscess or pus due to infection. this infection is most likely due to your tooth decay over a long period of time which has spread to bone and around your soft tissues like muscles. in the face region swelling increases rapidly in size due to multiple natural pathways that connect each other. it is a potentially dangerous situation. the abscess needs to be drained quickly. if allowed to progress then it may lead to infection spreading to brain or even may lead to breathing difficulty. i suggest you antibiotic augmentin 625 mg twice daily along with analgesics. contact an oral surgeon or a dentist as soon as possible for physical evaluation and take the medicine with consent. follow up and get the tooth treated once infection subsides. do warm salt water rinses and apply ice to the swelling. do not apply heat as it will spread the infection further. the probable causes:tooth infection or abscess spread to vital spaces in the face. probable diagnosis:space infection due to tooth decay. treatment plan:1. abscess drainage. 2. antibiotics. 3. analgesics. 4. serratiopeptidase or other proteolytic enzymes. regarding follow up:for further information consult a dentist online. ---> <link> |
### Human:\nis it necessary to replace my tooth crown after 9 years?\n\n### Assistant: most crowns can last up to 15 years depending on the type of material used for making crown. sometimes crown replacement is neccessary when there is excessive wear or fracture in crown or there are complications due to tooth decay. so if that is the reason why that dentist suggested you crown replacement then it is neccessary. otherwise if the crown is fine and it is kept plaque free then no need to replace it. for further information consult a dentist online --> <link> |
### Human:\nfollowing skin firming treatment i got very large bulges on my lower face. is this normal?\n\n### Assistant: you might be suffering from granuloma formation following allergic reaction to injected substance. in some cases they may take years to subside. a physical examination is required to confirm the diagnosis and a long course of prednisolone may be needed to hasten the recovery. for further information consult a plastic surgeon online --> <link> |
### Human:\nwhat could be the reason for increased heart rate of my pregnant wife?\n\n### Assistant: tachycardia which she had was mostly probably psvt (paroxysmal supraventricular tachycardia) or other svt (supraventricular tachycardia) which are usually episodic in nature. so the reading which you had of 123 was probably not due to her old heart problem psvt but it was sinus tachycardia may be because of activities or stress dehydration pain etc. and baseline heart rate at the time was also probably in the same range. heart rate is the highly variable parameter. heart rate normally changes with many things like anxiety activities fever dehydration and many other and this is very well normal. the heart rate of 120 to 140 could normally be achieved. if one has an episode of psvt then he would be symptomatic like severe palpitations shortness of breath chest pain and heart rate is usually above 150. so the heart rate of 95 is normal and no need to worry. the heart rate of 123 was not probably psvt or svt but just a sinus tachycardia. if it was then these are episodic tachycardia and returns to baseline on their own. if she has repeat episodes then she should cough hard to abort the episode and may be neck massage if taught by a doctor after neck examination. for further information consult a cardiologist online --> <link> |
### Human:\ni have toothache even after applying fluoride varnish? why does this happen?\n\n### Assistant: dental varnish contains fluoride is anticarious and hence prevents progression of tooth decay. pit caries are very minute and very minimal cavities that are superficially present on the teeth. pit caries do not require fillings because to do the filling a little bit of normal tooth structure has to be drilled. so varnish is preferable in very small cavities like yours. rarely small pit caries seen clinically might have progressed deeply (in a triangular pattern with apex seen outside but broad base deep inside the tooth). yours might be of this type and hence causing pain. follow up with a dentist online after taking an iopa (intraoral periapical x-ray) to confirm the deep caries --> <link> |
### Human:\nhow long will it take to get cured of lichen planus?\n\n### Assistant: lichen planus is a chronic and self-limiting disease. it has been seen that skin lesions subside within 9-12 months in about 50 percent of the cases. since you are still developing fresh lesions you will have to take a course of tablet prednisolone 20 mg daily for 6 weeks which can be reduced gradually. you seem to have severe itching which is not responding much to levocetirizine. i would recommend you take tablet hydroxyzine 25 mg twice daily till the itchy subsides. along with this apply clobetasol propionate on the itchy areas. but if large surface area is involved dilute it in a moisturizing lotion in the ratio of 1:4. this will surely help you. the probable causes:1. immune dysfunction. 2. genetic causes. 3. dental amalgam. 4. stress. 5. anxiety. 6. depression. differential diagnosis:lichenoid drug eruption. probable diagnosis:lichen planus. preventive measures:reduce stress and anxiety. regarding follow up:revert back after four weeks for follow up to a dermatologist online. ---> <link> |
### Human:\nthough my ekg showed sinus tachycardia why did not my doctor worry about that?\n\n### Assistant: i understand you are worried. please do not worry. sinus tachycardia is just fast heart rate and yours is just slightly elevated. probably you were a little anxious during the time of the examination. st and t changes are often seen in normal healthy patients. it could be due to some medications. it is highly unlikely that you have any cardiac related issues at this age. but if you have experienced any chest pain of recent or shortness of breath then it could be a cause for worry. if you do have symptoms such as shortness of breath or chest pain then i will advise that you repeat the ekg test as a conclusion because it cannot be drawn from one ekg test result. for further information consult a cardiologist online --> <link> |
### Human:\nhow to cure my father's severe cold and cough?\n\n### Assistant: your father is suffering from bronchial asthma. the current medications foracort 200 mcg inhaler (budesonide and formoterol) and nasonex (mometasone) nasal spray were given for asthma. as there is no relief even after taking tablet clavam (amoxicillin and clavulanate) and tablet prednisolone it indicates that the dose of current inhaler is not sufficient. so i suggest that it is important to increase the dose of foracort inhaler to 400 mcg two puffs twice daily followed by gargling. i also suggest levolin inhaler (levosalbutamol) two puffs thrice daily and benz pearls (benzonatate) two puffs twice daily. consult your doctor discuss with him or her and then take the medicines with consent. for further information consult a pulmonologist online --> <link> |
### Human:\ni have inappropriate sinus tachycardia. should i get a pacemaker?\n\n### Assistant: firstly do not get depressed this is not a life-threatening condition and may resolve with time. the symptoms may be troublesome for some time. how much are your resting and maximum heart rate? you should get yourself evaluated by a psychiatrist for anxiety and depression which i think is causing your poor quality of life. i assume all other causes are ruled out like thyroid low hemoglobin and postural orthostatic tachycardia syndrome. the echocardiogram is also normal i guess. in treatment it is better to continue medicines because results of ablation are not very good and it may give rise to a need for a permanent pacemaker. a pacemaker is also not a good option in your age group as strenuous activities and heavy sports need to be restricted after this. besides regular surgeries to replace batteries may be troublesome. so i think you should continue with medicine. i suggest taking beta blockers like metoprolol 25 mg once a day or ciplar la (propranolol) 20 mg once a day. this should be tried rather than ivabradine. consult your specialist doctor discuss with him or her and start taking the medicine after their consent. hope this helps you and get back if you have any doubts. for more information consult a cardiologist online --> <link> |
### Human:\ncan i take prednisolone for asthma?\n\n### Assistant: the thing is it takes one to two months to stabilize asthma in the case of taking inhaled steroids. please confirm whether your inhaled drugs contains fluticasone or beclomethasone as these are inhaled steroids for asthma. i suggest you prednisolone 40 mg once a day for a week then 30 mg for next week then 20mg for next and then 10mg and 5 mg and stop. by that time your inhaled steroids will begin to work. also i suggest you oral drugs like tablet deriphylline retard 300 mg twice or tablet doxofylline 400 mg twice a day. in addition to the above i suggest tablet containing montelukast with levocetirizine daily at night for a month. consult your specialist doctor discuss with him or her and take treatment for asthma with consent. for further information consult an internal medicine physician online --> <link> |
### Human:\ntwo of my wisdom teeth are impacted. is it better to remove?\n\n### Assistant: cavities or tooth decay is chronic infections that spread further at a slow rate in most cases. the other thing to consider is any pain or associated symptoms with the cavities which are indicative of active acute infection that has already spread deeper. so if the cavities are without symptoms then it would be fine to wait for a few months as well. however depending on the current state of infection which can be evident from x-ray i could give a more conclusive answer. about the wisdom teeth if these are unerupted at your age then it is recommended that you get them removed as they present a chance for cyst formation etc. it is not urgent though. this is more prophylactic than definitive. complications of removing wisdom teeth depend upon the location and position of the wisdom teeth. yes a very small chance for more complications at a later age. but the overall complexity would have been informed by the dentist or oral surgeon already. for further information consult a dentist online --> <link> |
### Human:\nwould lad lesion cause tachycardia?\n\n### Assistant: blockage of 70% is referred to as noncritical blockage. i suggest tablet ecosprin 75 mg (aspirin) every night so that the blockage will not progress in the future. tachycardia can be because of a large number of causes varying from anxiety stress anemia decreased coronary blood supply and defective electrical currents in the heart. tachycardia can be of two types. sinus tachycardia and arrhythmias. in sinus tachycardia heart rate increases but the rhythm of the heart remains normal. this can be corrected easily with the help of beta blocker. arrhythmias can cause disturbed rhythm of the heart and are to be taken very seriously. they can even be fatal. i would suggest you to go for an ecg 2d echo and holter test for getting evaluated. if you have an ecg then attach a copy so that i can see the basic rhythms of your heart. smoking and alcohol can also cause palpitations. but you have not mentioned them. for further information consult a cardiologist online --> <link> |
### Human:\nam i in trouble with 20% gum bone loss at the age of 45?\n\n### Assistant: the amount of bone loss that is 20% is not alarming at 45 years of age. it is routinely seen in patients at this age. there is no need to worry as it does not mean that the tooth will fall off soon. try to maintain the current level by using a warm salt water gargle twice a day or as much as possible or even a mouthwash solution will help. go for routine checkup once in every six months and get your teeth cleaned to maintain good oral hygiene. the x-ray would have been more helpful for me to give a better diagnosis. kindly watch out for loose teeth and show to your dentist. for further information consult a periodontist online --><link> |
### Human:\nmy teeth has gradually becoming yellow. what can be done?\n\n### Assistant: i suggest you visit a dentist and get your teeth cleaned for gum pain and bleeding. for yellow teeth use baking soda salt and lemon juice paste to brush your teeth and then use normal tooth paste. use this paste twice a week only and it will give you good whitening. also you should maintain oral hygiene properly and use mouthwash after brushing. you can use peel of banana to rub on teeth for whitening but that is not applicable everywhere. visit the dentist soon to get relief from gum pain and bleeding. wish you a good dental health and happiness. for further information consult a dentist online --> <link> |
### Human:\ni feel bone on the extraction site. how to get it fixed?\n\n### Assistant: i have read through your complaint and the relevant details. the bone exposure is a common thing after extraction of teeth. but as far as there is no pain you need not worry about it. may be the extraction was a bit difficult on the lower left wisdom tooth and the gums are healing slowly. please do not disturb the healing process by touching the socket with the tongue often. this might delay healing even further. also do not aggressively brush or rub salt over that area. sutures are not indicated during the healing process. if at all it is considered it should have been put immediately after the extraction. keep observing the region for another week and if not healed or becomes painful then you go to the dentist for application of a healing paste. meanwhile maintain good oral hygiene and gargle lukewarm salt water twice daily. this will flush out the debris locked in the socket and promote healing. thank you. for further information consult a dentist online --> <link> |
### Human:\nhow will the doctor identify my lazy eye vision percentage?\n\n### Assistant: there are many methods to check vision according to the age of the patient. it is different for preverbal or verbal children and for adults. many types of vision charts available. snellen chart is one of them. there are etdrs chart early treatment diabetic retinopathy study) keeler logmar chart bailey-lovie chart etc. for lazy eye usually crowded charts are preferred with more letters in one row like etdrs chart. then some other tests are also done like color vision stereopsis (depth perception) near vision refraction for best corrected visual acuity and complete eye examination to rule out any cause of decreased vision in lazy eye. you need a full eye examination. your eye doctor will do accordingly and then advise appropriate treatment. for further information consult an eye care ophthalmologist online --><link> |
### Human:\nwhat can be the reason for blurry image itchy eyes and headache?\n\n### Assistant: actually there are many causes of decreased vision and itching for which you need to rub your eyes. please answer a few questions. since how long you are using glasses? when you had your last refraction? do you have any eye allergy itching watering or redness that get worse in specific season? is this problem persist all day or it is more in the morning or evening? have you got an eye examination or using any drops currently? so from the complaints you described there may be just a change in refraction. if your refraction (glass number) is changing again and again then you might need to get a full eye examination and a few investigations. in cases with repeated change in refraction quickly there are chances of a condition called keratoconus in which shape of the cornea becomes conical and gets thin. at your age the cause of excessive rubbing may be allergic conjunctivitis called vernal keratoconjunctivitis (conjunctivitis due to some seasonal allergy). keratoconus is more common in people who have vernal keratoconjunctivitis. other causes may some congenital corneal dystrophy in which superficial corneal layers are peeled off with mild rubbing and cause blurred vision. so i would advise you to get a complete eye examination and your eye doctor can order some investigations like corneal topography if needed. then further management will depend on the eye examination. revert back with the answers to the above questions to an eye care ophthalmologist online --> <link> |
### Human:\nhow do i recover from excess saliva production?\n\n### Assistant: the causes of hypersalivation include excessive starch intake reflux disease pancreatitis liver disease oral infections and decreased saliva clearance. so before trying any medication try some lifestyle modification. if that did not help then you can use some medication. hope this will help you and wishing you a faster recovery. treatment plan:1. avoid high starch food like potato bread cereals rice and corn. 2. maintain oral hygiene. 3. avoid spicy and fried foods. regarding follow up:revert back for further information to an ent otolaryngologist online. ---> <link> |
### Human:\ni am a 30 year old male suffering from glaucoma since 2 years. i have heaviness and itching in my eyes\n\n### Assistant: i need a few answers from you before deciding on the reasons for heaviness or itching. can you please give the details for the following questions? are you on anti-glaucoma medication? if so can you name them? when was the last eye examination done what was the eye pressure? what is the grade of glaucoma? itching can be because of specific anti-glaucoma medications. i need to know the eye pressure to decide whether your current heaviness is due to the anti-glaucoma medications. this is to decide whether we need to change or continue the medication or decide on any other modalities of eye pressure control in relation to the severity of glaucoma. revert back with the details to an eye care ophthalmologist online --> <link> |
### Human:\ni had phenyl and suffering from throat inflammation. please help.\n\n### Assistant: obviously you will have some complications of the chemical substance you have drunk. mucosa of upper gastrointestinal and respiratory tract is more sensible to react against chemicals than the stomach. also you have protected your stomach somehow by using allegra (fexofenadine) pantos (pantoprazole) and sucralfate. now i would recommend you to consult an ent specialist to check your throat and ear tubes. i suggest you take allegra dexamethasone 4 mg twice daily and if your ears or nose feels blocked then xylometazoline by nasal drops. consult your doctor discuss with him or her and take the medicine with consent. you would better consult an ent doctor and a gastroenterologist as soon as possible for further information consult an internal medicine physician online --> <link> |
### Human:\nhow many times a day should i brush my teeth?\n\n### Assistant: welcome to icliniq. com. the best oral hygiene maintenance method is to brush your teeth with a soft or medium toothbrush and fluoride toothpaste. the electronic toothbrush does not offer any real additional benefit to normal individuals. it is the movements of the toothbrush made by our hands that bring about thorough cleaning. most of the toothpastes available in the market are good as long as they contain up to 1000 ppm fluoride. brushing three times is good. the main goal is to clean the food deposits from all areas. rinsing the mouth after meals is good yet a simple method to keep the mouth clean. using a mouthwash causes no real problem in relation to upsetting the microflora or healthy bacteria. you can continue to use it once a day. professional cleaning is recommended every 6 to 12 months depending on your plaque and calculus forming tendency. due to plaque deposition over a long period there is temporary decalcification that might occur on the tooth surface. thus on professional cleaning when it is removed there will a slight increased sensitivity. however it does not remove the enamel layer at a significant level. so once we continue to use the fluoride toothpaste with a toothbrush along with natural fluoride in water the tooth surface gets remineralized. and then the sensitivity disappears. for further information consult a dentist online --> <link> |
### Human:\nwhy does running nose sneezing and blocked nose happen?\n\n### Assistant: i have gone through your query and can understand your health concern. running nose can be due to upper respiratory tract infection. you can take tablet allegra m (combination of montelukast and fexofenadine) twice daily for about three days. warm water gargles with salt added in it will help you if done thrice a day. you can try steam inhalation with capsule karvol added in it three to four times a day. while taking steam just break the capsule and add the liquid part in hot water and inhale it for 15 minutes. if you have bad throat infection also then you can take tablet levofloxacin 500 mg once daily for five days. hope you get well soon. for further information consult a general medicine physician online --> <link> |
### Human:\nwhat is the reason for my disturbed sleep and morning drowsiness?\n\n### Assistant: i have gone through your query. you are suffering from two problems. one is nasal block and the other is sleep disturbance which may be insomnia. you can stop xaria plus (combination of montelukast and fexofenadine). instead of that you can take flutiflo-ft - fluticasone nasal spray once daily along with nasoclear nasal drops as and when required. sleep disturbance may be due to insomnia and so need sleep hygiene. stop drinking coffee or tea in the evening do regular exercises in the evening and sleep in the lateral position. try simple changes to your daytime and pre-bedtime routine. keep a regular sleep schedule go to sleep and get up at the same time each day including the weekends. set aside enough time for sleep. most people need at least seven to eight hours each night in order to feel good and be productive. make sure your bedroom is dark cool and quiet. cover electrical displays use heavy curtains or shades to block light from windows or try a sleep mask to shield your eyes. turn off your television smartphone and computer a few hours before your bedtime. the type of light these screens emit can stimulate your brain suppress the production of melatonin and interfere with your body’s internal clock. will try conservative management initially and if not improving then you may need sleep study and medications like melatonin. i want to know whether you have snoring. the probable causes:stress related sleep disorder. investigations to be done:sleep study after one month. differential diagnosis:obstructive sleep apnea (osa). probable diagnosis:insomnia. treatment plan:conservative management like sleep hygiene avoid coffee and tea and do regular exercises. regarding follow up:revert back after a month to a sleep medicine physician online. ---> <link> |
### Human:\ni had sex in the 5th week of pregnancy and saw vaginal bleeding. why?\n\n### Assistant: at five weeks of pregnancy if you have had intercourse with your husband which was not advisable the bleeding is likely to be decidual separation at the uteroplacental junction and should well be ruled out by an urgent transvaginal ultrasound. it would be prudent to rule out any retroplacental clot which if seen indicates threatened miscarriage. ideally you should visit your casualty and get the ultrasound done. if things are fine then you should practice absolute bed rest with progestational support till the bleeding stops. traveling is not advised at all. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nwhy am i getting prolonged foul order vaginal bleeding?\n\n### Assistant: you can bleed more sometimes due to irregular menses because of hormonal (chemical) levels of your body and its effect. but you can bleed also due to cervical erosions and infection there. i personally never recommend tampons. because your menstrual blood contains some bacteria and pathogens which can infect. and when you use tampons due to the collected blood it gives a media to growth of that bacteria. the body can resist infection up to a limit and as the limit crosses you get signs and symptoms of infection for which you may have to take treatment. now in your case foul-smelling discharge and discoloration of the discharge are the signs of infection. now i have to see actually where the infection is. so best consult your nearby gynecologist. let him see where the infection is and what type of discharge actually is. and if required then send the discharge for examination. by this we will know the type of infection and can give treatment accordingly. most probably you are having history which seems to be likely bacterial vaginosis. it is a mixed infection. you will need to take the antibiotic course for 10 to 15 days and follow some precautions to avoid recurrence. now as far as antibiotics are concerned i have to see the first type and nature of discharge and smell. so better get consulted nearby for that. kindly keep up the following precautions: do not use tampons. use pads and change more frequently during menses. keep the area around the vagina as dry as possible especially during menses. change underwear more frequently if required. use cotton underwear if possible. drink more water as your urine becomes clear. do clean vaginal area and immediately after urination and after every time you do sex. these will help to avoid recurrence. and firstly complete the drug course to completely eradicate the infection. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ni had depo injection and i am bleeding continuously. is there any way to stop the vaginal bleeding?\n\n### Assistant: i understand that you are a candidate in whom implanon did not suit well. it is good that you got it removed. you switched over to depot injection almost immediately. ideally you should have given a gap of a month and should have been placed on antifibrinolytics for the control of bleeding. nevertheless now that the depot shot is in some irregularity in periods is expected for 2 months or so. but this present bleeding can be reduced and stopped by antifibrinolytics like tablet tranexamic acid 500mg thrice a day for 5 days. you may choose to start them as early as possible. they do not have any side effects. but will help you stop the bleeding. for further follow up consult a gynaecologist online --> <link> |