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### Human:\nis it fine to exercise with knee pain?\n\n### Assistant: from your description it appears that you may have anterior knee pain which sometimes presents as pain at the back of the knee. the second possibility is that you have over done your exercise and hamstrings are sore and the lower end of the knee cap is inflamed. either way you should rest and ice the area of pain and give it time. i suggest you add nsaids (nonsteroidal anti-inflammatory drugs) for a week for an additional anti-inflammatory action. for further information consult an orthopaedician and traumatologist online --> <link>

### Human:\nsuffering from anxiety restlessness and taking clonazepam & mirtazapine. i had depression & panic attacks for the last 7 years. need a second opinion.\n\n### Assistant: depression anxiety restlessness and panic attacks are best respond to a combination of a selective serotonin reuptake inhibitors (ssris) and benzodiazepines. mirtazapine is not the most efficient ant depressant and it is not a true ssri as fluoxetine paroxetine citalopram and sertraline are. i recommend 20 to 40mg of paroxetine (slowly titrated up from 10mg) and 1mg of either clonazepam or ativan (lorazepam) every 8 hours as needed for anxiety. glaucoma precludes use of any anticholinergics such as hydroxyzine or benadryl (diphenhydramine). ssris are also at times likely to make glaucoma worse but a preliminary trial is always worth it. revert back to a psychiatrist online for further help --> <link>

### Human:\ncan a thyroid patient eat soybean and fenugreek?\n\n### Assistant: patients with hypothyroidism usually gain weight. your issue is weight loss which is seen in hyperthyroidism. as your thyroid tsh is in the normal range you can continue the same treatment. for gaining weight you need to take food which is adequate that is it should be rich in calorie and protein like eggs and green vegetables. kindly manage to take appropriate calories for your age and then have some physical activity so that it will increase your weight. for further information consult an internal medicine physician online --> <link>

### Human:\ni am not getting my periods after taking fenugreek seeds. why?\n\n### Assistant: fenugreek seed cannot affect your fertility do not worry. a delayed period could be because of stress or hormonal imbalance so please get a urine pregnancy test to rule out pregnancy first. for further queries consult an infertility specialist online --> <link>

### Human:\nkindly suggest me a therapy to overcome heat allergy.\n\n### Assistant: your problem is a characteristic of cholinergic urticaria. it is a type of urticaria where patients are allergic to their own sweat. so whenever a patient sweats for example due to heat sun stress exercise. etc. the patient develops hives. levocetirizine can suppress the problem till you take it. once you stop taking it your problem will recur. the management actually depends on you. if you are fine taking cetirizine daily then no harm or else you can go for biological treatment which is a new form of treatment. it can permanently cure the problem and you may no longer require cetirizine. they are very safe with almost no side effect. for further information contact a dermatologist online --> <link>

### Human:\ncan taking multiple antibiotics cause redness and dryness of vagina?\n\n### Assistant: how are you doing? sorry to hear what you have been through. i feel you are having an imbalance in the normal and abnormal organism growth. for a normal vagina you need both normal and abnormal organisms. when you take too many antibiotics one after other it kills most of the abnormal organisms so the balance is shifted and you get symptoms. now let me give you a list of things you can do: if sexually active abstinence at least till you are fully better. also have your partner checked. check his urine and semen for any significant infection. have a urine culture and sensitivity if there is any sterile pyuria that is pus cells without any growth have only the sensitive antibiotics for the minimum duration. get a vaginal swab for culture and sensitivity. antifungals and antibiotics can be used if needed. get your blood sugars and thyroid profile checked. avoid vaginal douches. use bland or inert vaginal washes just to wash the exterior. and no need to use an unnecessary vaginal suppository. keep the perineal and vaginal area as dry as possible. avoid synthetic undergarments as they hold water for long use cotton ones. do not use any undergarment at night. keep taking probiotics. your bmi (basal mass index) is in the lower limit. so have a lot of fruits vegetables juices curd milk egg white high-protein and low-fat diet. take a lot of citrus fruits as this improves your resistance and immunity. avoid any local cosmetics or new washing powder. hope i have been of help to you do write back. all the best. for further queries consult an obstetrician and gynaecologist online --> <link>

### Human:\nother than baclofen which medicine can be used for muscle stiffness?\n\n### Assistant: thank you for the detailed information. i am happy to see your father improve gradually. here is what i suggest. there is no other medicine for stiffness. however physiotherapy should be carried out aggressively to prevent worsening of stiffness. one should rule out infection of the bed sore. if there is infection antibiotics are needed and rarely surgical debridement might be indicated. if there is no infection you can also apply phenytoin powder on the bed sore. the powder helps to hasten the healing process. i do see that there are chances of improvement. but i believe that he will not be able to do his daily activities independently and will remain dependent on others. in the latest scan i see that there is hydrocephalus also called post traumatic hydrocephalus. if the craniotomy flap is tense and there is increase in the water content in the brain he will benefit from ventriculoperitoneal shunt surgery to relieve the water accumulation in the brain. this surgery can be done by the same neurosurgeon who performed the first surgery. i cannot comment whether he will be able to speak or not. all i can say is that he might improve in his sensorium (consciousness) some more. for further information consult a neurosurgeon online --> <link>

### Human:\nmy fiance is having diabetes type 2. will she face any problem during pregnancy?\n\n### Assistant: i read through your query and understood your concern. she can take progesterone tablets (medroxyprogesterone 10mg twice daily) to postpone her period. these tablets may increase the requirement of antidiabetic medicines (tablets/insulin). so she needs to monitor her blood sugar level (at least two/three times during the period she is taking tablets) to make sure that sugar control is fine. contraceptive pills used nowadays are low dose pills and have little/no impact on diabetes. even if sugar levels increase it can be treated by increasing the dose of antidiabetic medicines. so she can use low dose contraceptive pills. just consult your physician once before starting those pills to make sure that the medicines do not interact with each other. during pregnancy - if her sugar control is fine from 3 months before pregnancy during pregnancy and till delivery of baby there will practically be no problem to the mother and baby. if sugar control is not good there may be many problems about which there is no need to worry right now. revert back to a gynaecologist online for further queries --> <link>

### Human:\none of the hairs in eyebrow has changed to blond. is that normal?\n\n### Assistant: in your paternal family is there any history or case of vitiligo in which a person develop white patches or graying of hairs? right now i can say that you can get it trimmed for now. if there is a genetic history of vitiligo in your family then there can be many chances for you to develope such thing and do notice it next time on all your hair growing area. for now you can take tablet follihair (biotin) multivitamin tablet take it once in a day for one month and get your cbc (complete blood count) done. for further information consult a hair transplant surgeon online --> <link>

### Human:\nmy son has severe constipation after taking paxil. please help.\n\n### Assistant: i can understand your concern regarding your son's gastric problem after taking paxil (paroxetine) as it is a drug of ssri (selective serotonin reuptake inhibitors) group which is known to cause constipation in children. i suggest to prevent constipation after consulting your specialist doctor you reduce paxil dose up to a half tablet and gradually increase it up to an effective optimal dose. give high fiber diet increase water intake and encourage him for mild to moderate exercise. do not worry as these symptoms are temporary and are resolved with time. for further queries consult a psychiatrist online --> <link>

### Human:\nwhy is my son having continuous chest congestion?\n\n### Assistant: first off all i would suggest you to carry out chest x-ray and complete blood count to rule out lung infection like bronchitis. foracort is a combination of budesonide a corticosteroid and anti-inflammatory and formoterol a long-acting bronchodilator used to control his symptoms and improve lung function. this drug will not affect his immunity. it is most probably only due to allergy that is triggering his symptoms. common allergens could be dust pollution in metro hairs of house pets cold etc. yes you are right as your son will grow his body will tolerate better. the best supplements to boost your child’s immune system are vitamin d and zinc. the herbs elderberry (sambucus) and astragalus are best for recurrent respiratory tract infections. for allergies fish oil vitamin c and nettles are good. revert back after the tests to an internal medicine physician online --> <link>

### Human:\ncan essential tremor get transferred genetically?\n\n### Assistant: i have read your question with care and understand your doubts regarding essential tremors. if not treated the person will not be able to do or will do with much difficulty works involving fingers like writing mixing food button shirts etc. activities which require co-ordinated movements of the fingers will be affected. essential tremors can be due to various reasons and a few of these reasons are transmitted genetically. a few are acquired. even among the ones which are transmitted genetically it can be ad ar xd xr that is autosomal dominant autosomal resistant x-linked dominant and x-linked resistant respectively. so unless we know the exact cause of this tremor we cannot answer about genetic transmission. without knowing the exact cause the answer for this question is 0 to 100 (0 for acquired and 100 for ad). the cure of essential tremor depends on the cause. a few causes can be cured completely a few causes can be controlled and a few cannot be cured at all. again the link with other illness and disorders depends on the cause of the tremor. coming to this particular patient who has this when going to new places or during anxiety this tremors can be controlled with proper medication. you have to consult a neurosurgeon who has had experience in successfully treating such patients for physical evaluation. for further information consult a neuro surgeon online --> <link>

### Human:\non application of selsun blue shampoo my cheek turned white. please help.\n\n### Assistant: what do you mean by white patches? was it diagnosed as pityriasis versicolor or vitiligo? please send images. what medications have you used till now? revert back with the answers to the above questions to a dermatologist online --> <link>

### Human:\ndoes the absence of the white half moon on nails indicate a thyroid problem?\n\n### Assistant: the absence of the white half moon also called as lunula is not uncommon and may be a normal variant and there is no need to worry about it. i guess rest of your nail is normal. however it can be associated with low hemoglobin and inadequate diet. treatment is not needed for this condition but underlying condition needs to be treated. there is no direct relation with thyroid disease but you can get yourself tested if you are having symptoms like lethargy constipation weight gain etc. you should also get your hemoglobin tested. focus on a balanced diet with green leafy vegetables fruits etc. hope this helps you and get back if you have any doubts. for further queries consult an internal medicine physician online --> <link>

### Human:\nwhy do i feel weak while sitting and working?\n\n### Assistant: there are various causes like thyroid problems anemia vitamin deficiency especially vitamin d and even psychological issues which are the most common. you should get hemoglobin levels thyroid function test and vitamin d levels checked. i suggest you try doing the following: try taking multivitamin supplements like syrup zincovit or a to z two teaspoons once a day for 3 to 4 weeks. replace tea with coffee and have two to three times a day especially before some important work which will provide adequate interest and stimulation. regular exercises or sports will be helpful. gradually taper off addictions if any. you will probably need vitamin d supplements after the test. try doing yoga in the morning. do you have any psychological issues like stress or depressive? if yes then you need to consult a psychiatrist. revert with more information to a general medicine physician online --> <link>

### Human:\nis leucoderma curable?\n\n### Assistant: with your descriptions it seems that you are having focal vitiligo or chemical leucoderma due to footwear. it is primarily an autoimmune disease with a familial predisposition presented with chalky white or milky white in appearance. other autoimmune diseases may be associated like pernicious anemia diabetes alopecia areata (patchy hair loss) and thyroid disorder. so you need to do blood sugar t3 t4 and tsh (thyroid stimulating hormone). i suggest ointment tacrolimus 0. 1% during night hours and mometasone 0. 1% cream in the daytime for six months or may be more depending on your response to the treatment. revert back after a month to a dermatologist online --> <link>

### Human:\nhow to control premature ejaculation?\n\n### Assistant: i have read and understood your problem. premature ejaculation is very common problem and is usually not associated with any disease. but may be due to anxiety and sometimes however may be problem with prostate gland and thyroid hormone. you can learn to control premature ejaculation by doing this exercise. pull your muscles that you pull at the end of urination for few seconds then release repeat this several times daily. another is stop-start technique: when you feel that you are going to ejaculate stop the sexual stimulation and divert your mind the penis will relax. after sometime start the stimulation again and repeat the procedure. over few months you will gradually increase your ejaculation time. most often it is a chronic problem; you have to take medicines in between and period off medicine. you can apply lignocaine gel to head of penis 10 minutes before sex and wipe it off before starting sex. usually medicines like dapoxetine 60 mg are given two to three hours before sex but you have to get a prescription from your doctor. best wishes. for further information consult a sexologist online --><link>

### Human:\ncan psychiatric drugs induce constipation?\n\n### Assistant: for motion formation one needs to take at least 1 to 1/2 liters of liquid in a day and eat lot of vegetables and fruits. psychiatric drugs and antibiotics can induce constipation. we need to enhance gut motility and bulk the motion. please try the following combo to get rid of constipation: pegred or pegmove (polyethylene glycol) three scoops with a glass water. lactihep (lactitol) four teaspoons at bed time. velgut (probiotics) morning and night half an hour after food. albol or bendex 400 (albendazole) one tablet chew at bed time. for further information consult a medical gastroenterologist online --> <link>

### Human:\nhow to treat premature ejaculation through ayurveda?\n\n### Assistant: you need to improve your stamina first to have a better sex life. eat healthy nutritious food like almonds dates milk fruits and sprouts. do workout for 45 minutes daily to improve stamina. ashwagandha rasayana - this is an excellent ayurveda medicine for stamina improvement. take one teaspoon of this medicine twice daily before food. shilajitwadi lauha vati - this helps to treat premature ejaculation. take one tablet twice daily after food. take them for two months and consult again for a follow up. revert back after two months to an ayurveda specialist online --> <link>

### Human:\ni have thyroid problem my hr and bp fluctuates often. why?\n\n### Assistant: as seen in your brief history there are some fluctuations in your blood pressure as well as heart rate. i would advise you to get an ecg done as soon as possible as we have to see what sort of heart rhythm are you on. the doctor who has suggested you propranolol must have done your ecg. so if it is a sinus rhythm (normal fluctuating rhythm) then it is not much to worry about. but if it is some sort of abnormal rhythm (arrhythmia) then it has to be taken care of. secondly propranolol 20 mg thrice a day is quite a heavy dose. propranolol 10 mg twice a day should be started and should be increased every week if required. if you are having chest discomfort after having propranolol then just drop the medication for this morning and noon and see if you are normal. as of now i would like to have a detailed history of you as cardiology suggestion can only be given after taking a detailed history. what is your age? is there any history of early onset of cardiac disease in your family? from how long are you hypertensive? are you an anxious personality? how is your sleep? do you have heartburn or gastritis or or flatulence very often? please explain your lifestyle? do you smoke or drink alcohol? do you have any history of arrhythmias in the family? was propranolol advised by your gp or cardiologist? revert back with the answers to the above questions to a cardiologist online --> <link>

### Human:\nhow to cure premature ejaculation?\n\n### Assistant: as you know that the first thing in medicine is establishing a diagnosis which is correct. so i would like to ask you a few questions. did you consult a psychiatrist before this consultation for your problem? since when have you been married? was this problem since marriage? or there was a time of normality between marriage and start of this problem? if there was a time of normality then what was its duration? is erection proper? what is the frequency of intercourse? do you have this problem of premature ejaculation every time you do sexual intercourse? do you suffer from any medical or psychiatric problem? if yes then what and since when? are there any medications which you are taking? if yes what and since when? what is the approximate time you take to ejaculate after penetration? do you feel tense or anxious during sexual intercourse? how is your general health and nutritional status? are you addicted to any substances? do you have any family history of medical or psychiatric problem? revert back with the answers for the above questions to a sexologist online --> <link>

### Human:\nhow to overcome premature ejaculation?\n\n### Assistant: please answer few questions. how long it has been there? let me know your complete sexual history. since when are you sexually active? and number of partners? what is your masturbation history? do you suffer from any systemic illness such as diabetes and hypertension? for further information consult a sexologist online --> <link>

### Human:\nis my premature ejaculation due to fear or a lifelong problem?\n\n### Assistant: i read your query and understand your concerns. from the available description it appears that there is a psychogenic premature ejaculation. holding it for 30 minutes while having oral sex and not holding even for a few minutes during penetrative sex is clearly indicative of psychological premature ejaculation. there is no indication that you have a lifelong premature ejaculation. it is definitely treatable either with medication or psychotherapy. i understand your fear about medication but there is no indication that it causes decrease in sex drive. in regard to other methods of treatment kegel exercise has the most value. through kegel exercise try to hold ejaculation up to 15 seconds initially and increase by 1 or 2 seconds per day. the results may take time but there will be a definite improvement. for further doubts consult an andrologist online --> <link>

### Human:\nhow to overcome premature ejaculation using ayurvedic medicines?\n\n### Assistant: the best medicine for premature ejaculation is regular intercourse with shortened period of foreplay. also avoid long gaps between coitus (sexual intercourse). we never suggest any type of spray lotion or oil application during intercourse because it might harm your genital organ. ayurvedic oral medicines may be taken. capsule stresscom 2 capsules to be taken twice daily with milk in the initial phase. for severe and chronic cases other medicines are added depending upon the condition. consult an ayurveda specialist online to assess your condition --> <link>

### Human:\nsuffering from premature ejaculation. i ejaculate faster and the sperm comes out quickly.\n\n### Assistant: you are suffering premature ejaculation. it is not a disease only a complaint. it may be due to stress fear poor sleep smoking etc. you can take the capsule lvate at 7. 30 pm daily for three months. it works gradually and has excellent result without side effects. follow up with a sexologist online after three months --> <link>

### Human:\ni am facing premature ejaculation. how do i overcome it?\n\n### Assistant: i completely emphasize with you. the problem of premature ejaculation is quite common and is distressing to a young man but is seldom discussed. see most of the time the problem is secondary to the anxiety attached to your expectations in the bed. it has been wrongly projected by unscientific magazine articles and porn that a man can last for 30 minutes or more. honestly most of the male ejaculate before 5 minutes. when you are anxious about not lasting long in bed you actually do not enjoy the act of intercourse and keep on thinking about prolonging the act without enjoying it. the preoccupation and anxiety about not lasting enough in fact cause hyperarousal and lead to premature ejaculation. moreover when the male start to thrust himself into the partner the moment he undress leads to early termination of coital act (the sexual union that takes place between male and female during insertion of penis into the vagina). there are also lots of young man who are suffering from premature ejaculation without any associated anxiety or apprehension. such men as well as you may benefit by taking oral medication like tablet dapoxetine or paroxetine before sexual act. but in your case i would like to suggest relaxation techniques like breathing exercises and progressive muscular relaxation. regarding your problem pertaining to non-retractable foreskin my opinion is that you must consult a surgeon. it is always better to remove foreskin if it is causing inflammation or itchiness. non-retractable foreskin is often associated with problems of genital hygiene that may subsequently lead to chronic infections. so make an appointment with a general surgeon. for further queries consult a sexologist online --> <link>

### Human:\ndoes thyroid problem delay pregnancy?\n\n### Assistant: i suggest you follow the same dose as you are not a hyperthyroid yet. also if you are planning for your marriage and pregnancy then this tsh value is normal. if the tsh (thyroid stimulating hormone) value is less than 0. 3 u/ml then the dosage of tablet has to be reduced. for further information consult an endocrinologist online --> <link>

### Human:\nwhy is the tip of my penis turning white?\n\n### Assistant: please send me an image. it might be vitiligo or balanitis xerotica obliterans. revert with more information to a urologist online --> <link>

### Human:\nhow to correct premature ejaculation and nonretractable foreskin?\n\n### Assistant: i read your query and understood your concern. the condition that you described is known as acquired phimosis. is the surface of your foreskin healthy? or is there some erosion itching or ulcer? and since how long have you had it? if the superficial skin is normal the best option would be to consider circumcision. else if it has any signs and symptoms we can treat it accordingly and this might improve the condition. regarding premature ejaculation that you talked about can you tell me the average time of ejaculation? is the time based on copulation or masturbation? revert back with the answers for the above questions to a sexologist online --> <link>

### Human:\nthyroid problem. taking homeopathy medicines. female 42 5 feet. what should she do\n\n### Assistant: i fully appreciate your concerns. you have not mentioned whether thyroid is underworking or overworking. thyroid gland produces thyroid hormone. thyroid hormone deficiency occurs if thyroid gland is underactive (hypothyroidism). under these circumstances the patient needs daily dose of thyroid hormone supplementation. no other treatment is required. if thyroid gland is hyperactive (hyperthyroidism) medicines to curb hyperactivity are given. i will be able to give helpful advice if you send me thyroid hormone levels estimation if done. i personally feel that homeopathic treatment will not help. i am sure that you will benefit from the advice. please feel free to revert back to an endocrinologist online for further clarifications --> <link>

### Human:\ncan thyroid problem be the reason for stress and anxiety?\n\n### Assistant: though your tsh (thyroid-stimulating hormone) is raised it does not require treatment with thyroxine but needs monitoring. follow steps of sleep hygiene such as sleeping and waking up at regular time avoiding caffeinated drinks at least 8 hours before sleep avoid using television mobile laptop etc. half an hour before sleep instead do relaxing activities like taking a hot shower etc. practice relaxation techniques like breath relaxation exercise daily. maintain a journal and log down any distressing thought on it. if these methods do not help then consult a psychiatrist either on this platform or nearby for detailed evaluation and treatment. for further information consult a psychiatrist online --> <link>

### Human:\nkindly suggest a solution for my son's continuous fever.\n\n### Assistant: it would be helpful if you do a cbc (complete blood count) and crp (c-reactive protein). from that we can understand the level of infection. also tonsillitis can also be so severe that it may last for up to 10 days. betadine gargle three times a day with warm water for three days are advisable as it acts locally on the throat. for further information consult a child health specialist online --> <link>

### Human:\ni suffer from premature ejaculation and poor erection. i have tried herbal/ayurveda products with no results at all. please help.\n\n### Assistant: i read your query and understand the concern expressed by you. in regard to the current medication i would like to inform you that parocen cr is one option for premature ejaculation but does not have any effect on weak erection. it can be said that in last three years a new molecule is approved for the treatment of premature ejaculation which is equally effective and do not have common side effects encountered with parocen cr or other drugs which were in use three years back. i am not sure why your doctor prescribed you nano leo as it has minimal effect on erection. it is used for increasing testosterone level which has more effect on desire rather than erection. as you informed that you do not have any problem with desire the possibility of using nano leo is ruled out. regarding the viagra it has definite effect on erection and there is no doubt that it can be effective in your case. having said this i would like to know what was your initial problem premature ejaculation or weak erection? i commonly observed that people with erection problem try to rush the sexual intercourse because of fear that they will not able to maintain the erection for sufficient time. this kind of rushing develops artificial premature ejaculation. i need to inform you that if you developed your premature ejaculation in response to erection problem then there is need to treat only erection problem. as the cause suggests with treatment of erection problem the premature ejaculation will be treated automatically. in case you feel that both the problems are independent then there is need to address both issues simultaneously for correction of the problem. before we move to treatment part of the problem we need to identify the possible cause of the problem. i request you to post following details in the follow up query so that the cause of problem can be determined and so the treatment. 1. what do you mean by weak erections and premature ejaculation? describe what you think in detail. 2. how did the problem start whether it was of acute onset or was it on and off initially? 3. progress of the problem in the last six months. 4. duration of sexual activity - both maximum and minimum duration in last one year. 3. frequency of the problem in a week or in a month. 4. what are the factors that increase the problem in bedroom. 5. factors that relieve the problem - thoughts situations partner place etc. 6. do you get early morning or night erections? 7. if yes how frequent? 8. your marital status and partner details. 9. effect on your marriage or relationship so far. 10. details of any other medical illnesses. 11. medications you are receiving currently. 12. medications which you tried till date and their results. 13. any investigations done so far and if yes details of the same. as you know erectile dysfunction is a complex disorder it needs thorough evaluation for treatment. revert back to a sexologist online for further follow up --> <link>

### Human:\nmy daughter has cough. shall i give her dexona?\n\n### Assistant: please do cbc (complete blood count) and a chest x-ray before starting dexona (dexamethasone) as it is a steroid. also there may be a history of childhood asthma (hyper-reactive airway disease) and it is better to be sure before giving this medicine. this mostly looks like hyper-reactive airway disease for which the initial treatment is a common cough and cold medicines. if this does not reduce then you should add dexona or even better hydrocortisone. later on you should add montelukast and if this also does not take care of the issue then nebulization with duolin (salbutamol and ipratropium) and budecort (budesonide) is advised. the last drug route of choice is inhalers. these are the steps involved in the treatment and control of hyper-reactive airway disease. this treatment plan should be made by a physician in person after detailed evaluation. as of now you can use dexona but with the consent of the physician and after the tests that i told you so that we can be sure that there is no infection. please note that hyper-reactive airway disease is an age bound process and usually resolves by the age of 8 years. sometimes very rarely it may last up to 12 years. the medicines explained to you above only help in controlling the disease and they do not cure it. for further information consult a paediatrician online --> <link>

### Human:\ni have severe constipation and bloating problem with slight vaginal bleeding. please help.\n\n### Assistant: i would need a little bit more history how many times during a week do you have a bowel movement? please go online and type bristol stool chart and let me know the consistency and type of the stools you are having in general from a month. have you had diarrhea before the given month? do you have to strain to defecate? how are your menstrual cycles usually? any family history of thyroid disorders or colon cancer? do you feel very cold when everyone is comfortable? have you lost any weight lately? revert with more information to an internal medicine physician online --> <link>

### Human:\ncan vitiligo occur in later stages of life?\n\n### Assistant: vitiligo can be inherited in the family but not in every member of the generation. it is not necessary for vitiligo to develop in childhood; the onset can be at any stage of life. inheritance was thought to be autosomal dominant with variable expression and incomplete penetrance. it means the next generation may or may not have vitiligo. there is fair chance that the next generation may not have it and can skip generations. vitiligo is not predictable. so there are equal chances. for further information consult a dermatologist online --> <link>

### Human:\ni need a second opinion regarding itp.\n\n### Assistant: isolated low platelet count with normal hemoglobin and cbc (complete blood count) usually is the key laboratory finding for itp (idiopathic thrombocytopenic purpura) as there in this case. it is the diagnosis of exclusion however. i need few more details about his medical history. did he ever had gingival bleeding epistaxis (nose bleeding) or any spontaneous bruising? any history of dark foul smelling stools or melena? is there evidence of viral illness like fever or diarrhea or upper respiratory tract infection? does he have any splenomegaly? itp is a primary immune mediated destruction of platelets by self-generated antibodies to platelets. it is of two types acute and chronic. acute itp usually follows infection and has spontaneous resolution in eight weeks or two months. chronic itp persists longer than six months without any cause. management includes conservative and observation alone for the one who do not have any signs of bleeding or mild cutaneous manifestations as in this case. in case of any bleeding or life threatening complications i order to suppress immune mediated destruction of platelets which will require iv immunoglobulin methylprednisolone and platelet transfusion. as of now he can be managed conservatively and continuous watch on bleeding manifestations should be followed. if the condition persists for more than six months that is if it progresses to chronic itp then drugs like eltrombopag and nplate - romiplostim can be tried to stimulate platelet production for the one who experience inadequate response to steroids. now platelet count and bleeding manifestations are to be continuously monitored till it reaches normal and prednisone dose should be tapered to avoid long term complications of corticosteroids. as i said do watch for bleeding manifestations like large spontaneous bruises melena gingival bleeds gastrointestinal bleeding altered sensorium and confusion. do not let him to play as falls may lead to hematomas and internal bleeds. do not worry. in most cases it resolves spontaneously. for further information consult a general medicine physician online --> <link>

### Human:\ni am having constipation problem and a feeling of incomplete evacuation. how to solve it?\n\n### Assistant: we are here to help you. you probably are suffering from chronic constipation associated with acid reflux disease and that requires evaluation for the cause. if no cause is found we would say that you have idiopathic constipation. i would advise you the following. consult your specialist doctor discuss with him or her and take treatment with consent. get a thyroid function test done as hypothyroidism might be the cause of the constipation that you are having. i suggest laxative like lactulose in the night. increase fiber in the diet and take fruits like papaya which are bulk forming. i suggest a combination of pantoprazole and levosulpiride once daily. another thing that you can take is isabgol husk. you can take three teaspoons full in night time and as it is bulk-forming. it may help you with your constipation. once you are constipation free you do not strain during stools and our piles problem would go away on itself. for further information consult a medical gastroenterologist online --> <link>

### Human:\ni guess my constipation and blocked urination are interlinked. please help.\n\n### Assistant: chronic constipation is a delicate issue that worsens one's quality of life and is hardly solved definitively. except the watery diet it requires bowel enemas time after time and use of laxatives continuously. if you can apply enemas then do it right now to empty your bowel and thus ease the urination. it seems to be a mechanical obstruction of your urinary tract by the pressure of the rectum to the urinary ways or prostate. enlarged prostate and bladder weakness may have developed in the course of your chronic constipation. if you cannot urinate even after the defecation you may need bladder catheterization and you would better go to your healthcare center. continue your watery diet use high fiber foods fruits and vegetables. use laxatives daily such as lactulose if you feel difficulty with bowel movements. also do physical activity every day. for further information consult an internal medicine physician online --> <link>

### Human:\nmy legs are itchy and red. is that due to insect bite?\n\n### Assistant: it looks like some bed bug bitten case. avoid scratching that area if you develop the itch. i suggest you antihistamine drug like tablet levocetirizine 5 mg twice daily for five days and tablet acenac-p (aceclofenac and paracetamol) twice daily for five days. consult your specialist doctor discuss with him or her and take medicine with consent. apply clindamycin lotion and do not wash the area to avoid any bacterial infection. avoid touching that area frequently and do not apply anything over it. for further information consult a dermatologist online --> <link>

### Human:\nhow long should i continue levocet m for itchy throat?\n\n### Assistant: your symptoms seem to suggest that you are suffering from allergy. levocet m (levocetirizine and montelukast) is given for the same purpose. it is true that the medicine should be taken for a few months regularly. it has minimal side effects like dryness of mouth drowsiness and daytime sleepiness. it is advised that you take levocet m in the night and avoid driving after taking the medicine. ideally i would like to see your nose using nasendoscopy which is an office procedure. also i would like to know more details about the surgery that was done. if you have the papers then you may please scan the same to me in a query as this will let us diagnose your current condition. for allergies we also suggest nasal spray like metaspray (mometasone) or flomist (fluticasone). consult your specialist doctor discuss with him or her and take the treatment with consent. these sprays are taken in the morning and in the evening two puffs in each nostril for about two weeks and thereafter the dose is reduced and stopped after a month or two. i advice you to take the following blood test as well serum total ige. this will give an indication about the allergy status and we can investigate further to know which allergens cause allergy in you. for further information consult an ent otolaryngologist online --> <link>

### Human:\nare acidity and constipation the withdrawal symptoms of quitting smoking?\n\n### Assistant: it is good that you have stopped smoking. but the withdrawal symptoms do not manifest as acidity. although it can cause constipation but not after a month of quitting. your cholesterol levels are high and it is the cause for persistent gerd (gastroesophageal reflux disease). your ldl (low-density lipoprotein) levels are also high which is bad cholesterol. also your sgot (serum glutamic-oxaloacetic transaminase) levels are high which suggests liver injury. i would suggest you to try lifestyle modifications initially to reduce your cholesterol levels since your values are not very high. target should be total cholesterol lower than 180 and ldl lower than 100. to release constipation increase fiber in your diet and avoid fatty and fried foods. drink lots of water and do regular exercise. for further doubts consult an internal medicine physician online --> <link>

### Human:\nis it true that schizophrenia runs in family?\n\n### Assistant: schizophrenia is a complex psychiatric disorder and sometimes tend to run in families. however it does not imply it is a monogenic disorder where the inheritance rate of disease is higher and more easily predictable. currently there is no scientific evidence to support your doubt that whether marrying your boyfriend will increase the risk of schizophrenia in your to be child very significant. so let us not get too worried. for further information consult an internal medicine physician online --> <link>

### Human:\nkindly let me know some medicine for itchy throat?\n\n### Assistant: this itching like symptom is known as post nasal drip. the best medicine would be the use of anti-allergic combination like levocetirizine and montelukast once daily at night. consult your specialist doctor discuss with him or her and take the medicine with consent. do steam inhalation regularly for at least 10 days. revert back after 10 days to a pulmonologist online --> <link>

### Human:\nis stammering a genetic problem?\n\n### Assistant: stammering has got a multiple etiology and pathogenesis. a hereditary component in this has been extensively studied. a recent study was done including 12 children and 5 generations of the family were investigated. the hereditary component is not the only thing that is important. there are other factors related to environmental like the way children are brought up the circumstances the child faces etc. which will decide this. chances of the heriditary component are variable accordingly to different studies. it differs with the genetic component of mother and father if both are having this chances of around 25% according to some studies. if only one parent is having then chances are still less. also the mode of inheritance is also not clearly identified. there is a significant limitation in the available literature on these studies. my final opinion is the chances are less if the child is brought up in a healthy environment and family with a proper speech there from childhood. it should never be a cause to stop marrying i suppose. for further information consult an family physician online --> <link>

### Human:\ndoes chronic constipation lead to prostatitis?\n\n### Assistant: as you suspect the symptoms might be due to chronic prostatitis or a similar entity chronic prostatic pain syndrome. it needs a per rectal examination. per rectal examination is not that painful as you suspect. urine culture after a per rectal examination will turn to be positive if it is chronic prostatitis. it needs a 4 week course of trimethoprim alpha blocker drugs and anti-inflammatory drugs. it has to be treated with trimethoprim or levofloxacin. the probable causes:secondary to uti (urinary tract infection). differential diagnosis:chronic prostatic pain syndrome. regarding follow up:for further queries consult an urologist online. ---> <link>

### Human:\nhow to prevent further deterioration of gap between the front teeth?\n\n### Assistant: i have read through your complaint and the relevant details. tooth gaps in the front are inherited in families to a certain extent. a study has even proved that there is as high as 62. 5% of patients have midline gap running in families. you also have mentioned that one of your incisor teeth is rotated. this means the tooth has adjusted to space during the eruption of other permanent teeth in that row. these midline gaps can be easily corrected. there are a lot of methods to correct them. but considering your age i advise you to visit your nearby orthodontist that is braces specialist to analyse the condition. you need not worry that your teeth are deteriorating because gap closure treatment through braces does not involve any grinding of any tooth. also i would recommend you to choose braces treatment in order to correct the rotated tooth as well as the closure of the gap for a successful long time result. this is better comparing any filling procedures which cannot be claimed to be permanent. the braces treatment takes up to one year to complete. but it is worth the wait. you can smile without any shy. for further information consult a dentist online --> <link>

### Human:\nis levocetirizine sufficient to cure nasal congestion and cough?\n\n### Assistant: your infection will be most probably a viral infection because of the season now. however we can be sure of that only after a swab is taken and it is cultured to see if there grows any bacteria in it. i give you the following suggestions to take care of the problem. however only after a thorough examination i will able to arrive at a more confirm diagnosis and institute decisive treatment. levocetirizine can be continued in the night alone. mostly the dose prescribed is 5 mg. for cough try some cough lozenges which can be taken orally. some expectorant syrup will help lighten the mucus and help cough the sputum out better. if you get fever take paracetamol 650 mg. take abundant rest if fever ensues. if fever present then it is prudent to consult a doctor and take the appropriate antibiotics. cold and nasal congestion can be alleviated using nasal decongestant drops like xylometazoline 0. 1% or oxymetazoline 0. 05%. take three drops in each nostril and lie down for 10 minutes. thereafter take steam inhalation. this i suggest you to do twice daily for three days. take salt water gargles three to four times a day. take plenty of hot fluids and refrain from having any cold products or drinks. avoid smoking and drinking during the course of all these medications. better to avoid them altogether. if fever does not relieve then you must consult a doctor. it could be worsening and you may require antibiotics or injections. if you get throat pain then it is a sign of inflammation and salt water gargles will be helpful. because of throat infection your nodes may get enlarged and become painful. if cough is not productive and if it is dry you should be seen by a doctor to ascertain if any wheeze is present. if so you have to take bronchodilators to ease the bronchial passages for air and mucus to pass through. as the details provided are insufficient and i have not examined you i cannot be decisive whether the infection is a viral or bacterial one. i cannot be sure regarding whether the upper respiratory tract presentation is of some other disease like dengue leptospirosis h1n1 etc. however the latter chances are less do not worry for now. but promptly consult with a doctor in case you are not relieved of symptoms. here i would like to emphasize the importance of green leafy vegetables to be taken daily nutritious protein rich food regular exercise and breathing exercise which if performed regularly can help prevent such infections. differential diagnosis:1. viral rhinopharyngitis. 2. acute upper respiratory tract infection. regarding follow up:for further information consult an allergy specialist online. ---> <link>

### Human:\nplease help with my allergic reaction to cherries.\n\n### Assistant: you got an allergic reaction and there is no need to worry. i suggest antihistamines and tablet montek-lc containing montelukast with levocetirizine. i also suggest antacids along with that. consult your doctor discuss with him or her and take the medicine with consent. beware of cherries next time and wash them thoroughly before eating. for further information consult an internal medicine physician online --> <link>

### Human:\ncan you suggest an alternative to accutane for acne?\n\n### Assistant: you should visit your physician as soon as possible. all these can be symptoms of obstructive jaundice. to confirm get your blood tested for complete blood count and liver function test. also get a urine routine microscopic test and ultrasound abdomen. stop oral isotretinoin and continue applying topical medications like a combination (clindamycin and adapalene) gel at bedtime or any other creams or gel that you are using. for further information consult a dermatologist online --><link>

### Human:\nmy friend's son has been diagnosed with hypochondroplasia. kindly suggest the best treatment.\n\n### Assistant: hypochondroplasia is a rare and genetically inherited condition. it involves the skeletal system and the child's height and weight are definitely low. and birth history also suggests some abnormality. what about the parents status is anyone affected or are they normal? very rare tests have been performed and he has been examined at reputed institutes and already seen by genetic specialist. the child needs a multispeciality/multidisciplinary approach: 1. he might not reach normal height. there is no specific treatment for that. growth hormone which we use in other conditions would not help him. there are some limb lengthening surgeries done later in life. these are complex surgeries which involves orthopaedics and should be done in multispeciality setups. some other movement restrictions can occur at elbows/knees and these can be managed by orthopaedicians and helped by physiotherapists. 2. enlarged head due to more fluid in the brain. this rarely requires surgery and can be done by a neurosurgeon. mri brain does not show any such features now. if any symptoms appear then probably he will need a repeat mri. 3. fits occur in a few children. this can be treated at any children's centre and can be seen by a paediatrician or a neurologist. 4. with respect to the development special teaching/training programs might be required. psychological support is needed as the child grows up which can be rendered by a child psychologist/psychiatrist. 5. hearing problems are frequent and hence get regular check ups done by an ent specialist/paediatrician who will guide you. unfortunately there are no medications to cure this disease. genetic disorders can affect many body systems. the best we can do is treat the symptoms that are caused. there are more severe forms of the disease which can be life threatening. hypochondroplasia is only a milder form. hope this information is helpful. be in regular follow up with a paediatrician online who will guide to the concerned specialist when required --> <link>

### Human:\nis it safe to take levocetirizine daily?\n\n### Assistant: it seems that you have seasonal allergies may be due to dust pollens pets etc. so the best solution is to first find out the cause of allergy and to take preventive measures. cetirizine can be taken but only for short durations. gradually stop cetirizine. you can take homeopathy medicine kali bich 30 potency (kali bichromicum - potassium dichromate). take five drops in little water thrice daily. take this medicine half an hour before meals. you can use mask when you step out from home. do more physical exercise and morning walk for inner strength and yoga. follow the instructions and revert back after a month. for further information consult a homeopathic physician online --> <link>

### Human:\ni have ocular hypertension will it lead to glaucoma? is there a risk of inheritance and blindness?\n\n### Assistant: i reviewed your history. it seems from the history that you are having ocular hypertension. since the results of visual field optic disc changes and oct are normal there is no glaucoma. but treatment of ocular hypertension is necessary for you to prevent development of glaucoma. hence you need to start the treatment and aim should be to bring the intraocular pressure below 16 mmhg and keep it around 14-15 mmhg. if treatment and follow up is done the risk of blindness is minimal or nil but better follow up and treatment is important in your case. glaucoma is known to be inherited and hence your children need examination in late adulthood probably at around 30 years after one baseline evaluation now. but do remember not all children will have glaucoma only evaluation is required. if there is no glaucoma then the risk is same as for general population. hope it helps. consult an eye care ophthalmologist online for further clarifications --> <link>

### Human:\ni want my eyebrows and eyelashes to be thicker. help me.\n\n### Assistant: thickness and size of eyelashes and eyebrows depend on your genetic inheritance. if your genetic makeup indicates your eyelashes to be thin then they will not grow bigger than your genes allow. in case your genetic material indicates your eyelashes to be thick and beautiful and because of some disease they do not grow well the following steps will help: treat dandruff or any other fungal infection of scalp and skin underlying eyebrows. apply almond oil not refined almond oil (since it has mineral oil mixed with it) but pure almond oil namely badam rogan. it will make your eyebrows grow thicker gradually. consult an ayurveda specialist online for further queries --> <link>

### Human:\nare high sugar and raised liver enzymes side effects of protonix?\n\n### Assistant: is this the only liver function test you have? i wanted to trend it. plaquenil (hydroxychloroquine) and protonix (pantoprazole) both can cause elevated liver function test but it is relatively rare with protonix. i also want to make sure that you are not using aspirin tylenol or cholesterol medications since they can have direct effects on the liver. another important point is that the slight elevation of lipase and blood sugar can happen in pancreatitis which again could be a rare side effect of protonix. but this point goes against the fact that the elevation of blood sugar is out of the proportion to the lipase levels. a person who has prediabetes may develop full blown diabetes transiently under physiological stress. i was trying to understand if you had been tested for diabetes ever and if this blood sugar was obtained in fasting. for high blood sugars i would suggest that you try to avoid high carbohydrate diet soda bakery products white bread or pasta and juices. hydrate yourself with plenty of water. can you please share your symptoms and for how long did you have them? please also share if you have been worked up for lupus or autoimmune hepatitis and your entire medication list if you can? revert back with the details to an internal medicine physician online --><link>

### Human:\nhow to increase my height? i am 23 years old.\n\n### Assistant: growth in terms of height drastically reduces after puberty. you have not mentioned your gender. theoretically with proper nutrition and under ideal circumstances growth in height stops in women at 18 years and in men at 24 years. this does not consider other factors like family tendencies and genetic inheritance. i suggest you to have nutritionally rich food like milk and milk products egg yolk lean meat like fish fresh fruits and vegetables. you can also indulge in stretching exercises and yoga that will give you better posture and help you to look taller. if you are overweight focus on losing weight. sleep for at least 8 hours a day. you need to drink 6-8 glasses of water a day to detoxify your body. following these tips will help in maintaining ideal body condition. that coupled with yoga and other exercises should help you. consult a nutritionist online for further follow up ---><link>

### Human:\ncan cocaine cause elevation in lfts?\n\n### Assistant: first of all cocaine did not make lft (liver function test) rise just taking it for two days. it is possible only if you have been taking cocaine from long time. second thing is alt (alanine transaminase) 90 and ast (aspartate transminase) 86 are not that high values which will make any damage to your liver. please answer the following questions to help you in detail. do you take alcohol? if so since when and how many times a day? did you have any fever in the past two months? had any medications like pain killers or antibiotics or herbal products recently? did you gain any weight in the past four months? revert back with the answers for the above questions to a general medicine physician online --> <link>

### Human:\nwhy was i prescribed with folic acid glycomet and oosure for delayed period?\n\n### Assistant: your doctor started medicine on the basis of your delayed periods and considering it as pcos (polycystic ovarian syndrome). that is why glycomet (metformin) and oosure. you must get yourself investigated and confirm the reason for delay. as for now since 13 days are over you should have done a urine for pregnancy test. if not done then get a scan done which will tell you the reason for delay whether pregnancy or it will show if polycystic ovaries. moreover since it will be on day 2 of cycle and it will guide your gynecologist about the number of follicles in the ovary. if the scan is fine then i will advise you to get yourself investigated for conceiving including your husband's semen examination. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\nwhat is the reason for delayed periods after having protected sex?\n\n### Assistant: how are you doing? pregnancy need not be the only reason for no periods. if you have used proper protection and the urine test for pregnancy is negative then you do not have to worry about pregnancy. any young lady will take about 19 to 21 years of age to have a mature brain-ovary hormone axis so till then once in a while you may miss your periods. next month it will be fine. is there any recent sudden increase or decrease in body weight? or any episode of significant mental or physical stress or anxiety happiness depression? any recent history of hormone use to alter periods? get a thyroid profile and serum prolactin level checked if abnormal it needs correction to have ovulation on time. as you have ruled out pregnancy i suggest taking any of the oral birth control pills contraceptive pills or 21 pills packet like tablet novelon dear 21 ovral g duoluton l or intimacy plus 3. take one tablet twice a day for ten days and throw away the 21st pill no matter what the cause is she will get her periods within 7 to 10 days. consult your specialist doctor discuss with him or her and start taking the medicine after their consent. for more information consult an obstetrician and gynaecologist online --> <link>

### Human:\nmenstrual period delayed for 45 days now. pregnancy test came negative. what could it be?\n\n### Assistant: if you are having delayed period there could be lots of reasons for it. first on the list is pregnancy which you have ruled out already. second cause could be pcod which gives rise to multiple tiny cysts in your ovaries with failure in ovulation thereby leading to no menstruation. third cause is hormonal imbalance or thyroid related issues. so i would suggest you to check your thyroid and prolactin staus and also get a tvs done to see the condition of your ovaries. for bringing out your periods you can try medroxyprogesterone acetate 10mg daily for 5 days. however it will not cure your primary cause. you must find out the primary cause to get permanent relief. consult an obstetrician and gynaecologist online --> <link>

### Human:\ncan taking two i-pills within a span of two weeks cause delayed periods?\n\n### Assistant: i have read and understood your problem. period starting early is due to effect of i-pill. you do not need to do anything. but if you have taken two i-pills in two weeks for contraception then it is better to continue with femilon (combination of desogestrel and ethinyl estradiol). for further doubts consult an obstetrician and gynaecologist online --> <link>

### Human:\nwhy do antibiotics clear acne?\n\n### Assistant: i have read your query. yes acne is caused by a bacteria called propionibacterium acnes but beside this other factors also play in forming acne. change in keratinization pattern in pilosebaceous unit which leads to a keratinous material to cause blocking of sebum secretion leads to comedone formation. these comedones plugging and complex interaction between androgens and bacteria in the plugged pilosebaceous units leads to inflammation. this is the reason for using antibiotics for the management of acne along with medicine like retinoids (adapalene or isotretinoin) for maintaining keratinization. for further doubts consult a dermatologist online --> <link>

### Human:\nwould antibiotics during pregnancy cause any harm?\n\n### Assistant: taking another course of antibiotics would cause no harm but infection if occurs again and again may be harmful to pregnancy. you are right in your worry that it may be an extra course as your wife took one recently. but as i said it is better to play on the safe side in pregnancy. there is no harm. she can take another course of antibiotics and please get her blood sugar levels. high sugar levels can sometimes be a reason for recurrent urinary infection. kindly advise her to take plenty of fluids. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\ncould delayed periods be a sign of early onset of menopause?\n\n### Assistant: if you have been regular with your menses these years and this is the first episode at 53 years of age when the menses have been delayed by two weeks the causes can be a possible initiation of perimenopausal stage where menses are often delayed for a month or two and slowly tend to stop in next one to two years. perimenopausal stage can be verified with the hormonal fsh (follicle stimulating hormone) and lh (luteinizing hormone) levels which if high shall indicate an onset of perimenopausal stage. however it is suggested that pregnancy should anyways be ruled out and if negative then you can wait naturally for your menses to resume. hence try maintaining a menstrual calendar and keep a mark for your dates duration of flow and quantity to evaluate the possible onset of a perimenopausal state. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\ndelayed period after abortion. please help.\n\n### Assistant: please ask her to wait for a week for her period to start. if it does not start by then she can repeat urine pregnancy test. if the test turns out to be negative ask her to take tablet medroxyprogesterone acetate 10 mg twice daily for five days. period normally starts within a week of stopping tablets. try to avoid unprotected sex during these seven days. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\nis antibiotic a must for seasonal allergic cough?\n\n### Assistant: with the conversation i understand that you are a 33 year old male suffering from cough especially during the months of september and october through the years. therefore it is clear that you are suffering from allergic bronchitis. it is considered to be seasonal. this cough exacerbates in specific months like september and october in your case. during such exacerbation it is advisable to take a steroid bronchodilator and an antibiotic. in your case decadron (dexamethasone) is the steroid proair hfa aerosol (albuterol) is the bronchodilator and zithromax z-pak (azithromycin) is the antibiotic. accordingly antibiotic should be prescribed only if infection is present and if there is yellow or green colored sputum production fever and chest congestion. bronchodilator in the form of aerosol spray helps to relieve bronchospasm and to get rid of any inflammation associated with it. i would suggest you to continue with the aerosol spray as prescribed by your doctor. check for few days. if the symptoms of cough recur then start the antibiotics. when the allergic bronchitis exacerbates you can use proair inhaler and seroflo inhaler (combination of fluticasone and salmeterol) or budecort (budesonide) inhaler together. the two inhalers have a specific way of usage. you can check it with your physician. for further information consult an allergy specialist online --> <link>

### Human:\nhow to manage my mother's plantar fasciitis?\n\n### Assistant: plantar fasciitis which is inflammation of foot tissue can be reduced by decrease weight bearing by wearing different footwear and by physiotherapy. tens (transcutaneous electrical nerve stimulation) will not be an effective one. you need to take ultrasound therapy with analgesic cream use and it will be more effective. tens therapy is only temporary and will not give a problem solving approach. even though it will not give any side effect there will not be a benefit too. so kindly take ultrasound therapy which is essentially needed for 15 days and the protocol is 1 mhz and 1. 5 w/sq cm for 10 minutes daily. for further information consult a physiotherapist online --> <link>

### Human:\ncan antibiotic affect the outcome of hiv test?\n\n### Assistant: as i am not aware of your previous history. please explain your problem in detail. revert back with a detailed history to a hiv aids specialist online --> <link>

### Human:\ni have a terrible upper back and shoulder pain and i feel drowsy. what to do?\n\n### Assistant: i would like the following details. did you take any x-ray? have you tried physiotherapy? was the mri with or without contrast? do you feel missed heartbeats when you feel drowsy? do you get sweaty or get a sinking feeling? if yes then you need a 24- hour holter ecg (electrocardiography) reading to rule out any arrhythmia. if you have a click on the neck which is painful and makes you faint or feel drowsy then i think you need an mra (magnetic resonance angiogram). i will also suggest you consult an ent specialist. revert with more information to a fitness expert online --> <link>

### Human:\nmy operated knee is comparatively weak. why?\n\n### Assistant: it usually happens when the physiotherapy was not progressively increased or physiotherapy was done intermittently. weakness is due to muscles not being conditioned to presurgery levels. you need to increase the level of exercises. start jogging cycling and training with weights. doing this for one month properly will get you back to presurgery levels. probable diagnosis:ligament with slight weakness. regarding follow up:revert after a month to an orthopaedician and traumatologist online. ---> <link>

### Human:\ncan physiotherapy heal diastasis recti?\n\n### Assistant: first of all congratulations for delivering a beautiful baby. i have gone through your medical history in detail. diastasis of 2. 5 cm is considered a moderate degree of diastasis as far as our classification is considered. diastasis is usually hard to heal up completely only with physiotherapy. since the defect is bony it takes lots of aggressive manouvers to get the bones back together. initial three to four weeks after delivery are the most important days if you want to get back the diastasis to normal with physiotherapy. if you have an immediate post-delivery x-ray then you can get a new x-ray done and compare the diastasis gap in both x-rays to see the progress. if it is still the same even today then there are very fewer chances that this may improve only with physiotherapy. you can use gradually compressing pelvic belt which can be tightened gradually day by day. if even this does not help then you may need surgery to get the diastasis normal. try and post an x-ray of the pelvis here so that i can guide you better. for further information consult a physiotherapist online --> <link>

### Human:\nwhat is the treatment for the fungal infection on my right hand?\n\n### Assistant: have you applied any creams? do you have a history of diabetes or hypertension? in the case of a fungal infection you can try using onabet (sertaconazole) cream or episert (sertaconazole) cream or dk gel (miconazole) twice a day. but if there is a recurrence then oral antifungal medications should be considered. please send images so i can suggest some medicines. revert with more information to a dermatologist online --> <link>

### Human:\nwill antibiotics reduce the effect of oral contraceptive pills?\n\n### Assistant: while some antibiotics do induce hepatic enzymes to decrease the efficacy of contraceptive pills amoxicillin is not one of them and can be safely used without the fear of contraceptive failure. however it is important to stick to the contraceptive schedule. if you have taken crisanta (ethinyl estradiol) regularly without missing any pills then you can rely on it completely. if you have missed a couple of pills or more then it will be prudent to use a backup method like condom. crisanta has to be used regularly as advised. there is no modification in the course or dosage necessary. no backup contraceptive required if you have not missed any pills in this cycle and have been taking crisanta for more than one cycle. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\nwhat can be the reason for back pain and stiffness?\n\n### Assistant: from the way you described it seems that you have a locked back. so you need a few medicines and physiotherapy. instructions to reduce back pain and stiffness are as follows: avoid lifting heavy weights sitting for a long time and two wheeler rides. avoid arching your back; instead bend your knees to pick up something from the floor. improve your posture while sitting and try to get up from your chair for every 20 minutes. take a quick walk around then continue working and always sit on a chair with back support. do not get up suddenly from a sleeping position. rather turn to the side and then get up. take bed rest if you feel severe pain. do hot fomentations locally over the affected area at least twice a day. i suggest you to apply oxalgin gel (diclofenac) for local application twice a day. i also suggest tablet pregabalin 75 mg one tablet at night for 15 days before food at 7 pm every day and tablet etoricoxib 60 mg one tablet at morning and night for 10 days after food. you can take rabeprazole 20 mg one tablet at night for 10 days before food and shelcal (calcium carbonate and vitamin d3) 500 mg one tablet at morning and night for 30 days before food. take d-shine 60 k one tablet daily for ten days and then once a month for 11 months. take these tablets only if you are not allergic to them. consult your specialist doctor discuss with him or her and take the medicine with their consent. these tablets will also help the heaviness of the head. if back stiffness does not reduce then you will need some blood investigation. do physiotherapy like mckenzie back extension exercises back core strengthening exercises glute strengthening exercises and passive straight leg raising exercises. these exercises can be done initially under a supervision of a physiotherapist or learn to do it at home. only regular exercises can give the result. once the pain gets reduced then do the following activities like swimming yoga and walking which are good for you. jogging running and weight lifting may aggravate back problems. the probable causes:1. locked back. 2. ankylosing spondylitis. regarding follow up:revert back if stiffness persists even after seven days to a orthopaedician and traumatologist online. ---> <link>

### Human:\ndelayed periods even after taking gestin. what is the reason?\n\n### Assistant: tablet gestin (allylestrenol) contains natural progesterone which is given for 5 days to bring about withdrawal bleeding. you have not mentioned how long you have taken the drug. withdrawal bleeding usually occurs 48 hours after stopping the drug to up to 7 days. if you are still in that period then you should wait for your period to commence. if you are over that then i suggest you to do certain tests like transvaginal sonography tsh (thyroid stimulating hormone) and amh (anti-mullerian hormone testing). considering your age you could be in your perimenopause (stage nearing menopause) where menstrual irregularities are common. revert back after the tests to an obstetrician and gynaecologist online --> <link>

### Human:\ni am having problems with my whole skeletal system. please help.\n\n### Assistant: are the findings that you have quoted your impression or seen and mentioned by a physiotherapist or doctor? have you been prescribed any physiotherapy? have you had bloods taken to rule out any other cause of muscle weakness fatigue? do you exercise regularly? sometimes the things you have mentioned are postural and get fixed through proper physiotherapy. though the scoliosis is mild first it needs to be investigated and confirmed by x-rays and the degree documented such that any progress can be picked up. have your vitamin d levels checked? please get yourself examined and i am fairly hopeful that manual therapy and physiotherapy will work in most cases. revert back with the asked details to a chiropractor online --> <link>

### Human:\ncan you advise medication for fungal infection?\n\n### Assistant: fungal infection indeed is very problematic if it becomes recurrent. first of all you keep the following precaution in mind. do not keep the area wet at all. use powder frequently to keep it dry. avoid itching and do not scratch it. change the undergarments regularly. avoid excessive sweating and wet clothes. do not apply any general or steroid creams like betnovate etc. do not stop the medicine once you cure. continue medicine for long time to completely kill the fungal. check diabetes and thyroid it is really recurrent even after proper treatment. now treatment part: ketoconazole cream (kz cream) plus tablet terbinafine (gris odt) 250 mg for two months. terbinafine cream plus fluconazole 150 mg twice in a week for two months. tablet itraconazole 200 mg twice in a day and kz cream for one month these are treatment combinations. please continue any one of it. for further information consult a dermatologist online --> <link>

### Human:\nwhat is the treatment for vaginal fungal infection?\n\n### Assistant: the fungal vaginal pessary usually dissolves intravaginal. you may experience some vaginal discharge mixed whitish fluid which can be candidial infection and also some amount of dissolved medication. i suggest you to wash yourself with alkaline vaginal wash and then re-insert the tablet at night again and continue for at least six nights. consult your doctor discuss with him or her and take the medicine with their consent. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\nplease help with my recurrent fungal infection.\n\n### Assistant: with your given description it looks like resistant tinea cruris infections or may be erythrasma (skin condition affecting the folds in the body) you have not mentioned the duration of individual drugs you have taken. itraconazole is a good drug for this but you have to take 100 mg daily for around 28 days. along with this you can try sertaconazole cream with fusidic acid cream to cover erythrasma twice daily for minimum of three months. follow certain general measures such as: avoid heat moisture and maceration (softening by soaking). dry the body folds finger and toe webs thoroughly after bathing. the probable causes:may be not taken full duration of the course of medicines for fungal infection. investigations to be done:1. blood sugar. 2. skin scraping for koh (potassium hydroxide). differential diagnosis:1. tinea cruris. 2. erythrasma. 3. candidal dermatitis. probable diagnosis:recalcitrant tinea cruris. regarding follow up:revert back after the tests to a dermatologist online. ---> <link>

### Human:\ncan fungal infection cause low grade fever?\n\n### Assistant: this is a chronic fever which is called as pyrexia of unknown origin when we are unable to ascertain a cause. as your blood tests and x-ray are normal lung infection is ruled out. conditions causing chronic fever are numerous. also certain infections like tuberculosis hiv and malignancies can cause it. but in your case it is unlikely as there is no weight loss or other risk factors neither you have an x-ray abnormality. now we move to the lymph nodes. do you have any lymph node swelling? if yes then get it tested. try to get an ultrasound of abdomen to rule out lymphadenopathy. get a urine routine and culture as sometimes a mild urine infection can get unnoticed and cause fever. get a blood glucose and renal function test too. if everything comes normal then we should look for anemia. a low hemoglobin can cause low grade fever and fatigue. fungal infections usually cause severe illness. to confirm if it is a fungal infection a blood culture is required. for further information consult a general medicine physician online --> <link>

### Human:\ni have fungal infection in my ear. is it mandatory to stay at the hospital overnight for a microsuction?\n\n### Assistant: i would like to tell you that fungal infection in ear is quite common and it may be treated by: cleaning the ear: cleaning may be done by suction or syringing or by cotton swab. antifungal ear drops to be used three or four times a day. anti-inflammatory medicine to relieve pain and swelling in the ear canal. most of the times patients are treated as out door patients but some times if there are some associated complications or patient's general condition is low due to some other associated diseases then hospitalization becomes essential. revert back to an ent otolaryngologist online for further follow up --> <link>

### Human:\nif someone with a fungal infection swims in a pool won't it spread to others through the water?\n\n### Assistant: i understand your concern. swimming is considered as a safe recreational activity. but that is not totally true. chlorination of water is known to kill most of the microorganisms (which include bacteria viruses fungi and parasites). but there are several factors to be considered like: 1) type of microorganism (some organisms may be resistant to chlorination). 2) adequate chlorination (if sufficient chlorine is not added there could be a chance of acquiring infection). 3) duration of chlorination (when a microorganism is introduced into the water the chlorine may not kill the organism right away some resistant organisms may survive longer in the water). 4) microbial load (the stage of infection of the infected person is also important during the acute acute/highly infective stage chances of spreading infection may be higher). it is very important for people with skin infections or diarrhoea to stay away from the pools for a period of 14days after recovery. this can only be monitored by the people entering the pool themselves. if you are swimming regularly try not to swallow water while swimming. take a shower immediately after swimming. if you develop any symptoms like rashes over the skin or diarrhoea consult your doctor immediately. request the pool authorities to put up a notice requesting members to stay away from the pool if they are sick. if you have kids who are swimming follow the same advice and change their nappies immediately after swimming. also take your kids to the toilet every 30 minutes during their swimming session to prevent them from excreting in the pool. consult a general practitioner online for further follow up ---><link>

### Human:\nare there remedies to stop early maturity?\n\n### Assistant: hypothyroidism itself can be one of the causes of this prematurity. when have you got thyroid levels done? i suggest you to repeat if not done recently. what is the height of the child and her current weight? how much dose of thyroid hormone you are giving? investigations to be done:1. ultrasonography of neck. 2. anti-tpo antibody (anti-thyroid peroxidase) 3. check levels of t3 t4 and tsh (thyroid-stimulating hormone). regarding follow up:revert back with the answers to the above questions to a child health specialist online. ---> <link>

### Human:\nwhat could be the potential risk of not taking medicine for hypothyroidism?\n\n### Assistant: i have a few follow up questions. please answer them. what was the reason for the hypothyroidism and growth hormone deficiency? were there any other hormone deficiencies as well? what other medical problems do you have? when did you last have your thyroid blood work done? can you send the results of the laboratory? treatment for hypothyroidism is extremely important as it is a metabolic hormone and your body and all organs need it for functioning well. without this everything in the body can get sluggish such as weight gain depression tiredness and cold intolerance and in extreme cases it will lead to hospitalization complications like hypothermia (decreased body temperature) slow heart rate and coma. growth hormone deficiency treatment is required for growth of bones and muscles in childhood but in adulthood the treatment recommendation will depend on the cause of the deficiency. revert back with the answers to the above questions to an endocrinologist online --> <link>

### Human:\ncan menstrual cycle affect diabetes blood work?\n\n### Assistant: no blood results of sugars are not affected by normal physiological changes in the body. the menstrual period is a physiological stress on the body. if your body is producing normal levels of insulin to control the sugars then it will go ahead with normal production. only when you do something out of normal like excessive exercise or fever or any medications or certain steroid tablets or injections then the blood sugar will be affected. hope the bleeding was not massive or very painful. if these were excessive and out of normal levels then blood sugars may slightly change. also the hormones in periods from ovaries do not affect the blood sugars. for further doubts consult an obstetrician and gynaecologist online --> <link>

### Human:\ni am suffering from hypothyroidism and taking eltroxin and thyronorm. but cholesterol is raising. what to do?\n\n### Assistant: cholesterol may increase on its own or the increase may be secondary to hypothyroidism. a secondary raise will settle down after 8-12 weeks of optimal control of thyroid status. otherwise it will require consideration for medication. till that time please eat diet low in saturated fats/carbohydrates. avoid sweets and fried items. also you can start doing exercise under supervision. will provide more insight if you can come up with the actual lipid profile and thyroid status to an endocrinologist online --> <link>

### Human:\ncan diabetes make my hands itchy and numb?\n\n### Assistant: i am sorry to know that despite the best efforts you are not responding with current antidepressants and there are active symptoms. i suggest the following treatment given a diagnosis of diabetes with depression. tablet duloxetine (duzela m) 30 mg in the morning and 30 mg in the evening. the reason for recommending this medicine is because it is quite effective for pain symptoms associated with diabetic neuropathy along with depression. tablet aripiprazole (arpizol) 5 mg in the morning. although it comes from an antipsychotic group of medicines my purpose here is to augment the action of antidepressants while addressing anger associated with depression. tablet lonazep (clonazepam) can be continued as per the current level if there is adequate sleep. in case sleep has been an issue despite the medicines i will recommend upping the dose of lonazep to 0. 5 mg at bedtime. regarding vilazodone i think it should be removed as it is causing intolerable side effects. also this particular antidepressant has little role in pain associated with neuropathy and i think duloxetine will be a better option. there is need to stop tobacco. this is because many of the medicines mentioned above have poor efficacy when tobacco is consumed. you need to consult your diabetes doctor as poor control of diabetes could be a significant reason for the poor response. consult your specialist doctor discuss with him or her and start taking the medicines after their consent. in case you have more questions feel free to write back to me. for further queries consult an andrologist online --> <link>

### Human:\ni have hypothyroidism. i want to reduce weight. please advise me the diet and exercises.\n\n### Assistant: your weight gain may be partially due to hypothyroidism. you may start with brisk walking for 20 minutes daily and gradually increase it to 45 minutes daily. please do not lift heavy weights at this age. this may cause more harm than benefit. try oats muesli brown bread egg whites for breakfast. lunch should be a complete meal with no ghee on rotis. dinner can be soup veggies with roti dalia(broken wheat) dal roti. do not be on empty stomach for more than 2 hours during day time or the time you are awake. take light snacks fruits juices shakes in between your meals. else your metabolism can slow down. please tell me how much thyroxine are you taking and your tsh level and medicine details so that i can see whether thyroid is not the cause of your problem. please note: not eating for long periods or being on empty stomach could slow down metabolism and potentially increase weight. already hypothyroidism itself slows down metabolism. so do not fast but eat little meals. definitely you will lose weight if you follow this. revert back to an endocrinologist online for further help --> <link>

### Human:\nwill diet and exercise regress mild concentric lvh?\n\n### Assistant: do not worry completely stop smoking and alcohol forever. do not restart again as it will adversely affect your health. i suggest you try taking these following medicines. consult your specialist doctor discuss with him or her and start taking the medicines after their consent. tablet aztor 10 (atorvastatin) once daily after dinner. tablet cardace 2. 5 (ramipril) one tablet before breakfast this will bring down your blood pressure. your target blood pressure should be 120/80 mmhg. avoid fried fatty salty and spicy food. we will review after two months. revert after two months to a cardiologist online --> <link>

### Human:\nhow to monitor diabetes?\n\n### Assistant: instead of kombiglyze (combination of saxagliptin and metformin hydrochloride extended release) take tablet tenepride (teneligliptin) and also take metformin (exermet or glyciphage) extended release 1000 mg in the afternoon. get an x-ray of the pain region and upload it with the opinion of a radiologist which will be given by radiologist in all scan centers. tablet tayo 60 k is the most important one for vitamin d. take one tablet a week. if possible get sun sessions between 11 am to 1 pm stand under direct sunlight for 15 minutes. get a glucometer. make a chart of your blood glucose readings as fasting morning (before breakfast advisable to take only water) postprandial (take tablet before breakfast and check 2 hours after breakfast) prelunch (just before lunch) and pre-dinner. maintain this chart in all seven days of a week. if sugar level is below 100 then contact your doctor immediately. if tiredness sweating or other symptom occurs check sugar at that time immediately and mention what is the problem time and sugar level. from your blood test it is evident that you have high hs-crp high hba1c low vitamin d and b12 low iron and low mean corpuscular hemoglobin concentration (mchc). chronic carbohydrates based diet and less vitamin d caused diabetes in you. stress also may be a factor. revert back with the readings chart to a general practitioner online --> <link>

### Human:\nplease suggest some exercise and supplement for weak bones.\n\n### Assistant: i have understood your concern. dislocation is accidental slippage of bone from the actual space and when it happens it will make surrounding muscles ligaments and capsule over stretch and so ultimately pain will be due to all structures. first you need to strengthen the surrounding muscles perfectly with the faith that you will improve. it may take six months or more. do not worry about it and you need to have more patience. in supervision of skilled physiotherapist you need to do all exercise. you can take some pain relieving modalities like ift and swd therapies (interferential therapy and short wave diathermy) by which pain intensity will decrease. but this is not a permanent option. non-vegetarian food will not affect much. i insist to rely on pure vegetarian protein and calcium diet. take bananas and milk as much as possible. avoid junk foods and do proper exercise. for further information consult a fitness expert online --> <link>

### Human:\nwill diabetes during pregnancy affect the baby?\n\n### Assistant: we are here to help you. diabetes is a big problem and so the pregnancy during diabetes is labeled as high risk pregnancy. it is very uncertain to know what side effect might occur. however the side effects can vary from person to person. it is very difficult to comment about what actually might have happened to the baby. if the sugar level gets low during cesarean section then yes the baby is at risk. high blood sugar instantly does not stop the heart or affect the baby. it affects the mother by making her more prone to infection and diabetic ketoacidosis (body produces excess ketones). uncontrolled blood sugar during pregnancy will affect the baby. for further doubts consult an internal medicine physician online --> <link>

### Human:\nis there any exercise to tighten the bulbospongiosus muscle?\n\n### Assistant: first of all bulbospongiosus and pubococcygeus are the different part of pelvic floor muscles and kegel exercise works on all these muscles to strengthen them. there are no separate exercises for individual muscle. it is important to know for what reason you want to do this exercise. is there any urinary problem or sexual problem or any other? so that if your problem is not getting cured with this exercise then further treatment can be offered. to get best result of this exercise you should perform it at least three times a day with at least 20-30 repetitions. for further information consult an obstetrician and gynaecologist online --> <link>

### Human:\ni had diabetes during pregancy 4 years back. when my baby was born the sugar levels were normal\n\n### Assistant: it is well known that diabetes during pregnancy is a forerunner for diabetes in later life. it is good that you checked your blood levels faithfully after your delivery and that is why you were able to identify the high levels. having found out about these high levels it is time for you to meet a physician or diabetologist to start treatment. the target sugar level for fasting is 100 and for 2 hours after a meal is 140 mg/dl. adhering to a strict diet and regular exercise may reverse diabetes completely in early stages. you have not mentioned your age or desire for future pregnancy. in either case we can help you. for further information consult a diabetologist online --> <link>

### Human:\nevery time i exercise on treadmill my legs are itching. how do i prevent this?\n\n### Assistant: i want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. i have thoroughly gone through your case and understand your genuine health concerns. the probable causes:this is a very common problem for a lot of treadmill users doing cardio exercises. the main issue is the sensitivity of the skin. it looks very simple but i found this fact after a research on 150 people of different ages and with different health status but with the same issue of blushing and itching on the legs while using the treadmill. reasons: dry skin in the legs. wearing tight clothes/jeans or trousers while exercising on the treadmill. wearing tight and above ankle socks. treatment plan:1. wear cotton-only trousers (100% cotton; not mixed with any synthetic fiber). 2. it is better to wear ankle socks compared to above ankle socks. 3. wax properly and timely on the legs and apply eucerin cream (extra dry treatment lotion) on the legs especially when doing the treadmill. 4. there must be a proper ventilation in the room where you do the treadmill. 5. keep a judicious supply of water to avoid dehydration. 6. you need to keep a good and healthy diet full of vitamins minerals and fluids (vegetables salads fruits salmon fish nuts dry fruits). 7. avoid caffeinated drinks like coffee tea beverages energy drinks etc. 8. it is possible that you may still feel itching and redness for the first couple of days so it is better to take tablet cetirizine 1 hour before workout. and apply hydrocortisone cream if you feel that the redness is not going away on its own after an hour of completing workout. in a few days you will not get the problem anymore. regarding follow up:for further clarifications consult a general practitioner online. ---> <link>

### Human:\nis stretching exercise helpful for tight foreskin?\n\n### Assistant: you seem to be having tight foreskin which is called phimosis. there are two options available for this problem namely preputioplasty and circumcision. it is better to correct this problem before marriage. otherwise it would lead to paraphimosis following intercourse. for further information consult a urologist online --><link>

### Human:\nwhile doing exercise i feel shortness of breath and sweating. why?\n\n### Assistant: thanks for consulting me at this platform. i have thoroughly gone through your case and can well understand your genuine health concerns. i think you need to carry out taking the same medication as this is a mandatory medication. exercise induced asthma may also cause shortness of breath. excess sweating is natural and this is also a side effect of almost every medication used for lowering heart rate. it is called postural hypotension in which you feel sleepy and sometimes weak when standing up from sitting position. for further information consult a cardiologist online --> <link>

### Human:\nexercises to do when one has ankylosing spondylitis with an andersson lesion.\n\n### Assistant: hi you have to inform us your age duration of symptoms whether you are on any medical management extent of your body joints and spine involvement etc. considering all these have been done i would suggest you to concentrate on deep breathing exercises and pranayama. also we advise you to avoid the use of high pillows or a soft bed. now as you know the chest expansion is limited when one is having ankylosing spondylitis swimming is a good exercise that helps most joints in addition to the back. you may also need to check your vitamin d status and the calcium phosphorous and alkaline phosphatase levels. yoga can be tried but will have to be individually tailored. all the best for a sporty day. consult a physiotherapist online --> <link>

### Human:\nwill exercise or diet help me in normal delivery?\n\n### Assistant: the following aid in normal delivery: your stature must be tall. there should be adequate pelvis. the baby should be in vertex position. this can be predicted only when you cross 37 weeks. you can have a normal diet and regular antenatal exercises till then. yoga also helps but you are too early in pregnancy to predict the same. for further follow up consult a gynaecologist online --> <link>

### Human:\nplease help me through ayurveda to clear acne.\n\n### Assistant: as you are 21 year old the acne is mainly due to hormonal changes. as far as scars are concerned do not peel or squeeze your acne. the scars which are already present can be lightened off. for acne try herbal things at home because the cause is very important. as your hormones will get balanced with age the acne will start reducing. take turmeric and sandalwood powder and add rose water to it. make a paste and apply this paste early in the morning. after 10 minutes wash it off gently with water and wipe your face with a soft cotton towel. for scars i suggest you apply aloe vera gel on them twice a day. this will help in lighting them. use mild herbal face wash and do not use harsh soap for face. avoid going directly in sunlight apply sunscreen before going outside. avoid taking the stress avoid excessive spicy and junk food caffeinated drinks etc. drink plenty of liquids and take fresh fruits and vegetables. however if acne is due to some infection then you need to visit a nearby dermatologist otherwise hormonal related acne problem will settle down with time. for further information consult an ayurveda specialist online --> <link>