Question 1

I've been diagnosed with gallstones and my MRCP shows cholelithiasis along with a lower insertion of the cystic duct into the CHD My LFTs are off with SGOT at 115 SGPT 289 ALP 141 and total bilirubin 16 The MRCP also suggests chronic liver disease with a contracted right lobe enlarged caudate lobe and mildly irregular margins My doctor recommended a lap cholecystectomy but I'm worried about what's causing the liver disease and how it should be treated Can you explain the possible causes and treatment options

Accepted Answer

Gallstone treatment depends on whether the stones cause symptoms. If asymptomatic, they often don't require treatment, but if they cause pain or complications, surgery to remove the gallbladder (cholecystectomy) is the standard treatment. Medications like ursodeoxycholic acid can sometimes dissolve small, cholesterol-based stones

Question 2

I'm really concerned about this habit I've developed of inserting my finger into my anus. I did it yesterday, and a couple of hours later, when I did it again, I noticed this slimy, jelly-like stuff on my finger. There's no blood, pain, or any other symptoms, but this always seems to happen when I do it again soon after the first time. Is this slime supposed to be there? Does the fingering cause it? I've read online that other people who've done anal fingering have noticed it too, so is it always present? I really want to stop this habit, and I'm feeling worried. Please guide me on what to do.

Accepted Answer

Rabies Vaccination and Post-Exposure Prophylaxis (PEP)

_Timing of Vaccination_

1. _Immediate vaccination recommended_: The World Health Organization (WHO) recommends immediate vaccination after exposure to rabies, ideally within 24-48 hours.
2. _Vaccination during incubation period_: If vaccination is administered during the incubation period (before symptoms appear), it can still be effective in preventing rabies.

_Your Situation_

1. _Delayed vaccination_: You received vaccinations 6-7 years after the initial exposure.
2. _Multiple vaccinations_: You have taken a total of 17 vaccinations from 2008-2016.

_Reassurance and Recommendations_

1. _Low risk of rabies_: Given the long incubation period and the fact that you have not shown any symptoms, the risk of rabies is low.
2. _No need for further vaccinations_: You have already received multiple vaccinations, and further vaccinations are unlikely to provide additional benefits.
3. _Consult a doctor for reassurance_: Schedule a consultation with a doctor or a rabies expert to discuss your concerns and receive reassurance.
4. _Address anxiety and depression_: Consider seeking professional help to manage your anxiety and depression related to the fear of rabies.

Question 3

I'm a 32-year-old male, and I'm a bit worried about my recent liver test results. My SGOT is 63 and my SGPT is 70. Should I be concerned about these numbers? Also, my bilirubin level is 1.26. Could you please advise me on whether these are dangerous and suggest any medicine or lifestyle changes I should consider?

Accepted Answer

Smegma is a normal, harmless substance.

To get rid of smegma:

Retract your foreskin and gently wash the area with warm water and mild soap.
Use a gentle, fragrance-free cleanser to avoid irritation.
Avoid using harsh or abrasive products.
Dry the area thoroughly after washing.
Repeat this process 2-3 times a week.

Consult a urologist or healthcare professional if you experience discomfort, pain, or difficulty retracting your foreskin.

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