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<s>[INST] 52 Yrs, 5 8 155lbs exc cond. Had mohs 12 days ago. Side side bridge of close 1cm wound. Linear type close..stitches from side upper bridge down to crease of nose to near ala. Had fluid buildup under skin coming from closed 1cm wound which pooled above ala in area of upper nasolabial fold after surgery. swelling that side of face now almost gone axcept there is a hardened capsule area protruding which extends under skin from bottom of original surgical 1cm wound site down to nasolabial fold. This has pretty well defined margins and is about the size and shape of an omega 3 liquid oblong capsule. it is somewhat pliable but still quite hard....skin is a bit red in area....slightly sore. Even though hard....could this still be residual swelling or any ideas.....again it extends from bottom base of original surgical wound [/INST] Mohs surgery, also called Mohs micrographic surgery, is a precise surgical technique that is used to remove all parts of cancerous skin tumors, while preserving as much healthy tissue as possible.Patients should expect to receive specific wound care instructions from their surgeon. Generally, however, wounds that have been repaired with absorbable stitches or skin grafts should be kept covered with a bandage for one week. Wounds that have been repaired using nonabsorbable stitches should also be covered with a bandage that should be replaced daily until the stitches are removed one to two weeks later. Signs of infection ( redness, pain, drainage) should be reported to the physician immediately.(Thanks) </s>

<s>[INST] Hello, I ve had what I can only describe as a mild nagging pain the bottom of my right rib area which has slowly over the last few weeks got worse and spreads upwards and down and now starting to get short bouts of breathlessness more having to concentrate on breathing. And a slight popping in right ear? Any suggestions please [/INST] Hello As you explain the history I would recommend you to be seen by your doctor. Regards Dr. Jolanda </s>

<s>[INST] Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. [/INST] Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> </s>

<s>[INST] I have bruises/brown spots on the inside of my mouth (2-3 cm in diameter located on the inside of my cheeks). They don't hurt, but have a less smooth surface than other parts in my mouth. I felt them first about 2 weeks ago, but have grown since then. [/INST] Hello,A possible explanation would be trauma from biting your cheek. You could grind your teeth at night and catch your cheek. You may damage the tissue and have some bleeding. Any difficulties with your bite with sharp edges or broken teeth? Any recent changes such as dental work, change in health care products, diet that could cause an allergic reaction? Rinse the area with warm salt water and continue to monitor for changes. If you repeat the trauma, that could explain the increase in size. I suggest you consult with your dentist. A clinical exam would provide you the best diagnosis. The concern is to rule out a serious condition such as a cancer. There are other infections possible and once diagnosed, medication may be an option to improve the condition. Your overall health needs to be reviewed with your dentist as well. Changes to your health, medications, diet, dental health etc. all need to considered. Keep proper oral hygiene, good nutrition with balanced vitamins, and stay hydrated.Thank you for your inquiry. Please consider providing additional details after you have considered my suggestions. I hope that I have provided helpful information and would be glad to answer additional questions. </s>

<s>[INST] I have a bad tooth and the taste of pus in my mouth. There is some swelling and pain around my cheek and the top of my neck . I think I also have a wisdom tooth coming through, but I cannot be too sure. I am taking painkillers, applying ice packs and swilling my mouth out with salty water. I went to see a dentist but with Christmas coming up, I will have to wait a few days before I can be seen unless you think I should see someone sooner. What should I do? Thank you for your time. [/INST] hello & welcome most probably u are suffering from pericornitis. This is a type of infection caused by partially erupted wisdom tooth. in such cases only painkillers are not sufficient you have to do an antibiotic course including Amoxycilline 500mg TDS, Metronidazole 400 mg TDS , Ibuprofen 400 mg TDS, & warm saline rinses. Than visit to your dentist as soon as possible and go for a check X-ray. take care. </s>

<s>[INST] My mother is 81 and have been taking the procrit injections for about six months and it doesn t appear that the injections have changed her red blood cells at all along with the cost of these shots there has been no change actually her count is going down I am not sure if she needs to continue with the procrit since I am not seeing any change . I read you should see a change between 2-6 weeks she does have definite kidneys issues.. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. In this case in my opinion if the injection it’s not effective than you should not use it any more . Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] My heart has been racing for a couple weeks now. Heart rates ranging on average from 111 to 122. I do nothing to cause this. It is like this even while sitting down doing nothing. Along with this and for even longer my left arm has felt like it has a rubber band around it cutting off circulation or something. It sometimes gets so painful i can not hold it up to wash my hair or even put it in a pony tail. Well now the last few days I ve been having an issue with my neck. It feels as if the main arteries (or at least the largest ones) on both sides are a out to explode. It mainly feels like this if i move in certain positions, do any kind of work and most definitely cough. Coughings the worst. It also feels as iff the sensation may be starting to go down into my right shoulder a bit. What is going on and how worried should i be? I ve told two of my doctors about my heart rate and my arm and they just brush it off. [/INST] Hi welcome to hcmI understand your query and concern.Irregular heart beat in your case are suggestive of any arrhythmias of heart which means abnormal conduction abnormality of heart.I advise you to get an ECG,2 D Echo of your heart immediately to confirm the diagnosis.I also advise you to get lipid profile,complete blood picture,chest x ray immediately as a part of routine check up.Drugs like Amiodarone,Betaloc,Pantop 40 mg will be helpful in your case.Avoid stress and anxiety.Avoid smoking ,alcohol,fatty foods.Abnormal lipid profile if present in your case should be treated with atorvastatin.Monitor blood pressure and heart rate immediately.EP study and radiofrequency ablation will be the procedure of choice.Consult your cardiologist for expert management.Post your further queries if any,Thank you. </s>

<s>[INST] In layman's language what is meant by: both kidneys are normal. at least 2 hyperechoic foci posterior acoustic shadowing are seen in the interpolar region of the left kidney adjacent to an anechoic structure with the largest measuring 0.51mm? what should i do? [/INST] HelloYour findings may suggest two small calculus in left kidney.You may need clinical correlation and calculus dissolving drugs like magnesium citrate syrup etc.It is good that there is no complications like hydronephrosis etc in kidney due to calculus.As calculus is small,it is expected that calculus will flush out out of the body with medicines and adequate hydration.You may need to drink plenty of water.Anechoic structure in kidney may be a simple cyst.Generally it is not concerning.Take CareDr.Indu Bhushan </s>

<s>[INST] My daughter is 3 years old. she has problem of running nose for last 6 months I am living in Bangalore. My daughter is 3 years old. she has problem of running nose for last 6 months. Almost all medicine we tried like sinarest, cetrizine, teczine and other antibiotics and even Homeopathy also but it worked temporary. on x-ray, adenoid enlarged is diagonsed and doctor told generally till 5 years, childern have this problem and it will automatically cure after 5 year age. but as she is suffering now regularly. Shall we continue to give those medicines or she does not required. i need permanent cure. is it bangalore based allergy . any other best medication, Pl advise, the best treatment. [/INST] Dear Aravind does your daughter gets mouth breathing and snoring at night. usually children suffer common cold 2 to 3 times a year. if its regularly not subsiding you have to consult ent surgeon to rule out is adenoid enlarged in most of the case which happens. usually it get subsides by age of 5 years. another possibilty might be allergy of living in bangalore which you cant avoid. and another thing is most common cause of allergy is fro dust and mites from home. keep windows close and wash her bedsheets once fortnight in hot water and dry in hot sun try to find is she get eating after particular food avoid those things. </s>

<s>[INST] Painful skin rash on the arm. Could it be a spider bite?I have what I think is a spider bite on my thigh. It s a red ring, about 1.5 inches in diameter. It s raised and hard in the center with what looks like a white speck right in the middle. It s been there a couple of days and is painful to the touch and just a little sore. What do you think it may be? [/INST] Hello. Thanks for writing to us at healthcaremagicSeems like it is bacterial infection of the skin, since it is sore and probably has a central pus point. Spider bites are different, burning is a prominent feature in spider bite, and they usually do have some itching, as well.If you were one of my patients I would have treated you empirically with an oral antibiotic; one from penicillin group of drugs (cloxacillin or flucloxacillin). That would be good enough. It is a prescription drug, therefore, you must ask for a prescription of these from your physician.Topically you may use an OTC topical antibacterial e.g 2% mupirocin cream, twice daily.An OTC pain killer would provide you symptomatic relief from pain and swelling.Regards </s>

<s>[INST] hi my 2 and a half year old son has been having episodes where he turns blue around his mouth it usally happens when he wakes up and at random times throughout the day on a daily bases, it is unrelated to temperature there is a history of heart disease in our family ( high cholesterol, high blood pressure in both sides grandparents, his father has an arrythmia, his grandmother and sister both have an asd his sister also has a pda) do you think his blue spells could be heart related. [/INST] Hi... By what you quote and keeping in mind the strong family history of congenital heart disease, I definitely feel that this cyanosis or bluish discoloration is related to heart. I suggest you get an echocardiogram of the heart done. It might be a congenital cyanotic heart disease.Regards - Dr. Sumanth </s>

<s>[INST] Dear Doctor, I am 63 year old male patient underwent P C T A with stenting to R C A using 3 * 38 mm PromusElement strnt through the right femoral approach on 04 - 01 - 2014 . As I was highly allergic to Asprin I was adviced the following medicines Prasita 10 mg 1- 0- 0 Stiloz 100 mg 1 - 0- 1 Persantine 100 mg 1 - 0 - 0 Metastartan 50 mg 1 - 0 - 0 Atorva 10 mg 0 - 0 -1 Pantocid 40 mg 1 - 0 -1 Blisto 1 M F 1 - 0 - 0 But because my blood sugar has raised , as per my request , the doctor has stpooed Stiloz tablets and sugar levels have become normal. But since the implantation of Stent , after the administration of Persantin and Prasita , I am unable to walk even a few yards (before that I used 4-5 K M in the morning .Now the Knee pain has increased abnormally making me unable to stand even 10 minutes and also unable to walk by which my regular work is hampered. Hence, Irequest you please suggest me the ways to overcome this ailment and become normal. With kind regards. SESHADRI. K. V. [/INST] Hi,Apply hot pack twice and start knee isometrics exercises (put a towel roll under your knee and press it down with the help of your thigh muscles), hold it for 10 secs and repeat for 10 times. Along with ankle exercises stretching exercises of lower limb specially hamstring muscles will help you. Ensure that you take good calcium and protein rich diet avoid fried items. Hope you will find the answer useful. Let me know if I can assist you further. Regards,Dr. Harsh Swarup </s>

<s>[INST] I am 35 f on celexa for anxiety. did have random chests pain before meds now only once and a great while i get them. NOW, I am suddenly getting random pauses or a skip in my heart beat? 55 beats, pause, 10 beats, pause, 9 beats, pause 35 beats, pause, thats where I stopped counting to come on here and ask why! I am scarred! should I get my meds upped? I have been good on celexa for 11 mons and now all of a suddan this! [/INST] Hello!Welcome and thank you for asking on HCM!I passed carefully through your question and would explain that Celexa can lead to QT prolongation and cardiac arrhythmia as a possible adverse effects. For this reason, I would recommend consulting with your attending physician and performing a resting ECG to investigate for this disorder. Some blood lab tests (complete blood count, blood electrolytes, thyroid hormone levels) are needed to exclude other metabolic causes that may trigger this clinical scenario. An ambulatory 24-48 hours ECG monitoring would help investigate for possible cardiac arrhythmia. If cardiac arrhythmia or prolonged QT interval in ECG is detected, you may need to stop taking Celexa. You should discuss with your doctor on the above issues. Kind regards, Dr. Iliri </s>

<s>[INST] My 3yo son has been diagnosed with an ear infection swimmer s ear . He was prescribed Otocomb otic ear drops to be administered 3 times per day. My issue is that the drops are terribly thick and I cannot get them into his ear properly. I don t think they are actually making it into the ear canal. His ear is so sore I cannot massage it and he wont stay lying on his side long enough for the drops to run down his ear. Should these drops be so thick, and is there an alternative drop which is thinner and more likely to run down into his ear canal? [/INST] If you or your child has an earache that is ofte accompanied by a stuffy or runny nose and a sore throat and fever, it is likely that the ear pain is due to an ear infection. Medicine for Ear Infections To ease the pain of an ear infection, your doctor may recommend a pain reliever, typically acetaminophen or ibuprofen, which also helps reduce a fever. Aspirin should be avoided in children because of the threat of Reye's syndrome. Pain can also be reduced by using gentle heat from a heating pad, but be very careful when using heating pads with children.The drops can be thick. You can use the thinner drops however </s>

<s>[INST] Hello my five year old son was circumcised two days ago. He is still screaming a lot when it s time to urinate. It s not the actual urination that hurts him, he says he can t pee unless he pushes and the pushing is what hurts. He also seems to have great difficulty going even though he has to go pretty bad. Should I be concerned? [/INST] Yes please... This is not routine after 5 days so after circumscission. I suggest you get back to your pediatric surgeon immediately.It might be a stricture which is developing.Regards - Dr. Sumanth </s>

<s>[INST] I have a hard pea sized lump come up on my bum cheeks.. There is no head and I ve tried squeezing gently but nothing is coming out.. It s very uncomfortable to sit down. I ve been having hot bath and put a hot water bottle in it for heat but it seems to be doing nothing. I ve tried tea tree and also anti septic creams but it s still there. What is it and how can I get rid of it. Not sure if it is a boil or not. [/INST] hi. based from your description, it could be a cystic formation, lipoma or a fibroma. it is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. definitive management is surgical excision with proper antibiotic treatment.hope this helps. good day!! ~dr.kaye </s>

<s>[INST] My sister s Blood sugar is 201.I have given her a long lasting dose if insulin 2 hours ago..Is that still too high and what should I do? Also she has issues with high blood pressure and her heart Her vitals are ad follows 101/71 and her heart rate is 67 Is that ok? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. From your description, I can deduct that 201 mg/dl is not a fasting blood sugar result. (because she had a long lasting insulin injection 2 hours ago.) It is not too high, don't worry. This result is not dangerous for your sister. My advice is to increase 2 UI her insulin doses (you can start tomorrow with the increased dose) and to check her fasting and post prandial (2 hours after meals) blood sugar again. If the result do not return to "normal diabetic range", I suggest to consult her treating doctor because your sister may need to change her insulin schedule to control her diabetes. About her vitals, her blood pressure is "a little bit" low, but is can be normal for the females. Anyway, if she take anti hypertensive drugs, I suggest to lower the doses of the medication. Her heart rate is OK. Hope i have answered to all your questions. If you have other doubts,feel free and ask. </s>

<s>[INST] Hi doctor, I recently had an open lymph node biopsy with lymph node extraction. Since the moment I woke up from the general anesthesia, I realize that my trapezius muscle is not functional and my ear is numb. My doctor, who is a qualified ENT specialist, told me that it is unlikely to be an accessory nerve damage and I should just wait for the swelling to go down. My cut is 3 cm long just under my ear.  I am 4 days post op, and my wound is healing nicely, but absolutely no sign of trapezius working. I had an ultrasound of the neck in A and E, and there is no hematoma or fluid present in the wound. I was prescribed to have Neiromidin by the Emergency Room doctor. I have attached my photo for your reference. [/INST] Hello. NCV for bilateral accessory nerves. For further information consult a neurologist online.---> </s>

<s>[INST] Hello doctor, I am 17 years old. I had sex with my partner on the 24th day of the menustruation cycle. I used Today vaginal pill before intercourse. On the next day i.e. 25th day, within 30 hours, I also took i-pill to be sure not to be pregnant. Now my period which was on due is still missing. What are the chances of my pregnancy? What should I do to terminate it, if I am pregnant? Kindly help me out. [/INST] Hello. I have reviewed your query thoroughly. I-pill or emergency contraceptive pills have very minimal chance of failure if taken immediately after intercourse within 24 hours and chances of failure gradually increase after that even if taken within 72 hours. There is about one to two percent chance of failure of an emergency pill or i-pill in your case. But we can be quite sure of its success if withdrawal bleeding occurred within four to five days after taking the pill, confirming the shedding of layer of the endometrium. Based on the dates given by you, today must be 8 days following the date of the intercourse. In that case, to find out if you are pregnant, you can get a serum beta hCG (human chorionic gonadotrophin) testing done. For the urine pregnancy tests to show the result if pregnant, it must be at least 10 to 14 days following intercourse. If you want to know urgently whether you are pregnant, you can get serum beta hCG testing. If you can wait another week, you can get a urine pregnancy testing, which if positive must be followed up by ultrasound imaging. Only after then and after consulting an obstetrician, should the abortion be planned under guidance. Furthermore, if you are sexually active regularly, it is better to choose other regular contraceptive methods after consulting an obstetrician and gynecologist instead of i-pill. I-pills are meant to be taken only in case of unexpected accidental unprotected sex, but not on a regular basis. </s>

<s>[INST] Recommended medications for alopecia. Are they effective? Do they have any side effect? 0 answers, 5 views Posted in: Hair Loss Edited 3 minutes ago Intense pain after routine colonoscopy, CT shows Mesentary Panniculitis. Is surgery necessary to improve ? [/INST] Hello, Yes, partially. There is currently no cure for alopecia areata, although there are some forms of treatment that can be suggested by doctors to help hair re-grow more quickly. Other medications that can be prescribed that either promote hair growth or affect the immune system include Minoxidil, Anthralin, SADBE, and DPCP. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician </s>

<s>[INST] My mom is having an aneurysm clipping surgery in two weeks, i wanted to know the likelyhood that she could pass away during surgery she is 48 95lbs and 5 7 she has COPD, coronary artery disease, heart disease, a 30% blockage in one of her arteries, tachycardia issues, very low blood pressure, and multiple other vascular and cariac related problems. she is also on a pretty large amount of medications, some of which she will have to stop taking for the surgery i would again, like to know how likely it is that she will make it out of surgery and survive? thank you so much [/INST] dear patient your mother is suffering from heart disease and aortic aneurysm.since the successful surgery depends on multiple factor so we I can not predict without other details.. there are some score which are required to calculate. but as far as studies conducted in various part of world, 10 year survival is 60 %..and mortality risk during surgery is 8-10 % </s>

<s>[INST] Hello doctor, I have a blue or grey or purplish raisin sized lump next to my anus for three to four days now. I believe it is hemorrhoid but as I have never had one before and I am not sure. It almost looks as if a small blood clot is inside due to the blueish hue. It is not painful (maybe slightly uncomfortable at worst), it is not itchy, and it does not bleed. I never had rectal bleeding or any blood in my stool, and I have no abdominal pain or discomfort. Several days ago I did strain slightly while passing a massive bowel movement and it was after this BM I noticed a bit of soreness around my anus and then felt and discovered this lump. I have no other symptoms or issues other than this small lump. I am a 31-year-old healthy female with no medical history, I take no medications other than an over the counter multivitamin, and I have no known allergies. Is there a way for me to send a photo for reference? [/INST] Hello. I saw the image (attachment removed to protect patient identity). It looks more like external hemorrhoid with a blood clot within. Is it increasing in size? How are your bowel habits, frequency, and stool consistency? Please revert with details so that I can give a specific opinion. </s>

<s>[INST] I have an 11 year old son. He has been sick since April. He had a Hgb of 7 and total iron 12, Ferritin 2. Checked by gastroenterology and no sign of bleeding. Hematologist diagnosed iron deficiency anemia. Takes 170 mg elemental iron daily. Within 2 weeks, iron levels normal. His last blood work came back and the MCV, MCH, MCHC remain LOW. No change. This time his RBC are too high and his eosinophil count continues to rise to 730. He still has toxic granulation. His reticulate count is .8 and his platelets are down in the normal range now. His WBC went from 4 to 6.4. What is happening and what does this mean. I don t think that iron deficiency anemia is the cause of the small red cells. His Hgb is now 12 which is good. What does this mean and what should we be doing or looking for to get him back to normal? [/INST] Hi Iron deficiency is no one cause of small RBCs .If Pheripheral blood film of you baby is normal , his hemoglobin is increasing with iron , his examination is normal , it will take 2-3 months of iron therphy for RBCs to be normal.thanks </s>

<s>[INST] Hello doctor, I am a 25-year-old female. I have been experiencing worsening symptoms over the past three months. I was thinking pregnancy but that was tested negative with a gynecologist and PC, two blood labs for HCG and one CBC, as well as a thyroid and hormone test. My symptoms are: frequent headaches and shock-like pain below the right temple, migraines that last for days, dizziness even when resting in bed, weight gain, fatigue and sleep for 14 hours straight, change in taste i.e. toothpaste taste like hairspray and Kombucha tastes like hairspray, smelling burning plastic and no one else can smell it, losing balance when trying to do yoga and work, seeing shiny flex of light, pain in back, stiffness in shoulders and neck, numbness in the foot for a week, tingling in arms and fingers, painful electric shocks in the leg, mood changes crying and laughing for no reason. Menstrual changes show shorter cycles and never before pregnant but nipples have left yellow streaks in the bra, fumbling with tools at work. My current medications are Effexor 37.5 mg, Smarty Pants multivitamin, Vitamin B complex. I also consume daily probiotics. [/INST] Hi. Your symptoms apart from migraines are due to nerve involvement causing parosmia (altered taste sensation) most probably due to Vitamin B12 deficiency. Methylcobalamine (or vitamin B12) supplement 1500 mcg per day for a few weeks is usually advised and you are already taking it. For migraines you can try, Aspirin, Ibuprofen 400 mg to 800 mg every six to eight hours, Naproxen initially 500 mg then 250 mg every six hours, Ketoprofen 25 to 50 mg every six to eight hours. One of these can be tried, should be available over the counter. If one of these is not effective then you may need one of the prescription medications mentioned below specific for migraines e.g. Sumatriptan, Zolmitriptan, Eletriptan, Naratriptan. </s>

<s>[INST] Hello, I am having issues with my right foot . I am a 33 year old male and this problem has existed for several years now but has progressively gotten worse over the past 2 years. it seems to be mostly in the area between the big toe and where the big toe connects to the rest of the foot on the bottom side of my foot. as i spend more time on it throughout the day it spreads slowly back into the main muscle of my arch. it is a painful but more so it feels kind of Nerve-ish kinda like when you hit your funny bone. later in the day it feels like its swollen but doesn t look like it. when i wake up in the morning it feels fine and slowly gets worse by the end of the day, no matter how much or little i m on it. I went to see a foot doctor here is what he said... there is a round tendon that connects the toes to the foot that help to spring up as we walk and mine on my big toe is two little circles meaning either i was born that way or I injured it at some point but should be memorable because it would be extremely painful that very moment if so. he taped it up to release tension and said keep it that way for two days, gave me a prescription and seemed to believe I would be all better afterwards, although he did not suggest i stay off it, i did manage to completely stay off it for two whole days, but still no results. sorry to be so long but does this sound like anything you have dealt with before? I really hope it is fixable. hank you for your time, and i look forward to hearing back soon [/INST] HiThank you for your question.From the symptoms you have described the pain is coming from imflammation of first metatarsophalangeal joint. Such a localized pain associated with swelling is unlikely to be nerve related pain. It may be related to intrinsic structure of foot causing metatarsalgia or remote trauma. You will also need blood tests for level of inflammatory markers in the blood.Please let me know if you have any questions. </s>

<s>[INST] Dear sir My mother aged around 45 has mental illness since my birth.I dont know the way to cure.Is it possible to cure?.She is talking about old hapennings,about some personalities like that talking self.Please tell some advice.i m in india,chennai.Awaiting your kind reply. Thanks&Regards A.Saravana vel [/INST] Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are concerned about your mother's psychological problems. From the limited information that you have provided, it is not possible to make a diagnosis at this time.A detailed evaluation and psychological assessment is necessary to arrive at a definitive diagnosis and to start treatment. Effective treatment is available in the form of medication and psychological therapy. So, I would advise you take her to a psychiatrist for a detailed evaluation and further help. Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist </s>

<s>[INST] Hello, my 11 year old son has moderate pectus excavatum on the left side. Lately he has been complaining about hearing his own heart beat "I can hear my heartbeat in my ears and it bugs me." When I checked his resting pulse it was at 126 BPM. I can see his heart pumping through his chest. He weighs 68lbs. Should I take him to a cardiologist? His pediatrician said she would be monitoring him every year. His last physical examination was in March. Is it possible that his condition has worsened? [/INST] Yes, take him to a doctor to be examined. A resting pulse of 126 is too fast, especially if he is feeling an annoying sensation of his heartbeat. There are many medical problems that can cause speeding of the heartbeat, some of which are caused by a cardiac arrhythmia and some which are caused by other medical problems (anemia, dehydration, hormone problems, infections, etc.). Take him to the doctor for a complete history, physical exam, and routine blood work and EKG. That will find the underlying cause of your son's problem.Good luck, and let us know what happens. </s>

<s>[INST] I had a radical nephrectomy due to cancer in September of 2016. Chemo and radiation not needed. Since that time, I have developed a prolapse. I have also had 4 UTIs since September. Are these connected in any way? If so, what can I do and what kind of specialist would I need to see? [/INST] Hi, I am sorry for the health problems you are going through. You report to have had a radical nephrectomy due to cancer in September 2016. Here I need to stop and ask a few details regarding the primary cancer: was it found in the kidneys? or in the nearby organs? If you have any test report or any other report regarding the intervention, I kindly ask to send to me to analyze the findings myself. If a radical nephrectomy has been carried out, it means that one kidney is completely removed; while there is the other kidney left. The one left is overloaded, and it is common to have UTIs after the intervention. So, you need to get close and frequent consultation with:- nephrologist- urologist- oncologistHope this helps. All the best and God bless! </s>

<s>[INST] I have frequent urinary tract infections. A few years ago I was taken to the emergency room with a temp of 106.7 after passing out in the kitchen. I was septic. I am diabetic, drink lots of water and other fluids. What can you suggest for me as a home remedy? [/INST] Hi ThereAfter going through your query I understand your concern.I would like to tell you that Urinary tract infections are more common, more severe, and carry worse outcomes in patients with diabetes & oftenly caused by resistant pathogens. Poor immune system, poor metabolic control, and incomplete bladder emptying, fungal infection may all contribute to the enhanced risk of urinary tract infections.The treatment for your UTI will depend on what type of infection it is. But You can prevent UTI by practicing good Hygiene techniques like- Wiping front to back is essential- Go to the bathroom and empty your bladder immediately after sexual intercourse.- Every time you empty your bladder, try to make sure it is fully empty.- Keep your diabetes under the best possible control.Hope to have been Helpful. Kind RegardsDr. Navneet Bansal </s>

<s>[INST] Hi, My father is a kidney patient and had undergone renal transplant 2 years ago. There was some virus of Hepatitis C found. From the last one and a half month he was suffering from Jaundice and he is admitted in hospital 10 days ago. Due to infection of Hepatitis C, his Creatinine rose to 7.2 and urea rose to 290. Doctors took him for dialysis and after 2 hours of dialysis he had brain hammerage. Now from the last 2 days he s on ventilation and his situation is very critical. His heartbeat, BP, and pulse are running normal and we have seen minor reactions from his side also. Please tell me is there any chances of life for him and can his life be as normal as before? [/INST] hi, I'm so sorry you're dealing with so many health issues of your father . I wish I could give you the straight answer you so desperately need; He has multiorgan dysfunction . Please talk to your physician who will be in a better position to answer. take care. </s>

<s>[INST] My 3 week old has green stools and won't sleep for more than 30 minutes at a time. And, she's been spitting up more often. This started Tuesday night. I haven't eaten anything out of the ordinary, and I make sure that when I nurse her, she completely finishes before I switch her to the other side. [/INST] Green stools are extremely normal in children of this age. It is not a cause of concern. It occurs due to rapid transit of the fecal matter through the large intestines and so the bile pigments do not get the time to get converted to the yellow pigment of stool. You need not worry. Just continue breast feeding as usual.Sleeping habits of babies may vary and you need not worry about that too. </s>

<s>[INST] My left arm often goes numb while sitting and watching tv as well as sometimes when I am sleeping. I can understand while sitting watching tv since I am often leaning or propped on my left side but do you have any suggestions on why this would happen? [/INST] hi,the site where it goes numb is important, as you would be aware these symptoms are due to pressure on nerves, and sometimes, even if the pressure is less, the threshold of working is reduced due to diabetes, or vitamin deficency. If i would have been consulting you then, I would advice you to get blood investigations to ascertain the level of vitamins in blood, check sugar level, and see if you are developing neuropthy. </s>

<s>[INST] I have started taking 2mg Coversyl and low dose asprin daily. Since then I have not had a firm erection. Is the medicine responsible? I'm 63 years old and over weight (40% body fat) but that has never effected me before. This problem is current with the start of the medication. [/INST] Helloyes, Coversyl can cause ED. I suggest you to start physical exercise and eat healthy food with adequate proteins . It should be helped in 4-6 weeks or ask your doctor to change the medicine.DR SAATIISH JHUNTRRAA </s>

<s>[INST] Hello ive been on implanon for 3 years and 3 months. While on implanon my periods stopped completely and now that my implanon is expired i still havent had a period.. my question to you is, should i be worried about not having a period yet and is it possible for me to concieve with an expired implanon still in my arm? [/INST] Hello, you don't need to worry for your periods. It will come back within 4-6 months after the body has adjusted its hormone levels. Implanon is a hormone based contraceptive which is effective only for 3years. You can get pregnant with expired implanon as the hormone it was releasing is finished and your status is you are using no contraceptive at present so there are chances of conceiving without periods similar to conceiving in lactational amenorhoea. Therefore if you do not desire to get pregnant then remove the expired one and get a new implanon inserted or use ocp or injections as per your choice. </s>

<s>[INST] Hello, I am a 22 year old, male. I have a very sensitive skin, even after using sunscreens, it is tanned. Suggest me any skin whitening pills. [/INST] Hi, Thanks for writing to us. As such there are no skin whitening pills. Glutathione pills are marketed as skin whitening pill, but its use is not recommended by doctors. It is essential to know how you use your sunscreen. Sunscreens with SPF 30 are good for regular use. Sunscreen should be applied at least half an hour prior to stepping out and should be repeated for every three hours. Sunscreen use is advised in between 10 am to 4 pm. (Know all about sunprotection and sunscreens) Also use a Kojic acid and Glycolic acid based cream daily like Kojivit plus gel or Rejuglow gel once in a day. And use Vitamin C Serum at night. Take a diet rich in fruits and nuts. You may also apply tomato pulp, turmeric mixed in yogurt to improve skin tone apart from the creams suggested above. Also you may take few sessions of chemical peels. Consult a dermatologist online for further help --> </s>

<s>[INST] Hello docs n experts, Since yesterday I m ejaculating red semen. I noticed it yesterday while masturbating, even today I seen same thing when I was trying to confirm was it a normal one day case or a serious issue. Now I think it is a serious problem for me. Please help me. [/INST] HelloThanks for your query,based on the facts that you have posted it appears that you have ejaculated red coloured semen (Haematospermia) after masturbation ..This could be either due to 1)Rough handling of your penis with firm grip of the hand resulting into injury to urethra while masturbating or 2) Infection of the seminal vesicle .Please consult qualified Urologist for clinical evaluation and get following tests done to confirm the diagnosis,1) Semen examination and culture .2) Trans Rectal Ultrasound scanning (TRUS).Further treatment will depend upon final diagnosis.Dr.Patil. </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... Hi, my 14 month old son has had a small raised blister like dot the size of a pin head on his forehead for the last 2 months. He bumped it the other day and it bled everywhere and now its even more pronounced like a bigger blister. Is it a broken capillary and will it go away as it looks awful on his pale skin? [/INST] what you has described is seems to be a hemangioma, a vascular growth, red colour, smaller didn't require treatment, larger needs, not much to very. </s>

<s>[INST] Hello, I am 23 years old female and I ve been having dull pain in my lower right side of stomache and back. I have a small lump diagnal from belly button and it hurts when pressed on. my youngest son stepped on me the other day and I just wanted to go through the roof. I have loss of appetite and also lost some weight. I had a low grade fever the other night I wasn t doing anything active I was sitting on chair and just felt like I was getting really hot all sudden. AC and fan was even on and usually I am always cold. I took temp and it was 100.0 Used cold rag and it went back down to normal. I am scheduled for ultrasound to be done tomorrow. also had went to ER they thought it is just a strain on right groind. I had urine test done twice and came back no infections. Also just had bloodwork done today. I just found out today from my doctors office that in my ultra sound that I have a large amount of fluid on my I think she said Pelvix area and Shows I have a Ovarian Cyst that ruptured. I ask her what I should do about it they said take warm soaks and take over counter meds for pain. Is that really it? [/INST] Welcome to Healthcare Magic You have not mentioned you bowel habits. You could be suffering from TB of the intestine or a possible malignancy, but nothing can be said unless you get a full workup. TB is known to cause weight loss, night sweats. Do get worked up for this. You need to eat a diet rich in proteins like pulses, cereals, eggs, chicken, lean meat, soyabean. Eat plenty of fresh fruits and vegetables. Drink plenty of water as well for proper bowel motion. </s>

<s>[INST] hello, pt has bleeding on the brain can t drill to relieve pressure they say. like in a coma state but he has tears in his eyes running down his face when talk to him but doesn t move , feels his hand squeese your finger once in a while not a strong grip. nurses says its not a anurisom not a heart attack tests show. what could it possible be? i am 5 hours from the pt to go see him. i work in a medical field and i am checking things out on the computer. pt is on a breathing machine at this time also. [/INST] Hi, I am Dr.Bruno. I have read your question with care and understand your concerns. Let me try to help you Question : What causes bleeding in the brain?Bleeding in Brain occurs more commonly due to 1. Injury to Head 2. Problem in Blood Vessels. This can be congenital problems like Arterio Venous Malformations or acquired problems like Atherosclerosis.3. High Blood PressureSome times it can be a combination of various factorsHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care. </s>

<s>[INST] Hi Dr. please let me know that i was positive for HSV IGM and reactive for IGG 3 months back and after Ayurvedic Medicine now i got IGM negative and still IGG is reactive still I m taking the same medicine until the virus leaves my body, my problem is IGG is reactive means that it is positive? [/INST] Hello,if you test positive for HSV IgG and not IgM, it means that your Herpes infection is not recent-i.e. from the past 2 months.Individuals with recent infection are more likely to test positive for both or IgM alone, which in your case was 3 months ago. Since you got treated with Ayurvedic medicine, thats why your blood test now shows IgM negative-which means you are not currently infected and IgG positive which means you had prior exposure to it more than 2 months ago. </s>

<s>[INST] My son fell on his elbow and another child fell on top of his arm. It happened just yesterday so it s still swollen and squishy around his elbow? He complains it hurts when he stretches his elbow? Any suggestions on if I should take him to see a doctor. [/INST] Hello, Usually, kids have growing bones and are quite flexible. This types of pain go away with simple hot water fermentation and crepe bandage. But to be on a safer side an x-ray is advised as bones are still into the growing stages and the bone end plates are prone to have inflammation, and that is the reason your son is complaining about pain at the elbow anterior aspect. Taking x-ray will be of choice. Post which support of elbow brace and hot water fermentation is advised. Slow and low-intensity range of motion exercises along with careful Strengthening will help improve the symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] Hi. I was walking down the stairs and I slipped and my ankle twisted and I landed on it. It hurts badly to walk and twist it. I just had a platelet shot in it because my ligaments are messed up and I have arthritis and tendonitis. Please help. Should I see a doctor? [/INST] Hi there thanks for your question. If you have any pain when you stand or walk on your injured ankle, it suggests severity of injury and warrants further work up whcih wil include a X ray at the least. Ice and rest usually give relief in pain and swelling over the first two days. But you are not expected to have pain on standing or walking in mild injuries.Such pain should suggest you to take your injury seriously to avoid long term ligament related pains. Hope this helps All the best. Regards. Dr.SBK </s>

<s>[INST] I was told I had a hernia because my naval kept bleeding where I had to place a pad on it.. I just had Gall Bladder surgery and the doctor when through my naval instead of another spot. I was told that I will bleed every month when I get my menstruation and there is nothing that can be done. I have pain and a very foul odor coming from my naval. Please tell me what I can do. [/INST] hi.it is best if you have it checked by a general surgeon for clinical evaluation. was it laparoscopic cholecystectomy that was done to you? there are incidents wherein post-surgery, this things happen in the previous naval port area of the patient. also, doctor's evaluation is needed to rule-out urachal cyst problems which might be causing the foul smelling discharge and infection. diagnostics and management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye </s>

<s>[INST] I have recently had a general blood test, as I was suffering from Hair loss, night swats and sore glands. The blood test came back Norman however my white blood cell count was low. Considering this was the only abnormality, should I have further investigations? My doctor suggested another CBC in 1 month. I am a 20 year only female, generally otherwise healthy, had glandular fever earlier this year. [/INST] Hi, dear. I have gone through your question. I can understand your concern. You have mild decreased wbc count. It is not a big worry. Simple viral infection can leads to this. So don't worry about ypur wbc count. Just repeat it once after a month. Not a cause of big worry. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] I have thick clear mucus the back of my throat. Ichoke when I eat and have to go spit it out. This is very bothersome. I don t go out to eat anymore because Im afraid I will choke in front of everyone. I do have many allergies but never had this problem. What can I do. [/INST] Thanks for your question on Health Care Magic. I can understand your concern. Choking in patients with allergy is mostly due to angioedema. It is sudden spasm of muscles of wind pipe and food pipe. Most common cause for angioedema is uncontrolled allergies. So in my opinion, you should consult allergy specialist and get done allergy testing. Best treatment of allergy is identification of allergen and if possible complete avoidance of it. So to know the allergens, allergy testing is must. You also need anti allergic drugs like montelukast.So consult allergist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] i am 52 year old woman i had heart problem 41/2 years ago i take lasix 40, cardizem cd 120, digoxin, synthroid, potassum once a day and toprol 2 times a day, my doctor reduced my lasix to 20, he said he that i should not be taking some of these medications anymore and slowly reducing, i thought once you are on these you cant come off, and will create a problem. i am very nervous in doing this. are there a lot of side effects to this. [/INST] All cardiac medicines have side effects and should neither be started/discontinued nor their dosage be altered without your doctor's advice. </s>

<s>[INST] i have a painless lump just below my left knee cap. I didn't notice it until i kneeled down and thought I knelt on a frog and move my knee to a different point on the floor just to find the same sensation I finally felt my knee cap and just below it there is another jello type knee cap. what is it? [/INST] Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This seems in relation with soft tissue lump may be sebaceous cyst or lipoma .* Strongly recommended to consult with a high resolution clinical photograph for better insight .Hope this clears your query .Welcome for further assistance .Regards . </s>

<s>[INST] My mother-in-law has terminal cancer and currently under the care of Hospice. Mornings seem good when she has energy but later in the day, she will "doze" during a conversation and become confused. She does not sleep long at night. It appears she has "black eyes." What does the black eyes mean and why can she just "doze" at not remember? [/INST] Black eyes can be due to head trauma caused by fall which is the common cause in hospice care.CT scan can be done to rule out it.Forgetfulness is quite common in elderly patients but ned to check out the medicine list which can be cause of diimentia. </s>

<s>[INST] I am suffering from backace due to disc difuse bulge in L4-L5, L5-SI . The Doctor has advised me Cartigen/Duo, Calcium Tab and Ubi Car Tablet once each in a day. Since I am also suffering from Ulcer , only Ultracet tab was recommended for severe pain. Pl advise. Preveen Raheja [/INST] Hi, Welcome to healthcare magic.your doctor has prescribed correct treatment.You can add vitD3 if your level of vitD3 is low (by blood test).I think your query got answered </s>

<s>[INST] my toddler had a fever for 2 days the day after he woke up with a red spots on his back and chest, it has also spreaded to his neck and behind his ears. his lymph nodes are swollen in the back of his neck. Also I have noticed he has a pink ring around his eye. [/INST] Hi, by what you quote it seems that your child has probably got allergic reaction or insect bite. Allergic reaction could be due to anything like dust, hay while insect bite will have red centre with a dot that resembles sting. I think you should give hydroxizine syrup PO 5 ml three times a day for 3 days. Take care. </s>

<s>[INST] l am a 51yrs old sudanese schoolteacher 5 ft six inches of height 55kgs weight diagnoesd in Kuwait chest hospital in 1989 as a vsd sevesre pulmonary hypertension and not indicated for surgery i got married in 1998 with three duaghters 12_10_8 .l know my case very well and l ve heart disease history a younger brother had died of heart failure and four youger brothers died in their baby hood they were likely have the same disease .my parents are close relatives and they still alive with reasnable health according to thier age.l was hospitalised in1986and 2006 for haemoptasis. I have been suffering recently from feet swelling and neck and shoulders stiffness specially when l carry any something over ten kilos of weight accompanied with a high fever and l feel the area very hot a two days ago echo showed that the case is normal a chest xray showed in the day that heart is not enlarged but not in good health other lab results 2days ago esr 8 mm/h.hb119.5percent uricacid 6.0 my question is what are the exepected symptoms and comlications in this case and how to deal with them.email: YYYY@YYYY cell 0000 [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You are having pulmonary hypertension (PH) due to valvular heart disease (VSD). Surgical correction is the best treatment at the time of diagnosis. I am still surprised why surgery was not advised in 1986. Anyways, future complications for PH with VSD are 1. Right sided heart failure 2. Congestive heart failure 3. Arrhythmia 4. Uncontrolled hemoptysis. So to prevent all these, you should definitely get done 2D echo regularly. Avoid excess salt and water in diet. Start Tadalafil or Bosentan for PH. Do chest physiotherapy and deep breathing exercises. Start low dose diuretics. Hope I have solved your query. I will be happy to help you further. Wish you good health! Thanks. </s>

<s>[INST] I have for over a month been having upper adominal pain. I went to the ER about 2-3 weeks ago. They did a ultrasound of my upper abdomin and said my stomach was inflamed. Said it was a ulcer . They pain went away for about a week then came back. Now i am breaking out in sweats feeling hot and cold chills. When i feel hot my husband says i feel cold. I am a 32 yr old female i have not had a ulcer since i was 15-16 years old. [/INST] Hi welcome to Health care magic forum. Thanks for calling H.C.M.F. You had abdominal pain, and cured after treatment.After a week, the pain again recurred, with chills and sweating. It appears to be due to some infection in the G.I.tract, like typhoid, Or infective hepatitis. It may take some time for it to be exhibit. I advise you to consult a physician for diagnosis and treatment. You may need to have gastroscopy besides other routine tests for confirmation. Wishing for a quick recovery. Best regards. </s>

<s>[INST] Hi I am 29 year old i had a operation in my head named as suprasellar craniopharyngioma a cyst in two place of the head part , where operation done and only the liquid in the cyst is struckked but they didnt removed the cyst bag etc... this operation done on jan 2013 still now no issues, but some time head pain occur due to system work etc.. my doubt is they didnt removed the cyst so it may occur in future again and i would like to know whether shall i take cod liver oil tablets for my health and few more advice what food items shall i take. Thanks in Advance regards Anitha [/INST] Hi Anitha and thanks for the query.I am so sorry to hear about this cyst and the operation you underwent. i am however comforted that you have been feeling a lot better since the procedure except for minor headaches. This is normal and eve without head surgery, we all get headaches now and then.When a cyst is opened, it can be totally removed, if possible or not removed. When it cannot be removed, it is sufficiently destroyed so as to prevent future recollections. I am pretty convinced that this is what you was done in your case.Though the chances are real that it can recur but these are very small. I am confident you had the best possible procedure given the surrounding circumstances.There is no need in changing your diet or eating any specialised products. You may at will but not that they have any impact on the disease condition that you had. The decision is entirely yours to make.I hope that you find this helpful. I wish you well. Feel free to ask for more information if need be.Thanks.Dr. Ditah, MD </s>

<s>[INST] Dear respected senior Doctr, one of my patient got internal pain on the right side of the chest. Even there is no any reason of fracture ? Sign and Symptom of the patient. *lost of apetide *headaches. *billy pain *breathing problem. Pliz do a helpline for me [/INST] Thanks for your question on HCM.In my opinion you should get done chest x ray first. As all the symptoms you are mentioning are favours lung infection.So chest x ray is needed to diagnose pneumonia.If this is normal than get done PFT (Pulmonary Function Test) to rule out bronchitis.So better to consult pulmonoligist and get done chest x ray and PFT to rule out pneumonia and bronchitis. </s>

<s>[INST] I have had the feeling of a lump in my throat for six months. It is relieved when I eat and sleep but comes right back. I also feel a tightness in my chest and feel that I have to burp a lot. My endoscopy came back normal with a little gastritis. Could I have a hernia that was missed? [/INST] Hello!Thank you for the query.Hiatal hernia is usually clearly visible during gastroscopy. So it is rather not the case. What seems the most probable reason of your symptoms is GERD (gastroesophageal reflux disease). It is caused by stomach acid regurgitation to the esophagus. It may cause a chest tightness and lump in the throat as well.GERD should be treated with medicines called PPIs (proton pump inhibitors) like Omeprasole.You should also improve your diet: avoid fatty foods, spicy foods, chocolate, coffee, alcohol, orange juices.If diet and medicines want be helpful, you should consider surgery called fundoplication.Hope this will help.Regards. </s>

<s>[INST] Hello Doctor, I am 27 Year old woman, I am planing for baby since last two years and did not get any success, I got two abortion in this period. The Cyst was only 5 to 6 weeks old. The date was Jan 2010 to Apr 2010. After that there is no pregnancy achived. Please help what should I do. Do me or my husband any medical prescription pla advice? [/INST] Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.you are young and healthy there is no reason wjy u shuldnt be able to cncieve just make sure you get al the tests done like ultra sound hormone levels every thing than doc wil be able to figure out whts the prob do it like fr ur self and also do ur husbands semen analyisis that wil help mean while stay happy and calm eat healthy and you wil be fineI hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan </s>

<s>[INST] Hi, I am 21 year old female.I was diagnosed with intestinal Tb in july 2012. I had symptoms of extreme pain in abdomen sometimes which grew more both in intensity and in frequency, specially after the meals. More intense pain also resulted in vomiting many a times. I started avoiding food as it caused pain. I was already underweight (39 kgs), and then my weight loss became more severe. Also i had coughing problem from many months but it is prominent only in morning time. Doctors said it is allergic cough and has nothing to do with the problem of TB.They even saw the reports of my digital xray and said i have no infection in lungs. The CT Scan reports revealed that i was having some obstruction in the ilio cecal junction. I was given a treatment of intestinal TB for 9 months. My treatment ended in March 2013. After that the pain went away. I also regained my appetite. But still i face the problem of coughing in morning and also i have a problem in digesting vegetables with seeds like brinjal,lady finger etc. What are the possible reasons for this? Also what are the precautions i should take that this disease does not occur again. [/INST] Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.If you have taken full course of Anti tubercular drug, and you have been declared as cured then you don't have to do any particular thing to prevent the recurrence of Tuberculosis.Since you are having cough now, just get :1. Xray Chest2. Sputum for AFB3. ESR.This is my best opinion for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney, MD </s>

<s>[INST] Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? [/INST] Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] my 22 mth old daughter has couple red spots on legs, few in genital area and now approx 10 down side her body, under her arm and down towards her tummy - all look the same, red, yellow small blister in middle and all surrounded by circular bluish bruise like thing-what could they be? [/INST] Hi....skin lesions are best diagnosed and treated after direct visualisation. Please upload images on this forum and get back to us.Regards - Dr. Sumanth </s>

<s>[INST] my left side of my chest hurts a lot. along with my stomach and all of my joints. when I stand I get super dizzy and see black spots crowding my vision. I have also experienced a sudden weight loss of twelve pounds within the span of 2 months.Do you have any ideas what can be causing this? [/INST] Thanks for your question on Health care magic. I can understand your concern. By your history and description, we should rule out cardiac and pulmonary causes for your symptoms. So better to first get done ecg and 2d echo to rule out Cardiovascular causes. Also get done chest x ray to rule out pulmonary causes. If all of the above investigations are normal then you are mostly having stress and anxiety related symptoms. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Wish you good health. Thanks. </s>

<s>[INST] Hi, I am ashwin from bangalore im 25yr old and working in BPO night shift. 2yrs back i was in deep love with a girl & broked up when i was in love i couldn't concentrate on anything her face was in my mind.And my long term goal has been delayed so due to all these once in a month or twice in a week I FEEL LOW MOOD & DULL feeling rejected/no interest on anything/feeling lonely but after that next day i will be full sportive cool guy as iam always. Please help me out of this how to stop this, this is spoiling my career life cannot achive my long term goal which requires lot & lot's of focus & concentrate...PLEASE HELP ME. [/INST] Hi dear . I had gone through your query . I understand your concern .low mood / longiness / loss of interest in activities etc may indicate depression .If it persist through out day since 2 week then diagnosis is confirmed depression acc. To DSM IV.You need proper psychological evaluation and treatment .Depression can be treated with medicine / psychotherapy /behaviour therapy / ECT choices depend upon clinical presentation.Medicines like amitriptiline / SSRI and benzodiazapine will help to reduce mood swings.In SSRI sertraline / escitalopram / peroxetine will help .Exercise and meditation can help .Ensure proper sleep and diet .I hope I have answered your concern .Feel free to ask .Thank you . </s>

<s>[INST] Hello, Today I received results from a d dimer test that came out at .58 (.4 being normal). What are the chances of it being a blood clot or worse? I read that this may be an indicator for something severe like cancer? Can the levels of d dimer indicate the likelihood of it being something severe? What are the chances of it being a fluke in the blood test? [/INST] Hello and thank you for sending your question.We use the d-dimer Test as a guide if we have clinical suspicion for a possible blood clot. In your case there must have been some reason which caused your doctor to order this blood test. I imagine your doctor has considered other testing for blood clots such as ultrasound of the legs or possibly a CT scan of the chest. It is extremely difficult to predict the probability of a blood clot with a mildly elevated test results which you have reported. What needs to be done is clinical correlation which means your doctor needs to consider the test results and the possibility of additional testing to rule out possible blood clots.This blood test has no validity in diagnosis of cancer so this result cannot be correlated to any cancer diagnosis.i would encourage you to discuss this test result with your doctor and review your current symptoms to see if your doctor thinks additional diagnostic testing is needed.Thanks again for sending your question.Dr. Galamaga </s>

<s>[INST] ecg showed 1st degree blocked,,,can do angriogram for this patient?age 54 yrs old,,,weight 90 kg,,,,,case hypertesion on treatment 6 years,,,,,,patient in metapolol 100mg bd and adalat 10mg tds. nearly 1 years having pitting edeoma on both legs,,,last week did echo showed some blocked,,,,doctor started with t. fresumide 10mg od,,,t.slow k 600mg od,,,t. aspirin 75mg od,,,t.peridopril 2md od and cont t. metoprolol 100mg bd,,,doctor stopped t.adalat. [/INST] Hi,First degree AV block is not dangerous. It is neither a contraindication nor an indication for angiography. Everything depends on patient complaints and underlying heart disease. From the medication you mentioned I could conclude that the patient has an underlying heart disease, which is more important that the block. So the further decision depends on that disease and not the block, which is not dangerous.Take careCome back if you have any further questions </s>

<s>[INST] I am 42 yrs old. I had occasional light pain in left renal region and on USG, hydronephrosis was found in left kidney. After CT scan, it was found malrotated left kidney. Doctors suggested DTPA scan and in DTPA scan left kidney is 15% and Rt Kidney is 85% functional. Now doctor suggests, nephrectomy but also said its not urgency. I want to know its prognosis and further course of action. If I do not go for nephrectomy, then what will happen? [/INST] HIThank for asking to HCMI really appreciate your concern, looking to the history given here it all depends upon the severity of clinical complaint I could say that this is not that much need to worry because what the finding suggested is not such disease of anomaly that could put the life in danger, better go for second opinion, hope this information helps you, have a nice day. </s>

<s>[INST] My aunt is taking a large number of prescription medicines, I don t think they are helping her. Clonidine 0.2 mg 2x/day. Escitalopram 10 mg 1x/day; Risperidone 0.5 mg, am, 1mg, pm.; Levothyroxine 112 mg 1x/day; Donepezil 10 mg. 1x/day. She is tired, racing mind, worries, depressed and does not seem to be improving. [/INST] histop risperidone and clonidine fatigue might be a side effect of these medicinesalso increase escitalopram to 15mg or 20mg for a better mood and worries.monitor her blood pressure almost daily for other health issues.thank u </s>

<s>[INST] Hi, my daughter 3.5 yrs has fallen into some steps knocking her front top right tooth. We have had X-rays and the outcome was a fracture. It is now 3 days on and the tooth Itself has dropped 5mm and the gums are red and inflamed. It is starting to effect her speach and chewing capabilities. As it is the weekend we can not see a dentist hence being here. Any advice greatly appreciated. [/INST] Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain due to trauma the the tooth has got PARTIAL AVULSION from the socket and due to it it has hanging in mouth leading to difficulty in chewing and speaking and even there can be pain,along with it there is a possibility that the tooth will completely get avulsed from the socket and there will be loss of tooth..You need an immediate dental assistance and should consult an emergency room and there you may get a dentist available or can guide you to reach a dentist as soon as possible..In case if the tooth falls you should store it in either milk or mild salt solution or saliva so that when you see the dentist he can replace it in the socket and splint it to save the tooth..In case if the tooth is partially avulsed the dentist can gently place the tooth back in position in the socket using aseptic precautions and splint it using orthodontic wires along with initiating root canal treatment of the tooth and gradually the tooth will take its place in the socket and starts healing..But you cannot wait for long and you need to take her to a dentist immediately..As of now you can give her tylenol or Ibuprofen in case of pain..Hope this information helps..If you find the answer helpful please give me a Five Star Review and click on found the answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.. </s>

<s>[INST] Worked in yard with chainsaw cutting limbs about 8 inches thing for about 8 hours. Two hours later on n s verse pain. Took 2 500 mg of Tylenol and am drinking lots of water thought those two things would help also using heating pad with no relief. What do I do now . In severe pain especially the arms [/INST] Hello, The pain in the arm seems to be related to the over the use of the muscle. I suggest using anti-inflammatory medications such as Acetaminophen. I also suggest using anti-inflammatory cream for local application such as Voltaren cream. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician </s>

<s>[INST] i have slight headache, sputum with blood streak, slight fever, yellow urine, catarrh. it was like this from around September last year to February this year, then it left and started from about two weeks ago. what could be responsible? I am 40 years old, weighs 87 kg and have no known history of sickness other than malaria once in a while. I live in Lagos, Nigeria [/INST] Hello. Welcome to HCM.I am Dr Jigar(ID Specialist).Blood streaked sputum for such prolong period must be evaluated thoroughly.In my opinion you should consult physician and get thoroughly examined yourself. Also get chest x ray done. In blood reports cbc , perioheral smear and BT, CT, APTT should be done. Give sputum specimen for routine and microscopic examination to rule out infectious agents.Reasons for such illness are many like:BronchitisTuberculosisAutoimmune diseasesMalignancy etc.So you should get it confirmed..i hope this will help you..Give your valuable feedback.Dr Jigar. </s>

<s>[INST] Hello - in an attempt to pick me up and throw me over his shoulder like a jokester barbarian, my husband accidentally put too much pressure directly in the center of my chest and it now is very tender. I don t have any bruising or swelling, but I can t lie down flat, cough or do certain movements, like push down the trunk of my car, without pain. I ve looked up common symptoms for bruised/broken ribs/sternum but everything says I would have swelling and/or bruising, but I don t. It s extremely sensitive in the center of my chest and outward to the left. I can breathe deeply with some sensitivity, but not unbearable, but it does hurt when I put my shoulders back to sit up straight. Any thoughts? [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. You are having blunt chest trauma. And because of this, you are facing musculoskeletal injury. No need to worry much for this as it will gradually improve over the time of 1-2 weeks. Follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Apply warm water pad on affected areas. 5. Take painkiller and anti inflammatory drugs. Don't worry, you will be fine with all these. If not improving after 1-2 weeks then consult doctor and get done chest x ray to rule out internal lung injury. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Dear Sir/Madam, My name is karthika from pune. I'm pregnant(LMP 29.12.2016) I had my sonography in 50days(7 weeks). Result is no fetal pole and yolk sac. gestational sac measured 1.33cm. Gestational sac age mentioned in my report 5 weeks 1 day. Dr said come again after 2 weeks for sonography test and dr says delayed conception 50% chances to fetal pole growth and 50% chances to miscarriage . Now going 8+ weeks. I have all pregnancy symptoms. I'm feeling in beat or pulse feeling in my lower abdomen its mean increase blood volume.That means my baby is growing or???. I'm waiting for my second sonography test i feel very scarring.(I have regular period 29 days cycle). Plz suggest me [/INST] Hello,Just wait for the next scan. Don't become so anxious. Secondly, at the time there is slow growth.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai </s>

<s>[INST] Dear sir/Madam, I am Muhammad Jawad, 26 years (male). I face problem in my chest (Chest congestion). I have visited several doctors. Some recommended Levofloxacin 500 mg full dose some prescribed Moxifloxacin but in vain. One doctor recommended Monteleukast sodium 10 mg once daily. I feel better when I take this drug but feel chest congestion again when give up this drug. Normally my congestion starts when I am in rest position. My congestion is severe in places with high number of pollen. Kindly let me know what my problem is. Is it pollen allergy or something else? And one more thing, I often suffer from chest infection as well. I am smoker but I have reduced smoking. I don’t smoke more than 3 cigarettes per day. Kindly let me know my disease and how to cope with this problem. Thanks very much. [/INST] Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, possibility of pollen allergy and related allergic bronchitis is high in your case. You are chronic smoker. And due to smoke, lung defense is reduced in your case. So recurrent chest infection is common in smokers. So you should quit smoking as soon as possible. Your symptoms are worsen after pollen exposure and you are relieved with montelukast (anti allergic drug). This clearly suggest that you are having allergic bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) for the diagnosis of bronchitis. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Oral combination of antihistamine and anti allergic drugs is also important in your case. So consult pulmonologist and discuss all these. Quit smoking as soon as possible. Hope I have solved your query. Wish you good health. Thanks. </s>

<s>[INST] I know that Scarlet fever is typically a childhood disease. My friend s newborn contracted Scarlet fever. I babysat him two days ago (a day after the rash began), but I am also a caregiver for seniors. Is it possible for me to be a carrier of the infection even if I haven t had any symptoms? [/INST] Hi thanks for asking question.The organism (sterptococci)lead to scarlet fever can spread through personal contact.It can be hospital acquired also.Scarlet fever mostly affect child and it have no long term serious side effect on health.It can be treated with antibiotic.So dont worry about it.If you have symptoms then antibiotic will be taken.I hope i have solve your query </s>

<s>[INST] i am having very oily skin...ii will get pimples for that...i use tissue paper or kerchief ..is there any drug/ointment to treat this problem?? [/INST] i am usin clindamycin for my acne ia that effective. </s>

<s>[INST] My mom has a severe toothache that goes all through her lower jaw its been there for two days now and no matter what she does she cant get rid of it she has tried Advil and b.c powder but neither work what should i do it make the pain stop?The pain comes and go's. [/INST] Hello,Thanks for consulting HCMRead your query as your mom had pain in tooth this pain can be due to carious tooth , decayed tooth or infection in tooth due to abscess formation may be periapicak abcess or periodontal abcess. Dont worry I will suggest you to consult dentist for oral examination and investigations iopa xray of tooth to rule out the cause of pain nd go for its treatment . In meantime do warm saline rinses two - three times a day, for pain your can give her medicine like ketrol dt diasolve in water or diclomol sp . Consult dentist for treatment as early as possible for treatment. Hope this will help you. </s>

<s>[INST] Hi doctor,I sometimes get shoulder pain. I consume alcohol once a week. I am attaching my LFT report, please advice. My bilirubin direct is 0.10 mg/dL, bilirubin indirect is 0.5 mg/dL, SGOT is 35 U/L, SGPT is 79 U/L, and ALP is 68 U/L. [/INST] Hi. Your reports (attachment removed to protect patient identity) are normal. For more information consult a medical gastroenterologist online --> </s>

<s>[INST] hi i have had a heart attack in 2007 i had 3 stents i also have h.a.v.s hand arm vibration syndrome and i have recently been diognosed whith p.a.d..-p.v.d. i have had the pain in my legs since 2006 i am convinced this is wot brought on my heart attack now i have a simaler pain in both arms when i overstretch i get cramp pain so bad i think my arm is going to explode do u think this is related to p.a.d. ore p.v.d. im having angioplasty in my leg in 1 weeks time should i mention this pain in my arms to my consultant ? [/INST] Hi,Welcome.PAD is blockage in arteries other than organs. Their blockage can cause severe limb pain.If you also have similar pain in the arm too, you should definitely tell this to your doctor so that it can be evaluated properly.Thanks </s>

<s>[INST] sir i m 22 years old boy.. actually i was injured badly in a bus acciden specially my facial region and have multiple facial bone fractures 1 years ago .... so now i want to have my previous facial structre is it possible through bone reconstruction ? please help me [/INST] Hello, You can go for facial reconstruction. Consult a plastic surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician </s>

<s>[INST] i recently had pneumonia and i just finished the antibiotics the doctor prescribed to me. I felt better for about 2 days however, now when i breath i can feel the pain in my chest i felt before. i am worried that it has gotten worse or had not gotten better. what should i do? [/INST] Thanks for your question on HCM.I want to ask you few questions. 1. Have you undergone chest x ray?2. Do you hav fever at present?If you are running fever at present than antibiotics should changed.And no fever only chest pain than wait for 7 days, complete the course of antibiotics. Repeat chest x ray after 1 week to see for any improvement or any worsening. If worsening is there than consult pulmonologist and get done bronchoscopy and BAL analysis for identification of oganism. This will help in directing the antibiotics. </s>

<s>[INST] My 7 month old has had a fever with no other symptoms for the past 2 days. She is braking out in chills when her fever comes back. The tylenol helps for about 5 hours. Should I be concerned? She dose not arrear to be teething and her temp has been between 101 102.5. [/INST] Hello, I understand your concerns. The duration of action for tylenol is only about 4 hours and the fever will recur until her body is fighting the virus. If she is feeding okay, and is active when she does not have fever, it is not concerning.Warning Signs:1. She is lethargic and drowsy even when she doesnt have fever2. She is refusing feeds 3. She is peeing less than once in 6 hours4. She has fast breathing 5. SHe is irritable and crying continuouslyIf any of the above are present, take her to a pediatrician. Otherwise, the fever should settle in another day or two.Has this answered your question? Hope she gets well soon! </s>

<s>[INST] I was in a car accident a week ago. i have a serious bruise with a lump on shin. My calf also burns and feels very tight. They xrayd it at the er after accident but it was severly swollen at the time and didnt see anyfractures. should i go back to dr? [/INST] Dear Sir/ Madam Does passive movements of your toes/ ankle cause pain in the calf. Are you on blood thinners like Warfarin?. Examination of peripheral pulses is to be done. Compartment syndrome should be ruled out. It is recommend to elevate your leg under two pillows and to do active toe movements and visit your treating doctor. Other possibilities could be contusion of your calf muscles, Deep vein thrombosis . Regards Dr. Pvssmjagannadham, Orthopaedic Surgeon </s>

<s>[INST] I have had an itchy rash on my back, hips, hairline, and top of bottom. I had a lump appear in my vagina I popped it and the pain went away but the lump is still there and frequently itches. Now I have a painful lump on the left side base of my skull. [/INST] Hi, You seem to suffer from multiple problems. Itching on various parts of the body may be due to irritation or allergy. For that, you consult the dermatologist. And for the lump in vagina consult the gynaecologist and for the lump on neck, consult the surgeon. Thorough examination and investigations are needed before any advice or treatment. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] The thing is i have a dark complexion and i want to have a fairer ones so what r the remedies and procedures could you please tell me ? [/INST] If you are looking at going fairer than your original complexion; you need expert guidance. A diet full in Antioxidants like Vit C and Sunprotection will help you fight tanning and regain your original colour back. Lots of water and physical protection like full sleeves; hats etc. also play a good role in Sunprotection in addition to regular Sunscreen application. For removing the tan and skin lightening you can opt for a programme of chemical peels under the guidance of your dermatologist. Also avialable are intravenous lightening agents which you can discuss with your dermatologist </s>

<s>[INST] Hello Sir, I have question on semen analysis. Please can you clarifyas per results have less Sperm count and also A- Rapid progressive motility is only 10 it should be =>50 how ca i increase. Is there any problem to get pregnancy.what kind of suggestion i'll take please. [/INST] Hi, .Yes, you definitely will have problem with lesser sperm count and poor motility to get your partner conceived. There may be some reason for this problem. Varicocele, undescended testes or certain occupation like working near furnace, using highly vibrating vehicles or instruments, atomic or radiation places or certain drugs can cause these problem.Varicocele and undescended needs surgical correction. If you consult your physician he/she will guide you for further investigation after examination and needful advice.Get a baby as soon as possible. Dr S.murugan </s>

<s>[INST] I need anziety meds bad i have hard attack at twenrty one an can t see my son twelver year old son an im just starting a good job inside i just have anziety so bad it feels like sombody is stepping on my chest in to my mouth. but idint knw what to to do im a hard worker an machinist but i need some anxeity meds to cope threw the day. you could reach me at316-621-1838 Thank you much Travis Cunningha WWW.WWWW.WW [/INST] HIThank for asking to HCMI really appreciate your concern looking to your history given here I could say that the best medicine for the anxiety to control your thought keep your moral value high, low down your stress level, if this fails then in my opinion better to consult the psychiatrist, hope this information helps you, take care and have good day. </s>

<s>[INST] My nephew 40 years old has a continuing haemaglobin problem. He had a heart attack 16 months ago when his blood level was 7 and has had multiple blood transfusions since then. He also has had endoscopopys and colonoscopys plus a camera and the only results to date are that he has some damage to the lining of his stomach from medication . I feel there is an underlyng problem as his energy levels are very poor. [/INST] Hello,Damage to the lining of the GI tract is prone to bleeding.In such case he might blood constantly.This lose of blood may decrease the Hemoglobin level and cause anemia.He may need biopsy of the GI tract to find the type of lesion.Consult a Gastroenterologist. </s>

<s>[INST] Hello,Three years ago; I had my wisdom teeth removed. I bled a lot and it was extremely painful for weeks. The surgeon had difficulties extracting them as they were big and weren't growing in the right direction (too big for my mouth) some of my teeth began moving, re-adjusting into my mouth, creating a gap between two of the top back teeth whereas I lost the temporary bandage I had on the bottom back teeth. I had a check up a year or so later and everything was fine. But then, my jaw began making incredibly loud noises when I chewed, opened my mouth and often began to crack while the side would hurt a little but nothing major. I never had any real pain, just mainly my jaw cracking and making noises. Later again, my tooth began being more sensitive to cold, showing a deep hole where the bandage used to be. Until recently, the side of the tooth seemed to have weakened, being loose. One evening, I ran my tongue over it and it fell into my mouth. I didn't bleed, it didn't hurt or anything. The inside was a little darkened and the piece that broke wasn't big, shorter than a pinky nail. Now, it hurts a little and I looked into the mirror and the inside of the tooth is gone, leaving my flesh/gum bare... I think it is the sensation of having no tooth when I move my tongue or it being exposed like that that hurts, but it goes through phases... Sometimes it will, sometimes it won't. How can I stop it from being like this? It brings me more discomfort than pain, as if something was stuck when it isn't. I live in the country side and my car broke down, leaving me unable to travel far. The dentist near my house can't give me an appointment until mid-August... will it be okay until then? I feel it is already partially late but I have tried many times to get dentist appointments and with life getting in the way and all the waiting for appointments, moving out, exams, it was simply impossible. Could the tooth breaking be a result of it getting damaged when I got my wisdom teeth removed? Is it possible to fix the tooth so I can not lose it as it is my second molar. I know it may sound silly but I am really scared and one of my fears is to lose my teeth. Thanks for your kind response. [/INST] Hi..Welcome to Healthcare Magic.I have gone through your query and can understand your health concerns..As per your explanation i have come to a conclusion that the second molar which is bothering you got fractured not due to any trauma but due to loss of bandage[filling] and infection leading to caries due to which the tooth got weakened and a part of it has got broken..Due to fracture of the tooth the inner portion of the tooth that is the inner dentine is exposed and the central portion of the tooth that is PULP which contains nerves and blood vessels has got a thinner covering on it now, so whenever you eat or drink something hot or cold there must be sensitivity and discomfort..As per the symptoms I can evaluate that the tooth can be saved but it needs treatment and consulting a dentist is needed..The dentist will take an x-ray and evaluate the condition of the tooth..In case if the Pup is not exposed and there is a considerable layer of dentine over the pulp then filling of the tooth with a permanent filling material followed by Capping of the tooth is the treatment to be done..In case if the pulp is exposed then the Root Canal Treatment has to be done and then the tooth has to be capped after 15 to 2O days..As of now if there is pain you can take Advil [Ibuprofen]..You should not wait and get appointment with a dentist soon as more the time will go off more will be the decay and there are chances that the tooth can fracture completely as well as there can be an outbreak of severe pain..Hope this information helps..If you find the answer helpful please give me a Five Star Review and click on found the answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.. </s>

<s>[INST] I work at a daycare and one of my children swung their head back and hit me right on my brow bone about my left eye. It was swollen all day yesterday and today it is still a little swollen. It is very painful if I move my eyebrow or make any facial movement. There is no visible bruising that I can see, but I was hit pretty hard. Any tips to make a quick recovery? [/INST] Hello,I can understand your concern. The injury you have got may take some days to heal. You can do ice application over the area to have relief in swelling. In addition, you can take painkiller like Acetaminophen 500 mg or Ibuprofen 400 mg to have relief in the pain. Unfortunately, there is less that can be done for faster recovery in such cases as the body takes it own time to heal such injuries. However, if the swelling or pain worsen, you should see a physician for physical examination of the area.I hope this answer helps you. Thank you for choosing HCM. I wish you feel better soon.Best,Dr. Viraj Shah </s>

<s>[INST] Hi doctor, My throat has been hurting very bad for five days now. My tonsils are swollen and my entire throat is very red. On the back of my throat, I have yellow and red bumps. I have been running a low-grade fever off and on. I have been aching all over and cold. My ears hurt too. It hurts to swallow. I have tried over the counter medicine and it has not helped. [/INST] Hi. I have gone through the history and image (attachment removed to protect patient identity). You have got chronic tonsillitis. Take antibiotics if you have got fever as of now. If the drugs are not working, it means you have used it so much unnecessarily already. In that case, you need to change the antibiotic you have already taken before. Other co-existing conditions you may be having which must be examined for. But right now complete the course of drug you have started or visit a doctor to change the drugs but add steam inhalation, warm saline gargles, and lozenges. </s>

<s>[INST] My daughter(2 and half old) is not feeling well for past six days.. She s having high temperature, During the morning only. I am taking colpol and sinerst.Also giving bifilac and cepodem as antibiotic. As per dr advice I took platelet counts and maleria test. Maleria is negative, platelet count is 1.6 million. Dr asked another test on Monday(2/1/17). Really confused. What would be the reason for high temperature. Pls suggest. [/INST] hi, high fever for 6 days can be due to typhoid, malarial infection, lower respiratory tract infection urinary tract infection. Since, you have already done malarial test. chances of Malaria infection are ruled out. for other causes, you should do blood test like typhidot IGM, x ray chest to look for chest infection and urine routine microscopy test and urine culture test. Since child is already on antibiotic, the antibiotic needs to be upgraded. based on reports, the antibiotic needs to be changed. review with reports. Take care. </s>

<s>[INST] About 2 weeks ago my upper arms became so sore and lifting my arms caused pain. I have spasms in them if I move them a certain way. My lower back feels like knives are stabbing me, about 5-6 inches below my waist. It moves from one side to the other. I am normally an energetic person, but for the last few weeks have had a lot of fatigue. I also have been on a z-pak for a chronic cough, that started after my husband had a bout of ? Bronchitis. I did develop a parasite this past summer, and bowels have been different ever since. This is all strange for me! I feel yukky, and I m not sure what to do, or who to see. Thanks, Carla [/INST] Hi, It can be due to spine related problems like a prolapsed disc. Consult an orthopedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] Hello doctor, I had unprotected sex 90 days back and my symptoms now are penis pain. The body pains, muscles pain, and my upper lips have white spots. Two months ago, I got a sinus surgery. I am afraid of HIV. After 65 days of the exposure, I had an RNA-PCR test done, p24 and a duo combo test. In 90 days, I had a Western Blot and ELISA test and everything came negative. I have a tonsils problem too. [/INST] Hello. I have gone through your problem and understand your concern. As all the test for HIV (human immunodeficiency virus) are negative at the initial level and after 90 days, it means you are not infected with this virus. So do not panic. Pain at multiple sites can be due to other medical conditions that are psychological in origin because of excessive worry and anxiety. For white spots on the upper lips, get a consultation with a dermatologist to find the cause of it. Probably you are having too much anxiety as to suffering from a serious infection. In such situations, SSRI (selective serotonin reuptake inhibitors) and psychotherapy are helpful. For more information consult a sexologist online --> </s>

<s>[INST] I was recently diagnosed with dilated cardiomyopathy. My EF is 35%. I take 3.125 mg of Coreg twice per day. Today, while sitting watching a video, my heart rate, which is usually in the 72 - 78 beats per minute range was up around 90 beats per minute. I also had a single shooting pain down my left arm and a general feeling of numbness in the arm after that. I had this happen once before and the shooting pain in my left arm was so strong it woke me out of a sound sleep. Do you have any idea what might be causing the shooting pain and racing heart rate? Is this something I should be going to the ER for?Thanks,Scott [/INST] The pain in cardiomyopathy could be due to coronary artery disease / angina. You should go in for more tests to know the exact cause and have treatment accordingly. Yes it could be serious. </s>

<s>[INST] i had pneumonia about a month ago and for a while i felt as if i was back to normal. but about a week ago i started getting the tightness and wheezing in my chest again and there has been some pressure around my adams apple. it also has appeared swollen. is this apart of getting over pneumonia? or is something else happening? [/INST] Hello dearWarm welcome to Healthcaremagic.comI have gone through your query in depth .* There are different conditions for the same as - lung infection of various kinds as bronchitis , pneumonia or else . - decreased respiratory drive from previous pneumonia . - Additional bacterial or viral contamination obstructing the airway .Hope this will help you .Regards . </s>

<s>[INST] Hi doctor, I feel like I need help with depression and anger. I am a single mom and constantly feel irritated mostly with myself. I cannot seem to be able to do the simplest tasks. It is an effort to get up, to shower, and to get dressed. The only reason I do it is because I am a mom. I feel so guilty all the time that my little girl is left with just me, as her dad is not interested. It is not postnatal, as I have had periods like this before her birth. And my bond with her is so strong, and she is the only good and right thing I have ever done. I am so sad, and my esteem is rock bottom, and I have learned to hide it well. I put a smile on, but I feel it is getting worse, and I do not go out anymore. I am losing touch with most of my friends. My doctors have this system, where you speak to the receptionist, then they have a phone interview to see if you need an appointment. I am terrified they will just laugh at me and tell me to go away. [/INST] Hi. I understand how difficult it is to struggle every day with yourself, to fight the anger and depression within you. I have treated many patients who go through this trauma every day. My advice for you would be, try taking the following. Please follow this advice for a week, and if you find it helpful, feel free to revert. Revert after a week to a family physician online --> </s>

<s>[INST] hi doctor, i am from delhi, india, my son who is 11 years old was chased by a stray dog yesterday and clawed, though there is no blood marks on the spot but he has got redness in the area which is very minimal. Please let me know if we need anti rabies vaccination for this, please note again he was not bitten but clawed. [/INST] Hello,Welcome to HCM,Dogs are known reservoir of rabies virus and can transmit to human beings by biting. Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As there was no bleeding from the bite site, according WHO categorization it is categorized into Cat II. So cat II bite should receive following treatment.1.Wash the wound thoroughly with soap and water.2.Active immunization with anti rabies vaccine on days 0,3,7,14 and 28.3.Inj TT, 0.5 ml, IM4.A course of Antibiotics like Tab Augmentin, twice daily for 5 days.Thank you. </s>

<s>[INST] my fiance has a lump by his inner thigh close to the side of his penis. it almost looked oblong. He also has a round lump in upper stomache. We thought it might be a hernia because he just had a mesh done earlier this year . He went to the dr and had a mri. Well today he had a fo;;ow up and the cd from the mri. The dr checked him and said it is not a hernia and that it is a mass. He is scheduling a CT so they can see it better he said. im worried and i know he is to. A couple of years ago my fiance had cerbral stroke. Im hoping that doesnt manifest again. Should we be concerned? im trying to type this before he gets back from the store. i dont want him to know im worried [/INST] Hi, Scrotal masses are common findings in primary care and can develop from all anatomical structures of the scrotum. In this report, we present the case of an unusual testicular mass caused by the migration in the scrotum of a mesh used for inguinal hernia repair. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Monish De, Oncologist </s>

<s>[INST] Hello my sister got into car wreck about a year ago which resulted in a piece of glass cutting her upper bicep triceps area about an inch deep. She claims she is losing feeling in her arm over a year later even though she got medical attention. what could be causing this? can nerve damage determinate over a year after its healed? My sister like to excoriate and refuses to go to the doctor. So I wonder is this possible and she should see a doctor or just attention seeking. Also when the injury did heal up she did see a doctor and they said everything was healed and she didn t even need rehab. [/INST] Hello dear,I understand your concerns.Sharp injury to arm can very well result in a nerve injury.'Losing feeling in arm' is a vague term as one may have this complaint if he has weakness in arm or even if he has sensations loss in the arm.It can even be somatization of symptoms.But if it was a nerve injury,she should have got the symptoms early on, very shortly after the injury and not now.It may very well be an attention seeking behaviour only.Still,to rule out any possibility,I would like to suggest you to go to a neurologist so that he can actually examine your sister and give his expert comments.I hope it helps you. </s>

<s>[INST] I was diagnosed with Bronchitus, a double ear infection and sinus infection on the 17th of this month. I had to go back to the doctor for different meds and a nebulizer treatment Friday the 20th and back to another doc on Monday the 23. I have been on a z-pack, steroids, cough syrup with codeine and have had an at home nebulizer for 2 days and am currently taking levaquin. Today I am exhausted and having crazy hot flashes with sweats followed closely by extreme cold. Am I going insane? what can I do to fix this? I m afraid to go back to the doctor, because I am never sick and I am worried they are going to think I am just whinning. [/INST] Thanks for your question on Health Care Magic. I can understand your concern. Get a chest x ray done, if it is normal, no need to worry for lung infection. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>

<s>[INST] I have a son with Down Syndrome. He has celiac disease. He also has a small esophagus, which has bee nstretched 5 times. It doesn t seem to help. Tonight he started eatin g a gluten free cupcake and he was in the bathroom trying to throw up. I asked him what was wrong and he said he choked on the cake. Is it possible that he has aspirated a crumb or two? He is 41 yrs and is nev er sick - hasn t had even a cold in19 yrs. [/INST] Hello and welcome to HCM,Short esophagus can be the cause of choking.Aspiration is different from choking.Aspiration is food particle entering the trachea and thus lungs.Choking is impaction of food particle in the esophagus.Thus, clinical assessment of the esophagus needs to be done to locate the choked food particle and thus its removal.Thanks and take careDr Shailja P Wahal </s>

<s>[INST] hello doctors,i have a question:my wife she has taken an emergeny pill as longynon(only the ochre color pills) 4 on the first 24hr and other 4 within 12 hours of the firts shot,are we safe for an unwanted pregnancy?one more thing:she has vomited after half an hour of taking teh second shot,bu short afterwards she has taken another 4 ...sanjay [/INST] Hi, I think there is very little chance of pregnancy if you have taken emergency pill. However failures also occur sometimes. So, if her periods get delayed, do a urine pregnancy test at home. If positive consult a doctor if you don't want pregnancy. If negative wait for your periods. Regards Dr khushboo </s>