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<s>[INST] please recommend diagnosis test for typhoid. My age is 35 years,am 5-10 feet long,72 kg weight. For a week long i was much lethargic especially in evenings having 99F temp.My doctor is of the view that i am suffering from Typhoid and started Ciproflaxacin without any test. [/INST] HI, thanks for using healthcare magicTyphoid would be diagnosed using blood and stool samples. Multiple samples are normally used to make sure that the result is accurate.The samples are sent to the lab so that they can determine whether the bacteria that causes this infection , is present.I hope this helps </s>

<s>[INST] Hi I am using Formonide 400 inhaler.. I heard that once I start this i wont be able to stop . Is it correct?My uncle started with Asthalin and now he is using formonide.. For me my doctor gave me formonide for breathing difficulty coz of high allergy [/INST] hi welcome to HCMit is not correct that once you start inhaler you wont be able to stopthe main idea of prescribing inhaled medications is - low dose medications could be used when compared to oral medication which have many side effects though the later are cheaper,and secondly the site of action of medications will be in lung itselfregarding your query your uncle might be initially having intermittent asthma later on when it got converted to persistent asthma he might have been prescribed on formonide.regarding your case your doctor might step down your therapy from formonide based on your response to therapy and your symptomshope you got your answerwith warm regardsDr NSK </s>

<s>[INST] Hi, I m male 37 yrs old. I have been told that the inner stitches from my appendix taken out when I was 5 yrs old have somehow mended together. I m having discomfort on this side including internittent aches in thigh and less the calf muscle and the groin on the same area. Can this influence urination because during the last few weeks I ve been feeling a slight pain, almost the feeling of pressure. Any ideas? Thanks [/INST] Hello! Your history of appendicitis is not significant anymore as it was 32 year ago. Your symptoms are characteristic for urine tract infections and urine tract stones. That is why the first step you should take is to have urine test performed and abdomen ultrasound. The other reason of your chronic thigh and calf pain might be a Sciatic nerve compression. So if your pain does not go away for a long time you should have MRI of your backbone performed. Hope this will help Take Care </s>

<s>[INST] My 12 year old son is complaining of neck discomfort. He is constantly rotating his neck to get relief. Xray is clear.It is an ongoing problem. he complains of discomfort in his fingers and manipulates them to get relief. he has no pain or swelling.physio last year to his neck alleviated the problem but it has reoccurred in recent weeks [/INST] your child is suffering with a tic disorder .its a habit disorder without any pathology. it can be treated by education and counselling. </s>

<s>[INST] I am a 100lb 5'0 female....was given 50mg of benadryl prior to 6mg of Versed. While the benadryl was being added to my IV, I started to feel nauseous and then my heart started to palpitate. That followed with severe chest pains and the shakes. I couldnt talk and was terrified. That was on wednesday...i am still feeling out of it. occasional shakes and headaches, should I go to the ER? I tried to contact the physician but he was unreachable and my primary care MD is as well [/INST] Hello,Yes, you should be assessed by blood pressure monitoring and ECG. You should visit emergency.Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Varinder Joshi </s>

<s>[INST] Hello doctor, I am not sure if this is the right category to post my question in. My problem is with my mother-in-law. Or maybe the problem is with me, after all.My baby boy is now 8 months old. He is a handful most days. He is not the type that plays by himself and he gets bored really quickly. He is not crawling yet, but he is sort of mobile and very tiring to take care of. He needs constant attention all day long with no breaks except his two naps. Whenever I leave him in his crib to cook his meals or to go to the toilet, he screams horribly and continuously and will go on for at least half an hour, which is as much as I ever left him screaming. In the last two months, I have started feeling run down by all this crazy schedule. I used to be a relaxed, lazy individual and now I have something to do every minute. I cannot get a break and I cannot even think anymore. I started having migraines with aura, something I have never even heard of before, constant tension-type headaches and insomnia. And with these, also anger. A lot of anger. I never hurt the baby in any way, but I did scream at him a few times. I did cry in front of him. And I did have fights with my partner, also in front of the baby. In the last two weeks or so, the baby seems to not like me anymore. We used to have fun but now he is not responding to my jokes and my playfulness. Instead, he is becoming very attached to my mother-in-law. She comes twice a week to help and when he sees her, he squeals with delight and tries to jump out of my arms to be with her. He is obviously very happy to see her. When he sees me he could not care less, not even a smile. Once when he was on the couch and I extended my arms towards him and called him to come to me, he turned around and extended his arms towards his grandmother. Which I found humiliating and it filled me with rage. I could not sleep for days. I wake up at 3 to 4 AM and think about how he prefers his grandmother and how his grandmother is snooping into my life and at the same time, I need her since she offers me some time off. I feel stuck and have a lot, a lot of anger. I am ready to cut her visits off to once per week or less. I am furious at the thought that I gave up my life to stay here with this baby and care for him constantly and he prefers his cheery grandmother that comes in once in a while. I feel like I love my son less because of this. Generally, I loathe unrequited love and avoid it like the plague. I find it even more difficult to attend to his needs. I am ready to give up her help because the pleasure of the free time it gives me weighs less than the pain of seeing my baby reach out to her and ignoring me like that. I am so furious I am ready to part ways with my partner as well if he takes his mother's side. About my mother-in-law, she loves the baby but also intrudes upon my relationship with him. She always wants to hold him and pretty much tries to dictate how we raise him. But, this does not work, and I do things as I see fit. Overall, she has an influential position and I think the baby might respond to that also. I do not know. She is spoiling him and cuddling and cooing all the time she spends with him. And says stuff like 'come to granny. Granny loves you', 'you are so happy because granny is here, are not you?' etc. It makes me sick. Of course, she is very nice to me as much as she can. I am sure she is holding back a lot of privileges to be in my house with my baby. But, my baby becoming more attached to her and preferring her over me is something I cannot deal with. Do you think my baby stopped liking me because I raised my voice and was aggressive in his presence? Will it get better if I never do that again? I am really trying to, but it is hard for me. I have an explosive temper. What can I do? What should I do? I am at a loss. I am not good with managing my feelings and my relationship. I am super sensitive to rejection and tend to reject the people who reject me. But, this time it is my son and I feel like my love for him is fading away as the anger about the whole situation grows. My partner says I am being irrational and I reply that it is normal that problems stem from being irrational because that is what most people's problems are. Rational problems would probably involve calculus problems. So, why talk about that. Yes, I am irrational but that does not make this any less of a problem. He says I should see a psychiatrist, get some depression pills and then rethink this whole situation and decide if I really want to make his mother come less often. He seems involved in his work and inattentive to what is going on in the house. He says he will be more attentive to see if indeed the baby prefers his mother. All I know is, whatever his conclusion if I feel it is bothering me, then it does not matter what his so-called objective opinion is. I will want her out of my life, even if it means more work for me. [/INST] Hello. You can review with me for further follow-up. For further queries consult a psychologist counsellor online --> </s>

<s>[INST] HI i JUST WENT TO TO THE NEUROLOGIST TODAY AND HE SAID iI HAVE SPASTIC PAREPARESIS. I AM A 48 YEAR OLD FEMALE OTHERWISE IN GOOD HEALTH. THEY ARE DOING A SERIES OF TESTS T RULE OUT ANY OTHER CAUSES . DOES THIS CONDITION GET WORSE AND IS THERE ANY TREATMENT? [/INST] Hi,Thank you for posting your query.I have noted your symptoms and diagnosis made by your doctor.In spastic paraparesis, there is weakness of both legs and the tone of legs is increased.MRI of spine is required to find out the cause.It may be caused by infection such as tuberculosis or tumors in spinal cord. In both these conditions, the condition can worsen, if not treated.On the other hand, if appropriate treatment is given, such as anti-Tb treatment for tuberculosis and surgery in case of tumors, then, we can stop the progression.Physiotherapy would also be beneficial.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.     Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me: My blog: </s>

<s>[INST] Many people with psychiatric difficulties appear to have co-occurring physical problems such a lower and upper back pain, recurrent indigestion. Is there a documented relationship between the presence of positive psychiatric symptoms, and spinal column difficulties? [/INST] HiI had gone through your query.There are no direct relationship between these two.But spinal column difficulties make person stressful due to inability to maintain daily routine precisely.Chronic pain may associated with psychiatrist morbidity like stress, anxiety and depression.Pain can be part of somatization or psychological pain.There are psychological reason behind physical symptoms.Medicines like TCA, SSRI and anxiolytic can be useful.Better to go for psychological evaluation before taking any medicines.Consult psychiatrist and get help.I hope i have answered your query.Thank you. </s>

<s>[INST] I typically have a blood pressure that is 120 over 70 (sometimes a bit lower, sometimes a bit higher). I recently had severe panic attacks and it was very high (150 over 110 at one point). I have been taking Klonapin (1 and a half milligrams a day) and sometimes the pressure goes as low as 102 over 69...it never stays that low...but I m concerned. My sister is an RN and assures me that blood pressure fluxuates and I don t feel sick or dizzy...should I be concerned? [/INST] Hello, I understand your concern and would explain that some elevations of blood pressure values are quite normal during anxiety of physical activity. But, there is no need to worry about them. I would just recommend you to closely monitor your blood pressure values frequently during the day in the next days in the sitting position after 10 minutes of total relax. If your blood pressure values are within the normal ranges (125/85 mmHg) most of the time, there is no need for any changes in your therapy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST] 30year old female with no major medical history. 2 c-sections 6 and 4 years ago. i smashed pinky with hammer. tip busted and looked like it was almost going to fall off. just from the end of nail to end of finger. i have short nails so there is a little skin exposed at tip to where if i had longer nails you would not be able to see the tip. anyway, of course there is extreme pain, i almost fainted. it has been a couple hours and my 3 middle fingers are cold and white along with pinky finger. i also have pain going to the bend of my arm. to the inside of my elbow. is this normal? i didnt hit any other finger but my whole arm just about is sore. what should i do? [/INST] As you have smashed your finger you need to know that you need opinion of hand surgeon on your condition, the x rays will give more details of the case in question. </s>

<s>[INST] Hi...I ve become a little concerned with how some parts of my face seem to be losing pigment, or other parts have become darker possibly. It is primarily around my eyes and my forehead . I have no moles , or anything else, and have been spending an inordinate amount of time indoors lately as a result of school, so I m no longer outside in the sun like I used to be for most of my life up until about two years ago. [/INST] Hi , Thanks for writing in. The problem can be vitiligo ,IGH,polymorhic light eruption etc. Without actual visualisation of the skin it is not possible to comment on nature of pigmentation. Sun protection is most important for any cosmetic treatment. Use good quality sunscreen. Avoid sun exposure. Use brevoxyl face wash. Apply Kojivit cream at night over dark spots. Take lot of vitamin C in diet. Visit a dermatologist for proper examination and diagnosis who can also provide you some clinic based procedure like surgery and laser. Visit a dermatologist for some clinic based procedure like chemical peeling and laser. Hope this helps. Regards DrSudarshan MD Dermatology. </s>

<s>[INST] Hi, I have elevated liver enzymes, ALT = 196 and AST 181. The nurse (almost a doctor) I go to thinks I should have a liver biopsy. When it first went up I was on a medication that was known to elevate the liver enzymes but I got off of the 7 years ago. It never did go down. What is your opinion? thank you! Melanie [/INST] Hello, How old are you?? Since when you're on drugs?? Yes you may be suffering from chronic elevated liver enzymes may be due to fatty liver disease or non alcoholic fatty liver disease or infection or trauma etc.Until examination is done it is difficult to say what it is. Need to be evaluated for liver enzymes or ultrasound abdomen,viral markers and if necessary liver biopsy.Then only we have to come to conclusion.Also stop intake of liver toxic drugs , alcohol, smoking and pain killer medication.Eat green leafy vegetables, do regular exercise if symptoms not improved please consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu , Internal Medicine Specialist </s>

<s>[INST] I have been on simvastatin for a few years but over the past year have really experienced severe tmj. Although I have been a teeth grinder for many years when I sleep, mouth guards, dental treatments, etc, have not helped this problem. I was wondering if simvastatin could be causing the flare ups with my tmj? [/INST] Heloo pt-there are many possible cause tmj disorder-•     Muscle problems that affect jaw movement•     Pain in the face around the jaw joint•     Problems within the joint itselfsuggestions that may help relieve your TMD pain or discomfort: •     Yawn and chew (especially gum or ice) as little as possible.•     Avoid extreme jaw movements, such as yelling or singing.•     When you need to yawn, place a fist under your chin and press up. This can keep your mouth from opening too wide.•     Try to remember to keep your teeth slightly apart as often as you can. Keep in mind that it is natural for your jaw to open a little if your lips are closed.•     Sleep on your back, not on your stomach.•     Don't rest your chin on your hand or hold the telephone between your shoulder and ear.•     Try to reduce stressthanks </s>

<s>[INST] my 2 and a half month old baby girl has been coughing for a few days nw,the doc says shes got a bad chest and prescribed her med but t was no use,now i tok her back to the doc and he said he has to put canola in her head nd gv hr med through injections. [/INST] hi.2 and a half month baby with cough or fever or vomiting associated could be signs of sepsis or Bacteremia of which lower respiratory tract infection could be a source. if blood counts shows a total count of >15000 Iv antiobiotics will b better . and if there is fast breathing and on chest X-ray a patch or multiple infiltrates are seen you have got ur source for respiratory symptoms . a cannula in the head won't be necessary unless the doctor you went to found the need for it, it's better if there is a good communication and clearance of any doubts regarding the treatment options . :) do not worry hope this helps. </s>

<s>[INST] dear sir , i have a kid of years who is suffering with porencephaly and the MRI report states INDICATION : NOT MENTIONED. MRI BRAIN — REPORT Technical : TSE TI, T2 Wt. images of the Axial sections without IV contrast. *** Signals from orbits are normal, bilaterally. No masse:.; *** Signals from brain stem &.cerebellum are normal. *** Ventricular system is normal. *** Sulci, sylvian fissures & cisternal spaces are nortml. Gender Date & Time : M Age : 9 Mo . 25—May-13 10:06:12 AM ***Moderate size welldefined hypointensity on Ti, hyp,fintensity on T2 noted in the Lt.frontal lobe, paraventricular area with dilatation of adjacent to the frontal horn of the of Lt.lateral ventricle. (Porencephaly). * * * Paucity of white matter. IMPRESS ION : * MODERATE SIZE GLIOSIS IN THE LEFT FRONTAL LOBE & PARAVENTRICULAR AREA. {POSSIBILY DUE TO OLD HYPDXIC INJURY}. present condition is: no neck holding,hypotonic,vry little activity,no visual perception and spasms, currently we are using valporin{3ml 3 times},nootropil{2.5ml 3 times},and sabril {1/2 tablet 3 times},and lonazep 3 times a day could there be any cure atleast to make him self dependent. thanks for giving u r valuable time and advice, T.Suresh please let me know if any kind of treatment available sir [/INST] Thanks for posting your query at HealthCareMagic. Procencephaly is a condition where the cerebrum of our brain does not develop properly. Our nerves are made of basic unit neurons which have a small cell body and a long axon. The axons have an insulation. These insulated portions are arranged in the white matter while the cell bodies lie in the grey matter. Since he has paucity of the insulation or white matter, there is short circuit when the brain fires an impulse and a convulsion results. He is receiving valparin to prevent such convulsions. Since the brain controls the muscles, lack of portions that controls various muscles leads to hypotonia as a result of which there is no head holding.There is not cure for the condition as new brain tissue cannot be created. However, developmental assistance and supportive management based on his symptoms may be provided. Your doctor should be able to determine the exact supports he requires.Hope that will take care of your query. Feel free to communicate back in case of further queries if any. </s>

<s>[INST] Hello doctor, I have a small solid little thing on my arm that looks like a cyst or wart that I would like to get treated. I thought it to be a pimple so I tried to take it out with a small needle but was afraid to go deep. So, I did not achieve anything and I just made it red. It has grown a bit over a period of eight months and I cannot see a hair or blackhead or head on it. I would like to know what this is and how we can remove it. [/INST] Hi. I need some pictures to help you precisely. I cannot guess it by your description. Most probably, it might be an epidermoid cyst. Let me confirm when I see few pictures of it. For more information consult a dermatologist online --> </s>

<s>[INST] I have been running a fever off and on for over a week now. I saw my family doctor yesterday and the only thing he told me was that there was a virus going around. Could a virus cause you to have a fever for that long of a period of time? I have no energy and just plain feel awful. [/INST] HelloUsually fever caused by virus remains for 5-7 days depending on the type of virus ( in few cases even up to 10 days ) , while in body there develop immunity and antibodies formed against virus. But in your case fever is for 7 days , if there are no any other symptoms , wait for next 3-5 days and take tylenol ( paracetamol ) . Still , fever persists even after 10 days consult another physician and get his opinion. </s>

<s>[INST] I am having slight crawling sensation on my left temple at times for the past year. It happens every couple hours and goes away. It’s not painful and when I’m busy I don’t notice it. I’m also having frequent muscle spasms throughout my body about once an hour and they mostly effect my legs and arms and occasionally other muscles. I was worried about temporal arthritis but I’m only 21. I’m going back to my doctor in 2 days. I had an mri done of my abdomen because through blood tests it was found that I have elevated bilirubin (Gilbert’s syndrome). What should I be looking for? [/INST] Hi, The muscle spasm are not related to bilirubin and it may be due to something else. As a first line management, you can take analgesics like Acetaminophen or Diclofenac for pain relief. If symptoms persist, then better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? [/INST] Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online --> </s>

<s>[INST] hallo I have noticed a lump developing between my ear my jaw .. The area is very sore but is not painful if left untouched. I also have constant popping in my ears. I have not in anyway injured myself, or been knocked on the head at any time over the last few weeks .. I also have a cough ..Can you maybe tell me what it likely is ..? [/INST] Hi Dear,Welcome to HCM.Understanding your concern. As per your query pain behind ear and jaw could be because of impacted tooth. Sometimes impacted tooth get infected because in case of pericoronal flap there is deposition of food debris and bacteria ,which cause infection . I would suggest you to consult oral surgeon for proper examination and treatment . Doctor may order X-ray or orthopantomogram . Doctor may prescribe antibiotics like amoxicillin or in severe cases doctor may recommend impaction wisdom tooth means surgical extraction of wisdom tooth . Doctor may also rule rule out lipoma , cyst or osteoma . Doctor may also refer you to ENT specialist . For now maintain proper oral hygiene , do warm saline rinses and give warm compresses to affected area . Take ibuprofen or acetaminophen for pain and swelling.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari </s>

<s>[INST] My 20 month old baby girl has orange palms and feet. Her favorite Gerber baby foods are sweet potatoes, carrots, and squash. She s not very big on her greens and mixed veggies. Could this be the cause? Would like a professional opinion. Thanks Natalia s Mom [/INST] Hi...nothing to worry about. I appreciate your intelligence in quoting that she eats carrot preparations a lot. You are absolutely right on it. It is called carotenemia and the palms and soles will be looking yellowish orange. It is not a disease. Do not worry. Once carrot consumption comes down, it will abate by itself.Regards - Dr. Sumanth </s>

<s>[INST] on 31 OCt my child faced a dog. He is 5 years old. He is not sure whether there is scratch or bite but some blood flew from there on the face. The witness people told me that the mouth of dog did not reach to the face of my child from where blood flew. I was not sure and immediately contact to physicial He advised me to take vaccine. I agree but the injection was injected in gluteal region. Is there any chance of rabies. as I read that gluteal region should be avoided . Another thing is dog was seen on 9 th day. It means the dog was not died upto 9th day. After that I could not see it as was away from my town. Is there any reason to worry? [/INST] Hi...coming to your queries directly - 1. The animal being alive even on 9th day is good and it shows that it is not rabid.2. vaccination should be started and your doctor was right.3. Anti rabies vaccine should not be given in the gluteal region and infact not vaccine should be given there as is a pad of fat there. It should be given into the muscle.No reason to worry. But hereafter give the vaccines in the the lateral part of the thigh.Regards - Dr. Sumanth </s>

<s>[INST] I had root canal treatmentent filling last Tuesday and yesterday went back to have a permanent filling in the root canal. It took the dentist an age to do it and it was quite painful. Since then the pain is unbearable worse than before the treatment. Advice please [/INST] Thanks for posting your query to HCM.After going through your history, high point on the permanent restoration seems to be possible cause of pain.Please visit a dentist and get the high point reduced.Hope my answer will help you. </s>

<s>[INST] My son is 4 years old. He has been having stomach pains for the last 9 days. I took him the first day to the E.R. because he was curling up in the fetal position and crying with tears. They took an x ray and only saw that he was very constipated. He has been taking a dose of Miralax each day. About 6 days ago, he had a fever that lasted 2-3 days of about 102 degrees. Again he is having pain each day and is hardly eating. He is also having nosebleeds, I'm not sure if that is just due to season changes. [/INST] Hi ! Your son's fever shows that he has got some kind of infection irrespective of the origin of the pain abdomen. In paediatric age group, even simple upper respiratory tract infection can give rise to severe abdominal pain mimicking acute surgical abdomen at times. Nose bleeds could be related to the respiratory tract infection if he has it. Otherwise, one has to go for tests relating to bleeding disorders, and also have to rule out dengue fever. Last but not the least, any surgical abdomen has to be excluded which can be done by clinical and special radiological means. Also urinary tract infection has to be ruled out by simple urine test. I think you should take him to the treating doctor again if he is not getting relief. Wishing your son a quick recovery. </s>

<s>[INST] 50 yr old white male, with dark purplish bruise on inside of left arm near armpit, has a white center thats sighltly firm (entire brise is size of 50 cent piece, pear shaped and painless...didn't know it was there till wife noticed it. Now that I've touched it I can feel it and if touch it, it's slightly painful...barely registers on pain scale though) [/INST] HelloI share your concern.Looking at your description it might be related to enlarged lymph node, axillary abscess, sebaceous cyst or local hematoma.If possible please upload me a photograph and provide more information likeIf you are taking any medicine?Is there any history of discharge?relevant medical history.I would advise you to take an appointment with a general surgeon or your family physician as per your convenience for physical examination and further course of action.In case of enlarged lymph node you may require further investigation like CBC, ESR, CRP, liver function test, blood sugar and FNAC if need be.At the same time your doctor should rule out possibility of metastasis by physical examination about which your doctor knows.Hope you will find my answer informative and useful, please feel free to ask for further clarification, I will gladly answer you.Best wishes </s>

<s>[INST] Hi, greetings to U. Please explain me abt my 4D ultra sound result. Late Proliferative type of endometrium. Ovaries with some features of poly cystic ovaries . (Hypertrophied & Echogenic stroma) Inadequate folliculogenesis . Antral reserve-good in both ovaries. No uterine/ adexal mass. few nabothian cysts- cervix. No pelvic collections. hepatomegaly (17cms) with fatty infiltration. 3.0 x 3.0 cms hypoechoiec sol with good posterior enhancement and minimal vascularity in th 7th segment of liver -? atypical maemangima normally appearing GB, pancreas, spleen and kidneys. [/INST] Thanks. You need to consult an Endocrinologist and gynacologist for polycystic overies. For liver hemangioma, you can consult gastroenterologist after getting your liver function test. wish you good health. </s>

<s>[INST] Hi This is Khaliq Nawaz from Lahore, Pakistan. Age 50. I am heart patient amd taking medicines like Disprin, Lowplet, Merol and Rovista. Now i am suffering with asthmatic problem feeling wheezing, lot of cough with jelly like Sputum. Please advise medicine and test for cure of asthmatic problem. Thanks.Khaliq Nawaz [/INST] HiFirst you should do a chest x ray and than a spirometry test.After will be the right treatment according to the results.RegardsDr.Jolanda </s>

<s>[INST] I am 26 years old.I am married for 3 and half years. After one year of my marriage i was diagnosed with PCO and within 3 months I conceived.I delivered a baby last July, but within 15 minutes baby died due to heart problem. I started treatment after 6 months of my delivery, still i didn't conceive. I took letrozole, glucophage and follic acid tab for first 3 months, but i was not getting big follicle.then i took clomid, glucophage and follic acid tab now also am getting only small follicle.nowadays mentally i am very tired.Please help me to know how much chance is there to get a healthy baby?. [/INST] Hi welcome to hcm.I have gone through your question.Clomid is generally preacribed to stimulate follicle size.Glucophage to reduce blood glucose level.If your follicles dont mature upto the size that can rupture then i would suggest to change the medicines and you can go for injections also after consulting your gynecologist.If follicle develop properly then you can conceive.Hope i answered your question.Would be happy to help you further.Take care. </s>

<s>[INST] I'VE BEEN TAKING LISINOP/hCTZ 10-20 FOR A YEAR FOR ISOLATED HIGH BLOOD PRESSURE, IT WAS 160 OVER 8O AND WITH DRUG IS 140 OVER 70 TO 75. WOULD LIKE TO GET OFF THIS DRUG AND USE DIET TO CONTROL BLOOD PRESSURE. hOW DO i SAFELY WEAN MYSELF OFF THIS DRUG? [/INST] There is no diet that will control your blood pressure. If you are overweight or obese, then diet and exercise with emphasis on weight loss will be helpful. Even then, weight loss may not be a perfect or complete solution to your blood pressure control, so I recommend you work with your doctor if you are planning to do that. </s>

<s>[INST] My 11 year old daughter has complained about abdominal pain for several months. Her doctor first diagnosed her with constipation. This has been resolved for a month, but the pain continues. She claims it is in the upper portion of her abdomen, dull, and squeezing. She sometimes has nausea and weakness with the pain as well. Her bowl movements are now regular and she says they are normal. She does not have pain when she uses the bathroom. [/INST] Did you hear about irritable syndrome? Can be! The pains just relieve when a person goes to the bathroom. Did you try change her food habits? Reduce liquid and carbohydrates can help too. </s>

<s>[INST] Hi, my son of 6 years old has mentioned today that he has black spots in his vision. I ve sat him down in a dim room to make sure that he s not been looking at bright lights and then asked him to look at a blank wall again and he s still saying they re there. I ll take him to his opthamologist tomorrow but just wondered what it could be? I have a few floaters but they only developed as a adult - is it usual for a young child to have them? [/INST] yes they may occur at this age also floaters are very common but you should visit an ophthalmologist </s>

<s>[INST] hi i'm 33years old my problem is that till now i have not started my period and i can't share thing to any one i m married last 5 years and my husband is very nice to me. he never ask any question like why we dont hv baby till now . i m having normal sex life there is no problem but i m worried about can i concive or not . pls tell me if we dont hv period it means that we can't be concive i m 33year old my problem is that till now i hv not period . i can be pregnant or not if any lady who is not having his period till the age of 33 years it means that she cant be pregnant i m a married and having a normal sex life there is no problem . my husband is very nice to me he never have a problem if we dont have a baby but i m not pls suggest me today i went to a gyaecologist and she suggest some test and give some tabs to me but i just want to know that if i hv not period till now than there is a hope to get pregant or not plssssssssssss i m too much worried pls ans my question. [/INST] Hi Welcome to HealthcareMagic At the age of 33 if you are not getting periods it suggests you have some problem which need to be investigated. Not getting periods ( Amenorrhea ) could be due to various reasons affecting at different levels like uterus,ovary,pituitary, or hypothalamus. Getting regular periods suggests normal hormone levels , normal ovulation and normal anatomy. Problem at any of the above said level may also cause problem in conceiving. Consult a gynecologist who ll investigate you right from physical examination to few blood tests for hormones and few radiology scans . Take care . </s>

<s>[INST] My 13 yr old son started running a low grade fever about 2 wks ago. Went to dr; got amoxicillin. Fever lasted 6 days. Seemed okay for the next 7 days, then the same thing started again. On day 3 now. Dr prescribed antibiotic #2. should he have bloodwork done to determine if this is even an infection? Thanks! [/INST] Hello no need to worry .recurrent lo w grafe fever that lasted for 5-7 days indicates only that he has low immunity thats why he is catching infection early.no need to investigate </s>

<s>[INST] Age 40, 6'0", 183 lbs. healthy. Recent fertility sperm test shows normal morph, motility and concentration, but viscosity is high, liqeufaction 90 min and agglutination moderate. What supplements or changes to lifestyle may help to reduce viscosity and a liquefaction for better chances of fertilization? [/INST] HiAfter how many days of abstinence you collected the semen sample for test. If it is 5 days or more it can cause increased viscosity. So repeat test after two days of abstinence. Infection can cause increased viscosity. See andrologist and get semen culture sensitivity test and treatment accordingly.Take Antioxidants tablets. If still persistent you may need the help of intrauterine insemination with sperm washing </s>

<s>[INST] My husband has a lump where his leg meets his groin. It is not painful however sometimes itches very badly. At this time it appears to be very deep and hard. The lump comes and goes sometimes disappearing completely and then sometimes showing on the each side. He works outdoors and wants to know if this is due to getting hot & sweaty? Should we be concerned since it is not painful? [/INST] Hi, dearI have gone through your question. I can understand your concern. He has lump in both groin area and appear and disappear on regular basis. Most probably he may have inguinal hernia. He should go for examination and if it hernia then he should go for hernia repair surgery like meshplasty. Consult your doctor and take treatment accordingly. 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 got my ears pierced about 7 or 8 years ago I think but in the past year I've found it very difficult to wear any of my earrings. When I do, usually after a day or two my earring holes start to get really itchy and the only relief is to take out the earrings. Typically there is also a lot of green "stuff" coating my earrings. Also, my earring holes look black on the inside. Do you think this is an allergic reaction to the earrings? If so, what kind of earrings should I buy, and do you have any other advice? If it's not an allergy, then what is it? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The symptoms are definitely in keeping with allergic reactions to the material of the earrings. You would need to determine the material of the earrings that you are currently wearing and avoid these in the future. You may need to avoid synthetic material.I hope this helps. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James </s>

<s>[INST] Hi, I had my Gallbladder removed about 1 year ago and every few months I ll have a few weeks of intense gas, bloating , chest pain and what feels like tension headaches. I take Gas-X before I eat to try and help with the gas and Excedrin for the head pain, is this just due to not having my Gallbladder? [/INST] Hello. Thanks for choosing HealthcareMagic forum. After the gall bladder is removed, the bile juices which are essential for oily food digestion are not released in bulk after every meal as happens normally. So, there is the problem of indigestion and gas after taking an oily meal.You will have to take these medicines life long. Dr. Rakhi Tayal drrakhitayal@gmail.com </s>

<s>[INST] Good Day Doc, i have problems on my right arm, right hip and right leg.. Its painful especially on my back on the upper right side. I keep on pressing it. What should i do to relieve this kind of pain? I have also problems on my nose, its hard to breath i keep on throwing my saliva. It will trigger when the temperature is hot and cold. Please do help me...Thanks [/INST] Hello, As you have pain in right hand shoulder and leg. Mainly in hot and cold climate. I will suggest you to do some exercise. As pain in leg. You need to do strengthening exercises for your lower limb. As static quads. Static hams and some exercise which increases your lower limb strength. Same for upper limb too. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rohan Sham Deo </s>

<s>[INST] I am concerned about having a slightly red scrotum. It feels warmer than usual and comes and goes. I have recently changed jobs and it is very stressful. I am in sales and have to travel out of state a lot leaving my wife to take care of our 2 year old and she works full-time. [/INST] Hi and welcome to Healthcaremagic. Thank you for your query.Red scrotum may indicate torsion or epididimitis. Epididimitis is inflammation of part of testicle. This is usually treated with 10 days of antibiotics, usually ciprofloxacin and there are no permanent consequances. MAsturbation and intercourse should be avoided till pain persist, if possible since I may prolong inflammation course. Some more serious conditions such as tumors or torsion are rare but in doubtful cases you should do Doppler ultrasound or scintigraphy. In this particular case, I don’t think this is required.I hope I have answered you query. If you have any further questions you can contact us in every time.Kindly regards. Wish you a good health. </s>

<s>[INST] I am having a pulse-like sharp pain in the left side of my stomach it has got more often since i fell of a horse and twisted my back a couple of weeks ago and the pain has just been getting worse and more consistent plus some times the pain is unbearable and u dont know what to do [/INST] Hello there.. welcome to healthcare magic forum.. You need a ultrasound abdomen in order to rule out any injury to internal orgon ..So please consult a surgeon ASAP. Hope this helps. take care </s>

<s>[INST] Good morning.. I was born with a heart valve that was not perfect.. most recently I have had serious problems with my heart so I went on to see the public hospital.. they gave me pills for my blood pressure later to find out the pills they gave me was for 60 year olds.. I am now 22.. Every day I get palputations when I get the slightest excited or tensed.. I am now on a new chronic medication coralyn.. seems to work for the blood pressure but not the irregular heart beat.. It carries on for hours some times till I get relaxed.. but then there is pains in my heart witch goes to my left arm.. not Hectic pains.. But the palputations is keeping me from having a normal day.. what can I do?? I was already at the cardiologist but he wants to see me next year.. [/INST] Hello, For this reason, I would recommend performing an ambulatory 24-48 hours ECG monitoring in order to examine your heart rhythm trends for a prolonged time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST] my 30 mo. old grandson had a discharge in his belly button, pediatrican says she s never seen this before and is recommending him see a pediacric surgeon. the belly button has a nipple looking protrustion. he complains of pain occasionally and will pull on it. any ideas? [/INST] Hi, This is very commonly seen in a patient with vitellointestinal duct and this can be easily diagnosed with an ultrasound abdomen. Paediatric surgeon will be able to exercise this that and close it after which the symptoms will subside. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology </s>

<s>[INST] if a 70 year old female has a hemoglobin count of 8, weak, pale,10 dark stools and is taken to hospital and given 1 unit of blood and it drops to 7 and given 2 more units and only has a endosocopy done and sent home in 2 days but no answers and had 3 more dark stools after going home could there be bleeding somewhere? [/INST] Hi, dear. I have gone through your question. I can understand your concern. You have low hemoglobin and bloody stool. You should go for ultrasound abdomen and complete endoscopy. There should be bleeding somewhere in your gastrointestinal tract. Search for the cause and take treatment accordingly. 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 had a stinging bite like sensation on the outer right side of my leg just below the knee. A hard lump started to form and it became so very itchy for a while. Then painful with dark purple bruise like colouring. The swelling has gone down a little but the whole area is very painful to touch. Should i see a doctor asap. thank-you. [/INST] Hi,Welcome.Based on the facts of your query-You need to have treatment for-Unknown Insect Bite with Cellulitis with hard lump-which could be treated as follows-Get Second Opinion from SurgeonCold Compress-Tab Chymoral- 1 x 2 times per day.Tab- Motrin-4oo mgm. x 2 times per day.Tab-ZincovitAntibiotics-if need be,as decided from Surgeon.Hope this would help you to plan further treatment with your doctor.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS </s>

<s>[INST] I have symptoms with Lopressor that include vocal cord closure, extreme fatigue, too low B/p,mental confusion ,muscle weakness, light sensitivity, trouble breathing during the day...So...in desparation I cut 25 mg in half and many symptoms have begun to decrease. I suspect all smooth muscle were effected that is why I have so many symptoms. It was used to protect an aneurysm that will be fixed 21 july...AM I right about this? Lopressor could cause even more obstructive sleep apnea. I have celiac spru and am allergic to chemicals. [/INST] Thanks for your question on Healthcare Magic.I can understand your concern.Yes, your all symptoms are due to hypotension and bradycardia caused by lopressor.Lopressor is having metoprolol. It is beta blocker. It acts on reducing blood pressure and heart rate.You have given lopressor just for prophylaxis before aneurysm surgery.So possibility of hypotension is more in your case.So you are can cut down the dose to 12.5 mg.Drink plenty of fluids orally and keep yourself hydrated.Don't worry, you have done right thing by cutting down the dose.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] My mother is 95 1/2 and has dementia. She is frail and has copd. The pa now put her on .25 of morphine for pain which we, her children, haven t noticed her having pain. PA says she is having pain so needs the morphine rather than Ativan and Tylenol. She seems to be sleeping more and responding less since on morphine. We are very concerned. thank you [/INST] Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, her current symptoms are mostly due to morphine. Morphine is opioid analgesic. It acts directly on brain. Along with analgesic effect, it causes sedation and respiratory depression. So her more sleeping and responding less is mostly due to sedation of morphine. Another reason is high carbon dioxide (hypercarbia). COPD patients are known to develop hypercarbia if respiratory center in brain is suppressed. High carbon dioxide can cause lethargy, sleepiness etc. So better to stop morphine and consult pulmonologist to rule out hypercarbia. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. </s>

<s>[INST] my boyfriend got really sick last in the last few hours, he was vomiting quite a bit and he said it feels like he has to keep going to the bathroom, he has the chills and his right testicle and right side of his abdomen are very painful, what should we do? [/INST] Hello, It can be due to viral or bacterial infection of intestine or stomach lining. He can be prescribed antibiotic and antacid course for five days. He can take Rabeprazole like antacid and Ofloxacin & Ornidazole combination antibiotic. Don't give him spicy foods and give him more water. He can take ondensteron mouth dissolving tablet for vomiting SOS. He need to investigated with SGPT, SGOT estimation and CBC and stool analysis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician </s>

<s>[INST] My daughter just had a Microdiscectomy, L3/L4. Her sciatica is gone but, still is in severe pain at point of surgery. I asked nurses if they were going to give her something for inflammation but they never answered us. Would it be okay to give her Advil ? She is also taking Lyrica for pain. Surgery was this last Friday morning. Thank you. [/INST] Hi.I am Dr Mittal.I have read your query.First, the pain at surgical point is expected and is going to stay for a few days. The medicines can only make it dull. It cannot disappear.I would need to know whether she is still in hospital or has she been discharged and brought back home.If she is in hospital, please do not administer any medication to her without talking to your doctor. That is completely clear. You may however ask to talk the doctors and bring the matter to their attention if the nurses are not conveying the matter to the doctors. If she is discharged, you may consider giving her Advil. However, as I said, it will only reduce the pain to a dull pain. The pain cannot go away till the healing of the operative site is complete.Please feel free to contact us for any information or any clarificaion.Best of luck, Dr Mittal </s>

<s>[INST] I took my son to the doc for a bad cough and gave him hydromet. He fell asleep for a short period and woke up and threw up. I m assuming it s from the hydromet. Can I give him a different cough syrup since he threw up the other one or is it still in his body? [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.It need not necessarily be due to the syrup you gave. Cough itself can cause vomiting and nausea. Cough can be due to wheezing too. I suggest you not to change the medication by yourself, but if your country has got any license over the counter cough syrups which are licensed for this age. You can go ahead.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani </s>

<s>[INST] I have a bladder infection and also irritated below as well was feeling a lot of inflammation,I being to the doctor and had took all my medicine on just yesterday day and I have being using monistat 7 day treatment cream,I am still feeling the inflammation below and it is uncomfortable what else can I do. [/INST] Hello,Thanks for query on HCM"As"per your clinical history is concerned please follow like this -1)Take all medications as prescribed by your doctor and take it in timely, discuss with your treating Doctor about anti fungal medications like [Fluconazole]orally.2)Keep dry all skin folds after bath.3)Do not share other's towel, shoes and Combs.4)Wash your hands after touching other people 5)Do take one multivitamin along with a probiotics to boost your immune power. Drink more than 10 glasses of water every day and take fruits and vegetables regularly.Hope that helps </s>

<s>[INST] My daughter got a really bad rash on upper body came out very fast. I took her to doctor they said it must be viral checked for strep throat came back negative. Rash started to go away then a few day later got a really bad headache then that evening had high fever and vomiting. Back to doctors recheck for strep negative .A few days later went to her softball game very low key game she is only 9 yrs old. While in the out field she had hard time breathing and couldn t see her pupils where fully dilated is was a sunny day. She also got very pale went to the ER all they told me was its viral PLEASE HELP ME my daughter is a very healthy girl never ever had any problems [/INST] Hello, I suggest you to use a soothing lotion e.g calamine lotion to calm down the rashes. In addition, I suggest you take an oral antihistamine e.g Cetirizine tablet once a day for a few days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist </s>

<s>[INST] hi my son 5 yrs old had fever since yesterday and cough and vomiting,now he doesnt have cough and vomiting but still with fever,i was scared this morning when i saw his feet turn blue,i put his socks and it turned to normal,hes feet is cold,and my son still very tired [/INST] Hi...this looks like viral illness with peripheral vasoconstrictoin due to high fever. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.But if this recurs or if the urine output is falling down or has poor oral intake - I suggest you take him to the nearest emergency room immediately.Regards - Dr. Sumanth </s>

<s>[INST] Hi yes… i am a retired OB nurse, my girlfriends husband just had knee surgery on a recent total knee… they found a tumor inside the bone…. 1 day post op at home with lower chest pain in ribs area and in his back. He had general anesthesia for 1 and a half hours….. but finding it hard to breathe… i told them to call the Dr. i am concerned about possible blood clot to the lung??? what do you think [/INST] Hello dear, thanks for your question on HCM.Yes, you are right about possibility of blood clots in lung. This is known as Pulmonary Embolism (PE). And he is having following risk factors for PE1. General anesthesia2. Knee surgery3. Bone tumourHis symptoms are also favouring possibility of PE.So better to get done CT pulmonary angiography to rule out PE.Another possibility is fat embolism. As it is also seen after long bone surgery. In this instead of blood clots, fat globules from bone marrow reach the pulmonary artery and cause blockage.So consult pulmonologist and discuss about these possibilities. </s>

<s>[INST] Yes I had a medical abortion on 3/14/14 & had intercourse on 3/23 & condominium broke. I was not on any BC I was going to get my Rex on my 2week follow up. I took plan within 5 hrs & at my follow up appointment everything was good & am now on BC Loestrin Fe. Are my chances of getting pregnant again high? [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. If you have a condom accident, taking Plan B or another form of emergency contraceptive within 72 hours reduces your chance of getting pregnant by 90%. Furthermore, most women do not ovulate before two weeks after pregnancy. Therefore, I do not believe that you likely got pregnant from your condom accident. The birth control pills you are taking, Loestrin FE, should protect you against pregnancy effectively in the future. It becomes effective within seven days of starting the pill, and if you remember to take your pill every day and fall the package instructions, you should not conceive as the pill is greater than 99% effective in preventing pregnancy. So in summary, it is unlikely you conceived from your unprotected encounter and since you are on birth control pills now, your adequately protected against pregnancy.I hope I was able to adequately answer your question today, and that this information was helpful. Let me know if I can assist you further.Best wishes,Dr. Brown </s>

<s>[INST] I am a 55 year old man 6 weeks ago I was hospitalized. I was comatose for about 3weeks. I am mentaly ill. The medicines I was on are prolixon decanoate,lithium,cogentin,& wellbutrin. I am now on all but the wellbutrin. I am contemplateing trying another antidepressant. Would a tricyclic be safe? SSRI's are not recomended. [/INST] Hi there ~I understand your concerns. I however do not know why you were hospitalized. Assuming that the medication prescribed are for bipolar disorder, trying another antidepressant may not be safe if not under medical supervision. I also wonder why SSRIs are not recommended. If you can see a psychiatrist to explain these issues that would be great, otherwise there are many other mood stabilizers that can be used effectively without giving you the side effects of the tricyclics. I hope you understand. Take care and have a lovely day! </s>

<s>[INST] my endometrium echo complex appears is 13 mm in maximum thickness normal pelvic pain [/INST] Hello. Thanks for choosing HealthcareMagic forum. Endometrial echo of 13mm is normal and this thickness determines the amount of bleeding you will have during your periods.This cannot cause any pelvic pain. The pain you have might be due to chronic pelvic inflammation which can be corrected by good antibiotics. Dr. Rakhi Tayal drrakhitayal@gmail.com </s>

<s>[INST] my child is complaining that he is not hearing properly as some water had gone into his ear while swimming.went to an ent spl. who had prescribed penclav.after taking the medicine the child is getting ill.he si otherwise ok whether it is a must to get the antibiotic? [/INST] HiHe may be having diarrhoea from penclav. You can consult your specialist again and ask him to change antibiotics, usually Oflox or Levoflox is prescribed in such cases, duration of treatment remains sameTake care of the allergy if any, also in case of hearing loss, better to get an audiometry done to be on safer side </s>

<s>[INST] My 4 year old son developed a non-productive cough 2 days ago while visiting with my in-laws in Northern Virginia. They returned home to South Carolina last night, and he woke up this morning with a raised, splotchy rash all over his body. He s been on Benadryl throughout the day, and he just woke up from a nap with a fever of 102. I m not sure what s going on. [/INST] Hi...Thank you for consulting in Health Care magic.Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.By what you quote it should be an urticarial or a simple skin allergy. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST] Hello, I'm a 19 year old female.. My lungs ache constantly, and give off a sharp pain when I try to breathe. They feel heavy all the time, like they're full of cement. It gets worse with activity, especially with physical activity. As for my headache, my head pounds. Its really achy all over and causes me nausea. I'm always coughing up flem. I have recently came into contact with several people at work who had pneumonia since I am in retail. Help? [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, we should definitely rule out pneumonia and bronchitis in your case. Both these diseases cause cough, expectoration, breathing difficulty etc. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed for lung infection. PFT is must for the diagnosis of bronchitis.You may need antibiotic, inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] my dad is 67 years old. he has a very stressful home life. he still works delivering and unloading tires. recently he has been falling asleep after work. he also appears to be in pain while walking. he holds his hip/ thigh alot and limps when walking. besides divorcing my mom is there anything you could recommend? [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. Your father is stressed, alright. But it seems that he is enjoying his work schedule. If yes, let him continue. If not, he needs expert advise to come out of the stressful mind patterns. Stress good as well as bad. We should learn to understand positive stress and live with it. Consulting a psychologist should always help.If you require more of my help in this aspect, Please post a direct question to me in this URL. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] I have heard voices since I was a child, now at 50yrs old they just went away and all I get now is ocassionally I hear my name called. When I used to hear them talking I had images as well of them as imaginary people. sometimes I would feel like others could hear them. is it possible I am in remission for good? [/INST] Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.They are auditory hallucinations. They are heard only bu the patients having an illness and not by the others. Its still not scientifically proved, why there should be hallucinations. However they can be treated with antipsychotics like olanzapine , risperidone or aripiprazole etc. Hope I am able to answer your concerns.If you have any further query, I would be glad to help you.In future if you wish to contact me directly, you can use the below mentioned link:bit.ly/dr-srikanth-reddy </s>

<s>[INST] Today at work, I experienced some sudden sharp local pain in my right breast. When I got home, I remove my bra and had a lump appearing to be like a pimple with smaller bumps off to the side. I put some tree tea oil on it and it has cleared up somewhat. The pain has lessened, but that is probably because of the ibuprofen. [/INST] it is due to minor trauma/infection of the hair follicles and not to worry much!apply ice-cubes / ice packs and see!all the best! </s>

<s>[INST] Hi, I was taking an antibiotic, and the week prior i had a hep a, typhoid, and yellow fever shot. Also, i was taking Oxyelite pro. I took a blood test and my AST and ALT levels are 73 and 96 respectively... Other than that, everything else on my blood test is normal, i work out every week, and I'm in perfect shape. What could cause the high liver enzymes? [/INST] Hi.Thanks for posting query at HCM.Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal ( in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further.viral hepatitis ( HAV,HBV,HCV) are common cause of elevated liver enzymes. Typhoid fever may also affect liver and cause high liver enzymes. advice :- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages- decreased oil consumption (oily food)- NO red meat- green vegetables should be ingested daily- use lemon juice (lemonade) once in a day- reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks" and/or ultrasound.any further questions are welcomed.hope to answer your concern.wish you good health.regards,Dr Tayyab Malik </s>

<s>[INST] I have been dealing with an annoying feeling in my left back. Movement does not irritate it, neither does deep breathing. It is not a sharp or sore feeling just annoying light cramp like feeling. I have a family history of lung cancer at young ages. But I have had a early cancer screening in February 2017, a CAT scan in July and in October. Showing two nodules on the right lung but they have not grown so far. Nothing on the left lung as of October. My doctor is sending me to a pulmonary specialist but I am not sure if that is the right doctor. I have another CAT scan scheduled for Friday, which scares me because I know these scans are not healthy to have done so many times, so I am not sure if I should go. Any advise would be appreciated . [/INST] I will advise you take Ayurvedic medicine, it will solve your problem. 1) tab kanchanara gugglu 2bd 2) cap shallaki 2bd and 3) naryana taila for application. </s>

<s>[INST] Hi, I am currently doing research about the Nipah Virus. I would like to know if there are any drugs or vaccines that have been tested on humans and if they are effective or not. What are the aspects of the Nipah Virus that still remain vague? What are some future studies that will be conducted in hopes of finding a vaccine to combat the Nipah Virus? [/INST] HelloThe following reading is taken as such Gantz's infectious disease latest edition 2013 .Nipah viruses were responsible for outbreak of several febrile "ENCEPHALITIS" IN HUMANS in MALAYSIA in 1999.-The outbreak was associated with respiratory illness in pigs and was initially considered to be JUVENILE ENCEPHALITIS because of epidemiology.-Other outbreaks occurred in Bangladesh & INDIA.The N genes of NIPAH virus have 78 % nucleotide homology ,but this virus has no more than 49 % similarity with any other members of the PARAMYXOVIRINAE.Now about the clinic finding :The incubation period for NIPAH virus ranges from 4 to 18 days .The onset of disease may be influenza-like with high fever & myalgia.Sore throat , dizziness & drowsiness and disorientation can occur.Mortality is about 50%.Nipah viruses grow well in Vero cells.- A cytopathic effects usually develops within 3 days in most cases.-Required a level 4 lab.-Positive virus neutralization tests, only in a level 4 lab, are demonstrated by the inhibition of cytopathic effect producing by sera.---ELISA tests are less effective.-PCR available.The infection can be spread by the AEROSOL route, so care should be exercised as NIPAH VIRUS has been isolated in the respiratory secretions and urine of patients identified as having NIpah virus encephalitis in MALAYSIA & BANGLADESH.NO VACCINES or TREATMENT are available till 2013 .Future studies are continuous or not I DON'T KNOW.Hope this will be helpful for you. </s>

<s>[INST] Every night I lay down I have a tight burning sensation in my stomach/bowels that goes up to my hand and chest even up into my throat and in my pelvic area, I also get a twitchy feeling in my nerves that wakes me up and it makes my heart start pounding. I was wondering what you thought it could be? [/INST] Hello dear,The symptoms as mentioned in your post is attributed to accumulation of gas secondary to increased acid production in the stomach.Symptomatic relief can be obtained with intake of Pantoprazole preparation (to be taken twice a day before meals) & antacid gel (to be taken after meals).They prevent formation of excess acid in the stomach & provide symptomatic relief.And it is also needed that you take certain precautions regarding your diet & lifestyle, such as:1. Take soft, plain, non-spicy foods2. Drink lots of water to maintain adequate hydration3. Avoid fast foods & gas producing food products like cabbage, etc.4. Avoid smoking & alcohol.5. Keep away stress, think positive.There is no need to worry, you will be fine.Wishing a good health.Take care. </s>

<s>[INST] hi doc,Im Ruby 27 years old from Phillippines,my husband and i are planning to have a baby again.I give birth to my 1st child last July 3,2008.But unpotunitely our son died because of MSUD.he only lived for 23 days only.The genecologist said that there is a possibility to have MSUD childe again.Im polycestis women.My doctor give Dydrogesterone duphaston and Clomifene Citrate.Is this the right medicine for me to have a baby?how can I avoid my child from MSUD disease?please help me.Our life is empty because we have no children. [/INST] Hi Ruby ,This is Dr.Abrar Ahmed Khan From IndiaI Welcome You To HCM & Thanks For Asking Your Query Here You might be aware that Maple Syrup Urine Disease (MSUD) is a genetic disorder and it depends upon probability of passing the defective gene to the babyeach child has a 25% chance of receiving two mutated genes and having MSUD, 75 % chances of a normal baby with no MSUD but out of these 75 % there are 50% chances for receiving only one defective gene and being a carrier(means these baby will not have MSUD but will probably carry this Disease to their next generation), and a 25% chance for a completely normal baby who will neither have MSUD nor will carry it to the next generation Since MSUD is an inherited disease, there is no technique for prevention. But I would suggest you not to loose hope , trust in almighty and contact a A genetic counselor , he can help you determine your risk for having a baby with MSUD. a Genetic testing can tell you if you or your partner is a carrier of the diseaseand DNA testing can identify the disease in a fetus before birth so there is no need to worry , keep hope and best of luck I hope it help May God bless You </s>

<s>[INST] I recently had a UTI and was prescribed ke flex until I could see my dr. AT which time he took me off it because I had an e coli uti. But I can t determine what other med he prescribed due to the fact that I was once septic and I have quite a few med bottles. Can you please name at least one or two other medications that would have been conducive to an e coli UTI. [/INST] Hi, I understand your concern. The UTI caused by E.coli can be treated through antibiotics as per culture sensitivity testing result. So, ask to get an urine culture and sensitivity testing to determine the most sensitive antibiotic to use.Some antibiotic choice include quinolones (ciprofloxacin, levofloxacin, etc); trimethoprim-sulfamethoxazole, penicillins (amoxicillin, etc.). Wish fast recovery. </s>

<s>[INST] I have a deep cough that raises clear mucous. I have been xrayed and know there is no pneumonia or bronchitis. I do not have a history of asthma. My doc prescribed a week of prednisone which I have just started. But I wonder if Benzonatate might be helpful for this? [/INST] Hi, Benzonatate is a cough suppressant drug. Prednisone is an oral corticosteroid. Prednisone is effective only if it is an allergic etiology related cough. Since you don't have asthma or bronchitis, I don't think your cough will improve with prednisone. Better to take Benzonatate first as it is cough suppressant. It will definitely reduce your cough. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist </s>

<s>[INST] Some advice please.... my 8 yr old son swallowed a 2 euro coin 11 days ago, it was stuck in the esophagus on the day it happened and he was taken into surgery to have it removed, however they x rayed him in surgery and found it had dislodged and was going to the stomach. We were sent home told to return in 10 days if we do not find it as it would have to be removed. I returned today, day 11, he had x ray which showed the coin in the intsetine. Another Dr told us that we can go home and come back in 3 weeks if we have not found it. Is this last piece of advice ok? I feel like the 2 doctors are saying different things. He has no fever, is eating and going to toilet although with the help of laxatives. He has pain on and off. Many thanks for your time. [/INST] Hello, No, the doctor who has advised you to wait another 3 days is right. It is not a harmful one as a button battery and hence you can wait. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology </s>

<s>[INST] my 4 yr old son has been administered budecort inhaler for 3 months prior to now. now again my son is showing signs of dry cough . he has been advised asthalin inhaler now to upto 4 times a day. are these signs of asthma? i was told that my son suffers from broncho spasm . whats the difference between asthma and broncho spasm? [/INST] THESE ARE MILK THEORY DISEASECHILD NEEDS ONLY BREAST MILK FOR 2 YEARS AND NO MILK AFTER THAT AS OTHER MILK IS ANIMAL PROTEINS ND THESE ARE NOT COMPETIBLE WITH HUMAN PROTEINSAS WE ADD MILK AND DIARY CHILD STARTS GETTING MANY DISEASES AND THEY INCREASE WITH AGESO IF YOU WITHDRAW MILK AND DIARY PROTEINS FROM DIET CHILD WILL START REVERSING WITH SYMPTOMPS AND WILL RECOVER IN 3 MONTHSTILL THE WITHSRAWL EFFECT COMES GIVE SUPPORTIVE THERAPY SOSC </s>

<s>[INST] Over the last week I have had an odd sensation on my tongue, it feels like I burnt it, lack of taste and my tongue feels slightly swollen. Last night i got an odd sensation in the left side of my face in that the muscles tensed and Ic ould not open my moth properly. the left side of my face was at an odd angle [/INST] Thanks for using Health Care Magic.Read your query.The loss of taste and sensation ,face at an odd angle suggests the early symptoms of Bell's condition.You have not mentioned if the mouth opening is better after you got up or it the same till now.I would advice you to visit your oral and Maxillo-facial surgeon and have it checked up at the earliest to avoid any delay in the correct diagnosis and treatment.You will be requiring further test and scan to begin the treatment.Hope this was helpful.Thanks and regards. </s>

<s>[INST] My father-in-law had prostate cancer 20 years ago and had radiation pellets which made him outlive everyone else in his study. We just learned his PSA is now at an 8 and we re heading to him, but can you tell me what exactly that high a number means? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Definitely first you should consult the doctor. If that result does not show progressive disease then, maybe the increased level is due to radiation. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I would like you to advise me where I could find the best hospitals that could treat paralysis that caused to my brother who is 20 years old due to the exixtance of tumor in the spinal cord since 2004. He passed through a raidiation treatment to ensure the safety of this tumor as the doctors here in Egypt told us that it is impossible to remove it from this critical location. Thanks [/INST] HIThank for asking to HCMI really appreciate your concern but this forum actually gives the advise to the patients regarding there health issue in terms of diagnosis, treatment, prognosis, genera taking care, we does not provide any information about the hospitals or any thing else, hope you can understand this bye </s>

<s>[INST] i recently discovered a lump that looks like it's coming from inside the anus to the outside. It doesn't hurt and is not dark in color. When I first felt it, it felt like a wedgie. It's been about 2 weeks now and it hasn't gotten any bigger. It's gotten smaller where I don't feel it, but looks the same size. There is no pain or itching and my BM have been more soft that normal. Please let me know what I can do. Is there an OTC cream? Thank you! [/INST] Hi I am Dr Fahim and I will be helping you with your problem I have gone through your question. It appears that you are having Grade II or III hemorrhoids as you said a lump is coming out of anus. If it reduces back on its own then its Grade II and if it needs to be pushed back then its Grade III. There are four degrees of hemorrhoids, first two are treated conservatively mostly with injection sclerotherapy while grade 3 and 4 needs operations. You need a review by general surgeon. Who after performing Digital rectal examination and proctoscopy will assess the exact grades of the disease and will then guide you about further course of treatment depending upon in which grade it falls. You need not to worry too much as hemorrhoids is a common condition and easily treatable. I hope my answer will help you. Do rate my answer if you like it.Regards </s>

<s>[INST] Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? [/INST] Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> </s>

<s>[INST] For a few years now, Ive been having these pains in my chest. They re about in the middle of my sternum or in my lower left ribs. It s a kind of sudden, pinching feeling that makes it difficult to breath. These pains often go away after I just stay still and try my best to not irritate these pains. I am an 18 year old female, already diagnosed with PTSD. [/INST] Thanks for your question on HCM.I can understand your situation and problem.In my opinion it is PTSD (post traumatic stress disorder) related chest pain only. But better to rule out cardiac cause first. So get done ECG first to rule out cardiac cause. If ECG is normal than no need to worry for cardiac cause.PTSD can also lead to GERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this ,acid of the stomach tends to come up in the esophagus and cause the central chest pain.So avoid stress and anxiety. Be relax and calm. Take proton pump inhibitor for GERD. Consult psychiatrist for proper treatment of PTSD. You will be alright. Don't worry much. </s>

<s>[INST] family member involved in motorcycle accident with multiple fracture of pelvis and extremities is now experiencing abdominal distention and therefore the second surgery is postponed. could this distention be due to liver damage or more likely small bowels? [/INST] Hi, thanks for using HCM.Abdominal distension can be from gas intestinal perforation, or fluid like blood, injury to any organ , liver is also a possibility.Regards </s>

<s>[INST] In the last two weeks I ve had a CT scan, Brain MRI, 3 treatments of Solu Medrol. On Wed of this week I had a spinal tap, so of course I m sore and tired and today (Friday) I went in for Spinal MRI. They tried it twice and each time it started I got very cold and clamy. I felt like I was going to vomit. They discontinued the MRI since my body couldn t take anymore. I wasn t stressed about the MRI today, so I don t think it was due to anxiety. I had MRI last week of my brain and I was completely fine. After today s attempt at getting the spine MRI, I went to my car to leave and I ended up vomiting. I ve felt nauseated all day and now I m burning up with fever. Should I be worried? If I m still feverish tomorrow, should I see a Dr.? Thank you for your advice [/INST] I read your question carefully and I understand your concern.It is puzzling though, I have never encountered any report of such effects of MRI and furthermore there is no reason for the MRI to cause any of those symptoms, it's a harmless exam, doesn't carry any sort of radiation. So I think it must be a coincidence you must have some infection causing the fever, nausea and vomiting which is manifesting its symptoms.I hope to have been of help. </s>

<s>[INST] My boyfriend and I have been having unprotected sex for about a year now and I haven t gotten pregnant I don t know if it is me or him. I want to see a doctor but I m not sure how to go about it. Also he drinks ALOT of mountain dew and I heard it lowers sperm count and then men can t have kids [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. Please do not come into any conclusion from rumors. Such rumors are also available for cigarettes, liquor, coca cola etc. Please consult a infertility specialist for proper diagnosis and treatment.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] I am having strong pain in the centre of my chest, which is making it difficult for me to breathe in and out.I am slowly feeling it come inmy neck. I have exercised much. It has been over an hour. I ruled out the possibility of heart attack coz I am only 22 year old female. Please help let me know why is this pain? [/INST] Hello, I suggest you go to the hospital and do some examinations like some routine blood tests, ECG, cardiac sonography and a chest X-ray. These are needed to exclude any serious disease. And only after excluding this, it may be due to gastroesophageal reflux or muscle pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anila Skenderi, General & Family Physician </s>

<s>[INST] A small swelling look my neck in the right side and Doctor me advised for FNAC test. In the FNAC test, there is pus in my neck and diagnosis as T.B. My doctor prescribed my three tablet (Macox Plus 600 (Empty stomach in the morning) Macrozide 1500 (After meal at 3.00 P.M.) and Mycobutal 1000 (at Night). Whether these medicine is cure my TB and how much time this will take. B.P., Karnal [/INST] If the fnac done is positive for tb and your compliance with the medications is good.. cure to TB is likely.. the course of medications is 6 months if it's for the first time.. the cure requires the tablets to be taken without fail for that duration of time.. frequent follow ups are essential to monitor the improvement and look for side effects. . </s>

<s>[INST] Hi, Last night I have difficulty breathing and short of breath, when to see a GP and after few questions and checked my chest he gave me a nebulizer and sent me home after saying I might have an Asthma attack, which I doubt it because I never had a history of asthma as far as I know of. I was feeling much better after the nebulizer and was given 2 types of medicine. Singulair and Aerius . After taking those pills ths morning and a few hours later I felt a discomfort on the lymph under the jaw. It doesn t show any noticeable swell but it does feel like it is swelling. Do you know what is happening? This is the fisrt time that it happen. thanks [/INST] the correct diagnosis can be done after the omplete physical examination there can be so many causes leading to shortness of breath may ne respiratory problem lung problem heart and acid problems and after correct diagnosis you can follow tractof rxif you are feeling comfirtable can continue inhaler add bronchodilator syp and antacid </s>

<s>[INST] I have three members in my household. All three of us are experiencing a weird rash on our bodies. My son and I have eczema so that is what I thought it was but my dad is experiencing it now and he does not have eczema. The weirdest thing about it is I know on my son its presenting itself on my upper thighs and the top of my butt crack and on his gentals at bump. Not pimples and not pussy or oozing just bumps. I don't know if it is doing this to my dad as well though. [/INST] Hello.A possible diagnosis is fungal infection spread by one of the members of the family to another.It is also possible the appearance of rash after contaminated food ingested by the three.Go to your doctor.He will examine your injuries and will establish right diagnosis and treatment.I wish you good health.(If the answer has helped you, please indicate this) </s>

<s>[INST] I have paraesophageal lymph node x2. I have no symptoms. I have had endosopy x2 done within the past 6 months. no lymph node found on the first endo. On 2nd endo nonbleeding angioectasiis found in the duodenum, No finding to account for abdominal lymphadehopathy.Have had ct done whereas an enlarged lymph node was found. have had pet scan/ct done whereas showed a 2nd enarged node, size of 2 cm. Have had dcis a year ago, treated with partial mastectomy and radiation. Will have follow up with another endo ultrasound and biopy. Should I be concerned about lymphoma? [/INST] Hi and welcome to HCM, thanks for the query.at this point you should not be worried since most such findings are not indicating malignancy. enlarged lymoh nodes can be found in healthy people or as as reaction to any systemic infection. You need just regular follow up and thats all. Wish you good health.Regards </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...Hello i am in my b tech final year i am suffering from chest pain since 8 months.After completing my Manometry test the result is my chest plates have been shaken due to severe cough i have suffered gastric problem also now gastric problem is ok please suggest me medicines due to usage of NAPROXIN TAB i have encountered gastric problem in order to releive chest pain but there is no result. [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You stop naproxen. Start tab Pantoprazole. Also avoid spicy and oily food. Avoid smoking and alcohol if any. Also what kind of chest pain it is, does it occur on exertion or at rest only, does it increase on pressure, or any particular site. Get back with some information and if doesn't respond in one week then you will need some test.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode </s>

<s>[INST] Sir, I am prasad, My sister suffering from throught cancer She taken radition treatment for one month in Hyderbad. Now She cant eat anything. She drink with pipe only. Now She was very lean. How we save her life We don t know. I am working here one of the ngo office at R.T.Nagar. We are scanring about her life. She has two daughters her husband left. Now I am looking all those her treatment. Pl. telme. and save her life. And save my life also prasad, YYYY@YYYY [/INST] Hello Prasad, there is some diseases in our world which is out of our knowledge and ability. The disease you told is a very devastating disease. It has a very much higher incidence of metastasis in other areas. So, in this situation, prognosis of this disease seems to be very poor. There is little chance to save her. This is a very hard truth for you. So, donot expect much just keep carrying on the treatment and keep praying. Thats all, we can do. </s>

<s>[INST] Dear sir , I am suffering from stomache pain.For this i consult a doctor related with Gastroentrologist in Apolo hospital,Bhilai.That s why i did USG , ENDOSCOPY ,BLOOD , STOOL TEST .The result was infection in liver .For this the doctor prescribe me More medicines.But after taking medicines since 8days my pain problem is not reducing.So what i will do? [/INST] Hi , Welcome to healthcaremagic.com Can you let us know what are the results of the reports that are done. We will be able to answer your questions if you upload the results. Thanks Dr. Om Lakhani </s>

<s>[INST] Feeling lightheadedness, also dizziness, body shaking, and dry nose blockage. Sometimes just cannot breathe, also last 2 and 1/2 months, lost 4.5 kg. Suffering diabetes, taking Ameryl 1 mg , suffering from hyper tension, taking Telma 20 , feeling that it is something to do with brain. Please help [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The symptoms mentioned can occur when BP is too high, or there may be very low sugar (hypoglycemia). Since there is no mention about any BP readings or blood glucose levels (fasting, PP and HbA1c%), it is really difficult to comment.Weight loss is seen in uncontrolled hyperglycemia as a lot of glucose is lost through urine. Ideally a person with controlled diabetes should have Fasting glucose closer to 100 mg, PP 150 to 160 mg & HbA1c%Then one feels absolutely healthy and all the long term complications of diabetes can be either postponed or prevented. Similarly BP should be 120 -130/ 70 to 80 mm Hg. when on proper treatment. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Prabhakar Laxman Jathar </s>

<s>[INST] Age 64, Height 5'7" Having diabetes since my 31 years old, Creatine is now 8.3, the doctor asked me to do dialysis, I don’t have heart problem and pressure… Please advise me whether I can do transplantation? I am from srilanka, advise me how much it will take for the full course? Thanks Sam [/INST] At any time renal Transplantation is superior to dialysis in all aspects. However first year post Transplantation is very important. You should be regular in medicine intake that will be prescribed. Diabetic patients will be evaluated little carefully for fitness prior to Transplantation. In India it costs 4-6lakh rupees if you have matched donor from family. I'm not sure of cost in srilanka. All the best. if you have any questions feel free to consult me. </s>

<s>[INST] today i had an intercourse with my husband but during intercourse condom slipped. some of his sperm in the condom and some was outside of my vagina. now we both are not sure that sperm was inside me or not. now what can i do? may i take a contraceptive pill? suppose sperm was not inside me and i take the contraceptive pill, will it cause any danger?? [/INST] Hi, I understand your concern. 1. If you suspect some semen had leaked in vagina and if you don't want to conceive you better take plan B contraceptive within 72 hours of contraceptive. even if there is no conception , there will be no major complication except for delay in periods by 8-10 days. 2 A nother way to terminate preganancy are- - medical termination of pregnancy istill 49 days of pregnancy. - Surgical MTP ( vaginal )till 3 months of gestation, * When gestational age of fetus exceeds 12 weeks two registered practitioners are needed to perform the abortion legally. - Emcredil instillation - causes MTP till 5 months of gestation, - Histerotomy ( Per abdominal operation ) for removing pregnancy when other methods fail. Thanks. </s>

<s>[INST] Greetings doctor,I am 18 year old boy, uncircumcised. I have little bit of vitiligo. I have stopped consuming all the medicines for it now .I was prone to masturbation and did it pretty much everyday .My penis (glans) looks blue, dry and a bit brown and dark near the meatus(opening). I have very dry foreskin.I was using coconut oil as a remedy. I have a healthy diet but a bit sleep deprived routine due to studies.I have a loss of libido too. I am virgin. [/INST] DearWe understand your concernsI went through your details. Please understand, you must not misunderstand simple things and become anxious. Vitiligo is a chronic skin condition characterized by portions of the skin losing their pigment. On treatment the condition will be cured. You should continue treatment.You should not associate your vitiligo condition with your masturbation or sexual abilities. Masturbation is considered healthy if done in moderation. You can have one masturbation per day but not when you have skin problems. For the time being, keep away from masturbation. Coconut oil makes skin more dry. Instead you may use olive oil.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] hi i m tunisian, i i accidentally used toothbrush twice of someone who is vih infected stade sida it seems no blood on the tooth brush i met toothpast on before use seemsly i ve used it afeter one or two hours after he did in the first time and after 8 our in the second time i worry because i d have gingivostomatits afer and cold sore and back rash not seemsly dangerous? [/INST] hi and welcome, HIV infection is transmitted primarily via unprotected sexual intercourse, contaminated blood transfusions, hypodermic needles, and from mother to child. Bodily fluids, such as saliva and tears, do not transmit HIV. as you have mentioned using contaminated tooth brush will not lead to cross infection but you should avoid such practices. As for your oral symptoms you can visit a dentist and get the examination done for gingival infection, thorough deep scaling and root planing will help in relieving sympotoms. use antiseptic mouthwash chlorhexidine for oral rinsing which will help in healing the sores. take care. </s>

<s>[INST] Dear sir. I want to know the meaning of this in upper abdomin ultrasound findings. Its my friend s report. Kindly tell me its meaning. Also tell me what should he eat to overcome from it. Liver appears slightly hypoechoic .. intrahepatic biliary ducts are not dilated. [/INST] it is a very non specific report. hyopecheoic liver maybe seen in hepatitis.i suggest you tell the patient to get his LFT's done. </s>

<s>[INST] yes I ve been taking metroprolo tartrate 50 mg twice a day for many years. but just reciently I had to go to the hospital for a few day because of an infection , there I was told I did not have high blood pressure any more and to stop taking the medication. I tried that and my right leg got very swollen and my family doctor had me checked for blood clots and they found none. I started back with the metroprolo again and much of the swelling reduced . what to due and i read a side effect was hair loss am 58 know and am lossing most of my hair even legs. Is there a high blood pressure medicin that works better with no hire lose? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Yes, you should have Telmisartan chlorthalidone combination instead of Metoprolol then. So you should discuss with your doctor And request for change. Hope this helps you and get back if you have any doubts. </s>

<s>[INST] Hi, I have red spot on my body. I went to the doctor and he said that psoriasis and gave me some cream to put on even my head as well. Which is Oilatum Cream, Dovonex Cream and for my head is Sebco Coconut Oil Compound. I have been trying over a week now but it is not calm at all. I don t know of what was happen to me i so worry and depression! [/INST] hello welcome to health care magic Don't worry and relax. Psoriasis is a autoimmune disease of skin which is a chronic condition. It needs regular treatment for long duration. It might take a long time to control the disease. So you have to have patience. Have faith in your treating doctor. Discuss all the stuff with him. You can try some relaxation exercises like deep breathing, progressive muscle relaxation, yoga or meditation. Take help of a psychiatrist for some counselling sessions. Good luck Regards Dr. Gourav Monga Consultant Psychiatrist. </s>

<s>[INST] Hello, I was just wondering if I have symptoms of genital herpes/ warts or if it is agitation from shaving or is it bug bites? In the past few months I have had protected vaginal sex with several partners, but sometimes unprotected oral sex and fingering has occurred. The last time was a few days ago, but the window in the house i was in was open, and I have had two other red bite like marks on my arms and underarm since that day also. I have three under the skin red spots near and around my clitoris and they are very itchy, along with a slightly less itchy vagina, but these lumps are soothed by sudocream. This occurred on my genitals a day after shaving, but I have never had bumps like before, although i am prone to shaving rash. i was just wondering if this sounds like genital herpes and also how long symptoms take to first appear? Thanks in advance [/INST] Hello and thanks for your question. I have read your description of the problem. It could be bug bites or irritation from shaving but I will give you a description of herpes so you can see if this fits. If you are exposed to herpes it usually takes 2-7 days for the symptoms to appear. The herpes rash is small blisters and they are very painful. The pain is often described as burning pain. If you do not have pain it is probably not herpes. I hope this is helpful. </s>

<s>[INST] The other day, I was really angered and punched my wall. I was in horrible pain for days after that and a week later and my knuckle STILL hurts. My pinky knuckle. I can move it, but it still hurts when I put any pressure on it. There s also a bump/lump right below the knuckle. What does that mean? [/INST] Hello, There will be a contusion. Fracture is unlikely. Consult an orthopedician and get evaluated. An X-ray is required for further assessment. Hope I have answered the question. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] Hi Doc, Me and my Girlfriend had unprotected sex last night but I ejaculated on the outer part of her vagina...I clearly know she will not get pregnant but she don t want to give room for an error and has taken an I pill what could be the result in this case? Does it have any side effects for consuming it without any reason? Thanks... [/INST] Hello dearI understand your concernDo not worry, minor side effect will occur after consuming the I pill.Following are the side effects:Abdominal pain, Nausea or vomiting, Dizziness, FatigueHeadache, Breast tenderness, Bleeding between periods or heavier menstrual bleeding, Lower abdominal pain or crampsSo do not worryTake proper rest, eat healthy diet and avoid stressHope this may help youContact HCM for further health queryBest regardsDr. Sagar </s>

<s>[INST] On the front of my bottem gums I have a very small clear/light reddish colored spot. It looks like it is filled with some liquid. It is not painful at all but it won't go away. It's been there for about 2 and a half weeks. It kind of looks like there are a couple of little white spots under it too (but it could just be me being paranoid). If you have any idea what it could be I'd love to know. Thanks [/INST] Hi...Welcome to healthcare magic. As you mentioned you have lesion over gum that may be because of herpes leasion or other reasons. Diagnose a lesion by clinical evaluation..Start a treatment as per reason behind it.. Consult a oral medicine specialist for clinical examination and treatment. Get well soon.. Thank you. </s>