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<s>[INST] Hi my partner has very high blood pressure and sugar levels her also sweat excessively during the night to the point that he is saturated. He wont see a doctor I'm really concerned He also has a family history of heart disease on both mother and father's side of the family [/INST] Hihypetnsio and diabetes are one of he most important risk factors for coronary artery diseaseh/o of diaphoresis excessive sweating can be a symptom of stable angina , dont neglect it i would suggest you some of the base line tests of cardiology like 2 d echo,tmt , ecg to rule out the cause of diaphoresis, </s>

<s>[INST] HI doctor, my baby(2.6 yrs) had vomiting in the morning. I took her to the pediatrician doctor suggested Junior Lanzol. but after giving this tablet by mixing in 3 mil of water after her break fast she was fine for 2-3 hrs but after that her stomach is upset. Please suggest. She passed motions 2-3 time with in 1 hr of time. [/INST] Hello!Thank you for asking Healthcaremagic!Answer:From your description, it seems like a gastroenteritis.Most cases of gastroenteritis in children are mild and pass within five to seven days without any specific treatment. It is very important to drink plenty of fluids to prevent dehydration and use oral rehydration salts.If your child has pain and a high temperature, this can be relieved by giving liquid paracetamol. Medication to prevent vomiting and antidiarrhoeal medication are not usually recommended for children with gastroenteritis.I would suggest:1. Juices, fruits and vegetables2. Probiotic yoghurts are also available 4. Zincovit should help in recovery if diarrhoea is continuingIf he is running fever, stools contain blood/mucus/very offensive then it needs to be tested and may need antibiotics.I suggest you to consult the pediatrician again if the symptoms get worse.Hope my answer was helpful! Dr Suela. </s>

<s>[INST] I woke up this morning and it felt like I was being stabbed in my stomach. It is now 10 hours later and there is no relief. I ve taken antacids there is no burps or farts. It is somewhat painful to take a deep breath and I m occasionally nauseated. Will it ever end?! [/INST] Hi.This is utterly difficult to understand why the patient is still at home since you are suffering for 10 hours ans you say you have not consulted in ER or a Doctor. The probable reason can be either in the abdomen like intestinal obstruction or lymph node enlargement of a problem in the gall bladder or liver. Another possibility is that you have developed some problem in the pleura - the covering of the lungs as you are giving history of pain increase on deep breathing . Get a clinical examination and investigations to get a proper diagnosis and treatment. </s>

<s>[INST] my neck and back have presure wheh I stand too long or walk with out my wheel chair which i use to push that keeps my arms up while holding the handles, which then keeps my back straight and I then do not have presure on my neck or back. Do I need to have some kind of laser treatment or what? Thanks. [/INST] Hello!Welcome on Healthcaremagic!The chronic back pain could be related to a wrong posture or prolonged sitting position. For this reason, I would first recommend performing an X ray of the spinal column (cervical, thoracic and lumbar regions). A spine MRI may be necessary. If everything is OK, I would recommend trying physiotherapy, to help correct your posture and reinforce your back muscles. Hope you will find this answer helpful!Best wishes, Dr. Aida </s>

<s>[INST] Hello, I am a 46 year-old male. I have a type of lump inside the head of my dick. The pain associated with this condition is minimal, more of an irritation. This sensation is not constant. There are not any other symptoms, no burning while urinating, etc... [/INST] HI,Welcome with your query to HCM. Based on the facts of your query,you seems to have Globus Pharyngeus. Treatment- Surgeon's Second Opinion to fix causes of Painless Lump in the head of th penis- He would investigate your by physical examination and by FNAC Biopsy to rule out the Cancerous Growth of the penis. UroSurgeons help in diagnosis and ruling out other causes of such a penile growth is also needed. These doctors would fix the diagnosis and would treat it by needful surgical treatment as need be. This would help you to resolve your worry. Welcome for any further query in this regard Will appreciate writing your feedback review comments,to help the needy patients like you at HCM. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS </s>

<s>[INST] Hello , i have had IBS since i was around 20 and have always suffered with it but what im experiancing now is a major life changing thing ! i have slipped discs and had an epidural steriod injection last year in june , since then ive had nothing but trouble with my stomach and chest ! ive had barium swallows ecg`s and chest xrays but all come back inconclusive , as i type i have this pain in my stomach upper abdo and in my cheast like stabbing pains i been experiancing this since june ! im only 28 years of age but its getting me so depresed as my doctor doesnt really know what it is i just had some blood tests and the results come back ok , this is really affecting my life and just wanted to know what you htought about it ? im due for an endoscopy end of this month where they want to film how my stomach is working does this sound right ? Thanks [/INST] Hello, If you have had a series of tests already which have failed to show any definite pathology in the stomach or related organs and you have been examined by a doctor who wishes to perform an endoscopy then. By all means have that particular test completed before anything else. However, if this is also unable to demonstrate any pathology then, I believe you may wish to consider that anxiety and stress may be to blame for the symptoms. Abdominal pain, bloating, gassy feelings can be brought about by such psychological pressures and it may be worthwhile speaking to someone on how to perform relaxation exercises and on how to use breathing techniques to feel more comfortable both physically and mentally. You may wish to become part of a gym and get into a workout routine as well as this can also divert painful vague symptoms away from the referred area and improve your ability to relax once you've exerted yourself a bit. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist </s>

<s>[INST] hello, i take 5mg of ramipril daily and have started having severe paid and discomfort in my left knee, have had xray which suggests just wear and tear, but by end of day i am i real pain, could this be linked to ramipril and if so what can i take to reduce the pain, many thanks [/INST] Hello,ramipril has indeed been linked to joint and muscular pain but this is an uncommon side effect. Your doctor should first exclude other potential causes and only then attribute any symptom to ramipril. The only way to find out is to stop ramipril - let your doctor prescribe another drug instead of ramipril - and try to take it again when all symptoms are gone. If the symptoms recur then ramipril would have a high chance of being the real offender.I hope I've answered your question. Please let me know if you need further assistance.Kind Regards, Dr Panagiotis Zografakis,Internal Medicine Specialist </s>

<s>[INST] Hello, am 45 yrs old female , who has noticed small red bumps appearing on the sides of my neck , a couple under the throat. They do get inflamed and can feel sore to the touch. I do sometimes get a couple on the lower jaw...during my youth, i had t zone acne, ...the lower cheek was always clear. now that is changing, is it due to my age and hormones? [/INST] Hi! Good morning. I am Dr Shareef answering your query. Yes, it could be due to the hormonal changes in your body. I would advise you to please take appointment wiith a dermatologist in case it increases in its severity. </s>

<s>[INST] i have had problems with my heart skipping a beat every now and then for about 4 months or so. I have had a few ECG s and an ultra sound and not much come up. I have now had a 48 hour ECG but I am waiting for the results to come back.I am 26 years old 6 foot 2 inches tall and weigh about 189 pounds. I do regular exercise (running about 15 miles a week). I noticed my heart was skipping a beat quite regularly 2 weeks ago so I decided to not do any exercise last week to see if it stopped and it did! I really don t want to stop exercising, my aim is to run a marathon. Is my heart skipping a beat potentially dangerous, should I stop running? [/INST] Hi,Skipped heart beat could be simply VPC's (extra contraction from a normal heart) which can occur with exercise or it could be some other arrhythmia.Let the holter report come & further course of action will depend on its report. Holter is done when you are not exercising.I will also recommend you to undergo a TMT that will report these skipped heart beats during exercise.You can follow up with me after the report.ThanksTake care </s>

<s>[INST] i was suffering from typhoid so doctor has injected 10 injections of monocef 1mg but after that since 8 days i am having fever 99 to 100 degree please suggest me what treat and what pahological test to be done as second vedol test was negative but temp persist til today [/INST] Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that first of all you have to confirm typhoid with blood and stool culture and sensitivity testing for Salmonella typhi. It gives you a sensitivity pattern of the bavteria , if it resistant to the drug ceftriaxone than your infection will re appear. Take sensitive drug treatment under your doctors guidance for completed course. I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you. </s>

<s>[INST] I fell on Sunday and hit my face kind of hard and of course tensed up my neck - this morning woke up and have a hard time blinking my right eye one side of my tongue feels like novacane and some strange feeling in right side of face- my question is it from a concussion or bells palsey and can I fly with these conditions? [/INST] Dear patient difficulty in blinking one eye and one sided face decreased sensations are signs of Bell's palsy and since this has happened after trauma should be taken seriously. Please consult neurophysician nearby you for detailed evaluation and further treatment. Please avoid flying till you are examined by neurophyysician. </s>

<s>[INST] I am a 59 year old, white female. I have been diagnosed with lupus, thalessemia minor, and I have a stent in my LAD. My blood pressure is low to normal and my cholesteriol is normal. I've been feeling tired. My doctor recently took blood and the results are generally normal except I have elevated Leukocyte esterase 1+ and WBC of 6-10. My Creatinine is 1.13 and eGFR Non-Afr American is 53. My Ferritin count is 342. In addition, my Hemoglobin is 10.2, Hematocrit is 32.7, MCV is 71.6. MCH is 22.5, MCHC 31.4 and RDW is 17.1. Some of these results are because of my diagnosed problems. But I am concerned about what I've read about these other tests are they indicators of some kidney disorder? [/INST] Hello madam, You have been diagnosed with lupus and thallasemia minor . Lupus can affect kidneys and since you have a active urine sediment ie 6 wbc in urine , it is better to undergo a renal biopsy and stage your disease and accordingly take the treatment. The outcome of lupus kidney disease would depend on biopsy findings.Also you have mild anemia which may be due to thallasemia.kindly get a serum ferritin and tranferrin saturation ie Iron studies to guide your anemia management.Hope I was of help . Further queries , please get back to me. </s>

<s>[INST] My brother has colo rectal CA, I have read articles saying IV vitamin C can shrink the tumor. He is not into alternate medicine. They have given him 6 months to 1 1/2 years to live. But to take chemo is so devastating to most peoples quality of life, and to go though all that trauma when maybe this will shrink the tumor and give him some quality of life. it has also spread. Thanks [/INST] Hi, I had gone through your question and understand your concerns.I am afraid that the answer is no. There is no any scientific evidence that Vitamin C in any form can cause postitive effect on tumor spreading or shrinkage. So this is not good option as a replacement for chemotherapy. Vitamin c may improve immune system but there is no direct relation with tumor. So you should reconsider chmeotherapy with some less agressive protocols such as folfirinox. Vitamins in general can be taken and cant be harmful at least...Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. </s>

<s>[INST] I am having abdominal pain on my lower right side. It started kind of suddenly and has been getting worse the past couple of hours. It hurts when i press the area and coughing or sneezing make it hurt a lot more. It is a sharp stabbing pain. I haven t been feeling well and have been dizzy and nauseous and losing my appetite. I took my temperature and its a bit higher than normal. I never get fevers so its strange to me. I feel like it may be my appendix but I don t want to over react. Thank you. [/INST] Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] HI i have a cavity and lung tv( active) . i have started taking my medication before 1 month( each film coated tablet contains rifampicin bp 150mg,isoniazid bp 75mg and ethambutol hcl bp 275mg and i am olso taking a separate drug called ethambutol ip 800mg. now coz i coudn't find those drugs except ethambutol ip 800mg,i am planing to start AKT-3( ethambutol hydrochloride ip 800mg,isoniazid ip 800 and rifampicin ip 450mg. my question is....am i going to have a problem in the process of treatment [/INST] The dosages for TB depend on your weight. You should not exceed the doses you are prescribed because this can cause severe side effects that can be fatal, especially because the treatment of TB requires many months of treatment. It is also not advisable to take only 1 medication because this can cause your bacteria to become resistant and this can make it harder to treat your infection in the future. There are various regimens that can be used to treat tuberculosis. The CDC lists some of their recommendations here: </s>

<s>[INST] Hello doctor,I am a 28 year old male. I am married and have a child. But, my penis is small. It is 2 inches in the normal stage and 4.2 inches during erection. I do not have any sexual issue. I have a good erection and my wife is getting an orgasm. But, the issue is I cannot use the public toilets or swimming pool. I am depressed due to the penis size. Please advise good medicines to increase the size. [/INST] Hello. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions. For more information consult a sexologist online --> </s>

<s>[INST] I get tired when I breath. Like, when I breath, my heart starts to beat so fast. I m 15 years old, and from time to time I smoke marijuana, but this happened to me even before I started to smoke marijuana. Down between my neck (throat) and upper chests, I can feel like some type of pressure, and sometimes even when I move from one side to the other side, my heart starts to beat so fast and I get this weird pressure in my chest/between my chest and throat/neck. [/INST] Thanks for your question on HCM.In my opinion you are having stress and anxiety related chest discomfort.Since you are taking marijuana, better to rule out cardiac cause. So get done ECG to rule out cardiac cause. If ECG is normal than no need to worry much.Your symptoms like palpitation (rapid heart rate ),chest pressure and difficulty in breathing can be due to anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. And avoid marijuana smoking. It will only harm you. So quit as soon as possible. </s>

<s>[INST] I had an endoscopy this morning and was given these medications during the procedure. Fentanyl 100 mcg IV Propofol 200 mg IV Versed 2 mg IV After the procedure I started sneezing and my nose has been stuffy. Is this a reaction to the medications. I had no symptoms of a cold or allergy before the procedure this morning. [/INST] Hi, thanks for using healthcare magicIt is possible that your symptoms are due to an allergic response to one of these medications or may be related to any tubing that may have been used in the nasal passages (if this was done)The use of an oral antihistamine would help to reduce the symptoms. These can be obtained over the counter.I hope this helps </s>

<s>[INST] Hi. I get pains in my chest and upper back occasionally. About 18 months ago they got so bad that I was sent for an x-ray. It came back clear. They flared up again recently, and I had another taken. Again clear. The doctor said it must be costochondritis. I also suffer with pretty regular hoarseness and sore throats, plus what's been diagnosed as allergy-induced asthma (without inhalers I have random coughing fits). About a month ago the doctor gave me some antibiotics for a sinus/tonsil complaint. I have no cough. This week I again began to wake with chest pains, which became back pains later in the day. When I expectorated this morning I had mostly white sputum, but then two were a dirty green. More worryingly, one had a pea-sized lump of dark red blood in it. Almost purple. Should I go back to the doctor? Could the previous x-rays have been wrong? Or might it be a problem with my aesophagus?I am 37 and otherwise pretty fit, cycling for an hour a day and playing sport on the weekend. I don't smoke now, but did for about 15 years. [/INST] Hi. I can understand your concern. Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x ray is normal, no need to worry for lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>

<s>[INST] I have a pain in my right arm that starts under the arm pit down the arm ending just above the wrist. there is also some small bruises that appeared under my skin and I didn t bump into anything. It feels like there is a piano wire in my arm that is pulled tightly. I m wondering if this is something I should be overly concerned with or will it go away on its own [/INST] If you have some small bruises and blisters along a line for a few days - then probably you are suffering from herpes zoster infection.It normally goes on it's own but for pain relief you should consult your doctor </s>

<s>[INST] i have a broken finger which i had surgery on the have it pinned. it is now in a make shift cast. how long will this cast be on? or when i go for my 1 week appointment will they put a fiberglass cast on? should i be able to move my finger in there? because i can and it hurts. [/INST] Hello, It has to be kept for two to three weeks. Following cast removal, physiotherapy will help in faster recovery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician </s>

<s>[INST] doctor my mother is of 60 y old and from last some weeks her platelet are in between 93000 to 104000 all the other test are normal like hepB.C blood proteen abdominal ultasound but lft is rased want to know what can be the reason of platelet count down? [/INST] hi, your platelets count is mildly decreased. it not decreased much. causes of low platelets are many. some common are viral infection or malaria. however many times this happens that low platelets are there without any cause or symptoms. so dont worry it will come back to normal within few days. but go for repeat testing regularly till it becomes normal. and if you find any signs of bleeding then consult your doctor urgently. otherwise no any treatment required right now.thanks for using health care magic. </s>

<s>[INST] hi have problems with my lower back and recently have a burning sensation in my neck, the last couple of weeks l have felt dizzy more a foggy feeling in my head and dizzy. l allso suffer from anxiety and when i get this dizziness it doesnt help the anxiety at all. what could be causing the burning feeling in the back of my neck i have allso been told i have athrities,l shouldnt feel this way im only 40 and its restricting my life in so many ways hope you can give me some answers had a mri on lower back some thinkg wrong with my lumbar always pains in my hips and this has been going on for about 19 months my doctor said it will get better with time will it,hope you can help thanks [/INST] HiThanks for using healthcare magicIn that case, you should try some relaxation exercise and antidepressant with benzodiazepine. That would help to control these symptoms. Better to consult a psychiatrist for proper treatment. In case, you need further help, you can ask.Thanks </s>

<s>[INST] I hit just to the right of my tibia on the center console of a car. Then about 10 minutes later there was a large hematoma so I iced it which seemed to make the hematoma go down a little. Now I have a very large bruise that hurts even without touching it. Sometimes when it is touched it feels like a pinching sensation. The lump is small but still there and is extremely tender and sensitive. What should I do? Will this just take time? Are there any risks I should be concerned about? [/INST] Hi.When the hematoma is under tension , it will cause tremendous pain. Since this hematoma is under the periosteum, which is fixed to the bone , this causes such an extreme pain.Show to the Orthopedic Surgeon.He may decide to give you medicines or put a needle to drain this and put a pressure bandage. </s>

<s>[INST] I have the coil in, and the past week. I have had awful pains in the bottom off my back especially when bending down, they then go into the bottom off my stomach near my hips. I also keep getting terrible sharp pains in my vagina very painful, to the fact I have to sit on the toilet till they go away as if I sit on a chair putting pressure on it make the pain worse. And I spoke to a lady I work with and she said I could maybe have a kidney infection. Just wondered what you think before I go to doctors as hate going. thanks [/INST] HiThe coil itself could be a source of infection and the reason for your symptoms. Sometimes it can also be displaced and can cause such symptoms.If you have a urinary infection then only it can descend upto kineys and cause infection. </s>

<s>[INST] I ve been having pain in my lower left back caused by what I believe is a pinched nerve/sciatica??? The pain shoots down from the lower back to the hip to my thigh to the knee. It started Saturday afternoon and at that time I took four Tylenol (two in the afternoon and two at night) and applied Ben Gay. Getting in and out of bed is awful and my sister has to assist me. Yesterday morning I took one Advil and my sister put her back brace on me - to no avail. The pain continued and I took two Motrin around 3pm following a shower and applied a heating pad to the area. Again to no avail. Last night took two more Motrins and applied a patch and this morning got up feeling no better. Is there an anti-inflammatory over-the-counter or prescription that I can take other than Motrin or Advil and is there anything out there more potent than BenGay that I can apply to the affected area (lower left back, hip and thigh). HELP! Thank you in advance for your advice and assistance. [/INST] hi Simply popping pills without advice could be dangerous. i advice you to visit a spine surgeon or orthopedic surgeon and also get the MRI done to know the exact pathology in the spine . accordingly management can be planned </s>

<s>[INST] Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? [/INST] Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online --> </s>

<s>[INST] Hello doctor, I am 48 years old. I am experiencing weak erection and difficulty in sustaining the same. This condition was observed 10 years back. Also, there is premature ejaculation. Other physical ailments that I have are, I am suffering from hypertension and taking Amlopres-L (Amlodipine and Lisinopril) for the last 10 years, high cholesterol and triglycerides. My cholesterol level is 225 and triglyceride is 200 for the last 12 years. I used to do frequent masturbation in early age. I do have erection during morning hours many times, particularly after sound sleep or if I had long walk previous day. I am having Sildenafil 25 mg or 5 mg Cialis, which is effective enough. But, I wish to get rid of tablet support and live natural way. I consulted urologist today and he prescribed me Nano-Leo capsules and Modula 5 mg for 10 days. I wish to have your second opinion on this. Please guide. [/INST] Hi. For further doubts consult a sexologist online --> </s>

<s>[INST] Dear Concern Doctor , I am 35 years old and got married in 3 years back. We are trying to have a baby since last 3 years. But my problem are as follows: • Semen analysis report: Aazosparmia, • Testicular biopsy report: Incomplete sparmatocytic arrest. I am seeking for your valuable suggestion how can I get rid of this problem and be a father. [/INST] dear Doctor I'm 33 years old trying for a baby 4 years now had testicular biopsy report shows :spermatocytic maturation arrest is there any treatment that can improve my chances of becomin e father please help thank you </s>

<s>[INST] Hi my 16 month old daughter was discharged from hospital today after suffering with high temperature sickness, runny nose, cough and runs, since being home her temperature has gone back up to 40.1 we have given her calpol and calprofen and it has come down to 39.7 she has also been very sick again is this likely to be viral or should i take her back to the ward? [/INST] Hi, Persistent sickness for how many days? Unlikely for a 16-year-old to get viral illness to cause that amount of sickness. Please go for blood investigations for her with total counts, CRP, ESR blood culture, platelets, SGOT, SGPT and urine routine. Consult a GP for further treatment. Most likely, depending on symptoms, it is enteric fever. It can get treated with Cefixime or Azithromycin. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician </s>

<s>[INST] Husband is a quadripelegic, and he also has a pacer, Lately he has been experiencing some dizziness after I transfer him into his bed on the way up to a sitting up position. Today he was having a real hard time going up in the bed, his head; and it took about 3 x s before he was ok. He would not let me take his blood pressure. Cheri [/INST] Hi, This is possibly postural hypotension, you should make him check his blood pressure, its the main cause of this condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist </s>

<s>[INST] ive been on loestrin24 for 2 months & it adjusted to my body pretty quickly. also i am a PERFECT user, i take it at the EXACT same time every day. in the begining of my second pack i started taking clarithromycin, but continued to take my BCP. 4 days after i was done the antibiotic i had unprotected sex, but he used the withdraw method. what are my chances of being pregnant. [/INST] Hi there,It is great that you have been taking your Birth control pill regularly. And even if you took Clarithromycin, it is very effective in birth control, that is you will not get pregnant even though you did not use back up.There is a misconception that taking antibiotics makes birth control less effective, but this depends on the antibiotic, Clarithromycin is not an enzyme inducer, that means it will not effect the ability of the birth control even if taken together with birth control. So there is no chance that you could get pregnant.Do not worry and continue the Loestrin.Hope this helps.Regards. </s>

<s>[INST] I am a 33 year old female and have been diagnosed with the hpv virus in 2009. I was due for a pap smear this past february for follow up but have yet to do so. But the other day I used a douche for the first time in about 10 years as I had a strong odor during menustration the week before and when I removed the douche it had an orangey red discharge on some of the holes. So i rinsed it off and repeated the process but it came out again. Do you think this is something I should be concerned with since I have been diagnosed with hpv and the fact that my grandmother on my mom's side had hpv and died from vaginal cancer? [/INST] HiThanks for your query at HCM.I understand your concern and situation.I would like to tell you that you are too young to get genital cancer. It is usually seen after age of 45 years. In your case it seems to be part of menstruation. I see nothing to worry. But yes if you have the persistence of symptoms then you may go to gynaecologist for evaluation. Yes I suggest you to get PAP smears regularly done as you are high risk. You must also take the vaccination for HPV as prevention.Hope I answered your query.Best of healthDr. Sheetal Verma </s>

<s>[INST] Respected sir, according to ultra sonography reports i have epididymal cyst(pea sized) on my right testicle. But is it posiible for a cyst to be hard? Is there any way to stop it from growing in future? I also have vericocele in my left testicle, and my semen analysis report are not good, i have very low sperm count and low motile sperms. I feel pain on both sides. Pain is bearable, but still causes uncomfort. I am very much tensed. [/INST] Respected user , HiWarm welcome to Healthcaremagic.comI have gone through your concern in depth .* Cyst can be varibale in consistency , yes it can be hard .* There are no ways to stop it from growing in future .* Only remedy is surgery if more discomfort , pain or large size .Hope this will help you for sure .Always feel free to ask any further doubts .Regards . </s>

<s>[INST] Hi Doctor I am suffering with mouth infection since one month and I got fever after using antibiotics I have recovered after two weeks mouth infection started again there pink spots on the tongue and I also got mouth ulcer two days ago please help me I am very much worried [/INST] Hello,welcome to HCM,The history and the symptoms of mouth ulcers suggest me that you are having stress ulcer or Aphthous ulcer. These ulcer are common whenever there is episodes of fever and stress.This can be cured and prevented by taking following measures.1.Wash the mouth frequently with Chlorhexidene Mouth wash.2.Apply Ulgel over the ulcers.3.Take Vit B complex.4. If there is any infection You can take a course of antibiotics.Thank You. </s>

<s>[INST] My 13 year old son started not feeling good, and has went from normal to fever over 102 within a couple hours. I have given him motrin, and it keeps rising. He got a concussion last weekend, I dont think this has anything to do with each other, but should I call a doc or bring him in? [/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.Regards - Dr. Sumanth </s>

<s>[INST] Hi im concerned and in pain... my nipples have been erect for three days. the nipple is sore and tender. I am not on birth control and I am not pregnant. I am 40 years of age. I cant tell if its period related because I had an endo ablation in july... I have never had this before. there is no discharge, no other symptoms. my nipples are just erect and in pain... how do I deal with this? thank you [/INST] Hello, I have studied your case with diligence.There is possibility of benign lump or abcess in your breast leading to erect nipple.I will advise to consult your treating doctor for clinical examination of breast and then we can do required investigation.Mammography and ultrasound may help for detail diagnosis.So I will advise for clinical examination and as required MRI spine screening, and cardiac investigation.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care </s>

<s>[INST] dear madam like my mother..........i am 29 years newly married women. i would like to pregnent immediately.. depending upon my family situation... recently i consult doctor, she told you health condition is normal.... but recently my monthly menses received,,,,, what can i do amma? please help to counselling me.... i like to pregnant? reply me... what step i am doing? please send procedure..........in my home, more works i have done.... hard working... i feel this is one of the reason, i am not conceiving,... please reply me madam.. [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Tell your husband to check for semen analysis. If normal then don't worry you will get pregnant.You should have your intercourse during your ovulation period. That is count back 14 days from your last menses date and from that specific date have intercourse 2 days before and after.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Anusuya Ramesh </s>

<s>[INST] my periods are irregular,before 1month i went to a doctor she did some tests and scan then the result is i had a thyroid and bilateral polycystic ovaries it seems.she gave me IPRICAL,THYROXINE,BENFORCE-M. tablets to use...what will be the result and how can i get pregnancy give me some suggestions please.... [/INST] Hi.The first and most important step is to regularise your menstrual cycle. A regular or close to regular menstrual cycle is a strong indicator of a normal or close to normal hormonal function, which equals fertility and an environment good enough to support pregnancy as well.Only after your menstrual cycle is regular, we can introduce fertility drugs (e.g. clomiphene, hCG injections, etc.) which will help you conceive in no time.Best wishes. </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] Good afternoon. 2011/07/26 Yesterday I was at the doctor's office. My problem-abdominal pain. how can a doctor examining a patient does not, without examination and testing prescribe medication. I am 53 years and measured the temperature of the doctor, looked at his throat and with my words had decided what I needed medication ( Omeprazole 20, Aluminium MG.S, Dimethione-SOBHAN 40) I do not know their diagnosis. And as the doctor knows. not even examined the stomach. I would like to take a blood test for cancer. Learn what my inflammation. . Yesterday I was a little upper lip swollen with a small ulcer and the doctor attributed to me (Vitamin a+D-Sobhan). Today is a very swollen upper lip, increased 10 times. What do you advise me [/INST] HI.Thanks for your query. Sorry to know that some Doctors may not be having a proper clinical / physical examination. But in a normal circumstance a Doctor can get far more information and a probable diagnosis by your good, detailed history alone. I am sorry , here too I could only read what you have mentioned and going to comment upon the history you have provided. Well, back to your problems. The multiple ulcers you have could have been due to aphthous ulcers and the cause is not known . The probable cause is GI (gastro-intestinal) disturbance. and this is always tried to correct with appropriate antibiotics and metronidazole. So continue the medicines as advised by your Doctor and Vitamin A and D has to be taken in therapeutic dosage. Too much swelling of the upper lip looks to be due to either angio-neurotic edema or infection of the ulcer. The lips have a different tissue structure so the edema can be far more severe than other places in the body. You may need oral steroids for early settlement . </s>

<s>[INST] I m having Follicle size of 25x225 in right ovary and the Endometrium is 10.2 on the 15th day of my period. Doctor gave me HCG 5k on 12th day when the size of Follicle was 22x22 and Endometrium was 8.2. Today i undergone through sonography but the egg is not yet ruptured and not ovulate. What should I do to be pregnant this time? [/INST] Hi, I think you may need a higher dose of hcg next time. This cycle, you can take progesterone like susten or duphaston for 2 weeks. Do a urine pregnancy test after that. Hope it helps. </s>

<s>[INST] Last night I was sick pretty much on the hour from midnight until morning. Had a slight bout of diarrhoea as well although nothing to actually pass. Also have painful kidneys / lower back which I think is probably dehydration ... Any advice other than drinking lots of fluid (currently trying that but brings the sickness on)? [/INST] Hello, Welcome to HCM, Along with water you can add electrolyte powder which will help in combating dehydration. For pain you can take anti spasmodic s like dicyclomaine. If the diarrhea doesn't subside you can consult your doctor. Regards </s>

<s>[INST] I am looking for a doctor who would be able to diagnose an autoimmune disorder. I have psoriasis, another vaginal condition (also autoimmune). Also, I have over the past 2 months had joint pain and swelling and the cortisone shots and anti-inflammatory medication touched the problem I am in physical therapy and that has not helped either. Please recommend someone to see that might be a good diagnostician. Thanks [/INST] hi, i would suggest that you need to visit rheumatologist, they are the one who had an expertise for diagnosing autoimmune disorder. </s>

<s>[INST] There are white flakes and foamy substance floating in urine sample for past 5-6 days. Pateint s age is 72 years and in the report of Ultrasound KUBP, remarks are Grossly distended bladder with bilateral hydronephrosis and significant PVR Prostatic volume = 90 cc My e mail id is YYYY@YYYY [/INST] Hello,UTI (Urinary Tract Infection) with Benign prostatic hypertrophy.Based on the ultrasound report and the urine analysis you seem to be suffering from urine infection due to an enlarged prostate gland. You should consult your doctor for further evaluation and treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali </s>

<s>[INST] Hello, I know that this is a shot in the dark but do You have any addvice on the recovery from a traumatic frontal headinjury that I sustained in 1997? recovery is so slow that I am loosing the will to keep fighting it! Richard [/INST] First tell me how to occur head injury.pt ct brain reports becuase i want to know excetly injury where is present.howmuch old head injury.what is the complain right now?give me all history after i will help u. </s>

<s>[INST] Hi doctor,A week back, I had sex with my wife using a condom. The condom appeared to be a bit dry and we had rough sex. After sex, when I was washing up with soap I felt some burning sensation in the inner foreskin. There were some cuts. Also, when I pulled back the skin, I felt pain in my frenulum. The frenulum is a bit hard and swollen. It is not healing even after a week's time. I cannot have sex or even masturbate as it hurts. [/INST] Hi. For further information consult an internal medicine physician online --> </s>

<s>[INST] No energy - fatigue Had severe diarehha for two days and ate very little. Have dark stools, but they are no longer watery. Have eliminated nuts, berries and raisins from diet thinking it might be from diverticulitis. Have blood pressure problems - which I am prescribed Lisinopril/hydrocloothiazide 20/25 and because of the illness with diareaha my blood pressure is running 110/81 . I feel slowed, am 66 years old and have had history of colon cancer, diabetes and high blood pressure and high heart rate. My last colonoscopy was October 2014. [/INST] Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that dark stools are very concerning about a gastro intestinal hemorrhage (related to diverticulitis or any other disorders). Your past medical history for diverticulitis and colon cancer could be related to these symptoms. But a common viral gastro enteritis as the cause of this symptomatology can not be excluded. I recommend consulting with your gastroenterologist for a careful physical examination, an abdominal ultrasound, a stool analysis, some lab blood tests including: a complete blood count, PCR, sedimentation rate, CEA, CA19.9 (tumor antigenes), etc. A GI endoscopy is necessary to exlude possible lesions of the digestive tract if suspicions are raised. Meanwhile, I agree with your decision to temporary reduce the antihypertesive drugs doses (because of low blood pressure and dehydration) and take plenty of fluids. Hope to have been helpful!Best wishes, Dr. Iliri </s>

<s>[INST] SIR I 28 YRS OLD FROM ORISSA, I AM MUCH HABITUTED OF TOBACCO LST 5 YR BUT I FORGET TOBACCO FROM LAST 1 YEAR SIR MY PROBLEM IS PRESENTLY MY MOUTH NOT OPEN FULLY OPEND ONLY JUST ONE INCH KINDLY SUGEST ME WHAT I CAN DO FOR MY MOUTH PROBLEM? [/INST] hi, welcome to health magic, yes as the other doctors told you, u have sub mucous fibrosis, now this condition has to treated but treatment depends on the stage of oral submucous fibrosis, in the eraly cases injection theraphy helps but in the later stages surgery has to be done, it is best you see a oral maxillofacial surgeon who specilaises in treating submucous fibrosis you can contact me on 9879834033 Dr Adarsh Desai (Oral Maxillofacial Surgeon & Implantologist) Ahmedabad </s>

<s>[INST] I broke my left hip 2 1/2 years ago. I never was prescribed physical therapy. Since my surgery, I do not have the same flexibility (which should probably be expected); but, I have lost the ability to squat or raise my left leg keeping the knee facing forward. As I raise my leg, my knee turns to the left as does my foot. When walking it takes concentrated effort to not walk in a slew-footed manner. Is this normal? [/INST] Hi, as you described your concern, physical therapy is necessary after joint surgeries. But not to worry about walking, yes it is slightly abnormal if you are making efforts in normal walking. U can correct it but it will take a bit long time, you can start from general stretching of your hip muscle and can consult for gait training with physical therapist. I hope you will get benefits from this. Good luck. </s>

<s>[INST] Hi Dr. My son is 2 yrs and 5 months old.Was on Monteck LC Kid for a month in Sep for allergic cold which was causing fluid in his ears. The allergy as well as fluid in ear was resolved. He is now recovering from a cold. But I find that he still has some phlegm in his throat. He coughs only occassionally but sometimes seems as if he has a blocked nose. Is it ok to just give him Nasivion drops or will I need to give him Monteck LC kid again? [/INST] Hi... I have just read through your son's case history. Occasional cough with blocked nose doesn't require Montek-LC kid. I suggest you use only nasal drops. For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.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] I have a friend that takes: carvidolol, furosimide k-dur, niphipine calcitrol, creator,novalog, LevimerShe takes nothing with food a d usually eats hours after taking meds. She has kidney disease, acid reflux, getting ready for surgery next week, lost a significant amount of weight in about 2.5 monthsDiabetic, hypertension etc. Advice for her [/INST] Hello, Thanks for the query.If a person has uncontrolled blood glucose (hyperglycemia), then, a considerable amount of glucose is lost from the urine as kidneys are not able to reabsorb it. Persistent loss of blood glucose through urine does lead to weight loss as well as persistent weakness and tired feeling. Since she has chronic kidney disease, which also is a possible complication of diabetes only and hypertension which again contributes to kidney disease. In such situation it is very essential for her to achieve a greater level of glucose control. That will help in controlling kidney problem. Even for better outcome of the surgery strict glucose control is absolutely necessary. Off course during surgery and post -operatively for a short period she will be on Insulin for better glucose control. But later again strict glucose control is a must. Thanks. </s>

<s>[INST] Hi doc my mom has been diagnosed with urinary tract infection (e.Coli)..also stomach infection at the same time.got her urine culture report which doesn t mention cefudoxime s susceptibility...but the doctor has prescribed cetil250 for both the infections.do u think this wud help her.?. [/INST] Hi,It may be effective for both conditions. Cetil (cefuroxime) is commonly prescribed to treat infections caused by susceptible bacterial such as urinary tract infection, respiratory tract infections, and gastrointestinal infections.If the gastrointestinal infection is caused by a susceptible bacteria then cetil may be effective in eradicating the infection.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician </s>

<s>[INST] So Wednesday I started to get a stiff neck and it got worse. by Friday I had ear ache and a head ache now Sunday I also have popping and cracking in my nose and my balance is off. When I bend or turn I am dizzy and feel sick. Please help I don t want to be like this for Christmas !! [/INST] Hi i am Dr Ahmed Aly thanks for using HealthcareMagic site ,I had gone through your question and understand your concerns .. You may avoid bad sleeping postures ,vigorous movements and try spinal straightening exercises . For my patients i may recommend NSAIDs or painkillers like advil tabs when needed , hot gentle massages with topical gels of anti-inflammatory , B12 vitamin supplements and muscle relaxants will be effective for most of cases . If pain persist i recommend MRI for proper evaluation and management and follow up with her physician . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask. </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] my 7 year-old daughter has a soft lump on the upper left side of her head. She sometimes complain of headache and a sharp pain when she touches it. She had a bump probably 2 weeks ago but it was just recently that I noticed the lump on her head. Should I be worried about this? Please give me some insight. [/INST] Hello! Welcome to HCM.This lump can be dermoid or sebaceous cyst or less likely lipoma.These are all benign swellings.Infection in it causes inflammation & so is the pain.Many similar patients come to my clinic, I advise them X-ray skull lateral view to know if any intracranial extension is there.If there is no intracranial extension, then "excision biopsy" is done i.e. swelling is removed under local anaesthesia & sent for histopathological examination.Consult your doctor for control of inflammation with medicines first.Hope this helps.Wish you healthy life.Thanks.Regards. </s>

<s>[INST] Hi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you. [/INST] Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness. </s>

<s>[INST] Last Night I had wheezing while laying down to the point where I couldn't sleep, What triggered it is that I worked out for about 15 minutes after eating last night. The only remedy I could use to get any sleep was to sleep at the end of a couch elevated. any ideas? [/INST] Hi,You have not mentioned your age and any comorbidities.The chances for the breathlessness may be due to cardiac or respiratory problem. Since this is the first time and the breathlessness relieved sleeping at the end of a couch elevated, this suggests more due to cardiac causes. You are reduired to get checked for ECG, Echo cardiogram and chest Xray to diagnose/ruleout any systemic cause.Based on the report we can decide the right treatment as the line of management differ in each pathological condition.Hope this helps you.Regards </s>

<s>[INST] Hello doctor,My father is diabetic as well as a heart patient. Right now we performed a general checkup and in that, they mentioned creatine level is 1.4. How to reduce it? [/INST] Hello. It is impossible to reduce creatinine. As you see diabetes is a progressive disease and it affects the kidney. When we control our blood sugar strictly, we may postpone getting the kidney problem for many years. But if we do not control our blood sugar level strictly, we may get kidney problem soon. The point is, all diabetic people will get a kidney problem. It is only a matter of time. But there are some ways to prevent worsening of kidney problem. The blood sugar must be well below the normal levels. So please take care of your father's blood sugar level and control it, then the creatinine value may go back. Each laboratory has their own normal range based on the reagents and types of tests they do. See what is the normal range given for creatinine. If the normal range is more than 1.4, then no need to be afraid. Since he is also having heart problems, I want to ask you a few questions: 1. Is he having swelling in both legs? 2. Is he having difficulty in breathing even doing his routine activities? 3. Is he passing less urine? 4. Is he already on tablets which increases urination like Lasix or Dytor? If he is not on Lasix or Dytor and he is having swelling, we can start tablet Lasix which reduces the load to heart and kidney. I want to suggest a drug which prevent kidney failure. Please ask your father to start tablet Nefrosave twice a day after food which is good for kidneys. It can be taken with other tablets. Also, do a test called eGFR, which clearly says whether he has kidney problems or not. </s>

<s>[INST] I am a privately contracted care giver. My patient has been diagnosed w/ drug overdose induced schizophrenia. He has been on Abilify and Seroquel for 6 mos and is showing no improvement. I find it difficult to believe that ANY drug regimen could reduce ,much less reverse the effects of my client frying his brain on just about every illegal substance known. He has CONSTANT violent voices and hallucinations. ie. I am having difficulty trusting his psychaiatrist [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. From the available description it appears that your client is suffering with treatment resistant schizophrenia (Schizophrenia which fails to respond to two or more medications despite trial of adequate dose and duration).In such scenario Clozapine is the best suited option as it has shown efficacy in treatment resistant schizophrenia. In my opinion you need to discuss option of clozapine with his psychiatrist as next course of action. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I had a barium swallow test done ten days ago, since then I have had an overall sick feeling, dizziness , right sided flank pain in my right side back area, loose stools, low grade fever, also a lump or swelling in that same flank area along a lower rib that is sensitive to the touch.. fatigue, swollen neck glands, I have a history of kidney stones , and a sliding hiatal hernia repair in my near future. I am a 52 y o female, 200 lbs 5 5 [/INST] check for cold abscess.means tubercular abscess.also bacterial abscess.you need good ultrasound abdomen.also urine for AFB. </s>

<s>[INST] Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. [/INST] Hi. For further doubts consult a sexologist online --> </s>

<s>[INST] Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. [/INST] Hi. For further doubts consult a sexologist online --> </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] Hello, my niece is 30 years old and just had a seizure yesterday. Prior to the seizure she had symptoms that consist of becoming very hot and having a memory or flashback. When the episode was over she was white as a ghost and couldn t recall the flashback. This happened 5 times before the seizure. Then it happened again while in the hospital AFTER her seizure. An MRI was taken and we won t hear results until Friday, but I m so disturbed by this and wondered if you had any thoughts...Thank you! [/INST] Thanks for asking at Healthcare Magic. I read your question and I understand your concern. Seizure with aura and postictal state is mostly idiopathic in nature. MRI is done to ruled out serious problems like brain tumour and others like Basal ganglia calcification in case of parathyroid problems . Other tests are also done like serum calcium, renal function tests, serum magnesium and random blood sugar. Once all the investigations turned out to be normal then she doesn't need treatment for seizures until she suffered second attack of seizure. Hope it helps best. Don't forget to rate this answer and close the discussion at Healthcare Magic. Take your best care. Regards Dr Ejaz </s>

<s>[INST] Hi, My mother is an asthmatic patient. She has been suffering from this disease since 30 years. Her level of asthma is not like others. She is comfortable to breath in normal conditions easily.But when the weather changes or tends to be at peak, she falls off due to it. What I mean is, she started to feel choking during very cold winters or high summer. She gets some sound while breathing that time. Due to this condition she cannot focus on things, she just stays in bed. Currently the medicines which she is taking are Deriphyllin and inhaler. Is there any possible cure for asthma? Or is there at least some means to lower it down, so that she can actually live the life she want? Thank you. [/INST] Hello. Your mother is suffering from bronchial asthma and it is not well controlled at present. You have not specified which inhaler she takes regularly. Basically there are two types of inhalers. One is reliever for emergency use and the other one is controller which must be taken twice daily even if you feel better. You start her on Foracort inhaler 400 (Budesonide/Formoterol) two puffs twice daily followed by gargling and Duolin Inhaler (Ipratropium Bromide/Levosalbutamol) for quick relief in emergency. Also do spirometry test, PFT (Pulmonary Function Test) to confirm asthma. Other medical diseases like hypertension and diabetes if she has any must be well controlled. Inhaler must be always taken with Zerostat - VT spacer followed by gargling with plain cold water. Hope this answers your query. Consult a pulmonologist online for further follow up --> </s>

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

<s>[INST] I m south Asian and therefore my skin is somewhat dark, but I ve noticed that over the years I ve become darker. I was wondering as well that if using my laptop and phone so closely all the time causes problems of me becoming darker? I feel like I have various patches of dark/lighter skin on my face. I ve been using sun cream to stay lighter. What would you say I should do and what is the problem? [/INST] hello.. as u said ur having dark and light colour patches on ur face over many years.. i hope it is due to vitamin and iron deficiency in ur diet due to may b heavy work or stress. it might not b directly due to phone and lappy usage but due to neglecting proper diet .. i suggest u to take good diet full of vegetables and fruits and also multivitamin tablet daily one for one month.. if yet not recovered get ur blood test done for blood percentage.. i hope u wil get ur colour back soon.. all the best .. </s>

<s>[INST] i am on gabapentin for leg pain and also need both knees replaced....my shin has been hurting me as well as the back of my knee for about a month. I have had it xrayed and they say I also have bad arthritis behind my kneecap and that is probably where the pain comes from ...I can hardly walk anymore and live on vicodin, motrin 800 as well as pain patches in order to walk in a store for a bit...I am in the least pain when I sit...but I don't want to get a blood clot by sitting too long...I only get up every few hours to walk in the house and then I need to sit down again...My leg is constantly hurting and I have been checked for blood clots......If I get knee surgery, I am wondering if this pain will go away. Could my knee be causing my shin as well as the back of my leg to hurt so badly even while on 300 mg. of gabapentin twice a day??? Thank You! [/INST] No, gabapentin is not an analgesic. Though vicodin is a strong pain reliever. So gabapentin with vicodin and patches shall take care of the pain.Knee replacement shall help you overcome the pain. </s>

<s>[INST] I have severe right lower abdominal pain , I got admitted into hospital with suspected apendisitus but it come back it wasent that or ovary cysts or anything. Since they found that out they have just not done anything more for me and I m in agony the doctor gave me painkillers and I m taking over 4,000 mg a day witch can t be healthy anyway can you help? [/INST] Hi emilygibson. Thanks for your question. severe lower abdominal pain may be due to appendicitis or lower ureteric stones. as you need ultrasound abdomen to rule out these two common diseases. once it is confirmed that there are stones in the ureter of sze less than 8mm ,usually do not require any special treatment except pain killer and taking lots of fluids and somes antispasmodic drugs like dicyclomine. stones more than 8mm requires intervention. so better not to take pain killer for prolonged period. take care </s>

<s>[INST] dear respectable doctor , I am student studying in italy , I would like to recover or get rid of my bad smell comes from my mouth . I cant speak with other person when i speak because of bad smell they are not talking with me. This since 4 years that i am suffering please i do request to guide and give me some solution [/INST] Hello, Welcome Thanks for consulting HCM, I have gone through your query, for bad smell you can do is proper brushing twice daily. Do chlorhexidine mouthwash twice daily Do warm saline gargle two - three times a day Consult dentist and go for Scaling and root planning. Hope this will help you. </s>

<s>[INST] Hi my wife is on cipralex 5 mg and oleanz 5 mg once in night daily from past 7 years.. does she have to continue taking these medicines rest of her life? Also for a brief period her dose was reduced to 2.5 mg and she again went to depression again. so we reverted back to 5mg. will these medication be taken all her life any other alternate? [/INST] Hi and welcome to Healthcare Magic. Thanks for your question... The duration of treatment for depression usually depends on the number and severity of the episodes and whether there have been any relapses after stopping medication. If the initial episode has been severe or prolonged or if she has had more than 2 episodes or if she has a strong family history of depression, then she may have to take medication for a longer duration. It is also important to see if she has any predisposing factors for a recurrent depression like underlying thyroid abnormalities, certain vitamin deficiencies, etc. and treat them appropriately. In your wife's situation, since you have mentioned that there has been a clear relapse of symptoms on reducing the dosage of mediaction, I think that it is advisable to continue medication for a longer duration. 5mg of Cipralex is the minimum effective dosage of that medication for depression, and it is a relatively safe drug with minimal side effects. However, you can discuss with your psychiatrist if she needs to be continued on Oleanz (which is an anti-psychotic medication and is given only when there are 'psychotic' symptoms (delusions, hallucinations, etc.), in addition to the depressive symptoms. Please feel free to clarify any more doubts that you may have. All the best. -Dr. Jonas Sundarakumar Consultant Psychiatrist </s>

<s>[INST] my son have rheumatic fever, please help me Q : "he taking Penicillin LA 12,000 from last six months, he is 19 year old , he had a History of Rheumatic fever , and doctors says to take this penidure injection till five years at least. but still the joint pains, throat infections, chest pain and rashes will occur. he is studying engineering. he is not drawn picturs in board. hick neck is pain. What can he do? please give some idea. where we go to check. if any other Dr. available chennai [/INST] HIWell come to HCMAcute Rheumatic fever with the presence of staphylococcus needs anti biotic for three to four weeks with long acting penicillin but this may not prevent reduce the risk of rheumatic heart disease Penicillin actually works in acute condition to reduce the load of organism, bit this is necessary periodic medical examination is advisable, hope this helps. </s>

<s>[INST] Is it possible that a newly installed Pergo flooring is causing me breathing difficulties. It was installed along with a renovation that did have quite a bit of dust. The dust has been removed. We checked for mold and that came back negative. Typically when I am exposed do dust, my nose will run, I will get a sinus infection and my lungs will hurt. I am not having sinus issues. However, I have had to get and inhaler because my lungs are hurting and breathing is becoming more difficult and tight. I am extreemly sensitive to dust, smoke , cleaning agents, certain printers . . .I received a copy of the MSDS sheet on the Pergo flooring and it does talk about breathing difficulties, however, I am not sure if it is referencing the dust from cutting the wood during installation or the installed floor. [/INST] Hello, It does seem that your dust allergy has worsened after the new flooring was installed and if you were around at the time of installation, it would be unusual that such a high dust allergen load has upset your airways. If your peak flow is below 50% of your best reading, you need to be in hospital to sort out the lung. You do have multiple sensitivities and combination of things has led to the sudden worsening of symptoms. These include dust mites from old carpets, mold (not always seen), chemicals used to lay down the flooring etc. A Chest XRay is recommended to ensure there is no overt pneumonia or pleurisy. </s>

<s>[INST] My six years old grandson has not been sleeping at night hardly at all this week. The school calls his mom to come get him because he is not alert in class. Last night he didn t sleep at all...I am keeping him at home today. Around lunch he crashed, it s been three hours and I can t keep him awake. He has never had this problem before. My question is...Will it be ok to give him melatonin 3mg before bed time to help him rest better?? What could cause this?? Should we be concerned and take him to see the doctor??? [/INST] HI...there could be many reasons for day time sleepiness, but the most common in children in obesity and obstructive sleep apnoea syndrome which occurs due to inadequate sleep at night due to obesity and they snore a lot. Such children feel very sleepy in the morning and they try to keep up the sleep which they lost at night.If your grandson is obese this could be the cause....otherwise he needs evaluation regarding seizures too.I suggest you take him to a doctor.I do not recommend using Melatonin without ascertaining the cause for day time sleepiness.Regards - Dr. Sumanth </s>

<s>[INST] Hi, my periods usually starts by 17th of every month .. lasts for 3 ddays . n 12 th , 14 n 15 th had intercourse of dis sep month . with n without protection. took I-pill thrice on respective days.. n 17th was the date to start my period.. but dint get my periods ... n did upt test aftr 4 days n turned negative... n aftr 1 day startd deviry tab 10 mg for 5 days... n now its 2 day has stopped deviry tab .. but still get periods.. wat to do next.. go for upt again or beta hcg or wait for some more days to start bleed ? [/INST] Hi,You have given yourself excess hormones and this has upset your hormonal balance and this is why you did not see your cycle. As such, you had intercourse during the safe period and did not need the emergency pill at all. As the pill contains excess hormone, you can expect your cycle to get delayed. Your chances of conception are none. Please visit a gynecologist for further support immediately and do not self-medicate yourself any more. Wish you good health. </s>

<s>[INST] I am 21 yrs old 5'9" and I recently attempted autofellatio. I never achieved and gave up I was just curious. However, my bowels are obstructed and my stomach is bloated and feels tight. can you tell me what is wrong and how serious is it? and is there any stretches or exercises that I can do? [/INST] Hello Thank you for trusting HCM I don't think the activity cause bowel obstruction and bloating. The act may cause back ache or muscle spasm. May be other reason for it like altered bowel movements due change in diet. You may developed irritable bowels etc. Please consult your doctor and your not developed any hernia with bowel obstruction. </s>

<s>[INST] i think im pregnant? i hope not because i gave my bf a handjob and got jizz all ovr my hand n sum was on his pants i had my pants on n he wiped all th jizz away wit tissue bt then he felt my ass n stuff n we continued hookn up n i felt abit wet aftr dat n i chekd bt i dnt thnk iwas nthn i felt like peein so i went to th toilet n ddnt wash my hands.. [/INST] Hi, I understand your query, In the sex under the question, there is sleek chance of pregnancy .. as you had vaginal sex immediately after words. Just possible that remenants of semen might have reached mouth of uterus.. & cause conception. You should wait for your period as routine.. in case it doesn't come go for HPT after 8 days delay in menses. This will confirm / exclude pregnancy. Thanks. </s>

<s>[INST] Hey i'm 18 and all my life ive had very visible veins on my chest all to my shoulders. Ive never had problems with my heart or anything like that. I'm also not fair skinned and i tan easily. is there anything i can do to get rid of the veins or cover them up for my wedding ? [/INST] Hi Amber,Welcome to HCM.You should consult a physician to check out if there is any underlying cause for distended veins on the chest and shoulders. Normally veins on the chest and shoulder are not prominent. Some heart problems and liver problems may cause prominence of veins. If these can be excluded then these veins can be ignored and nothing much could be done about them except putting on a little bit of fat. Wish you all the best. </s>

<s>[INST] My 10 year old daughter has the black marking around her neck and under her arms she has been tested 3 times for diabeates because of her weight gain. Everytime it comes back negative. How do I get rid of this and should I have further testing done on her [/INST] Hi...this is called acanthosis nigricans and the only way to get out of it is to lose weight and get back to normal weight for age. NO medicines are there to decrease this black discoloration over the neck. This is related to obesity and will become normal once normal weight is restored.Regards - Dr. Sumanth </s>

<s>[INST] Hi, I have had chest pain in the left side for over 3 weeks now. The pain is mostly when I take a deep breath but today it seems to be happening when I bend down too. The pain has been strong at times & sometimes not even noticeable. It started in my chest for a few days, then it moved to my back, then my chest & back. For the last 2 weeks it's been in the chest. It is a heavy feeling along with the pain. I am almost 34, have smoked since I was 14 but just quit a day after this all started. What should I do? [/INST] Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .* This seems in relation with different possibilities as - lung infection or other pathology - chest wall or intercostal muscle ligament sprain or strain - diaphragm related - others .* Require physician consultation with x-ray chest for further management .Hope this will help you for sure .Regards . </s>

<s>[INST] My son age 24 went to emergency room with chest (upper abdomen) pain. After an EGG and some blood work, they said the EKG was abnormal and something about muscle on the heart. He has an apt to see a cardiologist on Friday. WHat does muscle on the heart mean? [/INST] as our body has muscles ,heart also has muscles which helps in the pumping action of the heart, these are involuntary striated muscles.so as ekg is abnormal and something is wrong with the heart muscles means there can be hypertrophy ,that means increased size of muscles that leads to increase size of the heart and that leads to ineffective pumping. </s>

<s>[INST] I am in my mid-twenty, I have a dry spot on the front of my scalp. The spot in only in one area it is not itcy, nor does it get red or have any other symptoms. I take good care of my hair, not sure why this has not went away. We are not experiencing hair loss either. I am starting to think I would need some treatment, but not sure what it can be. I have a sister who has this same problem, which have lasted years. But it forms as dark circular spot on her forehead,and now my mother has the same spot. We have used anti- dandruff shampoo and no results. Can you explain this? [/INST] Hi welcome to healthcaremagic As the disease is spreading in family, do not share the same comb., towel, soap, and clothing... pesonal hygiene must be maintained..you must be clinically evaluated... consult an dermatologist.. </s>

<s>[INST] Hi, I used to masturbate daily once is is good... Will it caused some issues in sperm count. Also I used to shake my dick slowly by watching porn videos for 2hrs continously after that I will masturbate. I can t able to control it. Will cause some health issues in future.... Guide me... [/INST] Hi, Masturbation does not affect the sperm count and motility. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] I went to my doctor yesterday to address my blood pressure. I have a family history but I have presented no symptoms until lately. I went to my doctor yesterday and was put on a low does diuretic. today my head is killing me i checked my bp an hour ago and it was 158/95 pulse was 97. Should I call my doctor again? [/INST] Hi thanks for asking question.While going to doctor what was your blood pressure before starting diuretic??Here you have high blood pressure.You might have skipped dose of drug so that rebound headache can occur.Because of high blood pressure also headache can occur.So continue with taking drug regularly.Low salt diet taken.If headache troublesome analgesic can taken like brufen or paracetamol.If you have associated congestion by viral infection then also headache can occur.for that decongestent taken.Avoid some triggering favor for headache like....loud noise, skipped meal, dehydration etc....If still bp increasing then consult doctor for taking sodium nitroprusside or other suitable drug by iv route.I hope your concern solved.Take care......Dr.Parth Goswami </s>

<s>[INST] I was bitten by a horsefly 9 days ago. I have a blister 1.1/2 in wide by almost 1/2" high. I have taken 2 days of flucloxacillin 500mg 4x a day. It was bright yellow to begin with but today is has turned a grey colour. Is this the antibiotics working or is it acting as an incubator! It's not painful apart from the odd twinge, the cellulitis has gone but the blister does not seem to be shrinking. I'm 67 and it's across the top of my foot. [/INST] Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it is towards the edge of healing.It is because that antibiotics you have taken is working. So that the infection is towards the healing end you are will be very clear with the blister.As this blister is very big in size it takes some time to heal. I advice you not to worry. Keep taking your drugs timely.Try to avoid injury to the blister. If it bursts than the nude skin expose to the atmosphere making it vulnerable to the infection.So keep the blister protected with shocks anf shoes covering.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM </s>

<s>[INST] my doctor thinks i might have cancer in the tonsil area? after scoping my throat he said that every thing looked clean but due to the lump on the left side of my neck he thinks the cancer started in the tonsil area. will have ct scan tomorrow. what can i expect? YYYY@YYYY [/INST] Hello,If you are feeling there is a lump in tonsillar area, then go for an incisional biopsy where the possibility of malignancy (cancer) can be found out accurately.Meet surgical oncologist or general surgeon for biopsy. Biopsy test only gives 100% diagnosis whether cancer or not.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siddartha </s>

<s>[INST] for months now i have been having problems trembling and twitching in the mouth/lip area. i have been suffering for along time with depression/ocd/anxiety/stress in which i have tried many ways to be stress free and was prescribed with fluoxetine 20mg, now i m not sure whether that has been the problem for this but i had to come of it because it seemed to make it worse. now i thought coming off the medication would relieve my problems but it has not. i am still getting the same problems, and it s affecting me socially and even when alone it still a big problem. recently i have been taking atenolol beta-blocker 50mg, but that to has not helped. it would be great help for someone to tell me what is going on, because i am not sure what to do now. i ve tried to diagnose my problems online, either i have some thyroid condition, tremor problems, or phycological issues. it would be great to get some help. [/INST] Hi Your problem looks like "Oro-facial Dyskinesia" ...in ordinary words "mouth-face disordered movements". Usually antipsychotics i.e medicines used for psychosis cause dyskinesias but sometimes SSRI antidepressants like Fluoxetene MAY cause this problem. Usually the first mode of treatment is stopping medication or decreasing the dose if stopping worsens the depression. We may also try some other medication to try and see if it helps. Unfortunately, for a few percentage of people, the problem is irreversible. BUT IT CAN NOT BE PREDICTED AS TO WHO WILL HAVE IRREVERSIBLE AND WHO WILL HAVE REVERSIBLE PROBLEMS. so we consider all cases as reversible and try our best. Please consult a psychiatrist for treatment. I would honestly like to know why so many patients, already under psychiatrists, don't tell them about their problems but seek help from other sources. I would really like to know so that I can not do what these psychiatrist may be doing wrong, if any. </s>

<s>[INST] Hi Doctor,I got AMH done and 2 labs had different reports. One had AMH of 0.6 and another 1.5 AMH.I just want to ask you that what Medicine can I take to Improve it. I had Endometriosis and my CYSt was removed last year and I was put on Lupride 11.25 and I dint get my periods for 6 months. After that I tried to conceive but No result. What is the next way to go to Conceive keeping in mind my AMH is low and do I stand a chance to get Pregnant? [/INST] Hi, I think you can take dehydroepiandrosterone tablets for 3 to 6 months and can try naturally on that. This medicine increases the AMH. So, you can conceive while you are using it. But to speed up the process, you can take some medicines like clomiphene for the growth of your eggs. Track your follicles growth by repeated ultrasound. When they become more than 17 mm, then you can take injection for rupturing the follicles. Be in contact with your husband for next 2 to 3 days. Take some progesterone for supporting pregnancy for next 2 weeks. Hope I have answered your question. If you have any other query I will be happy to help.Regards Dr khushboo </s>

<s>[INST] my right lower leg muscle between shin and calf has been tingling and a burn like feeling for a couple of weeks now. i dont belive i injured it. would you know what it could be? there is now bruising or discoloration, just sore once in a while. thx. for your help. from: L L [/INST] hitingling and burning are signs of deficiency, which could be of essential vitamins or micro minerals. you should take some multivitamin and mineral tablet for a period of 7 days and see if it works, things can correct with this simple measure, but if it dosent, then see your doctor and discuss your concern. </s>

<s>[INST] hi , i am suffering from polio on my right hand. i have started lifting weight for body workout. thought i can t engage my right hand in most of the exercise, i use it as a support. can there be any bad affect on my right hand. Its very thin compared to my left hand. [/INST] Hello, Moderate exercise even in polio-affected limbs is advisable. Care must be taken not to put too much weight because of the possible damage to tendons and muscles. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical </s>

<s>[INST] i had an infection in my navel recently and i sprayed it out with my shower head. afterwords i went to swab it out and it appeared(felt) like it had opened. I even stuck my finger in and it felt like it went very deep , much more than originaly. could my navel have opened somehow? [/INST] Hi, Thanks for posting in HCM. I understand your concern. Kindly do the following to overcome the infection in the naval area. 1. Wash the area with warm water and mild antiseptic solution like Savlon twice daily. 2. Apply Neomycin cream on the lesions after drying. 3. Take anti-inflammatory medication like Ibuprofen after food. Keep the area under good hygiene. Hope the information provided would be helpful. All the best. </s>

<s>[INST] Hi I am having pain in the center of the left side of my chest,like a shooting pain,it's been on and off for while it comes and goes,am 29year old male,also I have woke up this morning and am sniffing and there is blood in my spit,could you give me some answers. [/INST] Hello if the pain you describe is when you breath deep, and the episode of blood. It looks like pleuritic pain. Ie. The pain arises from inflammed covers of the lungs. I suggest you to get a chest X ray done if occasional cough is presentThe second probability is that you suffer from gastritis with some reflux in the food pipe which may have caused some blood in the spit. Do visit your local physician and evaluate for same. Hoping I could help. Dr. Priyank Mody For further assistance from my side you may connect through HCM @Http://doctor.healthcaremagic.com/doctors/dr-priyank-mody/70273 </s>

<s>[INST] I had an abscessed tooth removed last Thursday. There is currently no pain at the removal site. However, there is pain at the site where the abscess had formed, between the tooth and the cheek, and I am also now feeling like there is a small lump in thet area. Can you tell me what that lump is. I am still on my antibiotics regime. [/INST] hi..the lump is due to the deposition of pus in that area..evenif your teeth has got removed the pus within the absess has to drain outside.if the lump persist for more than a week,consult your dentist and he will drain the absess.its better to take your antibiotics after draining the absess,orelse it can result in antibioma..hope you get well soon. </s>

<s>[INST] I started experiencing tingling and numbness in my toes on both feet. I had a complete physical scheduled in a few weeks but the tingling and numbness became worse and spread to my calves and even in my upper legs. I went to the doctor before the physical and spoke to the doctor. He told me that the possible causes were diabetes, neuropathy, lower back problems or a vitamin B 12 deficiency .The doctor went ahead with the blood work and I was to return in a couple of weeks for the results. So I had a friend who is a diabetic check my blood sugar and it was normal. I went to the store and purchased a B12 / B complex and started taking it daily. Within about 7 days the symptoms subsided. When I went back to my doctor for the results I was shocked to find that my B12 levels were not low but high at 1800. The doctor took more blood and called me back two days later to tell me that my B12 levels were now over 2000 and to quit taking the supplement. However, He never explained why my levels were so high to begin with. I have cut back on the B12 and am now experiencing some numbness again in my toes. I am also having trouble sleeping. I go to sleep right away but wake up about two hours later with restlessness in my legs and my whole body. I usually just get up and go down stairs and watch TV for a while and then the pain will subside and I can go back to sleep. What could be causing these symptoms? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You have ruled two causes diabetic neuropathy and vitamin B12 deficiency. then most likely cause is lumbar canal stenosis (LCS).LCS means reduced space in spinal for nerves with decrease in blood supply and hence when you stand or walk tingling and numbness appears. Diagnosis can be confirmed by doing MRI of the lumbo sacral spine with screening of whole spine. Please get it done from radiology centre nearby you. Meanwhile start tab Pregalin x 75 mg one at bedtime. You need to visit orthopedic surgeon with report. Increase in vitamin B12 level in your blood may be due to increased intake. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi, I moved to the city for the first time in Sept. 11 (have lived in a very rural area before), and since spring began this year, I ve started to have symptoms that may be from allergies - runny nose , itchy eyes, occasionally a sore throat , even though I never showed signs of having allergies in the countryside. These symptoms have been fairly mild, so I haven t taken any medication. But today I ve been having shortness of breath for no apparent reason, and the allergy level in my city is quite high today. So I m wondering if shortness of breath can be linked to allergies. If so, what s the best course of action from here? [/INST] you symptoms sound like SAR or seasonal allergic rhinitis and allergic bronchitis. in thiscase, please get tested for allergies esp if any pollens. use of nasal sprays and inhalers during the allergic season will keep your problem under control </s>

<s>[INST] My mom just made me aware of something she has come across. She is 75 years old and not been doing well, weight loss , no apetite, gives out quickly so we have been going thru a serious of test and go back to the doctor Monday. Now she has informed me that yesterday she felt weird down in her vagina area. She explained to me, her daughter, like when you put in a tampon and and it s not fitting right. So in looking at it by her squatting and using a mirror it is a white sac about the size of a large butter bean. She said it wasn t hurting. What do you think? THey are trying to rule out cancer with her ?!?!?!? Please advise [/INST] Hi, as your mother is 75 years old there is a chance of perineal muscle weakness , support of uterus weakened. chance of cervical prolapse is very high. not seems to be related to cancer. so please consult a gynaecologist who will guide you regarding further management. </s>

<s>[INST] Hello, My name is BrianneI have an appointment tomorrow to receive my second birth control shot. My mom has to work so I was going to take myself but, they said that my parent or an adult who can sign for me had to be there. I'm 17 so I was wondering can't I go by myself without a parent because under consent and confidentiality laws I didn't even have to tell my mother. So can you help me figure this out. [/INST] Hi Brianne,Thanks for the query.Usually in some countries a person can give consent for contraceptive purposes only after 18 years.Possibly because of that your doctor or hospital people might have told like that.So better to take your mother along with you as per the rules.Ans also it will be good if some body accompanies you because sometimes side effects can occur to shots.If your mother is busy you can take help of some other family member. For more details you can ask me through: care. </s>

<s>[INST] Hi My 7 months old girl has some whitish to yellowish discharge coming out of her eye. It gathers every hour or so and gathers back after we clean it off. When she sleeps and wakes up the discharge spreads to her eyelids. Should I be worried, and what do you advice? [/INST] Hi, your child has got conjunctivitis infection. You should get the child examined by a ophthalmologist. </s>