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<s>[INST] I am having very bad pain in my lower back into my buttocks, anus and legs. It makes getting up from sitting, turning or getting up from the bed very painful and difficult. It started after straining to defecate. I do not have hemorrhoids. What could be the cause? FO [/INST] Hello, It can be due to perianal conditions like hemorrhoids it anal fissure. As of now take laxatives like lactulose for smoothen your bowel movements and for symptomatic relief. If symptoms persist, better to consult a gastroenterologist and go for a colonoscopy to evaluate the cause. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Dear doc, My mother is 90 years old. recently she had fever and sore throat. her blood test result was OK regarding RBC and WBC. But her ESR is 64 and it was a source of concern for her GP. her general health is OK and she suffers from lifelong artherosis. Is there any probability of malignancy? thanks [/INST] Welcome to H.C.M I am Dr Krishna Dubey.Dear friend , as per history given by you is in favor of increased E.S.R due to Arthrosis (-a chronic inflammation ) and recent infection (fever an dsore throat).As you told that her general health is ok then it is not looking due to any malignancy here.A chronic inflammation like Arthrosis is common cause of increased E.S.R.I advise you to repeat E.S.R , complete blood count and peripheral blood film after one week to rule out any other cause and to remove your doubt completely.Thanx for query. </s>

<s>[INST] I have low lymphocytes in blood test and it is six months after I recieved 40 sessions of radiation for prostate cancer. could the radiation treatment have effected lymphocytes production? My RBC count is normal 4.36 and my WBC seems normal at 4.9 and HGB is 13.5 and HCT is 40.1%. Only thing which seems low is lymphocytes? What should I do ..if anything? [/INST] Hi, dearI have gone through your question. I can understand your concern. No need to worry about low lymphocytes. Your total wbc count and rbc count is normal so there should be no any major cause. May be it is due to your radiation therapy. No any treatment is required right now. Just be relaxed. You should go for repeat complete blood count test after 1 month. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] My grandmother has this continuous problem for the last 20 years of heaviness in chest due to mucus build up. She always feels like a weight on her chest and constantly forces it out by coughing. She constantly draws the mucus up her nose to release it from her throat to get some relief. Can you advise what to do. [/INST] thanks for your questioni completely understand your issue.actually in obstructive airway disease or in lower resp tract infection and many other diseases mucosal glands in the bronchus gets hypertrophied or enlarged and so is the secretions from them.these secretions have to drained or expectorated out , if these secretions get retained or not expectorated then these will get secondary infection .if the secretions are yellow u need to give some antibiotics to clear up the infection .you can consult a pulmonologist to prescribe the drugs.to ease the expectoration of secretions steam inhalation should be done to loosen up the secretions .you need to consult a pulmonologist and a physiotherapist.thanks /regardsfeel free to ask more questionsmay god bless you with good health </s>

<s>[INST] Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. [/INST] Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.---> </s>

<s>[INST] I had sex, & I took his cum and put it inside me. I think it was only a small amount. The next day I got my period. Now its been 19 days and the first test I got Faint. Now i got negative. my abdomen is grown out, i have tender breasts, etc, etc. Am I pregnant? [/INST] If it is only 19 days , you should wait longer to find out whether your period is going to come or not. if not , only then do the pregnancy test . Tender breasts can occur in premenmstrual period without pregnancy also. </s>

<s>[INST] my penis is itchy and the foreskin looks a bit dry and flaky and tiny white spots appeared just under the head of my penis. It itches only a bit now, used to itch a lot a couple of weeks ago but is better now. Plus there is dirt like i havent washed it in days just over-night. What is it? [/INST] hellothank you for trusting HCMDear many causes for dry flaky itchy skin on penis.most common causes are1. friction:Dry masturbation, prolonged sexual activity, and even constant rubbing against clothing all create heat and friction. These can strip away the body’s natural lubricating oils, leaving the skin feeling dry and parched. Dry skin is also more susceptible to surface-level damage, meaning that even normal activities can cause microscopic tears in the outer layers of the skin; this can result in a penis that is sore and tender to the touch.2.Allergic Reactions — Skin allergies and contact dermatitis (eczema) can cause skin irritation, rash, flaking and dryness that can be difficult to combat. Some common culprits that cause adverse skin reactions may include the chemicals found in laundry detergents, soaps, latex, spermicides, deodorants and fragrances. Plants such as poison ivy, poison oak, and even ordinary grass can also cause allergic reactions in some men.3.Soap or body wash – Even in men who do not have allergies to the chemicals found in some personal care products, regular body bars and shower gels can cause dryness and extreme irritation of the penile skin. These products often contain detergents that are designed to clean away sweat, grease, and dirt, but may also strip the skin of its natural protective oils.4.Yeast Infections — While yeast infections (caused by the Candida albicans fungus) are more common in women, men can also be affected. Individuals who have a depressed immune system due to diabetes or other systemic disorders, who are undergoing chemotherapy, or who are taking certain medications may be more prone, but yeast infections (also known as thrush) can happen to anyone. Aside from dryness and peeling, symptoms can include painful cuts or fissures in the skin’s surface, as well as a thick, pasty or chunky discharge.so please avoid allergen,use moisturizer cream,use candid b gel for local application,if symptoms not improved please consult your dermatologist he/she will examine and treat you accordingly. I think I answered to your question if you have more questions feel free to ask.take care </s>

<s>[INST] I had a mammogram and a breast sonogram, both revealed a small (5 mm) mass under the nipple, it has not been diagnosed as cancer, it is thought to be benign, however a biopsy was recommended to be sure. I don t think it is necessary because I had this before and was told it was a cyst (benign) that is very common, they come and go. I have never had a biopsy before. Your thoughts? [/INST] HiSince your mammogram and breast sonogram revealed 5 mm mass i would advice you to go for the biopsy test just to confirm that it is not cancerous.It is a simple procedure where a thin needle is inserted into the mass which removes a sample of cells or fluid to look under the microscope.RegardsDR DE </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here..My daughter has a bad cough, and a temp of 38.9. She is 3. We took her to a doctor last night with a tempof 39 and he gave some anit-biotics which we had not used as neurofen had brought her temp down this morning. Tonight her temp is back up to 38.9, she has rapid breathing onf one foot is cold although hands are warm. She is alert and responding well when I speak to her. I wondered whether I should take her back to the hospital? I have just given her 5mls of Amoxcillin but nothing else. Thanks [/INST] Hi, You need to get back to the hospital to be checked again, and keep on neurofen and amoxicillin medication till you get there. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist </s>

<s>[INST] Hi doctor, I was about to get a complete blood test done to check certain parameters. I have attached herein the screen shot of the parameters. I wanted to know if I have masturbated before 36 hours of these tests then would the results be adversely affected? If so, how many hours should lapse after I last masturbate to get these tests done? [/INST] Hi. For further information consult a family physician online --> </s>

<s>[INST] hello,my name is Abu i m 22 m from india,i want to know that what are the use of nexito plus 0.5mg tablet as my doctor said i need to take tablet daily after dinner around 8pm. may i know what it helps in and how it works please do reply me thank you...! [/INST] Hello, The active ingredient in Nexito is a drug called Escitalopram. Escitalopram is used to treat depression and anxiety disorder. Hope my answer was helpful. If you have further queries feel free to contact me again. Regards, Dr. Dorina Gurabardhi, General & Family Physician </s>

<s>[INST] Hello doctor, I have been diagnosed with candida albicans in the throat through an endoscopy. I had a sore throat in the beginning and was misdiagnosed and given antibiotics which made things worse. I have been on Nystatin twice a day 5 ml each and Betadine twice a day for two weeks now. I have also taken two tablets of Diflucan 150 mg over the two weeks so one a week. The endoscopy today showed an improvement but not much from last week. Overall the improvement is around 60 to 70 % over the two weeks. How long does it take to treat it and can I take another Diflucan pill? My ENT is against it as he said it is harmful for the liver but my family doctor is saying it is alright and I should take it. Another doctor advised I should take Itraconazole 100 mg twice daily for seven days. I am not sure what to do. Please advise. Thanks. [/INST] Hello. Since already you have been diagnosed with candida infection there is no problem in taking one more tablet of Diflucan if you do not have any other comorbid conditions. If you want you can also try Clotrimazole oral paint for the same. The time taken depends upon your immune status. You need to rule out other immune compromised situations like diabetes mellitus or any other long-term drugs you are using. Hope that clears your doubt. For more information consult an ENT otolaryngologist online --> </s>

<s>[INST] I m 25 in excellent health and newly married. After my bachelors weekend and my honeymoon I ve dealt with puffy ankles. I went to doctor and my alt is 145. Doctor said I have liver damage and should never drink again. Has anyone else had this problem? [/INST] Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). There are many causes for elevation of ALT like alcohol intake Hepatitis B and C virus, wilson disease, autoimmune liver disease etc. . So I will suggest you to visit a gastroenterologist for evaluation and appropriate management. Meanwhile:1. Do reduce your weight by diet and exercise2. At least 30 minutes aerobic exercise per day3. Low fat diet4. take tablet Ursodeoxycholic acid and Vitamin EI hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. </s>

<s>[INST] Hi, my wife and I have recently had a resurgence in our sex life just this past month that has led to daily intercourse, many times through out the day. Just this past week, I've noticed the skin under my penis head, very red, very sensitive and what looks like some thin cuts around the circumference of my penis. During arousal and especially intercourse, I have felt pain. We've both been checked for STD's and have come back negative. What would can I do to avoid this problem. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Frictional cuts are very common on the foreskin during sexual intercourse in men who are not circumcised. I would recommend you to use fusidic acid ointment on the effected area twice daily for 4 days until the cuts are healed. Meanwhile use good amount of lubrication during sexual intercourse to decrease the friction. Lastly, I would recommend you to get circumcision done because repeated cuts and injuries on foreskin will cause inflammation and fibrosis on the foreskin. Which leads to tightening of foreskin and makes it difficult to retract foreskin over the glans penis leading to phimosis, which is quite painful condition. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hey doc, Resently i've noticed some small wart looking pimples growing around my vaginal area...I dont know what is it its growing...Its not painful or itching but it bothers me knowing that its there.. EVERYTIME I BATHE PASSES MY HANDS THERE, I FEEL IT ITS ALOT... Unusual, it was never there before..Would should i do? Should i consult a doctor immedately? [/INST] You should not delay your doctor's visit. It could be simple acne like or even a genital wart due to bacterial or fungal infeciton. If it is examined by the gynecologist, then you shall be able to come to a conclusion like what it is. </s>

<s>[INST] I fell down the stairs carrying my little girl the other day in the rain. I held her up in the air so I landed quite hard on my hip. It happened about a week ago. Although I can get around better now there is a large circle on my hip and upper thigh that is sore to the touch and is reAl red with fever in it? I hate going to the dr but do you think it could be serious? [/INST] HiWelcome to healthcaremagicI have gone through your query and understand your concern.This is hematoma ( collection of blood in and beneath skin). This is likely to resolve gradually with passage of time but as you have got fever so it is advisable to visit a doctor. You need analgesic such as ibuprofen for pain relief and antibiotics to control the infection. Vitamin B and C help in healing. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care. </s>

<s>[INST] Hello doctor, I am a 23 year old male. I am having pain in the upper back. When I sit on the chair in office the pain starts and it reduces when I stand, stretch or walk. I work for nine hours, from morning 11 to evening 8. I do not have any previous injuries or accidents. Eight days ago, I felt pain in the upper right back just below the shoulder. Then, the pain shifted to the upper middle back. When I sit and look into the computer screen, it pains more. When I look up, I feel relief. Give me your advice. [/INST] Hi. You have given an excellent description of a common problem in persons who have a desk-based job. The condition you are experiencing is due to poor posture. Stretching and looking away from your constant position is helpful as you have also figured out. Get up and move around after every half an hour. Keep the top of your computer screen at your eye level while sitting with your back supported in the chair. You can do intermittent stretches of your neck and shoulder muscles. Practice isometric and range of motion exercises of the neck which will help you a lot. Take painkillers and apply an anti-inflammatory gel locally for immediate relief. Do not take the painkillers for a long time. If you follow these instructions, these will help you recover in a few days. If the pain persists, investigations may be required. Consult an orthopaedician online if the pain persists --> </s>

<s>[INST] Hi doctor, I am a 27-year-old female. My weight is 124 kilograms, and my height is 159 cm. I am trying to have a child. I have an absence of periods for the past three years. I get my periods only after taking a birth control pill (Yasmin). I have done my ultrasound scan. I have all the symptoms of PCOS. Please see my pelvic ultrasound images and say about the abnormalities seen. Please help me. [/INST] Hi. I have gone through the images (attachment removed to protect patient identity). Your ultrasound scan shows a bilateral polycystic ovarian morphology. However, the antral follicle count is not so good (less than four). Having a good antral follicle count of 11 to 30 in ovaries with less number of follicles allows you to try naturally. Try to have assisted techniques that support to have a natural conception. It results in a better outcome. Your uterus and endometrium look fine with no abnormalities. There are no signs of infection in the pelvis. </s>

<s>[INST] i had sex on 14/15 febuary which was my ovulation period, i saw pinkish bleeding 19 febuary and felt some cramps in my lower abdomen for some day i did home pregnancy text which gave me nagative on the 27 febuary. by 27th febuary i saw another pinkish stain that flow through to saturday 29, 3oth was just spotting stain till today and few minute ago went to the toilet and saw brown stain at the same time saw flow of stain on my pad. my question now is am i likely to be pregnant [/INST] Hi dear, I have gone through your question and understand your concerns.Irregular spotting after intercourse in the ovulationpperiod is suggestive of pregnancy.I will suggest you to get a urine pregnancy test repeated after you have missed your expected periods.If positive, then you should take the further treatment accordingly.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma </s>

<s>[INST] My baby is 5 months and 3 weeks old. She usually gets these raid breathing spells that last for about 5 seconds. her breathing is very shallow and fast and she makes noises sometimes. she is not sick, as in fever, vomiting or coughing. Should i be worried. [/INST] HiAfter going through the history of your child it doesn't seem to be problematic. Usually baby has a irregular breathing ie for some seconds it will breath fast and for some it will be slower. This is usually a normal pattern in a new born child.If your baby is feeding well and having proper weight gain also achieving developmental milestones with age then no need to worry.Faster breathing needs special attention when associated with1] High grade fever.2] cough3] Feeding difficulties.4] Increased respiratory muscle activity.If any of above are present then please consult a pediatrician.Hope this helps you. </s>

<s>[INST] Hello doctor, I am a 25 year old male. I was recently diagnosed with an autoimmune disease called systemic sclerosis. I have been experiencing a couple of symptoms along with this disease. Could you please give me some advice on how to treat these symptoms, which I could pass on to my regular doctor. First is the Raynaud's phenomenon, this is not crucial as I do not experience this as much anymore, making sure my hands are always kept warm. But, if you have any other suggestions I would like to hear them. The one symptom that I am most concerned with is the generalized edema. It has started about 4 years ago and has gotten severely worse. Since then, I have been prescribed diuretics from my doctor. But, whenever I take them I will go through a process of losing about 10-15 lbs in water weight, then after a week of no drug or diet change, I used to go back to the same state as I was before taking the diuretics and sometimes much worse. My doctors and I think that this may be due to my capillaries being "leaky" and this leaking protein might surround the body tissue area. When I take the diuretics, my body flushes out the water, but at the same time the protein in the area senses a loss of water and sucks in more from my bloodstream by replacing the water I had just lost. However, my doctors are not quite entirely sure that, if this is, in fact, the root problem with water retention. I have kept a very strict diet when it comes to sodium and other things of that nature. Anything of a personal nature that comes to solving this problem that I have tried, have had no successful outcomes. I wanted to know if this is a case you have seen in many other patients with an autoimmune disease, especially the patients with systemic sclerosis. If it is so, is there any effective treatments for the water retention other than diuretics? Is there anything that I can recommend my doctor that will aid me in dropping this water weight and keeping it off? [/INST] Hi. According to my opinion, Raynaud's phenomenon is a part of CREST syndrome of systemic sclerosis. In case that is troubling you, the best treatment that I have found very successful is the use of crushed Sorbitrate tablets in coconut oil and apply them to massage over the extremities. This is a very economic and effective treatment. Now, as far as water retention is considered, this can occur in two cases: So, I would recommend you to get the following tests done: I hope, these investigations will be of great help. </s>

<s>[INST] For the last 4 days I have had a sharp pain on the right side of my head. the pain comes and last about 1 second. this happens every couple of minutes the pain is on the lower side of my head. I went to the doctor and he thinks its my neck that's the problem. no pain pills work. [/INST] Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.This kind of pain can be due to one of the following :1. Cluster Headache.2. Migraine3. Sinusitis.I need to know more details like any photophobia, phonophobia, any watering from eyes, any nausea or vomitings, any rhinitis??This is my personal opinion based on details available here. If you still have any query you may please ask me.Stay Healthy. Dr Anshul Varshney , MD </s>

<s>[INST] I have a strong history of breast and uterine cancer on my paternal side and would like to get genetic testing done but my PCM says I'm not at higher risk since its on my fathers side (my father died from colon cancer). I recently had an ultrasound done that showed a cyst on my left ovary but have been told that's normal. I am 53 years old, no menopause yet, never given birth. Should I be tested for BRCA 1 and 2? The paternal side: grandmother ovarian cancer and two aunts breast cancer all deceased. [/INST] Hello madam , Thanks for full details u mentioned to evaluate the problem u had. As ur paternal side grandmother and aunt suffered with breast cancer and ovarian cancer indicates they are ur second/third degree relatives. For BRCA 1 & BRCA 2 either maternal or paternal side ur are under high risk for inheriting the gene . Thus go for BRCA 1 & BRCA 2 testing. As u not attended menopause and u had no childs thus which increases ur general risk of developing cancer apart from gene defect . Thus i advice to go for yearly screening apart from BRCA gene screening. </s>

<s>[INST] My husbands blood sugar tested at 575 at 11 pm. He changed his insulin pump site and I s trying to go to sleep now. Our plan is for me to wake him at 1 am and test his sugar again. He is a type 1 diabetic, 60 yrs old, and a 6-bypass survivor. What should I expect for acceptable improvement, and what signs of danger do I need to watch for? He has been very irritable and was a bit confused earlier, but was able to clear up his thinking. I am worried about the possibility of his having a stroke, plus, we don t have any strips for testing for ketones - he was never educated on those, and I m new to all of it. Thanks for any advice you can offer. [/INST] Hello,Your husband is diagnosed with Type 1 diabetes, so his blood sugars control totally depends on Insulin and diet.He must regularly check blood sugars at least 2-3 times in a day and adjust the insulin dose as advised by your Diabetologist or physician. Also, you must be aware of symptoms of low blood sugar sometimes irritability, and confusion is part of this only.Regular monitoring of blood sugars, low carbohydrate diet, regular moderate physical activity will help to control blood sugars.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. DEEPAK M R </s>

<s>[INST] hi dr i have aproblem ihave jyst felt that my mastoid process enlargebut d its cosistency is hard like abone its uinilateral enlargement ,no pain,no redness nor inflamation,my hearing is normal but im so warry of that enlargement .. ineed a quick answer please :( [/INST] could be middle ear infection or jaw dislocation check middle ear infection firstyou should check both possibilitys Good Luck </s>

<s>[INST] i was scratched by a not so healthy looking cat this morning and it drew blood. I am 5 months pregnant. i cleaned the wound immediately and put on disinfectant...is there a large risk of toxoplasmosis? also, i have to bike on a pretty bumpy road to get to town, is this safe? [/INST] HI, thanks for using healthcare magicIt is understandable to be concerned but toxoplasmosis would be spread by contact with cat feces (stool).Because this is the normal way of transmission then your chance is very very low.In terms of the bike riding on a rough rode, if this can be limited or eliminated then this would be best.I hope this helps </s>

<s>[INST] I am 54 and am having trouble breathing lately. My doctor gave me an albuterol inhaler because he said I was breathing shallow. I just used the inhaler and it made it even harder for me to breath. What could possily e causing this. My chest is tight and I feel like someone is standing on top of it. [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. Albuterol is bronchodilator. So it is effective only if there is bronchospasm (bronchitis). Since you are not improving with albuterol and also have chest tightness and pressure, better to rule out cardiac cause for your symptoms. So get done ecg, 2d echo and stress test. You may need diuretics and other cardiac supportive drugs. Don't worry, you will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I am always hungry, miserably so, this has been going on for about 2 months and continually worsened. I try not to give in as I am already overweight which is a first for me also. I have been diagnosed with interstitial cystitis, and neurological problems they thought ms but I dont have certain symptoms that are required for that diagnosis, so they diagnosed me as neurological disorder, i also have some anxiety and depression, but that is not new. So tired of wanting to eat all the time and Im not exagerating and weight and hunger are new [/INST] Regarding MS, someone has to have neurologic deficits (like head nerves paresis, motor or sensory deficits, balance problems etc) and if this happens a head/spine MRI is required. If you are taking medications for your depressive disorders, the increased eating is usually an adverse effect of the drugs. You can consult your psychiatrist and maybe he can try and change your drugs. </s>

<s>[INST] Hi I have noticed a rash like coming up under my chest about a week ago. I looked it up and it seems like a yeast infection. Now its all over my chest its scarring me. I ve tried just about everything.I have insurance but the co pay is too high. Please help. [/INST] Hi, thanks for using healthcare magicFungal rashes can take a few weeks to respond to medication.You can consider continuing the use of the topical anti fungal but if the rash is extensive and spreading an oral antifungal may be needed.The oral anti fungal would require a prescription from your doctor.Examples of topical antifungals are ketoconazole, miconazole, econazoleThe short term use of an topical steroid may reduce any itching that may be present.I hope this helps </s>

<s>[INST] My 4 year old turns his head side to side to look out of the corner of his eye. Seems involuntary. He s unable to explain why he does this. It is not constant throughout the day and seems to occur when looking near and far. He did this last year and eye exam was WNL. Also having acute behavior changes, not sure if they are connected. [/INST] Hello, I wish I had video! It sounds like it could be a "simple tic." Children often develop involuntary small muscle contractions that they aren't even aware of. A tic just comes for no reason and goes away for no reason, anytime between a couple of days, to more typically a few months or so. There's not reason to pay attention to it (as hard as that is) or ask him to try to stop it (he may or may not be able to). Other examples you may have seen in other kids is squishing their nose, shrugging a shoulder or super blinking. However, you also mentioned behavior changes - although that is usually not related, any change that's sudden or new or unexplained should be further discussed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Lisa Baker </s>

<s>[INST] Severe abdominal cramping in the upper and lower quadrants mainly midline and left side, but right side hurts at times too. Hurts worse with movement. N/V. Diharrea x 2 days. Fever and chills yesterday. Today below normal temp. Sleeping a lot. Cannot eat. Decreased urination. Lethargy. Dizziness spinning and lightheadedness [/INST] Better to visit a doctor..General physical examination USG and other routine investigations including CBC,typhidot,KFT,urine analysis is required for further step. </s>

<s>[INST] Hi, I had a copper IUD fitted almost 6 weeks ago, on the first day of my period. No other medical conditions, medicaiotn, no hornomal contraceptives used for many many years. Noprmal full health, active lifestyle. One child, normal delivery, now aged 11. I have had a copper coil before but not for many years, and I do understand it takes some time to settle. My first period was longer heavier and more painful, and I have had a gap of two weeks without bleeding before it started again. I am now on to day 10 of an extremely heavy, extremely painful period, and the flow seems to be getting heavier and cramping worse, not better. What do you suggest? [/INST] HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1. You are right in judging the response of newly fitted IUD. Certainly it will take time for your body to get adjusted to this new IUD.2. I will suggest use of Tablet MEFTAL SPAS 2 to 3 times a day during the menstrual period as needed to overcome pain and bleeding. If needed Tab PAUSE 500 mg can be added 2 to 3 times in a day. You should aim at blood loss that needs 2 sanitary napkins per day and there is no passage of clots.3. If you still have heavy periods, a course of antibiotic like Cap Doxypal 100 mg 2 times a day for 10 days is advisable. Also, Tab REGESTRONE 5 mg 2 times a day for 5 days from day 21 to 25 of the cycle will help reduce menstrual bleeding.Last but not the least , Please get IUD checked up from your doctor every 3 monthly.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam Neurgaonkar </s>

<s>[INST] Currently on third day of a five day course of penicillin. Just getting worse, had conjunctivitis for four days, very swollen, red, blurred, giving me headaches. Now very sore throat, feels like its closing up on me. Chest tight and some back pain. General fatigue need to nap a lot and aches all over my body. Keep regurgitating green phelgm, stuck in my throat. Have anxiety disorder so know what that feels like, this is different. Am I just being a hypochondriac? Helen Stewart [/INST] HelloYou are on penicillin for conjunctivitis. You are also having headache, sore throat, chest pains and tightness. General fatigue you are having is most probably due to viral infection you are having. As you have history of anxiety disorder also so excessive fatigue in you is most likely due to somatic or hypochondriacal symptoms. Wait for some days so that symptoms get resolved if no relief occur then visit a psychiatrist for expert opinion.Thanks </s>

<s>[INST] Hello doctor, I got a piston in the right ear 30 years ago. I am 58 years old and 84 kg weight. I feel hard to hear now. I have attached my recent audiogram result details for your reference. [/INST] Hi. From the available information, it seems to me that you might have a condition called otosclerosis. Otosclerosis is a condition in which there is abnormal bone growth in the ear which prevents the sound vibrations from being conducted adequately from the external ear to the inner ear. This can be confirmed with a test known as a tympanogram. Once it is confirmed, you might have to undergo a revision surgery which is done by a surgeon. In most cases, it improves the hearing considerably. If it does not improve with this, you might have to opt for a hearing aid. For further information consult an audiologist online --> </s>

<s>[INST] Hi, my 21 year old daughter is takes 1 2 mg dilaudid for pain associated with acl/meniscus surgery about 10 days ago. She also takes 2 benadryl and a promethazine (for nausea and to help sleep). Her aunt gave her 10 MG melatonin from GNC to help her sleep. Is this ok to take or is that too much? Initially after her surgery she was taking 2 - 4 dilaudids (2 mg each). Thanks! [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.There should be no problem with the melatonin and her other medicines. Although she may be a little drowsy the next morning if she takes it along with the promethazine.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ralph Chambers </s>

<s>[INST] Hello doctor, Three and a half months ago, I fractured my humerus in a car accident. When I went to the hospital I had my arm put into a sling. Since then I have been going back to the hospital every three to four weeks for x-rays, what concerns me is that my doctors seem extremely unsure what to do because my arm has healed in an awkward way. They keep saying I should leave it for a few months but I cannot see how it will ever mend properly. I insisted strongly that they put me on the waiting list to have the bone replaced and have pins put in it, but they said it might not be worth the risk. I want to know what other professional opinions so I can make a more informed decision. I have posted a picture of the x-ray. [/INST] Hello doctor, Sorry to hear about your accident. From what I see on the Xrays attached, you sustained a humeral shaft fracture. (attachment removed to protect patient identity). These fractures tend to be very forgiving, that is, they do well in spite of a great deal of malalignment. Humerus has a thick muscle cover all around it, so healing is usually quick and predictable. The shoulder joint has an enormous range of movement. This helps in retaining the excellent function of the arm even with minor amounts of malalignment. In fact, up to 20 degrees of anterior (front to back) angulation, and up to 30 degrees of varus, valgus (side to side) angulation is acceptable. Also, unlike the legs, shortening is not much of a concern in upper limbs, and upto 3 cm of shortening is acceptable in a humeral shaft fracture. Your x-ray show exuberant callus (healing bone), and you are likely to achieve good union in due course of time. I would not worry about the x-ray appearance of your humerus. Even if it heals in a malaligned position, so long as the malalignment is within the acceptable limits, and the bony union is strong, I would consider this an excellent outcome. It is, however, advisable to continue following up with your orthopedic surgeon for repeat x-rays to make sure that the malalignment does not worsen and the healing progresses. You can try to make the x-rays look better by operating, but the function and appearance of your arm externally will remain the same, and you will be left with a surgical scar. In your case, since it has started healing, a long incision will have to be taken to open the entire bone, remove the healing callus, and realign the bone fragments. This will not only expose you to operative complications like blood loss (which will be very high because you cannot use a tourniquet for a fracture that are high in the arm) but also a risk of non-union of the fracture, as you will be stripping off the blood supply to the fracture surfaces. I hope this helps. Healing humeral shaft fracture. Healing humeral shaft fracture. Observation. </s>

<s>[INST] My grandson lives with me. He is seventeen months old. 13 days ago he had a cyst on his bottom which is now clear now I have noticed an open sore between his anus and butt cheek. It hurts when he has a bowel movement and when it is wiped. We do everything we can to keep it dry but it just wont heal. It s been about a week. Could very hard stools have anything to do with this? Thanks [/INST] Hi,Clean local part with plane water often and apply antibiotic cream.Passing hard stool will cause delaying healing due to rubbing against wound.It might require one course of antibiotic medicine if infection is severe.consult your doctor and get examined.Ok and take care. </s>

<s>[INST] i have beenn on birth control for 8 months i had unprotected sex and he ejaculated in me 3 times this month, i take it everyday around the same time i have not missed a pill this month. i have been having mild pregnancy symptoms of nausea in the morning a few days ago but i was also very nervous so my bf said it could be just all in my head from me being nervous and worried about being pregnant. i have also had frequent urinations. i took my first white pill today and i am worried i may be pregnant, i was also told that birth control (yaz, which i take) can cause thoose symptoms. i just switched back onto yaz this month so i was thinking it may be the cause of that. and if you know or are on yaz what day do you get your period like on what pill cause there are four. i use to be on yaz and im pretty sure i get it on the second pill. should i be worried at all i mean i am not going to do that again it was a very bad decision on both me and my bf but what are my chances of me being pregnant and if so what test should i take and when. thanks [/INST] Hallow Dear,If your are so regular with your birth control pills there is almost no possibility that you would be pregnant with the unprotected sex you had. You are right, the symptoms you have described like nausea and nervousness are the side effects of birth control pills. You need not worry about them. If nausea is making you uncomfortable, you may take proton pump inhibitor tablets like pantoprazole to control the acidity. Please do not change the birth control pills frequently. Continue with one brand that suits you best. I hope this helps you. Dr. Nishikant Shrotri </s>

<s>[INST] I have been sick for 1 month now. I had the flu that turned into bronchitis. I was on a zpack. And when I was done taking them and for several days later, there was no sign of really getting better. I don t have any insurance and am broke from being off work so long. Anyways my mom and dad ended up in the hospital and both with the flu, my dad with pneumonia also and my mom with bronchitis as well. She was on a rx that the doctor had told her was for people with pneumonia and they were big guns . She took them for seven days with no sign of getting better. The hospital took her off them and when she came home she to,d me to start taking her meds...I did for no other reason than I was so sick and couldn t afford meds. There are only 5 pills in a box and she has like 8 boxes. I told her on the back of each pill it says to take 1 every week. I to,d her that and she said no...take one everyday. So I have been. It is not an antibiotic like we thought at all. Three days ago was the first day I have felt human but by the evening time, I could not touch my legs from the knee down. There were these red blotches (like when you take a hot shower) all over my lower leg and they felt like the most horrid bruises ever. I have been running a fever since then as well and have a sore throat and a killer headache that feels like my head is being crushed. I feel good during the days but come the night everything comes back. Except the legs...they never stop hurting...tonight we looked at the side effects and it turns out it is fosomax....or actually what ever drug it is that starts with a A but is it s equal. I also take 880 mg of aleve every night because of major arthritis pain...I also have asthma and use an inhaler. It says do not lay down after taking it, I always do....and don t take with aleve...I always do....my lungs also hurt really bad like when you run in the cold....I am worried and don t know what to do. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. * As per the description, the skin condition of the lower limbs indicate severe drug induced eruptions. I recommend to immediately consult your family doctor for the same. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Accidentally took and chewed half a pill of Aleve, thinking it was a TUMS tablet, which was laying directly next to it on the dresser. Within minutes, I noticed the burning & odd sensation, and tried to spit out remainder of it.. Rinsed mouth thoroughly, then took the intended TUMS. Had a past with a very mild allergy to ibuprofen.. Is this incident anything to be concerned about? No immediate side effects. [/INST] Hi,I can understand your concern regarding the accidental ingestion of half a pill of Aleve. There is nothing to worry about it. In addition to TUMS you can also take a stomach acid suppressant such as pantoprazole to minimize the stomach acidity related issues caused by half a pill of Aleve. Aleve (naproxen) may also have a similar allergic potential as that of ibuprofen. So, if you experience difficulty in breathing or rash you must visit the emergency room immediately.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician </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] Hi. I think I'm a hypochondriac but I'm not sure because I'm not scared of having a particular disease. But I am "preoccupied with my body", as in I always freak out that my heart is going to stop, or I can't breathe, or something is wrong with my brain, or I can't swallow, or anything like that. It started around a year ago when I almost choked and I became very afraid of swallowing for fear of choking again. What do I do? [/INST] it could be treated either with medications or with psychotherapy. medication may include combination of antidepressant and anxiolytics. addition of opipramol may /. may not be necessary depending upon situation. psychotherapy specially cognitive behaviour therapy may be essentially helpful for hypochondriasis, counseling and reassurance to patient an family members support is also necessary. hope this answer guides you properly. </s>

<s>[INST] hi sir i am a medical student. i am now 23 i am a patient of posterior urethral valve ,and i had underwent valve abalation in my new born period.now for 6 months i had joint pain in my both knees . for that i had underwent full health check up. i was shocked when i came to know that my left side kidney is not visualised by ultrasound. my one kindney right side had underwent hypertrophy. my residual urine is40 ml. i have hb level more than 14.5 gm/dl. my uric acid level 6.8gm/dl. urea 30 mg/dl. creatininebin serum 1.0 gm /dl . i had mild pelvic calycix dilataton in my right side kidney. some times i have to give presure for my regular urination i had 2 attacks of u,t,i,i am now depressed now. pls help me to know about my life span .is there any way which protect me from knee joint pain and renal failure pls reply [/INST] Hi, Welcome to Health care magic forum. You had a problem with your urethra in the child hood means you have got some congenital problem regarding the urinary system. So for it is compensated, so you need not worry about the coming life, if you maintain a healthy kidney , it will be enough for the rest of the life. In hydronephrosis, the pelvic calycix dialatation may be common. The main thing here is the genital system, the testis, epidedymus, etc. I advise you to consult a urologist, for diagnosis. Don't worry you will be fine but get it confirmed. Thank you. </s>

<s>[INST] I’ve been having a pain right on my left temple that feels like the worst headache of my life for the past couple of months and also an infected tooth on the same side. I can't sleep because the pain hurts so bad it keeps me up. I've gone to the hospital, a headache specialist, and 3 different dentists. The only thing that has completely relieved this paid is when the dentist numbed my tooth and Penicillin the 2 different times I've taken it. I'm wondering if the Penicillin is stopping my infection in my tooth and that's why my headache goes away. Can an infected tooth be causing this pain in my temple? [/INST] Hi Dear,Understanding your concern. As per your query you have infected tooth which could be due to abscess, pulpitis and dental caries. Yes infected tooth leads to headache due to associated nerve supply.Need not to worry. I would suggest you to consult dentist once. Doctor may perform oral prophylaxis . Doctor may take x-ray of tooth to confirm the diagnosis . Doctor may also check the tooth for tenderness and check level of infection . If infection has already affected the pulp then doctor may recommend root canal therapy along with crown on it. For now do warm saline rinses several times a day and maintain proper oral hygiene. Take proper course of antibiotics to subside infection.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari </s>

<s>[INST] hi! my bp is 120/88.i am 37 yrs.i am also suffering from unreal thoughts which makes me depressed doctors prescibed me fludac 20mg.sometimes i do feel heviness in my arms and legs.for this she prescribed me nurotroy injection .how ever i hav not taken the medicineas i am very sceptical of taking medicine as once i had reactin from reglan and mexiron.please advice me/ [/INST] hi, welcome to health care magic Although you didn't specify your thoughts but fludac is a good antidepressant and very effective for obsessive compulsive disorder in which persons are in stress because of excessive, unwanted thoughts. chances are very high that you will get good benefit from this medicine, even if you don't have clear obsessive compulsive disorder. Fludac is an easily tolerable medicine and most patients take it without troublesome side effects. Probably you had dystonic reactions(rigidity of limbs, and slowing of movements) with reglan. This reaction is common with reglan, not with fludac. so rest assured and start fludac. Keep in mind that a good effect from fludac may take 6-8 weeks to start, so donot stop it earlier or without consultation with your doctor. best of luck </s>

<s>[INST] hi iam a female of 26yrs. my weight is 66kilograms my hight is 1.68m. i am asthmatic. i have backache sometimes in the upper part and often lower and i hear a crack in my neck when i try to elevat my head up . can you please give me a simple home managment. thanks [/INST] Hello,I had gone through the case and found that it might be case of spondylosis.So take calcium once a day and Vitamin D3 once a week.Do neck and back exercise. Avoid long time sitting work, pillow and soft mattress. When pain is severe then take mild painkiller and apply muscle relaxant gel.If possible then go for spine MRI and Vitamin D3 blood test So that you can get the diagnosis.Hope my answer will be effective for you.Thanks </s>

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

<s>[INST] My Total cholesterol number was 274m HDL 74 Trig.80 LDL 187 other than medication what can I do. I already walk 4 to 5 miles a day, no white sugar, no bread, eat oatmeal daily, no soda at all, kale, spinach and vegetables daily Basically everything I'm supposed to do. also fish oil and flax seed oil . I just need to get that LDL down. [/INST] Hi, It is good that you are doing the right therapeutic lifestyle and diet changes. That will help you bring down LDL and total cholesterol too. You need to have patience as such results will be seen after 3 months of following strictly the diet and lifestyle changes. Hope it helped! </s>

<s>[INST] am always having pains at my back especially under the scapula. I do feel the pain seriously whenever i wake up. But after several walk at the office and use of paracetamol, i will get a little bit relieved. Each time i go to the hospital the doctors always give me pain relief. Recently i was given a herbal tea. please what do i do. [/INST] Hi,it seems that due to stiffness of scapular muscles you get this problem.This might be due to lack of physical exercises.Go for shoulder exercises daily.apply analgesic, muscle relaxant cream locally.Ok and take care. </s>

<s>[INST] my father is a hemodialysis patient. He has low blood pressure before during and after dialysis. He is very sluggish and has no energy. He was recently prescribed a med to take before dialysis to help raise his blood pressure, it raises it a little but it doesn't say up during dialysis. He is 79 and is on a 4 hour treatment. He was on peritoneal dialysis for 5 years before going on hemo for the last three.Any suggestions on questions to ask his doctor or areas to pursue? [/INST] Hello sir/madam,There are multiple reasons for low BP. Kidney doctor might know what he is doing, but for someone to be always having low BP, makes me worry. Possible his weight can be increased on dialysis and if your father is eating during dialysis. let him know that not to eat as it will lower his BP.Thanks Dr.Katta </s>

<s>[INST] I have a very small soft lump under forhead, i have had it for about 3 yrs, its not painful it as not increased in size, and not really noticeable but i notice it. how can i get rid of this. I am 47 years old i am 145lbs, 5ft10 have no medical problems or taking any medicine [/INST] Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma or neurofibroma. Or it can be some benign cyst like sebaceous cyst or dermoid cyst. No need to big worry. You should go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] respected madam I am rbvkxnbks, from ernakulam district of kerala.Iam married and have no kid. On consult with urologists i am suffering from vericocele. USS was done.left testis size volume is very lesss. operation was done .there is any possibility to become a father [/INST] Hi, you would definitely be having a chance to become a father. There are multiple ways of doing that. But, first and foremost you should get a Semen analysis and culture done. Do let us know the report so we can know whether the Varicocele is having any effect on your sperm producing function. Then we can advice whether you need to get operated or not. Do not worry, there are multiple treatments available to help you become a father. You can contact me directly by visiting my Profile page or contacting Customer care.Take care, I will wait for your reports.Dr Rishi, New Delhi, India. </s>

<s>[INST] I am 12 weeks pregnant and im not sure if any of these are normal. I feel tired and dizzy all the time i can t shake it. On my left lower abdomen is kinda swollen and when i lie or sit there is a huge visible pulse there also my legs will turn purple and swell. On another note i keep getting and off and on again fever? [/INST] Hi,Dilated veins on lower leg, with fever, point towards deep vein thrombosis, which is known to occur in pregnancy.This should be evaluated as it can lead to a very serious condition called pulmonary embolism, which could be life threatening.I would like to know if you have any family history of diseases called thrombophillias? Did you have varicose veins before pregnancy.?You need to get a ultrasound of both your legs called Compression Duplex ultrasound and consult a physician immediately.Hope this helps.Regards. </s>

<s>[INST] I got dog biten on Oct 3rd,the punture wounds healed nicely but there is a huge hard knot there..Went to ER twice gave me antobotics both times and said the last round of antibotics should make the know go away and it hasn't.Do you know what may be going on? [/INST] Hello,Welcome to HCM, The symptoms of knot after being bitten by the dog, as it was a lacerated wound which had lead to loss of tissue due to which it has healed by leaving that scar.Even after taking two courses of antibiotics the knot suggest that the wound should be healed completely.I would suggest you to apply hot fermentation over the wound and also you have to take serratipeptidase for rapid reabsorbtion. Thank you. </s>

<s>[INST] I'm not a very smart person, so this might seem like a dumb question. I've had about ten ct scans over the past seven years, and about just as many X-rays. Have I put myself in any kind of danger? What are my short term and long term risks of getting cancer? [/INST] Hi, dearI have gone through your question. I can understand your concern. Ct scan and xray both are injurious to health. It gives you radiation exposure and radiation causes damage to the cells. It causes mutation and gives chance of cancer. Short term risk is not increase much but long term risk is definitely increased. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] Hi doctor, I have left-sided headaches from the last five days. I notice it more when I chew food. I have anxiety problems since last two years, for which I take Petril 0.25 daily. Please help me. How to get rid of these headaches? [/INST] Hi. I read your query and understand your concerns. I will be glad to help you further. Thanks and regards. For more information consult a neurologist online --> </s>

<s>[INST] Hi, I have a 4 yr old girl that woke up with a spotty red rash behind her ears, on her cheaks, chin forhead and scalp. There is no fever. The rash is not raised or course or blistered. She did have a throught infection with a fever. 10 days ago. What could it be? [/INST] Hi, As per your query you have symptoms of rashes behind ears, cheeks, chin forehead and scalp which seems to be viral infection and exposure to an allergen. Need not to worry. I would suggest you take a proper course of antihistamine drug. You should drink plenty of water. Maintain complete hygiene. If the condition doesn't get better in a month then consult dermatologist again for proper diagnosis and to rule out any underlying condition. The doctor may prescribe isotretinoin, steroid ointment or antibiotics course. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist </s>

<s>[INST] hi, i had blood spoting problem... may also had shortly vaginal infection .... i have married about 10 months old... still not pregnant... but now i have taking prolifen capsule since 4rth day of my period..... what the hell prob and how can i pregnant ??? [/INST] Hi, Thank for writing to us. The cause of spotting are due to hormonal imbalances. Now you are taking prolifen tablet which is a type of vitamin supplement which increase immune system and help you getting pregnant. Good luck. Regard Dr. Richa </s>

<s>[INST] Dear sir, my wife has been diagnosed with gall bladder stones . The US report says Gall bladder appears contracted and shows few small calculi in its lumen... Gall bladder walls are of normal thickness. No Pericholecystic collection seen. The Liver function test says: S: Amylase ---- 1502 U/L SGOT (AST)-----592 IU/L SGPT (ALT).-----421IU/L Bilirubin -----------0.9 Mg/dl Alkaline Phosphatase : 169 U/L She got acute pain in upper abdomen before 5 days followed next day we did all these tests. Kindly suggest the best Advice please. We are from Delhi. Regards Deepak - 0000 [/INST] Hi Deepak Thanks for writing in. The serum amylase report is very high. This suggests an acute pancreatitis which can explain the pain she had. Sometimes the stones in the gall bladder pass down to the pancreatic duct and obstruct it causing pancreatitis. Also the SGPT and SGOT are very high. I would suggest you get her admitted with some Gastroenterologist ASAP. A symptomatic gall stones requires a surgery. I would also be happy to review the tests reports , so please send me over all the tests reports in detail. Hope I have answered your query. If you have any further questions I will be happy to help Regards Dr. Om Lakhani </s>

<s>[INST] my last period started on 22 of feb and ended on 25th i had unprotected sex on 28th of feb after which i took an i- pill within two occurs of the same. today. i.e. on 22nd i m expecting my period but nothing, however yesterday i have spotted very little blood and it was the same thing today along with a little red lining but that was like hardly a few drops of blood. actually i had also consumed an i-pill in the month of January which made my period come 2 days earlier than the usual and a little bit of acne but nothing else. this there was a little acne again.. but I am really worried about being pregnant. i always use protection( condoms ) and have never let him cum inside me. it was just once when there wasn t one, still he pulled out i know not very reliable but I m a nervous wreck atm [/INST] Hi,Thank you for posting your question here, I will try to answer it to the best of my abilities.Stress can cause the dates of your period change, they can come later or earlier than what is normal for you. An i-pill within two hours of the intercourse was a good move and it should reduce the chances of you getting pregnant significantly.Take a home pregnancy test and you'll have the answer you're looking for. Although it highly probable that your period is just late this month.I hope this answered your question. </s>

<s>[INST] Thank you. I have had a cough for 4 and 1/2 years. I have been to several doctors and had several test done. They checked my Thyroid, put a tube down my nose for 24 hours and monitored when I ate, drank, and was at rest. One doctor said that I needed to have surgery on my esophagus and then another doctor tells me that it is the cancer med that I take for my breast cancer that I need to take for 1 and 1/2 years more. Another doctor said it is allergies and puts me on shots and pills. I does not help. I cough so hard I through up, and I sometimes feel like I am going to pass out. They have done chest x-rays, blood work, and ultra sound on my thyroid and they did not find any thing yet. Is there any thing that I can do or any test that I can ask the doctors to run on me. [/INST] Thanks for your question on HCM.In my opinion you should consult pulmonologist and get done PFT (Pulmonary Function Test) to rule out bronchitis. As untreated bronchitis can cause chronic cough (dry).Breast cancer patient after chemotgerapy and radiotherapy can develop bronchitis. So possibility of radiation induced bronchitis is more in your case.You may need inhaled bronchodilators and oral antihistamine drugs. </s>

<s>[INST] Hi doctor, I am 18 years old. A few days ago, I had a toothache on my molar teeth and have mobility when touched. I have a big hole in that tooth from my childhood. I guess the black circle is the vein of the tooth. I could not afford to get an implant tooth. I had pain in that tooth a year back and then now. Is it possible to cure with rebuilding this tooth instead of removing it? Here is the picture for your reference. [/INST] Hi. Long term curious untreated decay. 1. IOPA. 2. Check for the amount of mobility, whether it is sideways or up and down. Chronic pulpitis with periodontitis. 1. Root canal treatment. 2. Periodontal treatment. 3. Scaling. Follow up with the x-ray to a dentist online.---> </s>

<s>[INST] Hello doctor, Please tell me what are the things that can happen when you eat expired food. [/INST] Hello. If we eat food that is expired, the efficiency of the preservative is lost. So some organisms if present can multiply and can send some endotoxins. Also, the taste and odor can be altered. The food has a shelf life. If this is crossed some people can have diarrhea or acidity in the stomach. This can be due to the chemical nature of the food. </s>

<s>[INST] I have CRPS and changing medications Withdrawel from Percocet,Gabapentin Celexa, I have fever,chills,nausea shaking even though i am changing to Nucenta and Cymbalta. I have no appetite and would like some home remedies to feel better The past few weeks I have broken out in blisters like herpes on my arms ,legs breast and stomach and a few fever blisters What can i do feel better? [/INST] KEEP BLISTERS CLEAN,APPLY ANTISEPTIC,TAKE WATER WITH SUGAR & SALT TO CONTROL DEHYDRATION- THE BLISTERS COULD BE HERPES SIMPLEX WILL HEEL WHI IN SHORT PERIOD THANKS </s>

<s>[INST] I habitually wear sandals in the spring/summer with a strap between my big toe and second toe (thong type). I woke up Tuesday after wearing/walking in them all day Monday with a swollen big toe/foot and pain upon standing. What could be causing this. I have worn this type of shoe for years. [/INST] Dear patient Acute swelling of big toe without trauma mostly is due to gout. This disease is characterised by increased levels of serum levels of uric acid and deposition of uric acid crystals in small joints especially of big toe. This needs to be investigated with serum levels of uric acid from reputed lab nearby you. You need to consult expert orthopaedic surgeon with report. Meanwhile start tab diclofenac 50mg twice a day for pain relief. If serum uric acid levels are higher you need to take drugs to lower it. All the best. </s>

<s>[INST] I had a very weird period from May 2-May 6 or 7. I took a test a few days after my period was over just to make sure, and it came out negative. Even though my boyfriend and I have never gone past foreplay I thought I was pregnant so I'm still very traumatized about that pregnancy scare. We 'foreplayed' again a few days after that test. He placed his hand in his pants to fix his you know what and then he wiped it on his jeans, he wiped it again on my shorts before inserting his fingers.He said there was no pre-***. I took a test two days after that. Still negative. I'm thinking this is all just the effects of the pregnancy scare a week ago and I'm just traumatized but I just want your opinions. I think I'm supposed to be ovulating around now.. but I'm still feeling dry and my CM isn't clear or a lot.. it's just some drops of white when I wipe with my finger. Usually, there's a lot of CM after my period.. but this time around there's barely any. It feels warm down there and a little dry..Is there a possibility I could STILL be pregnant? I can't be, right? I mean, we've never had actual sex. Please help me ease my mind. I really don't want to be thinking of these things anymore. It's really hard to concentrate on anything else. :( [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Sperm needs a liquid media to get transported. If he has not ejaculated inside then you cannot get pregnant. Pregnancy cannot occur on foreplay.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal </s>

<s>[INST] well i am 12 years old and am weighing 67 kg am really depressed about it i dont feel happy at all am always ashamed to go out with others cause they are all slim am the only one odd it sickens and troubles me alot i really want to get slim and think like a naturally slim girl i ve tried alot of supplement but it dosent really works with me i need your help i know you are speacialist i just need the right tips ,answers ,vidoes and all those stuff you know please i really need your help please.............. sobs,,,, [/INST] hi..well, obesity per se is distressing..so please consult a dietician and a physician..then a psychiatrist..also bariatric surgery may be needed if required..so mental health issue may be addressed later following all these..have a healthy life.. </s>

<s>[INST] I had Upper Jaw surgery about two weeks ago to correct my underbite. Some of the swelling has receded but now one side is still a bit more inflamated. As I caress my cheeks I feel like there is a loose screw in the inside of one of my cheeks. Its not painful but the swelling wont recede. What is it? [/INST] thanks for your query, i have gone through your query, the swelling could be because of secondary infection. if you feel that the screw is moving then you consult your surgeon and get it checked and irrigated once. i hope my answer will help you. take care. </s>

<s>[INST] I had surgery two weeks ago to remove a 2" begin tumor on the right side of head behind the temple. Most of the swelling has gone, but I have a golf size lump with what is clearly liquid in it where the tumor use to reside. How long does it take to get this to go down? Can I get it drained? If i do get it drained will it return? [/INST] Hi, dear. I have gone through your question. I can understand your concern. You may have some cystic lesion. It will not cured byIitself. No need to drain. Because after draining there are high chance of recurrence. You should go for complete anucleation of cyst. Complete removal might help you.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] I have had a pain on my left side in the lower back region....frequent urination and bowel movements...this am I awoke with excruciating pain. The ER ruled out kidney stones BUT did not know what it could be. I am taking RX to control pain. Pain is manageable right now .. I am 64...do not drink or smoke Do not take medication Normal weight Healthy diet [/INST] HiThank you for asking HCMI have gone through your query. Your problem can be related to lumbar spondylosis or sacroiliac joint arthritis. A physical examination by an orthopedician will give clue for this. A X ray followed by MRI if needed will confirm the condition. Local corticosteroid injection will give pain relief in case of sacroiliac joint arthritis. NSAIDs like Nimusulide for short term will help in relieving symptoms. Muscle strengthening exercises and physiotherapy will help in case of long standing pain.Hope this may help you. Let me know if anything not clear.Thanks. </s>

<s>[INST] I have a possible stress fracture in the base of my 3rd toe. MRI and X-ray showed stress reaction. I don t know if that means full stress fracture. I ran a marathon last week and it is actually feeling Okay. I saw the Dr. yesterday and he sayss that I need to rest it if it is ever going to heal. He said that he could put me in a hard sandal or I could just wear my shoes with orthodics. I prefer not to use the sandal. I teach P. E. and I am on my feet all day. How long will I need to back off from running. I also teach spinning classes and assume that I can continue to do this. [/INST] Hi, Your doctor is right. You have to rest your leg, it will take a couple of weeks to one month for complete recovery. 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] II have a 2month old baby, he has been having a whitish discharge from the rigged ear after every birth. .I think he has an infection, this has been happening for the last 3weeks, I thought it was wax but my pharmacist prescribed cefixime..is that the right medication? [/INST] HiWelcome to HCMI would recommend an ENT opinion before starting antibiotics. Whitish sticky non offensive discharge might be ear wax.Cefixime is not the first line antibiotic for ear infection management as such. So hold on and go for a clinical examination. </s>

<s>[INST] hi doc,2 month back me and my fiance were involved in physical activity but we did not involve in intercoursebut my fiance now is having a feeling that she is pregnant as she has missed her periods for continuous three months, one month from before we were involved physically.please suggest me the best way to clarify our doubts regarding pregnancy. is it too late if at all she is pregnant by any chance? [/INST] Hello dear,I understand your concern.In my opinion as the true intercourse did not occur the chances of pregnancy is rare.But the cause of missed period should be evaluated. Usually after a week of missing a period urine pregnancy test is done.But now as it is 3 months I suggest you to consult doctor for physical examination and ultrasound if needed for definite diagnosis.The pregnancy might be rare as per your history but the cause of missed periods should be ruled out.Avoid stress as it also causes hormonal imbalance and make the cycles irregular.Best regards.... </s>

<s>[INST] I have been told I have a cyt like growth in my pancreas. My doctor referred me to a larger city specialist. This specialist said it had to come out. His schedule did not allow for as early a surgery as his colleague. I was booked for surgery, travelled to the larger centre, went through some more testing nd finally met the surgeon who was doing the surgery the next morning. She stated that she had decided to cancel the surgery and just monitor the growth. I was upset for I did not want this thing left to grow inside. A biopsy was done. I did not get the results for 6 weeks and then only because my original doctor kept calling for results. There were some begnein cells but also some questionable cells so that the report said a diagnosis could not be certain. I was again told I was put on the OR list. After 2 weeks of trying to reach the surgeon, she finally called me. She told me that she had again taken me off the surgery list and wanted to watch this growth and that I would have to fly to this big centre in 3 months for a scan. She was quite condescending about my doctor and our local imaging people's ability. I am getting a lot of mixed messages from her. My local doctor wants this thing out, so do I but she wants to wait and watch it. I am very nervous that this will turn bad. She says there is no chance of that happening. I have a family history of cancer. My mother, grandmother and everyone on my mother's side have died from cancer, 2 of them from pancreatic cancer. She cannot understand why I am worried about this and thinks I just want some surgery. My question is, do I have a reason to worry, do I push to have this growth taken out now. She did say that she would do it if I insisted. If she agrees to do it, can I trust her?Hope you can help me decide if I should push this and if yes, how do I go about it. [/INST] Hi and welcome to HCM.i dont htink you need surgery at this point. cysts and cancer are usually easily diagnosed by imaging techniques. Also some tumor markers can help to evaluiate this. If this was cancer it would already show aggresivity in these 6 weeks since pancreatic tumors are infiltrative. all you need is frequent follow up to se cyst size progression.Wish you good health. Regards </s>

<s>[INST] After I shave my legs, bikini area and arm pits the next day when my hair starts growin back the places I shaved itches almost constantly. After I scratch them, I get these bumps, kind of like razor rash . However I have tried new blades, different razors, shaving creams, gels, lotion, the bikini zone products... etc. But it still itches and over the years it seems to be getting worse. Is there something wrong with skin. [/INST] Hi, Thanks for posting your query I understand your concern regarding itching after shaving. There is nothing wrong with your skin. This is a very common with people who shave armpits or bikini area. I shall try to explain you The skin over the arm pits and bikini area is thin and sensitive and hair are thicker and coarser. Due to shaving very close to the skin, the sharp cut edges of the hair (may go under skin once you release skin after a stroke of razor) irritate the surrounding skin or internal structures in case of under skin hair , which leads to inflamatory process leading to itching and bumps . Once you scratch , this initiates a scratch itch cycle which further increases itching ang aggravates the condition. So it is best to avoid shaving too close to the skin. Since you have tried new blades , different creams lotions, I suggest you to go for permanent hair reduction with lasers. Hope this helps you </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,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] Hi Dr. My name is Kishor and I m 24 year old, I m doing masturbation from last 6 to 7 years daily.I want to know that masturbation is good for the health..??It will effect my further life.....??I m doing masturbation from last 6 to 7 years daily. [/INST] HelloThanks for query .It is natural and normal for a man to get indulged in masturbation at the age of adolescence .It is the safest way to get sexual satisfaction without a female partner .There is myth in a mind of common man that excessive masturbation is the reason many problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body .However excessive and frequent masturbation may lead to sexual problems like Erectile Dysfunction or Premature ejaculation in future.Dr.Patil. </s>

<s>[INST] I just had a laranscopy and esophopscopy done to idntify soft tissue under the base of my toune. My Dr. notoice one side of my sphenoid bone was larger and fractured it. I have had some relief but my vision doesn t seem as good and i get agitated easily. are these connected? [/INST] Hi, vision problem and scaphoid fracture is not connected both are completely different things. For scaphoid fracture consult orthopedic surgeon and for vision problem consult ophthalmologist. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon </s>

<s>[INST] I have had a ongoing cold with a cough for over 8 weeks. I went to GP and he gave me antibiotics and and inhaler and requested a chest X Ray which came back clear. My symptom persisted so I was then given steroids and a much stronger antibiotics which helped but a few days later my cold and cough got much worse so i went to AE. I stayed in hospital for 3 days and were given another X-Ray again clear and lots of blood test which showed a reduce white cell count. My temperature was up for a day or so and then returned to normal. I was asked to return to hospital for a CT Scan on my chest which has shown I have 3 shadows in 3 areas on my right lung. I am 49 and have smoked by only social now and again but not for a long time. I arranged to see a consultant in 10 days as his list are quite full to explain what this is as the hospital said that it was cancer. The consultant has since contacted me and told me that he believes the shadows are nothing sinister but I am going out of my mind with worry reading the internet and especially as my cold seems to be returning but no cough that has gone. I feel very alone and I m so scared. I don t want to have cancer [/INST] your low WBC count could be the result of antibiotic and other medicines usage it will get better in few weeks to months after stopping them.you need to work to improve your immunity to overcome cough it could be just allergic bronchitis or viral bronchitis or fungal first try to identify the triggers and avoid exposing yourself dust pollen exposed to too many birds (Poop) chemicals that you clean kitchen/ toilets spray chemicals tobaccosecond build your immune system by eating healthy nutritious dietI am a physician but inclined to use natural products available at home so drink raw honey lemon ginger juice syrupmilk with pepper turmeric powdergarlic pods crushed with pepper and salt cooked or raw the above ingredients build immunity while detoxify and eliminates phlegm from respiratory tree. last but not the least important is doing breathing exercises this sounds tough job as u r alone but writing to help itself signifies u r motivated to get better so worth a try good luck </s>

<s>[INST] Today I was wrestling with my 10 month old puppy and I lost balance and landed on him, well needless to say one of his canines went through the ulnar part of my wrist where the carpal bones are. I have tingling sensation in my ring finger and pinky finger, hurts to bend my wrist and it sometimes feels like my pinky finger to my elbow fell asleep on me, which is hasnt. Do I need to get a MRI? [/INST] HiWelcome to healthcaremagicAfter going through your query I concluded that you got injury to your wrist. You got injury to your wrist probably you got injury to your ulnar nerve leading to numbness and tingling in ring and little finger. Mecobalamine is helpful in recovering of nerve injury . Analgesic such as ibuprofen is useful in pain relief.MRI will be of use to see injury in details.You can discuss with your doctor about it. Hope your query get answered.If you have any clarification then please don't hesitate to write to us. I will be happy to answer your queries.You can also write to me directly on below link: you good health. Take care. </s>

<s>[INST] Hi, for a month now I've been having head pressure in my head. The pressure feels like when you lie upside down or a hand stand. It been constant and hasn't gone a way. Also very fatigue, short of breath.Iv had a the found a chat on my occipital horn of the right lateral. The neuro said it was fine. I have also been vomiting in the mornings,feeling heart paps. Or racing, my blood pressure has been dropping off and on, my heart also feels weak. What could cause this? Could it be lack of blood to the heart cause pressur? Could it be heart failure? What could it maybe be? [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. Yes, by your history and description, possibility of heart related diseases like heart failure or arrhythmia (rhythm disturbances in heart). So better to consult cardiologist and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo 4. Holter monitoring (24 hours continuous recording of ecg). If all these are normal then no need to worry for heart diseases. Sometimes, uncontrolled stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I have an abscess tooth and ive been to a dentist and currently on meds for the infection but the gum around my tooth is really swollen. I have a date tomorrow nite at six thirty and need swelling to be gone by then which is about 23 hrs from now. What can i find around my house that will get rid of the swelling? Help! And can i spread my tooth infection to my bf by kissing him? [/INST] hi, i read your problem,there is an infection in the tooth at that area because of that there is abscess and swelling...... for infection it is must to take medicine which you have taken......... but you did not tell that you are going for root canal treatment or extraction.......... these medicines are for infection not for swelling....... swelling will need drainage.......... after drainage swelling will disappear...... and this will not spread by kissing......... take care Dr.Gunjan Gupta </s>

<s>[INST] Hey! Im on the elleste duet 1mg for the last 13 days and now I feel as if I will have a period, that is, swallow belly and tireness. This is exactly howe I felt every time I hd my period. By the way I did not have a period for the last 4 months. I also feel very hangry the way I was feeling also when I was supposed to have a period. My GP told me, before i took them, that i will face some side effects but I should not worry because my body will get used to it after a month.. I did all the blood examinations before I took it and they were all normal. do you think I will have a period again? My concern is also whether I will gain weight because I feel hangry all the time..Thank you! [/INST] Hi, Possible side effects of Elleste duet include gut disturbances like nausea and vomiting, abdominal pain, bloating, flatulence, indigestion, weight gain, body edema and skin reactions such as rash and itching, acne, vaginal thrush, breast enlargement and menstrual bleeding or spotting. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician </s>

<s>[INST] Is microvascular leukoencephalopathy progressive? My mother had an MRI done in 2007 showing white matter disease, subcortical atrophy and small vessel disease. Over the past 6-7 years she had been falling in the house and I noticed after the falling she had been experiencing some forgetfulness. She has been to a neurologist about 5 years ago and he had given her a mini-mental state test, and sent her for neuropsych testing. She also suffers from renal insufficiency due to hypertension (she is in Stage 3). She was in stage 4 but a nephrologist has her in stage 3 due to the right medications. Her mother had died from uremic poisoning over 50 years ago (no dialysis then). Anyway, the neurologist based on his examinations and testing feels that she is in a mild to moderate stage of alzheimer. Her cardiologist told me that she has microvascular leukoencepahlopaty (she also has hardenining of the arteries). Her primary care physician feels that her dementia is microvascular (AKA vascular due to small vessel disease; she also has diabetes, coronary artery disease, hypertension, hypothyroidism, cholesterol.) She was a smoker, but stopped about 17 years ago. She also has perepheral artery disease. She is on many medications including aricept and namenda. She also experiences parkinson-like tremors. She had a eeg showing a slows of speech language done about 4 years ago. Based on what I have told you is this dementia of a vascular origin, or is it a mixed dementia? She is currently 86 years old and resides in a nursing home. I know I witnessed while she was at home some forgetfulness like leaving a stove on, poor hygiene, moods swings (verbally and hitting). Also, she would have auditory & visual hallucinations (hearing music, talking to imaginary people). I thought at this point she would be better in a facility where she is exposed to people her age and mind stimulation would be more available than staying at home with a home health aide. She had a sister who had passed away last year at 83 years old from alzheimer. Could both sisters have the same thing? I know her sister had hypertension and atrial fib. [/INST] Hello, Microvascular leukoencephalopathy is usually progressive, as one ages changes to blood vessels usually add up. Apart from her age (in itself a risk factor), she has all other risk factors like hypertension, diabetes, cholesterol changes etc., so while it is attempted to slow progression by controlling these factors it can't be stopped. As for whether she has Alzheimer's the forgetfulness and the hallucinations you describe are not common with vascular dementia, would go more in the favor of Alzheimer. However neurological exam, imaging and neuropsychological testing are necessary for a more complete assessment. In addition to that one doesn't exclude the other, it is common to have mixed dementia due to both Alzheimer changes as well as small blood vessels ones, they are both the most common causes of dementia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist </s>

<s>[INST] Hi, I woke up a few days ago with a sharp pain in the middle to right of my chest, under the right rib cage. Since then its been hard to take a full breath, cough and yawn. When i m lieing down i can feel a small lump just right of centre (1cm) which is tender, and the tenderness continues to the right under the rib cage. I m 30years old and have been living in Pattaya thailand for several years which has resulted in alot of drinking. I also remember getting a tight chest a couple of years back and when i stretch i expereinced a popping sensation across my rib cage (would come and go). The conclusion i have come to is that maybe i have had an enlarged liver (due to drinking) for quite sometime but haven t notice and carried on drinking, resulting in some sort of liver damage. Since having this pain 4 days ago, i have stopped drinking and gradually it feels like it getting slighty better. However i still cannot take a good breath and still its painful to touch, and this doesn t explain the lump in the centre of the chest. Any ideas? Thanks [/INST] Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This lump requires physical examination , but till this narration seems likely soft tissue lesion with deep neuronal involvement giving agony of pain .* Recommended to get primarily ultrasound examination , x-ray chest and further need of MRI has to be decided by the clinician .Hope this will help you .Always welcome for any future doubts .Regards . </s>

<s>[INST] my daughter is 3 years old, soon to be 4. Tonight when I was putting her to bed, I noticed small bumps on the outer side of her palms, almost to the outer side of her hand. It wasn t there earlier today and I m not sure what could be causing it. I have dermatitis on the palm off my right had, so I asked if the bumps were itchy, and she said no. So, what could be causing this. She has no other symptoms, so I m stunned. [/INST] Hello,Check for progress, it can be an insect bite or an allergic reaction. If no itching or pain, then it will subside by itself. If progressing, then see for color changes or any pus collection beneath the skin.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed </s>

<s>[INST] Hi..I wanna ask, I had my xray last year and recent year the result/impression was ptb right upper lobe..I had my sputum test and it s negative. I don t cough nor have fever.I just have a skinny bod.I don t know what to do now.it restrict me to have a job.it s really a hindrance to my employment.please I do need an advice. Tnx ;) [/INST] Hello,In the radiological report, you have diagnosed tuberculosis. But sputum is negative. Hence you can investigate with a more confirmatory test like sputum culture and Genexpert study.Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Parth Goswami </s>

<s>[INST] Dear Doctor,I am planning a trip to Uganda with my 16 month old little girl. I have had cerebral Malaria and am therefore a little paranoid about her catching any form of the disease. I usually take Malerone for my trips but what would be recommended for a toddler?Thank you. [/INST] Hi,It is safe to give malerone in paediatric population but dosage adjustment is required. A 16 month old girl approximately weighing around 11-15 kgs will require one malarone paediatric tablet (Atovaquone 62.5mg + Proguanil 25mg). Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Hazan </s>

<s>[INST] I have scoliosis and a slipped disk, I did something to both of my shoulders after ramming them into the door frame on accident, I had something happen to my neck after my car accident due to bad conditions, and now, I feel a lot of pain to the point it ll make me weak to move, and when I crack them or stretch to release the pain, I get this metal/ blood taste in my mouth and I can also literally feel my bones grinding against each other. It makes me get dizzy as well, to the point I ve blacked out a few times. Woke up to finding my head hitting the toilet. Is this something deeply concerning or am I just freaking out? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. There can be a number of causes. Treatment depends upon underlying cause. Spondylosis can be an important cause. Please upload medical notes and investigation reports if available. Thanks. Best regards. </s>

<s>[INST] sir,my friend's girl friend had her periods 8 days back.they both are 18 yrs old..today he said he met her..and eventually was on bed..he had sperms on his hand nd accidentally touched her vagina.he dint insert the penis.now he's afraid if she'l get pregnant..what is the possibility?..he's really upset [/INST] Hallow Dear,I believe when you say semen in the hand, you mean semen stained hand. By this he has not instilled some amount of semen in the vagina. Just touching vagina from outside the vagina should not be an issue of threat of pregnancy. To cause pregnancy, semen has to be injected inside the vagina or even at the introits. Then sperms in the semen can swim towards the egg through the uterus and tubes. I feel he should not be concerned about pregnancy. Please tell her also to get rid of the stress as stress itself can delay the menses. Let her wait expectantly for the menses to appear on time. If at all the menses are delayed, then she may think of performing pregnancy test on urine 8-10 days after the missed period; done earlier, these tests may report false negative results. Alternatively, she may opt for Beta hCG test which can give reliable results even few days before missed period. If the pregnancy test reports positive, she can terminate the pregnancy by medicines. However, I feel, this should not happen and she will get her menses in time.Dr. Nishikant Shrotri </s>

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

<s>[INST] My son is 7-and-a-half years old. For past 10 days, he is suferring from loose motions, occasional vomiting and severe gastric problems. Yesterday, we got his stool routine test done and there were pus cells present in his stool (80-100). I know this is high, but what does it signify? Is there any other infection / problem which is yet to be diagonsed? Our Pediatric has prescribed Taxim-o DT, 100mg to be taken twice a day. Is this the right dosage and medicine? Kindly assist. [/INST] Hello. I just read through your question.This is an antibiotic given to fight the bacterial infection found in the stoll sample. It is being given in the correct dosage for the correct reason. this should cure the illness. </s>

<s>[INST] hi. i need someone to talk to. someone who can help me take control of my emotions. im impulsive, cries over different things, gets angry and curses and once its done is trying to make amends. i do understand somehow why, i blame some people in my life, but in the end its me making the wrong decisions. But really if i had those loveones supporting me while i was growing up, i wouldnt have been acting like this at all. i want to take charge of my life. [/INST] Dear brother(?)/sister,It is unfortunate and I can understand that you suffer a lot nowadays. But be rest assured. You will be getting rid of all these in a short span of time. The symptoms you manifest are the classic symptoms of some depression. We, the human beings are basically animals with a social orientation.i.e social animals. We need someone to share. In your case upteenth time, could not find someone to share with. For your knowledge, I wish to narrow down your issues in a different perspective. Let me show you four persons within you. The dynamcis of these persons are measured with your interaction with your society and the society starts from your family itself. The first person within you is the "person known to you and your society- i.ie both the society and yourself are aware of you. This is your free area and you can interact with the society well in this area. The second person is the "One who is known to society only and you are unaware about this person. To be precise, it is what society thinks of you and you are not aware. You need to interact with the society well to know what the society thinks of you. The third person is the hidden personality within you. It is the person within you and not known to the society. That means there is a hidden aspect of you which is not known to the society. This is the only aspect which hinders you in your further advancement towards a fuller life. The fourth person is the one about whom neither you nor your society are aware of. The fourth one being the person not known to you and the society. The first area if you widen as much as possible you will be shifting yourself from ILLNESS to WELLNESS. The more you are with the society, more are the chances of your recovery. Find a person with whom you can confide everything. In case, you don't find, check for the psychologist available in town.You can consult a psychologist for a personality assessment an emotional release to deal with the other three areas. The balancing of the brain chemistry can be taken care of by a psychiatrist with a short duration medication. Get well soon,Dr Rajesh Thottingal Kalamrehabilitation Psychologist from India </s>

<s>[INST] yesterday my 4yr old got hit in the side of the head with a rock caused a small gash and blood. he seemed fine yesterday and lastnite. but today is really tired and complains of a stomach ache could this be a sign of a concussion or ssomething more serious? and should i take him to the er? [/INST] Hi...Thank you for consulting in Health Care magic. I understand your concern. First be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorium or behaviour. If none of them are present, I don't think you should worry about his trivial head injury. For pain you can give oral Paracetamol in the dose of 15mg/kg/dose(max ceiling dose 500mg) every 4-6th hourly. 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'm 24 with Hpertension type 2, from Thursday last week I have been feeling continuously drunk, disorientated and dizzy with muscle fatigue. I am unable to focus or see straight. I had almost exsactly the same simptoms before I went on medication, but now I'm on meds and I had my blood pressure and glucose levels checked all healthy and normal. What is causing my Ailment? [/INST] this maybe due to some blood pressure medications that you are on. please comfirm your blood pressure medications. also in view of persistent symptoms, i would advice you to do a mri brain and an ENT assessment </s>

<s>[INST] I m a boy, age 20, was suggested azee 500 by a skin doctor for my acne problem. he asked me to take 1 tablet early in the morning without eating anything. 1 tablet each for 3 days a week. it cured my acne problem for sometime. but again i have started getting acne problem and that too very aggressively. kindly help me about it. what should i do to resolve this skin problem forever...... [/INST] Hello, Thanks for writing your query to us. As your doctor has told to take Azee ,kindly continue the same for few more days. Maintain good hygiene , keep your face clean. Cetaphil face wash will help to keep your acne in control. Use sunscreen while going out of house. Eat healthy balanced diet. Drink more water. Also consult your dermatologist who will assess the severity of acne suggest you cream to apply locally. Take care. </s>

<s>[INST] Hello I would like to inquire about mild hepatomelagy. I was recently given an ultrasound and it showed that my liver was mildly enlarged due to being overweight. I am not a drinker but I would l like to know that if I did decide to drink alcohol would this hinder my effort to reverse this condition? Would it hurt me in anyway or effect my liver function so that this mild hepatomelagy becomes worse? Thanks [/INST] Hi thanks for asking question.Mild to moderate alcohol drink have no major adverse effect on our body..But you have hepatomegaly and probably fatty liver ....so better to avoid alcohol.Loose your weight. ..Take less fatty diet....Avoid bad fat diet like burger, pizza, cheese , meat etc....Once your BMI ideal and no hepatomegaly or fatty liver then you can consume alcohol.Safe limit is 20 gm per day....Take care.....Dr.Parth Goswami </s>

<s>[INST] Yes i have PKD stage 2 and i started having severe back pain yesterday and extreme itching around my back on the the right side my right side and my stomach. near my navel. What can i do to stop the itching and back pain. i do not have health insurance so i do not have a attending doctor [/INST] One cannot get rid of the pain in pkd disease forever unless doing nephrectomy. But that is necessary only in case of advanced renal failure or repeated infections of the cysts. Till that time one can use symptomatic treatment in the form of paracetamol and some other safer painkillers for which you need to visit a doctor... </s>

<s>[INST] Hi doctor, I had an extraction of two tumors of epithelial-myoepithelial carcinoma with a prominent dedifferentiated (high-grade transformation) myoepithelial component extracted from my nasal cavity before three years. MRI scans were performed to look for recurrences. In my previous MRI, I had a perfusion curve showing ascending plateau. I have significant weight loss for the past seven months. I have occasional nosebleeds with pain. I also have fever, sensitivity, and bleeding in the mouth palate occasionally. Currently, I am taking Iscador P series II injections three times a week, painkillers, and supplements. Please advice. [/INST] Hi. Please give your queries and concerns on pointwise. So that, I can answer them for you. I will point out the abnormalities present in the scan soon. </s>