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<s>[INST] 10 year old child with LD in reading, over last few years has gone from outgoing and energetic child to quiet and awkward socially. Daydreaming spells for about 2 years. Two weeks ago began having noticable absence seizures . EEG shows almost continuous partial seizure activity in all areas of brain. MRI shows atrophy in right frontal lobe and softening in right temporal horn. The radiologist said these changes are most likely due to trauma but the only significant trauma she has had is a concussion after tripping. She had oxygen for 2 minutes at birth with an apgar of 2 and 6. She is a hard working, happy child who tires easily and has a history of amblyopia (surgery correction), tonsillectomy and adenoidectomy, and surgical removal of stye on eye. Any ideas or suggestions of questions we should as the neurologist when we see him? [/INST] First of all there is confusion with seizures and EEG; you said absnce attacks of seizures but EEG is partial seizures activity; anyhow on safer side, start her on valproate 250 mg 2 times a day and start adjusting the dose depending upon her seizure control to a maximum of 600-800 mg per day. Atrophic changes could not be corrected and she needs continuous rehab for the LD she has. </s>

<s>[INST] Hi.I have s question. My husband has this bump in his belly button. Its looks reddish and some areas look like it peelef a little. Before he used to push it and he said it felt like liquid went out of da bump. But now it seems like its full of liquid and when he pushes it it just a bump now. (liquid bump) He was wondering wat it cud be. [/INST] Hello!From history, it seems to be an umbilical hernia.In my clinic, I look for impulse in swelling on coughing & palpate the defect beneath the swelling if any, to confirm the diagnosis.An ultrasound is advisable.If confirmed that it is hernia, after routine investigations & fitness, surgery is done.Hope this information is useful to you.Thanks. Regards. </s>

<s>[INST] I have fibromyalgia which you know is painfull.now when i am doing house work and i have to bend overmy legs from the knee down just stats to hurt and i don;t feel like there is enough blood in them,as soon as i stand up my legs have severe pain and i have to sit down--------annette mchenry [/INST] Hello welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advise. Pain in lower legs itself is a symptom of fibromyalgia. It can be due to muscle spasms also. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] Hi Doc I had a heavy night drinking got up the next day and found a small round red rash on my right lower back it was very tender and sore it only hurt if I cough or breath in deeply. It also was uncomfortable to sit, if I tense my muscles I can really feel the pain What do you think? [/INST] Hi, In my opinion, it could be a furuncle which is an infection of a hair follicle. If treatment is not initiated, it could lead to a systemic infection. Please do consult your Dermatologist to confirm the diagnosis and to initiate the treatment. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I had 4 of my wisdom teeth taken out 5 days ago. The pain is mostly gone but I can't extend my jaw very far. Without any discomfort I can stick two finger tips (middle and pointer finger one on top of the other) through my teeth. I tried doing jaw exercises the other day and they hurt. How long does it take the jaw to heal? [/INST] Thanks for your query, I have gone through your query.The limited mouth opening could be because of the inflammatory response to the bone cutting and the soft tissue injury. Nothing to worry, it will return back tonormal in 5-7days after extraction, do saline gargling and continue the antiinflammatory drugs.I hope my answer will help you, take care. </s>

<s>[INST] She is having 24 years old.Now suffering from small breathing problem.Earlier it was at the time of climbing step and at the time of tension.But today it came suddenly and continued for a long time.Earlier it was not like that.What can I do? Can U Suggest a solution for this and a good doctor for consult [/INST] Thanks for your question on Healthcare Magic.I can understand your concern.At young age (24years), asthma and acute bronchitis are likely cause for your worsening breathlessness.So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose asthma or bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only.You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with appropriate treatment.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hi! I'm having problems with my breath. I've tried licking my wrist & scraping the back of my tongue but I don't feel any particularly bad smell, it smells a bit sour, but nothing extreme. However whenever I'm in a room talking to people they discretely hold their noses. People smell my breath from 6 feet away. I've visited the dentist twice (my teeth are in perfect health, never had a cavity) and been to 3 ENTs, but they can't find anything wrong so I'm stumped. [/INST] Hello!Welcome to HCM.Gum infections can cause bad breath.As you saw your dentist and ruled out a dental cause, i suggest you to see your physician.Check if you have GERD.smoking and other tobacco habits also cause this.You did not mention anything about your general health. Diabetics,liver and kidney disease ,tonsillitis and other respiratory infections potentially cause halitosis.Check if you have a low salivary flow.If any of the above includes your general health, this has to be corrected immediately.Use saliva substitutes if you suffer low saliva flow.Keep away garlic,onion,tobacco products.Brush your teeth and tongue twice daily.Maintain a good oral hygiene.Regards. </s>

<s>[INST] sir my name is usman ali and i m from pakistan my mother is suffering from gathia disease her body joints are paining if we gave her medicines she got alergy alergy type of raises on body of red colors ... she is getting day by day weaker.. usman ali pakistan 0000 [/INST] Hello, As first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist better to consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician </s>

<s>[INST] Hello doctor, I have done some stupid things in my life. I had safe sex, but with many different girls. There was never a condom fail and each time I used a new condom. When I did it with the fourth girl, I noticed that the condom tip was broken. After that, I took PEP. On the 26th day post exposure, I had sex twice with another girl both times with protection and on the 30th day of PEP, my DNA PCR was not detectable. After 26 days, I again tested for HIV with RNA PCR and my result was not detectable. Again, I had sex with a girl twice. The exposure lasted only for a minute and soon I ejaculated inside a condom. Now, I am taking PEP. Please let me know what are the chances of me getting an HIV infection. [/INST] Hello. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards. For more information consult a sexologist online --> </s>

<s>[INST] my sister with mental disorder aged 25 has been prescribed tolaz and zepny-M tablets by her doctor.what can be the name of the disorder she's suffering from? [/INST] Hello kim; welcome to HealthcareMagic Tolaz is Olanzapine is drug used to treat Schizophrenia in acute phase and for maintainence and the related psychosis.As for Zepny-M even it may be related drug but the exact information is not available as the exact content is not known. Thanks </s>

<s>[INST] Hi in the recent week my knee s have started produce pain when placing weight upon.My job involve s being on my feet daily mostly upon a hard floor surface.Have not had knee problems prior,it has only starting occuring this week.I have not fallen or jarred nor knocked my knee s upon anything.Any suggest s as what might be causing such a reaction to start occuring recently? [/INST] Hello, In the present instance if you are feeling this pain first time, then most probably, this can be due to strain over your knee. To me at present it doesn't look to be e a a case of osteoarthritis knee. I will advise you following to have relief at your knee pain- 1. You should avoid heavy work. 2. You should take proper rest. 3. You may take a good analgesic like acetaminophen for relief from pain. 4. You main apply warm fomentation to get relief from pain. 5. You should also wear a knee cap to support your knee. You may have relief from this knee pain in in next 5 to 7 days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari </s>

<s>[INST] I am a 62 year old male, in general good health and a non smoker. I weigh 142 lbs. and have nearly all my life. Height is 5 11 . I ve had a history of lower back problems for about 20 years. The latest and worst occurred a week ago when I simply bent over and felt something give. Long story short, my lower back gradually stiffened with pain..walking or standing became virtually impossible after driving for 10 hours the next day. I ve been wearing a back support belt which helps with pain and mobility, but I ve noticed in the mirror that my lower torso has shifted to my left. Don t know if that s been the case all along or is a result of the injury. There is swelling on my lower right side and back. What s going on? [/INST] Hi,From history it seems that there might be having degenerative changes in your lower vertebrae producing osteo-artheritis.There is also possibility of having osteoporosis of bone.Go for x-ray lumbo-sacral region.Go for back extension exercises daily.Avoid weight lifting and bending from back.Take Calcium and Vitamin A and D supplements.Ok and take care. </s>

<s>[INST] I am 38 and I had an abnormal EKG today. They are sending me for furthering testing, but I was wondering what it could mean. I pass out sometimes, but I have low blood sugar and migranes, which could cause the passing out as well. I am 5feet 7inches and weigh about 125lbs.. [/INST] Hello,I passed carefully through your question and would explain that low blood sugar can lead to fainting. Anyway, your ECG is abnormal, cardiac arrhythmia should be excluded first. I would like to directly review your ECG report for a more professional opinion. Considering an abnormal ECG, other tests are needed: - a cardiac ultrasound- blood electrolytes- an ambulatory 24-48 hours ECG monitoring to investigate for cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ilir Sharka </s>

<s>[INST] Hi Dr. Narasi: My husband is scheduled for a CT in the morning due to high liver enzymes (10 times normal). I am very concerned because everything I have read is not good. Is there something I am not seeing that could be curable? He is 50 years old, type II diabetic. Thank you sir. [/INST] HelloElevated liver enzymes may mean raised ALT,AST,GGT,ALP etc.Increased ALT,GGT and AST may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.Your husband may need few more investigations like routine hemogram,random blood sugar,viral markers,lipid profile,ultrasound of abdomen.He is rightly suggested for CT scan.It is very helpful in assessing exact reason.He may need to take medicines after evaluation.Generally this is a manageable condition.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST] After just eating, i had a sudden sharp excruitating pain in my collar bone which has travelled down to my stomach. It only lasted 10 minutes but was so painful it hurt to breathe. I do suffer from IBS but have never had this sypmtom before, is this related? [/INST] Hello, Your symptoms could be related to abdominal distension or acid reflux. In my opinion, there is nothing to worry about! I would just recommend avoiding large meals and spice food and try to eat more frequently and in small portions. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist </s>

<s>[INST] hi, i m dental student preparing for pg, 25yrs old,5.1 inch,58kg.i have no medical history. i ws a bright student during my undergraduate days,but now a days i m nt able to conc on studies,not have enthusisam.i had a emotional trauma from my close freinds i didnt able to overcome from tat around 6 months,i counsulted my general physician she had precribed me tab.daxid 50mg for 10 days.after taking these tab. i m feeling bit confident and clam.si i would like to wheather i m suffering from depression or its just an axiety???????? should i take ssri???????? if yes then how to??????????? [/INST] HIThanks for using healthcare magicYou have adjustment disorder. In that case, you can take antidepressant like daxid or paroxetine. That would help you to control anxiety as well as depressive symptoms. You can also try some relaxation exercise like JPMR or deep breathing exercise. Better to consult your psychiatrist or physician for that. In case, you need further help, you can ask.Thanks </s>

<s>[INST] Due to alleregies, and change in weather I developed a strong cough and more sneezing than normal. I developed a very intese pain with each cough or sneeze under the right rib cage. I visited the er was advised I strained my muscle. That was 5 days ago, the pain medicine helped for a while but the pain remains. How long does it take to recover and when should I make an appointment to follow up? Also taking prescription medicine for the allergies and cough at this time. [/INST] Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* The pain is in relation with irritation of underlying parietal pleura through coughing .* Takes time according to the load of the pathology and extent of bronchitis or other lung insult .* Suggestions for better outcome - Continue current medicines .- Inhalation of vapors of boiled water with added tincture benzoin or karvol capsules morning and evening for 5 min. each with blanket covered over head helps tremendously .- Avoid smoking ( active or passive )- Deep breathing exercises , YOGA recover faster .- Follow up with doctor after medicines are over .Hope this helps you .Welcome for any future doubts .Regards dear . </s>

<s>[INST] Hello doctor, My gums near the area where the wisdom tooth should grow started feeling painful, but not much. Whenever I chew near that area, it would hurt. I thought of myself, it is probably because my wisdom tooth is coming out (as there was a sort of bulge where my wisdom tooth should come out). The next day, I noticed that the gums near the area where the wisdom tooth should grow started swelling around the tooth before it. And while looking into the mouth, I poked the swollen area accidentally, and pus came out of the swollen gums. What is that? Should I consult a dentist or just taking medicines is enough? If so, what medicine would you prescribe? [/INST] Hello. It seems like your wisdom tooth is on the way, but wisdom tooth does not erupt easily. They will take time and phases to erupt, so you will have to face this pain and swelling in some phases, maybe accompanied by fever even. Do salt water gargling. I would suggest to continue with warm water, and salt rinse five to six times daily, it will help you. I will not advise you to take painkillers. You can take an anti-inflammatory for the time being, Aceclofenac-P 500 mg twice daily for three days. Maintain good oral hygiene and rinse off your mouth after every meal. Follow up after three days. </s>

<s>[INST] My tooth on the right side of my middle tooth hurts. It right under the tooth, it doesn't hurt anywhere else. It hurts when I touch it and when I eat. I floss and rinse and brush daily, and I wear braces. I am a fourteen year old female. I sincerely hope that its not cavities since I hate having dental dilemma. I am already very careful with my braces and they should be removed in a couple of months. I eat quite healthy, yes I do eat junk from time to time, but my family eat lots of veggies and fruits, and we've given up pasta and white rice for kinois and brown rice. My mom has noticed that the gum on my left side has swelled up, so maybe that's the cause? If it is, how would that affect my tooth? Any suggestions to make the pain go away? I'm sorry, for asking all these questions, but I'd like to study dentistry when I'm older so I'm very interested and like to know what's happening in my mouth. Please respond asap and give details! Thanks! [/INST] Hi,Thanks for asking the query,Pain in the tooth indicates infection in the tooth that has involved the pulpal tissue, such type of infected tooth needs to be root canal treated to save it permanently.I would suggest you to get an x-ray and checkup done.Analgesics and antibiotics will give temporary relief.I would suggest you to consult to the Dentist and get the checkup done.Take care! </s>

<s>[INST] i have had a bladder infection was given cipro 250 mg for 7 days i was on the last pill and proceeded to experience severe pain and camping I was taken to hospital by friends and was give toreador and abuscapan as well as something for vomiting and saline solution. Finally went home after if could finally pee sent toreador and buscapan home with me that was on Sunday have been since until this morning woke up with sever back pain and leg pain i thought is was my vertebrae problem to i took a diclofenac and did go back to sleep now i have sever pain again although not in the same place as Sunday and chills and a headache The one doctor gave me 3 more days of cipro when ii went in to get the IV out another doctor gave me 5 days of macro bid it is not doing anything for me [/INST] hi.noted history of gallbladder pathology. if it is secondary to gallstones and your symptoms are occurring frequently and increasing in severity, it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. what you have is chronic cholecystitis, probably secondary to cholelithiasis (gallstones). the most important thing to take note here is that an elective or scheduled cholecystectomy has better post-operative outcomes and less risk of developing complications as compared to the one done emergently. diagnostics (such as ultrasound, liver function tests, blood count, etc.) and management (medical and surgical) will be directed accordingly. definitive treatment for gallstones is cholecystectomy or surgical removal of the gallbladder along with the stones. it can be done laparoscopically (goldstandard) or thru open technique. low fat diet is also recommended.hope this helps.good day!!~dr.kaye </s>

<s>[INST] About four months back I hit my head and got a slight concussion. About two months ago I started noticing a small lump where I hit my head. The lump grew a bit bigger and a few more appeared as well. I ve been getting migraines a lot and I never got them much before. The lumps don t cause pain but when I touch them I can definitly feel a lot of pressure and they are pretty hard. Any suggestions? [/INST] Hi,Welcome to HCM.Based on the facts you seem to suffer from Inclusion dermoid with fibrosed Hematoma at the hit site in the head.Or could be sebaceous cysts with acne,or could be dercums lipomatosis.These need to be ruled out.Remedy-USG and CT study of the skull would resolve the ambiguity in diagnosis.Consult Physician to investigate cause of Migrain.Avoid spicy/non-veg food / avoid alcohol,smoking,tobacco,if any.Hope this would resolve your anxiety and would help you to plan further treatment with your doctors.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS </s>

<s>[INST] Hello doctor,My heart is normal, but I have ventricular ectopic beats. Could these cause cardiac arrest and kill me at the age of 23? I worry about it every day. Kindly advice. [/INST] Hello. It is unusual for ventricular ectopics alone to cause cardiac arrest. Still, it depends on various factors like cause of ectopics, the morphology of ectopics, frequency of ectopics LV function on Echo. What symptoms do you have? Please provide your ECG and Echocardiography report. You have uploaded your photo as an attachment (attachment removed to protect patient identity). </s>

<s>[INST] what if you touched your Bf s penis and he had a pre-cum.. then afterwards you peed and touched your part down there to wash it.. could you get pregnant? [/INST] Hello. Thanks for choosing HealthcareMagic forum. You are not likely to get pregnant. You need not be so panicky.For pregnancy to happen your boy friend must penetrate inside you and has to leave the sperms directly inside the vagina and that too preferably deep inside you. Do not worry now. Dr. Rakhi Tayal drrakhitayal@gmail.com </s>

<s>[INST] I had alveoplasty on Monday and its now Saturday. The oral surgon mentioned that I had nerves close to my nasal cavity and jaw bone that may cause problems. I had 5 upper teeth pulled and the pain is till excruciating. Most of the day I have a throbbing pain and my cheek feels as if its buring. What should I tell the surgeon when I call him to ask him for more pain management? [/INST] Hello there, pain for the first three days is considered normal. Since it's already been a week, pain could be attributed to infection in that area. Please mention if you have any swelling? If so there are chances for the canine space infection. Visit your oral surgeon and get yourself evaluated. </s>

<s>[INST] my mom recently had 2 more stents ---she now has 6 in the right coronary artery and 1 in the left for a total of 7. Tonight she is complaining of pain in her collarbone. Yesterday she felt like she had gerd. Are these possible signs of a heart problem. Could there be a problem with a stent? Thanks, Betsy [/INST] Thanks for your question on Health Care Magic. I can understand your concern. No, these symptoms are not suggestive of heart problem or connected with problem in Stents. Pain in collar bone is more likely due to musculoskeletal pain. GERD is mostly due to stress or drug related gastritis or food related gastritis. So ask her to avoid stress and tension. Give her light food, avoid hot and spicy food. Give her proton pump inhibitors and prokinetic drugs for GERD. Apply warm water pad on affected areas for collar bone pain. She can take painkiller if pain is more. Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. </s>

<s>[INST] I have been taking 3600mg per day of gabapentin for 6 years with no side effects. I recently developed a red rash on my forehead and cheeks. I have been eating the same foods, taking the same vitamins , and prescription creams do not help it. The rash is hot and itchy. Could I have developed a delayed reaction to gabapentin? [/INST] Hi, it does not seem to be due to gabapentin as you have been taking it for years.I think you need to consult a dermatologist as the lesion is hot and itchy which suggests an underlying inflammation the cause of which should be searched for.take care </s>

<s>[INST] k..here it goes. A little over a month ago.I. had sex with a friend of mine that was staying with me from out of town. Have known the girl for a while. It was unprotected. Then on may 20th. I had unprotected sex with another friend at her bday party.again have known the girl for years. A few weeks later I was having diaherra and was a little tired. I had also recently started a new job and was working a lot of hours, for sometime 6 or 7 days in a row. Like a dumbass I went online to start researching and came across HIV. I went to the dr and they told me it was nothing. Last Sunday I decided to take one of the home access hiv tests whichis approved by the FDA..etc...on that Monday while I was waiting on the results..I noticed three nasty marks. On on my leg.one on my inner thigh opposite leg.and one on my chest..it was like a shot gun blast to the gut...lesions? I rushed to the ER..where the dr told me they were bug bites. The next day the results from the at home test came back negative. Since then I've still been a nervous wreck..I've notice dry skin on my hands and feet..which I don't know if its flaky skin" or what. There are what looks to be acne around my mouth and my throat which I had previously dismissed as acne or razor burn. Ii think my left armpit may be swollen..I don't know...and todya I have noticed really tiny red or purple dots.. in a couple. Places/on my body..I'm gonna take another test in a few weeks. [/INST] Short answer: No choice but to wait and retestLong answer:Hi there,From your query, I gather that you are worried more about whether you have contracted HIV from your two unprotected encounters, than you are about the various symptoms that you have described. However, since you have mentioned it, I will provide some simple solutions. The bug bites can be managed with a simple hydrocortisone cream to bring down the swelling and discomfort. Acne is common in areas you mentioned, and is usually managed with topical creams like benzoyl peroxide. If you are unsure as to whether there is a swelling in your armpit, you should show it to your regular doctor, as it could be a sign of other infections.Regarding the HIV per se, as you may have learned, HIV seroconversion is very vague and non-specific, and we usually do not proceed with extra steps other than to caution you on avoiding further sexual contact while waiting for the testing. You should be pretty safe if your HIV test was done at least a month after your last encounter. Be sure to repeat one last test 3 months from your last exposure risk to ensure the accuracy of even the oldest testing methods.I would advise you to refrain from any sexual encounters until the final test, and stress the need for responsible safe sex in the future. There are many other sexually transmitted diseases that you need to protect yourself from, like the far more common chlamydia and gonorrhea.Hope this helps. Let me know if you have further questions.Regards,Dr. Teh </s>

<s>[INST] Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. [/INST] Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help. </s>

<s>[INST] I have recently been working out with a trainer and i have found several painful lumps under my skin on my upper legs. I have fibromyalgia and have had painful lumps in my shoulder area befor but never this painful. Is this a typical symptom for people exercising and does massage tend to help? [/INST] hi,thank-you for providing the brief history of you.As these are muscular Lumps and undergoing physical therapy like - therapeutic ultrasound therapy and Myofascial release technique should helo make it better.Also for fibromyalgia you should undergo proper physical therapy and timely examination as wellin my clinical practice such cases respond well to physical therapy.regards Jay Indravadan Patel </s>

<s>[INST] Hi. I noticed a small abrasion on tip of my penis the very next morning I had rough sex with my girlfriend and it turned two days later into one single white-headed pimple. I have no pain and there is no discharge of any unusual fluid or any smell. what could it be? how to treat it? Thank You [/INST] It could very well be an abrasion. You dont need to do anything. Just give it rest and keep it clean. It will heal in a weeks time. But try and practice safe methods to avoid such problems in future. Take care. Dr Rishi, New Delhi, India. </s>

<s>[INST] Is there any pertinent information you can give me. As to how to best fight against the lupus diagnosis I have just recently been given. I am determined to fight this disease to the bitter end and I am Not going to let it get the best of me! I am a 69 yr old woman and have never had a major disease. in fact until I I was diagnosed I took nothing but vitamin supplements no prescription drugs. I ll try anything! [/INST] greeting..the medicine has limited role...Non steridal anti inflammatory.Hydrochloroquine.control the lupus.Oral Corticosteroid decrease the symptoms of inflammation...following tip may help full...plenty of rest and relax.learn strees managementReceived regular medical and dental careMaintain healthy balance dietDo not smookMaintain Vit-D,level within the recommended levelAvoid exposure to sunlight.ultraviolate light.Consult Rhumatilogist. </s>

<s>[INST] HI Doc. Our OB-Gyne ask my wife to take Duphaston 3x a day for 1 week, but he told us to come back in two weeks. So, can we buy another Duphaston for 1 week to make it two weeks? My wife has diagnose at early 5 weeks pregnant via Transvaginal Ultrasound, and they only see the Gestational Sac alone.. and it is normal that my wife feel comfortable after taking duphaston, especially her abdominal pain? Thank You and GOD BLESS Doctors [/INST] Hi.Thanks for your query.Read and understood that your wife has been advised and she is taking Duphaston - the progesterone. This is given to hold back the pregnancy. About the trans-vaginal ultrasonography- showing the sac, 5 weeks is too early to comment upon reports of Gestational sac. Yes, you have to take one more week as advised by her Gynecologist. Get the review ultrasonography after say a few weeks to see the progress of your baby </s>

<s>[INST] hi about 4 week ago i was assaulted and kicked in the face by a girl with heels on my eyes was mainly effected but xrays showed i was fine but they couldnt tell on my nose untill the swelling and bruising goes down it has now gone down, but i have a lump in the middle of my eyes at the top of my nose where it was scabbed of her heel the lump hurts what could it be should o go to the doctors? maybe chipped bone? [/INST] hI ! Good evening. I am Dr Shareef answering your query.Yes, you should go to your treating doctor for a review clinical examination of the swelling which lasted for last 4 weeks. It might not be possible to give an opinion without a clinical examination of the lump. This could be a missed fracture of nasal bone, or an organised hematoma. Till then, you could go for an anti-inflammatory drug along with a proton pump inhibitor.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef. </s>

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

<s>[INST] Hi, I am 31 years old. One month ago I had sufferedin influenja fever and after blood test doctor informed me that Bilirubbin level is beyond normal level and he prescribed me a medecine called Clavam among others now i want to know its functio ( Clavam ) in human body [/INST] Hi. Clavam is a mixture of amoxicillin and clavulanic acid and it's basically an antibiotic used to treat a variety of infections </s>

<s>[INST] I have paresthesia of chin lower lip and gingiva on the lower right side where the 3rd molar from the back was extracted and had poweder bone graft. I can feel the chin and lip but they feel weird whe touching or when I move them. On the X Ray post extraction , it showed that the drill went up to the nerve canal. It's been 8 days with no changes as far as I can tell. The lower teeth in front of the extraction are " numb " but feel uncomfortable when I press on them. Is this possibly reversible? what suggestions do you have ? [/INST] Hi..Thanks for the query..As per your complain it looks like during the extraction of the wisdom tooth or the third molar tooth there has been injury to the inferior dental nerve and it is leading to numbness in the lower gums, chin, lip etc as these areas are supplied by inferior dental nerve..I would therefore suggest you to consult an Oral Surgeon and get thoroughly evaluated and if needed an MRI SCAN can be advised to check for the condition of the nerve.In case if there is only injury to the nerve then it will gradually repair itself and the sensations will become normal and numbness will subside..In case if the nerve is broken or severed in two parts then there can be irreversible damage and the numbness can be permanent..So it will be better to get examined and treated accordingly..Hope this helps..Regards. </s>

<s>[INST] My son is 16 years old, in good shape, does sports actively. When doing a tennis session he complained about having difficulty yawning and taking a deep breath. He has earlier visited a doctor for similar symptoms but nothing diagnosed. Some web pages suggest such symptoms might be related to anxiety. Tennis can be a stressful game, especially if played competitively, as he occasionally does. He tends to be quite nervous before games, and sometimes loses games because of nerves. My question is, if this is about nerves, are there anxiety-relieving breathing techniques he could try to see if they work? [/INST] will playing u should talk to yourself and keep on reassuring that you are fine...this is part of suggestion..by this I will feel better and away from anxiety </s>

<s>[INST] Dr. am 32yrs,it took me over 7yrs to be pregnant and now am 22weeks pregnant i noticed fluid coming out of me,i then went to the hospital and was sent for a scan. dr the report shows that my baby is doing fine but that my amniotic fluid is moderately reduced. what am i expected to take to increase these fluid [/INST] HiI have gone through your complaints and sonogram report findings.feel sorry for your condition.its precious pregnancy for you.as you are saying fluid is coming out and scan shoews reduced liquor ,it means leaking liquor due to premature rupture of membranes.to avoid further decrease of liquor absolute bed rest is recommended.cervical stitching is also advised.complete bed rest and encourage fluid intake.scan once in two weeks to assess liquor and fetal growth.once you reach 36wks you can plan delivary.Thank youRegardsVasundhara </s>

<s>[INST] I am a 50 year woman. i fell and got a concussion with no brain bleed(2 ct scans) still having headaches ,was put on deepakote and adjusting dosage...still losing words and feel not 100 percent me again...momentsof frustrations and bad mood....q1 will i ever recover and q2 can having previous head injuries that were probably concusions but undiagnosed prolong length it takes to recover? [/INST] Hello. Thanks for asking from HCM.I can understand your concern. It is good that there was no blood clot in brain. Now coming to your first question, recovery from concussion always occurs. Sometimes it may take few days to months ( in case of multiple concussion). Regarding you second question, yes it is true that it takes more time to recover in case of past history of multiple episodes of concussion. But do not worry. For relief, you should: take bed rest: take diclofenac sodium for pain relief after proper prescription: take mood stabiliser like escitalopram after proper prescription: Try avoiding any head injury: avoid mental and physical stressThanks. Hope it will help you. Take care. </s>

<s>[INST] Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. [/INST] Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help. </s>

<s>[INST] I have extreme pain and swelling and redness in the lower half of my leg they gets some better through the day or after movement. Gets worse when laying down and lessons while standing. There is a new small sore that has open up for no apparent reason. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. This may be a beginning of leg cellulitis which is inflammation of subcutaneous tissues and may develop into diabetic foot or even diabetic gangrene so any swelling, redness or pain in legs in someone who has diabetes should be evaluated by medical professionals since antibiotics may have to be started as soon as possible to prevent spreading of infection. He should do at least basic blood tests and blood sugar to see if there is significant infection or not. Other causes include deep vein thrombosis or lymph edema and these should be checked with an ultrasound exam. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] My 2.5 month old had a pimple on his chin. I picked at it (I know, big mistake) and now it is red and swollen with a lot of puss behind it...looks to be infected. He cries when he nurses because it rubs it. Do I continue to leave it alone or will it get worse? [/INST] Hi...please do not leave it like that. It is getting infected and might turn out to be a pyoderma or skin and soft tissue infection of the region. It might require antibiotics orally and topically. I suggest you consult your pediatrician regarding this.Regards - Dr. Sumanth </s>

<s>[INST] i just got back from the chiropractor and he told me i have carpal tunnel . He had asked me about my fitness levels i am 18 and female and i do at least 30 min of jogging (2.5-4mi) 3-5 times a week and sometimes i follow up with a sport ( basketball or racquetball). He felt my arms for muscle and said i really didn t have any and suggested that maybe my hormone levels were low and i can t gain muscle as easily as a normal person, but because he doesn t specialize in that he cannot diagnose anything. What could be a possible fix or explanation as to why i am not gaining small amounts of natural muscle? [/INST] Hi welcome to H.C.M.Forum. regarding muscle growth depends upon the size of the parents and blood relatives. inspite you can try to cope up. use more of fats, tubers especially sweetpotato, fleshy fruits green leefy vegetables. incline more for junk foods .it is not a factor of harmones. thank you. </s>

<s>[INST] my child name is Soham Mandal .He is 8 month old suffering from cold and flu and whooping cough about six daya .when i go to doctor then he prescribed some medicine named MEGACLOV DS,(aMOXYCILLIN AND POTASSIUM CLAVULANTE),LEVOLINE(LEVOSALBUTAMOL),CORTOVIS(DEFLOZACORT)but he is not cure from this problem please tell me what can i do. [/INST] whooping cough(pertussis) causes sever cough with gasping like condition during aggressive cough. start with Syrup Azithromycin 10mg/kg single dose for 5 days.also give azithromycin for 5 days to all house hold contacts for prevention.dont forget to get your child vaccinated later on and give him a mask to cover his mouth.continue with a bronchodilator like asthalin or theoasthalin. nebulization with asthalin will give him good relief </s>

<s>[INST] Dr i had been last periods time is 12 june.i am do sex 24 june. my period is not coming in july on 12 th.i use i m check my pregency test. possitive .i use safty kit of surya company.my periods was start continue 10 days after 5-6 days less bluding. because i use clot tablet. completely 15 days period complete.bt i re-chek again positive.i take mathergin tablet but no change. what i doing now....... [/INST] hi..you have conceived and you have tried for its termination by taking methargin.. still your UPT is positive..dont self medicate..see your obstetrician for the management of condition..they may use medical methods for the termination, if it doesnot work, they may go for menstrual regulation by aspiration of contents of conception by MR syringe, if it doesnot help, then they may go for D and C.. </s>

<s>[INST] Recently I find that I m having trouble when driving to & from otherwise familiar & commonly visited locations around town. Similarly, I seem to easily forget what my plans had been or why. I m a 69 year old male in good physical condition. I have a MS degree in Synthetic Organic Chemistry & a PhD in Medicinal Chemistry & have spend a great deal of time developing drugs to treat Parkinson s Disease. I currently manufacture & market the premier products for cleaning disc phonograph recording, but this past few months has got the best of me. [/INST] try to take adequate sleep. sleep deprivation may some times cause lack of concentration. try to take adequate sleep before driving. </s>

<s>[INST] I am feeling a sudden back pain which is just 2inches below the neck, it comes suddenly, feeling like more burning rather than pain, after rubbing that part it disappears. I'm getting it sometimes but today it happened thrice. What it is? [/INST] Hi,Sonads. Thanks for query, It seems that you might have some muscle catch giving stiffness of muscles. Take analgesic tab. Apply analgesic cream. Ok and bye. </s>

<s>[INST] Hi need help. I am in my 21st week and have done my level 2 ultrasound . Doctor said that left kidney of my child is non functional but the right kidney is doing fine. here is whaht report says - Fetal left kidney is mildly enlarged, has echogenic cortex ans shows a minimal pelviectasis: likely to be a dysplastic kidney. It measures 24X11X10mm across. The right kidney has a normal contour, echo pattern and size. It measures 22X10X08 mm. there is no right renal pelviectasis. No ureteric dilatation is seen. The urinary bladder has a normal contour and capacity. There is no post-micturition residue. No other dysmorphic development anomaly is delineated. Can somebody pls advice the condition of my baby. What about the future life of my baby [/INST] Hallo Thanks for your query .You are in 21 weeks pregnancy and ultrasound scanning shows dysplastic left kidney.Your child's Rt kidney is functioning well.Since it is congenital anomaly nothing can be done .As the Rt kidney is functioning well you need not worry at all.There are proven facts that those who are born with only one kidney live normal life.Pl note Smt Indira Gandhi had only one kidney from birth. </s>

<s>[INST] By mistake I pour hotwater which was cooled down but not that much cool that it won t melt plastic.I pour this water in plastic water bottle and it changed shape because of hotness.my son had drunk this water.will it cause any harm.the shape of the bottle is not completely out but changed slightly [/INST] Hello. I just read through your question. There is no reason to be concerned about the water. Though the hot/warm water had this effect on the bottle, it willnot have any such effect inside your son. No need to be concerned. </s>

<s>[INST] my 11 month old son has had a fever for the last two days (temp 38-39) and tonight I have noticed two lumps behind his left ear and one behind his right. His temperature at the moment is 38.1 despite having panadol 4 hours ago. Should I take him to emergency tonight or wait until tomorrow? He took his fluids today but refused diet which is unusual for him. [/INST] Hi, welcome to forumFrom history I understand that there is mild grade fever with small lumps being both ears. The lumps are quite a common finding in kids if this age. About the fever , kindly sponge the child from top to bottom with normal tap water with each fever spike, along with fever medication. if fever continues even after 49-72 hours or if child had high fever the visit your pediatrician in OPD. no need to rush to ED </s>

<s>[INST] Shortness of breath about 7 years ago I had 7 blood clots in my lungs false memory for about 2 years getting better now but now I m starting to the breath in any movements I do don t have any real good movements at all anything I do I get shortness of breath [/INST] Hello,Breathlessness on exertion in your case suggests lung or heart origin.You need to consult a chest or cardiac physician, get investigated and start with needful treatment earliest.Till then, take rest, eat small servings every 3 hours and take tablet Deriphyllin over the counter till then for some relief.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vasudha Jayant Athavale </s>

<s>[INST] I swim almost everyday about 2-3 miles at my local YMCA. I have began to notice my hair falling off my arms, legs, ears, nose, and pubic region. It has not affected my head hair or facial hair. I use a good shampoo on my head and face. I use a good body wash with a body scrubber after each session. Although I have missed this several occasions, opting to shower later. What do you think is the deal? A friend of mine that I talked to last night said he experienced something simular to this and went to a Dermatologist and received a shot and some pills that help him. He was not able to recall the name of the medication. Could you please help me with this matter, it has my concern level up.Hi, may I answer your health queries right now ? Please type your query here... [/INST] Hi.As per your case history of hairfall.My treatment advice is – 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL. </s>

<s>[INST] I'm a 16 year old female and I've been having a lot of bleeding from my anus when I have a BM. I don't think I have haemorrhoids and I have a family history of bowel cancer so I'm really scared I have that, I'm too embarrassed to ask my parents of GP so please help! [/INST] Hi,From history it seems that you might be having internal hemorrhoids givingrise this problem.Consult surgeon and get examined.do not jump directly on cancer.Avoid constipation.Ok and take care. </s>

<s>[INST] I live in Tucson AZ and had valley fever about 15 years ago. One of my symptoms was vertigo. I now am having symptoms of vertigo (if I look up on straight down). I also had a red, bumpy rash (not itchy) on the front of my legs below the knees. I also feel fatigued, and malaise. Could I have valley fever again? I've heard you can get it again. [/INST] Hi I did review your concern. Tucson AZ is place where valley fever can occur. It is caused by Coccidiodomitis fungi. It generally presents as respiratory disease with fever.Vertigo is generally not seen with this infection. If you are experiencing vertigo I would recommend you to get yourself evaluated. Vertigo can occur due to inner ear or cerebellar or heart issues(light headedness). A neurologist needs to investigate your condition for that. The bumpy rash below your knee can be a manifestation of valley fever known as erythema nodosum. It can be confirmed by a punch biopsy.I hope this helps.Let me know if you have any more questions or concerns.wish you a very healthy life ahead. </s>

<s>[INST] I just noticed there is a soft round bulge just inside the opening of my vagina. It looks like the size of about a smallish lime. It is soft and looks vascular. There is no pain or bleeding. I am in menopause and 61 years old. No other symptoms exist. Sometimes I feel cramping, but not excessive or painful. Can you advise what it might be before I call the doctor in a panic. Thank you. [/INST] It may be a retention cyst, better to consult a gynecologist and get fnac done to know the nature of the swelling. Hope this helps you. </s>

<s>[INST] Hi, I am Ramesh from Chennai. I had severe cough for last one month. Two times, i suffered from difficult to breath properly, the whole night i have not slept...through the local doctor i came to know that i am suffering from wheezing....they inject me deriphyline injection.. is it curable.. please reply... [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. Yes, it is definitely curable. By your history and description, possibility of acute bronchitis is more likely. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I had a concussion 7 days ago I have memory loss of the attack to my person, I also have dizziness and blurred vision now, would like to know if I can fly, age55,6ft1inch tall, 230lbs., also have headache from left eye socket(eye socket feels empty) to left ear down to almost base of neck [/INST] Hello, I have noted your symptoms. Please get a brain CT scan done to rule out brain hemorrhage. If CT scan comes normal, you are fit to fly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sudhir Kumar </s>

<s>[INST] I was in a car wreck in July that caused my seatbelt and airbag to injure my sternum. My asthma is worse, I get a brain- freeze im my chest when I drink frozen drinks, and im getting red blotches on my cheeks and chest frequently. Could I have been allergic to the airbag dust? [/INST] Hello,Asthmatic are prone for dust allergy. The accident might have aggravated your asthmatic condition. The chest discomfort on intake of cold objects is due to bronchospasm which is a hyper reaction due to asthma. I would advice my patient to undergo a spirometry test to assess the severity of asthma. Secondly avoid cold drink to prevent such episodes in the future. Consult your doctor for more information. </s>

<s>[INST] hi i missed a few birth control pills in january and had unprotected sex, i have done some tests but have been negative, this week im having a few signs mainly being very hormonal and binge eating, also some abdominal pains. i get some flutters which are getting stronger and can be painful could i be pregnant [/INST] Hi ! Good evening. i am Dr Shareef answering your query.All the precautions including birth control pills are not 100% fool proof in protection against a pregnancy. If I were your doctor, I would go for a serum HCG determination and an ultrasound abdomen/pelvis if need be to rule this out and possibly consult a gynaecologist along with the investigation reports for further management .I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST] Hello.doctor My babby is 2 month I am feeding her nan formula 1.her wait on born was 2.5 she was born at 1 july and know her wait is 3.5 she offenly get rash on his back and she passes the stool as she drinks milk.plz sugges me is this nan goid for her? [/INST] HiThanks for writing to health care magic.Yes nan gold can be givenIt is safeWishing your child good healthRegardsDr Arun </s>

<s>[INST] I am just recovering from a significant bout of viral encephalitis. i am also on Neurontin and Plavix following discovery that i have had multiple mild strokes in my right temporal lobe caused by an atrial septal aneurysm. During the encephalitis I fevered at night for 16 days but in the morning my body temp varied from 94-97. since I stopped with the fevers (I went through a bout of antibiotics in case there was some tic disease, as well as Prednisone) my temperature is still consistently low - this morning 93.9 - currently 95.5. rarely does it go over 97.5 I also am feeling pretty wiped out. any thoughts? [/INST] hello friendgood to see you have recovered from a prolonged illnessThe thought I have is that your nutritional status would be low - because of he illness and because you may not have been fed as well as usual in view of your encephalitis.I suggest looking up at the nutritional status,and taking care of your diet in addition to your regular medicines and physiotherapyWhen your metabolism is low (due to low levels of nutrition) the body temperature is going to be low as well.Best of luckDr Mittal </s>

<s>[INST] I had my last menses end on 04/12/14. Since then I have had pain all along my right side. I have had my gall bladder removed in 08 so I thought it was something I ate. However, I have had bleeding since 04/18/14. I have also had severe allergies causing some conjuntivitis in my eyes and have not been able to see clearly for two days. I know they are probably unrelated but I was hoping it would go away by tonight so I could work. The pain is dull but constant in my side and my left eye is burning terribly. Should I go to the emergency room? [/INST] WELCOME. I READ YOUR HX. HERE IS UR PLAN.DONT WORRY. PLZ USE TOPICAL EYEDROPS CONTAINING AN ANTIHISTAMINE PLUS STEROID EG EFFEMOLINE EYE DROPS. FOR THE DULL PAIN PLZ TAKE TAB BUSCOPAN PLUS AND CAP NEXIUM 40 MG.IF U FEEL BETTER WITH THESE MEDS THEN NO NEED OF GOIN TO ER JUST FIX A ROUTINE FOLLOW UP VISIT WITH UR DOC.FIX AN EYE APPOINTMENT IN THE COMING DAYS TOO. HOPE THIS HELPS... </s>

<s>[INST] MY SISTER WHO IS 45 YEARS OLD HAS BEEN DIAGONISED AS HAVING EMPYEMA AND IS NOW IN APOLLO HOSP IN BANGALORE UNDERGOING TREATMENT FOR THE LAST22DAYS. THE PLEURAL FLUID HAS ALMOST BEEN DRAINED BUT NOW THE DOCTOR SAYS THERE IS AIR BUBBLES IN THE LUNGS WHICH IS CAUSE FOR CONCERN .KINDLY LET ME KNOW THE SERIOUNESS OF THE PROBLEM [/INST] Hi thanks for contacting HCM...Your sister is having lung infection in form of empyema....So for that antibiotic given....And if needed ICD insertated which has been done in your sister case....Now this air bubble can be from starting pneumothorax....In this condition patient suffer from chest pain and breathlessness also....It can be life threatening ...So constant observation needed....If dyspnea more and blood oxygen level falls then oxygen supplementation needed......If needed chest tube drainage necessary for relieving chest pressure...You are in good hospital ...So condition is serious and follow doctors advise....Take care ... </s>

<s>[INST] Hi I have had a sore nose for a couple weeks now and it has had scabs in that don t go away I have also developed a swollen cheek that is quite sore and glands in lower jaw underneath are sore too. Is this due to the nose sores or could something else be the cause? [/INST] dear friendyou certainly have some kind of infection which is causing this swelling and sore glands please do not tamper with the scabs and let them fall on their own as the face belong to th e area called the dangerous area of face which drains in the central sinus in the brain. please visit a doctor and get some antibiotic prescribed to control the infection. </s>

<s>[INST] I am experiencing a sharp pain between my left breast and collar bone, it is worsened by deep heaths sometimes, moving sometimes and even when I stay still the pain becomes sharper, it shoots up towards my shoulder or stays between breast and collar bone. What could this be? Should I see a doctor? [/INST] Hi I did review your concern.Such a sharp pain that worsens with deep breath can be due to musculoskeletal cause or pleurisy or pericardial cause.I would advice you to go see a doctor and get your self examined. At the basic he will do an ECG and get a chest xray done to find out more about the pain.I hope this helps.Wish you all the best.Thank you for choosing healthcare magic. </s>

<s>[INST] Hi Sir, I am having problem of kidney cancer; Brief about the reports. # Neoplastic renal mass lesion involving lower pole of left kidney. #A hyperechoic rounded lesion with fuzzy lateral margin is seen in the left kidney. An eccentric cystic with calcification is seen in the lesion. Low vasclarity is detected in the lesion on doppler. IMPRESSION: Cirrhosis with multiple hemangiomas in the liver Splenomegaly Left renal cortical vascular hyperechoic heterogenousfocal lesion. Suspicious of malignancy. Please advise what is the problem exectly? [/INST] hi welcome to healthcaremagic as per the reports it looks like renal cell carcinoma..needs further evaluation..treatment depends upon the age of the patient and histopathological examination </s>

<s>[INST] Hi,I have a sharp pain that comes in waves just below my ribcage that seems to be exasperated when lying on my back. I have crohns disease but am presently in remission. I take humira injections every fortnight. I also take slow K for low potassium levels. I also have been experiencing muscle spasms and tingling in my hands and mouth.I am 32 years, 51kg and 5ft 8 .Thank you for your help. [/INST] here the pain what you are experiencing could be side effect of humera injection which you are taking. I suggest visit your doctor for further guidelines.also check weather this pain was started before taking injection or after starting the treatment with humera injection. you have also explain here about the pain and tingling sensation in your hands it can be also related to cervical spine and disc. if there is a pain radiating from your neck to hand level then there might be a possibility you have a issue with your cervical spine or disc level.to have more clarity for your cervical pain i suggest to visit orthopaedic doctor or a physiotherapist and they will be able to diagnose your issue with different physical test they may ask you to go for some more test like every or blood test i suggest to do needful.at home i suggest to use hot pack on your painful area like lower rib as well as cervical spine to have shoothing and relaxing effect on your soft tissues which will also help you to have some more pain relief.Take care </s>

<s>[INST] My mother is currently on dobutamine and levophed for congestive heart failure. We want to be able to at least get her off of the levophed. The doctors are trying midodrine which has allowed us to lower the dosage of the levophed some, but not entirely. What other options are there? [/INST] Hello,Thanks for writing to Health Care magic, I am Dr , Muhammad Ahmad , I have read your question closely, I understand your concern and will be helping you with your health related problem.Levophed is actually one of the last resorts a doctor has in case of heart failure, when heart gets too weak to pump enough one needs it, there are not many options which can be as efficient as levophed but you can discuss with your doctors about digoxin, but usually patients on levophed are hard to switch to digoxin as digoxin is less potent and has more side effects.The only way your mother can get of levophed is only if she gets out of failure chronically by use of diuretics beta blockers ACE inhibitors etc, if here ejection fraction is too low and she is in ongoing failure than ionotropes are only choice.I hope this answered your question, If you have more queries I am happy to answer you.Regards.Dr.Muhammad Ahmad </s>

<s>[INST] hello doctor i need gynocologyst im 9 weeks pregnant my LM i m 21 yeas...married life spoans 1.2 years..i had irregular periood after marriage and when examined it was suggesootive of pcos and hupothyroidsm i had tablets for 3 months and my thyoid level was likely to be normal and dr. cut down dosage but i didnt test for pcos nw last two months i got my period regulr and now i m 10 days late..what o i want to do to regularise and to concieve??NB. i m with my hus for two concecutive mnths for the first time now after marriage [/INST] hi, You have taken treatment for Thyroid ,you have regular periods &you are with your husband for last 2 mths,-all these factors favour chances of pregnancy. If you aer 10 days late. urine preg. test would confirm the pregnancy.In case it's +ve get your thyroid treatment adjested earliest. &don't bother for PCOD. But if the test is -ve,go for PCOD treatment. Thznk you. </s>

<s>[INST] My 50 year old daughter - left side of her body had gone numb for about48 hrs and the hand and leg are not working. She has seed a neurologist previously for what thought to be an off and on type of MS. She went to the ER Tuesday afternoon and they did many test but did not have an answer (Posssible Cluster headache). She is supposed to see her Primary MD tomorrow and if he thinks it is necessary he will send her to the Neurologist Any ideas or questions [/INST] Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.She needs a neurologist consultation for sure. He will see the degree of weakness or paraplegia and will assess her physically to find out the cause of this weakness. Such conditions are slow healing and it will take some time too. MS patients are not always easy to diagnose. It also takes some time to diagnose even by a neurologist. So remain under supervision of neurologist for the whole treatment time.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to click on 'Ask me a question' directly from my profile. Have a wonderful time ahead.Regards!DR. MUHAMMAD M. HANIFUSA </s>

<s>[INST] Hi doctor,My mom has a brain hemorrhage. She has been unconscious. It has been two days since she is in ICU with artificial oxygen. Can you please comment more on this? [/INST] Hello. I have seen the report (attachment removed to protect patient identity). Your mother has pose a danger on the left side of the brain in a very critical area. The most common cause of this bleed is high blood pressure. In such a situation, patients take a long time to recover. The fact that the bleed is on the left side puts her at high risk of residual disability such as speech disturbance, memory disturbance even if she regains consciousness. The bleed is pretty bad and causing increased pressure within the skull which might pose danger to the remaining normal functioning brain. In such a situation, a decompressive craniotomy surgery may also be required. In the long term, she will take a long time to recover which can be up to six months. Whether and when she will regain consciousness, cannot be accurately predicted and depends a lot on her neurological status and co-morbid conditions such as control of diabetes, hypertension and heart disease if any. For more information consult a neuro surgeon online --> </s>

<s>[INST] Hi, About a month ago I started going on birth control (Micrognyon), a couple of weeks after I developed a very painful kidney infection . When my GP put me on anti biotics it began to leave my body, however it still wasn t fully gone, so the doctor put me back on the same Anti Biotics ( Penicillin ). However, when I was off the anti biotics, I began drinking alcohol again and sleeping with my partner again and it has seemed to return again! Although it is no way near as bad as it was, my side is very painful and it stings a little bit to urinate. I first slept with my partner in August and through the August/September time I was absolutely fine when he was using protection with no problems. I am starting to think it is something to do with my birth control pills. Do you think I should come off the pill for a month and start to use protection? Or perhaps change to another pill? I would greatly appreciate your help Thanks, Katie Lillywhite [/INST] HiUrine infections are sometimes very difficult to treat and require the right antibiotic. Firstly make sure a urine culture has been done and the antibiotic you are taking is the right one. Secondly intercourse increases chances of having a urine infection so you are having recurrent infections using a condom would be a good idea. Lastly, birth control pills do not cause urine infection , so you might want to continue them for added protection. Please remember some antibiotics reduce the effectiveness of these pills and cause unintentional pregnancies. Let me know if you have any other queriesThanks </s>

<s>[INST] My father was diagnosed with kidney cancer. The growth which is attached to his kidney is half the size of an apple. What I want to know is how long and how fast does kidney cancer spread to other parts of the body? He was diagnosed after having pain in lower back and stomache, no blood in urine. When they talk about stages of cancer, does that mean eventually the cancer goes through all these stages? [/INST] Hi, dearI have gone through your question. I can understand your concern. He may have renal cell carcinoma. It spread to the bone, lung or other body parts. Stage depends on size and spread of cancer. He should go for pet scan and mri. Then he should take treatment accordingly. Total nephrectomy or radical nephrectomy is the treatment of choice followed by chemotherapy. 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] Hi, I ve had this pain in my in lower middle on the right side of my back since yesterday. It s really intense in the morning but yesterday it went away after a couple of hours. It gets to the point where I can t stand up straight and my eyes tear up from the pain if I so much as laugh. Today it dulled after a while but it still hurts pretty sharply sometimes as the pressure builds and releases, it doesn t really matter much which position I m sitting in it just kind of comes and goes. I figured I probably just slept on it wrong, but a couple of friends had me worried about kidney stones or some kind of infection. I don t really have any other symptoms except a few times the pain has extended to my lower abdomen for a few minutes. [/INST] HI, This pain is most probably due to renal colic. To exclude causes of renal colic you should have an Ultrasonography Kidney Ureter and Bladder, Urine R/E and RFTs should be done. Then after the labs treatment should be according to the cause. If all the tests are normal you just take pain killers for a regular period of 07 days that will surely relieve your symptoms. I hope I am sucessful in solving your query if you have further you can ask me. Take care Get well soon. Regards, Dr. Azhar Sattar </s>

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

<s>[INST] I have had a bad disk in my lower back. I was told I needed to be careful. But A few months ago after having to do stuff I shouldn t. My back hurt so bad I made it to bed how I don t know! But my legs and feet were .The pain in my back was bad I all so had big like knot off to the side of the bad vertebrae. I put ice on it and it went away but!!! My back hurts I can t sit for very long, stand for very long,no lifting that is for sure. If my back starts to hurt I have to hurry to bed and lay flat. My Dr. Gave me Lidocaine patches they help but it is getting worse. Both legs are going numb and some times I can t feel my feet. It is scary!!! Well it go away? Thank You Susan [/INST] Hi Welcome to healthcare magic.you are suffering from prolapse intervertibral disc . PRIMARY TREATMENT of disc prolapse is rest and analgesics but sometimes operative treatment is needed decided by MRI report. </s>

<s>[INST] Hello doctor, My wife is 25 years old. She has been developing lot of moles on her body especially on hands and face. Initially they are very light almost like a small brown spot, but gradually they are becoming darker. They are incrementing periodically. What would be the reason for it? Is there any medication for it to stop and eradicate the issue? Thank you. [/INST] Hi. As you explained the disease that your wife has multiple small moles over face and hands, it certainly indicates solar lentigines. It is a multiple freckles type mole due to sun exposure. Now, let me explain the treatment and precautions. Avoid exposure to sunlight as much as you can. Cover body with clothes and cap while going out. Use sunscreen over face and hand every four hourly till evening. This will prevent further development of disease. Now to treat existing lentigines we can opt for laser. Creams will not be of much helpful in this. Q-switched Nd:YAG laser (neodymium-doped yttrium aluminium garnet) will be very useful. You can consult a doctor around you for this laser. One or two sitting would be enough to remove it completely. There is no side effect. It could be costlier, but results are good. </s>

<s>[INST] I m 30 years olf female and i have extra pulmonary tb I had swollen lymph node in neck but after completing two months of medication for tb Swollen node is healed I was losing wieght before i started treatement I m on medication since five months In between i had to stop tb medicine for a months time since liver enzymes were raised high Now i feel ok May i know am i going fine with this line of treatement [/INST] Hi!Welcome to HCM!The duration of treatment for extrapulmonary TB involving lymph nodes should be atleast 12 months. Since you have noticed improvement in the form of general well being, healing of the lymph nodes, weight gain, etc. But the fact that you had discontinued treatment in between due the raised liver enzymes. If the liver enzymes are raised using the conventional first line of drugs for TB then the doctor should prescribe the second line of anti TB drugs to complete the course. Incomplete & indequate treatment may result in failure of the treatment due to development of bacterial resistance.kindly consult your doctor for the remaining part of the treatment.Regards! </s>

<s>[INST] I am taking Amoxicillin 500mg x3 a day after having a chest infection a week tomorrow my last day of taking them is tomorrow, however I am on my period and the pain is awful and it is not a normal period it is just blood clot after blood clot I have never had it before and is really painful. Is it normal? [/INST] Hi,Amoxicillin is unlikely to cause blood clot during menses. Chest infection can act as a stressor on the body which can cause menstrual irregularities such as passing blood clots or having painful menses. Once the infection is eradicated you will resume your normal menstrual cycle. Complete the course of prescribed amoxicillin. However, if bleeding continues I would recommend you to consult a gynecologist to rule out other causes of passing blood clots.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, My son has a positive ANA and Scl 70. I just do not get it. I am in shock as I am sure anyone else would be. Does this mean for sure he has scleroderma? He has no symptoms. [/INST] Hello. Positive ANA (anti-nuclear antibody) suggestive of some form of autoimmune disorder or connective tissue disorder. Anti-Scl (scleroderma) positivity suggestive of scleroderma. But provide me your report as an attachment for giving more comment as I want to know reference range of anti-Scl 70 (anti-topoisomerase antibody) for that laboratory. For more information consult a general practitioner online --> </s>

<s>[INST] I did home insemination on friday around 11, we took all the proper procedures. I know it may be too early to tell, but my breast are sore, i ll be hungry, eat, get full and still want more a few hours or min later. My other half says i m hVaving mood swings. I noticed that I woke up twice lastnight to use the restroom, I was a little uncomfortable. The morning after insemination the lower part of my stomach hurt like I had held my urin forever! I have this pIn on my right side at times and I feel bloaded. I think it may come from me eating, but I m not sure. [/INST] Hi ! Even with all the precautions, there is always a chance for infection, and possibly it is a pelvic infection this time. This will give rise to pain in the lower abdomen. The soreness of the breast and feeling hungry might be a co incidental without any relation to this as it is too early to diagnose a pregnancy.Right side lower abdominal pain could be due to a co existing sub acute appendicitis, or salpingitis, or a urinary tract infection/calculi. If the syptoms persist, or increase your discomfort, I would suggest you to rather get yourself reviewed by your family physician.Wishing you an early recovery. </s>

<s>[INST] Hello doctor, I have been having constant moderate to severe headaches for the past four years, and I mean every single day, all day long, from the time I wake up to the time I fall asleep. Nothing OTC medicine has helped, nothing prescribed has helped. I have been told it is just a tension headache. I was prescribed a medicine but cant remember the name, it did not work. I had a CT scan done was told it came back clear. No one has been able to tell me why I have these headaches? It is getting me to where it is hard to function. I just cant take it anymore. I am waiting to see a specialist but not sure yet when that will be. The headache is not just on one spot, it is on my whole head, top of my head, the sides, my forehead, the back of my head, my neck, my eyes feel constantly strained, and my ears are always ringing. A doctor told me that my ears could be ringing if I take medicine on a daily basis. So far doctors could not figure out what it could be. Please help. [/INST] Hello. I would like to know some details about your headache. What is your age? Since when you started to have headaches? Is it four years only or even before that? Where do you feel that headache, in which areas of head? What kind of headache do you feel heavy, throbbing, stretching, bursting, shooting pain, electric current like pain, or some other kind? Is it severe, moderate or mild? Is your headache episodic or persistent? In episodic headache, how long time one episode of it lasts (from onset to complete relief without medication)? How frequent are these headache episodes before and now? Like how many times in a week? As you mentioned is it two times a week since beginning? Do you feel any vomiting or watering from eyes or redness in eyes or nasal congestion during headache? How is your day to day mood? How is your sleep and vision? Have you noticed any trigger factors for this headache? Do you have any ear discharge or hearing impairment? What medicines haveyou taken before and in what dosages? Are you taking any medicine now also? </s>

<s>[INST] i'm 55ys old with daily sexual intercourse. i have experienced few drops of blood in my breif coming from urethra.it was painless and infrequent,just 3 times over 40 days. it is not related to intercourse and i have no urinary symptoms.my ultrasound study showed enlarged prostate (vol. 32ml.) [/INST] Good day and thank you for being with healthcare magic! Blood in the urethra that is not related to sexual intercourse is worrisome for us urologist and you need to have a complete urological workup. The reason for this is blood In the urine and in the genitourinary system is a red flag for us we need to rule out cancer or malignancy. The more common condition that could cause this would be infection and stones in the urinary system but we have to rule out the most dreaded condition which is cancer. You need to have a urinalysis, and a ct urogram (CT SCAN with IV contrast of the abdomen) to check where the blood is coming from. IF those two comes out normal then a cystoscopy should be performed. Cystoscopy is inserting a scope in the bladder and looking inside to check the urethra, prostate and inside the bladder to rule out mass lesions inside and to determine where the blood is coming from. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: I would gladly help you. Best wishes. </s>

<s>[INST] hello dr I am a chronic back pain over 18 years deg disc and hurn disc I was told twice surg will do no good my old dr left and new doctor is taking my pain levels down way to far I don t have any quality of life im on opana 30 mil and 5mil oxy I was on more I do therapy ,back brace any answers [/INST] Hello, You can try Gabapentin which is quite effective for spine related problems that fail to respond with routine analgesics. If pain killers does not provide any relief, you can try steroid injection to spike which provide a pain free interval. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi doctor, Please suggest a good soap, lotion, or massage oil to improve the color. She is 3 months old. I already tried using pigeon soap, pigeon lotion, tedibar, Cetaphil lotion, olive oil. [/INST] Hello. As per evidence-based medicine, there is no such product which can improve color. In fact, it is not advisable to use any product which can or have an effect on skin color. For massage, any oil which suits the baby (coconut oil, olive oil) will do. The baby regains their original color by the age of 6 months. Every baby is unique and a genius in themselves. Focus on keeping her healthy. All other aspects are secondary. Happy to serve you. For more information consult a paediatrician online --> </s>

<s>[INST] Hello, i have had the mirena iud for about two years now... My periods have mostly been regular until recently.. They usually last 5 to 7 days and this time it only lasted 3 days... Ive also noticed that im fatigued throughout the day even during slow paced normal activities, i have alot of extra saliva (watery mouth), and for the past couple of days ive had tinderness in my nipples and a cloudy colored fluid leak out.. I took a pregnancy test and it came back negative. Should i wait a while and take another one or are these symptoms normal? [/INST] Hi,It is unlikely to be pregnancy. Please get serum beta hCG test done to confirm pregnancy. If not, just wait for few days during which you will feel fine.Regards </s>

<s>[INST] Hi my son was born with wet lung syndrome the doctor then told us he will have problems with his chest for a long time because of this, he has been sick since 2 weeks old. He has been diagnosed with asthma and allergies he has been hospitalized with broncho pneumonia, adenovirus and parainfluenza 3 and mycoplasma pneumonia. He has had grommets one due to wax that does not drain.he is always sick he has never been 100%. We have taken him to numerous peadiaticians and now we have to take him to a neurologist as his development is delayed. He had a ct scan at 8 months that was normal. Had EEG and reflux as well as heart test done not to mention all the chest X-rays. He is now 2. Why can I do to get him 100% thanks [/INST] Hi, I had gone through your question and understand your concerns. You should be worried but not too much. You may get back him to normal range.I see similar cases amongst young people who visit my clinic. In the first meeting, I advise my patients to go on lifestyle modifications for three months:- you should strictly follow hypoallergenic diet;- hypoallergenic environment;- absorbents to absorb allergens-Charcoal 1 tablet daily 10 days;- hepatoprotectors for cleaning liver -LIV 52 syrup 5ml twice a day,after 15 min before meal;-antihistamine if he has allergy now;-Vitamin D and Calcium;-proper diet:4 meals+fruits or fresh juice,meat,fish,egg;-walking 2 times for 2 hours in the morning and in the evening;-massage,exercise every day, development of speech.Start on these changes and get back to me in 2 to 3 months. Wish you and baby good health. </s>

<s>[INST] I have had bronchitis for about 3 weeks now, and I had severe coughing in which my chest hurt a lot.I felt it all around my rib cage, then on the right side, and now on the left side only.The severe coughing has stopped but when i lie down or apply pressure to the left side it still hurts a lot. could this be from coughing for so long? [/INST] Hi thanks for asking question.Here are few possibility regarding your chest pain.Mostly you have bronchitis that can be viral.And in viral infection muscular pain can occur as constitutional symptom.Symptomatic management done.Second ya because of excess coughing or heavy weight lifting muscular pain can occur.You can do your complete blood examination to differentiate viral from bacterial infection.If you have fever and pain increasing day by day then better to do chest x ray to see for consolidation as a cause of pneumonia.I hope my suggestion will help you.Wish you good health. </s>

<s>[INST] I had been on alt of medication for years and decided to stop taking it cold turkey. One of the medications was Plavix. I m not scheduled to see my doctor for a couple of months. So far I have not had any adverse symptoms. Am I taking a risk of recurring blood clots? I started on it 7 years ago after major surgery complications. It s just that I have had to take upwards of 20 pills everyday, and needed to see what affect not taking so much would have on my daily routine. It s been 3 days and I m functioning okay. What should I do? [/INST] Hello,the answer depends on important things, like why it was prescribed in the first place. If - for example - you had a coronary artery event or cerebrovascular disease then stopping it increases THE RISK of a new cardiovascular event. I've written RISK in capital to emphasize the fact that stopping plavix won't make any difference in symptoms or the way you feel. It just causes an increased risk for thrombosis (blood clots) which may cause the cardiovascular event. People with cardiovascular risk factors are already at increased risk for cardiovascular events, so if you're one of them, then plavix is - silently - protecting you.I hope you've found my answer helpful!If you'd like more information you can contact me again.Kind Regards! </s>

<s>[INST] my wife was prescribed noriday even though we have no sex She now stays in bed up to 22 hours a day in bed when she is home.She says it was for her acne is this possible? a I have found nothing on the internet to support this only that it can cause acne. [/INST] Hi....dear user., Thanks for choosing HCM., Noriday tablets .....are a type of hormonal contraceptive.... commonly known as the 'mini pill' or progestogen-only pill (POP)..... They contain the active ingredient norethisterone...., which is a synthetic progestogen....., similar to the natural progestogens...... The main sideeffects are.........Changes in menstrual bleeding, eg irregular bleeding..., or sometimes stopping of bleeding...., "Changes in sex drive ".Medicines and their possible side effects...., It can affect individual people in different ways. ..., The following are some of the side effects......, that are known to be associated with this medicine..., . Just because a side effect is stated here..., it does not mean that all people using this medicine will experience that or any side effect. Being hormonal drug ...no doubt it is comedogenic...produces ACNE...ok ...good luck </s>

<s>[INST] my 4mo old son just geiitng over rsv on nebuli abuterol ad amoxil for ear inf and a steroid for the bronc cords now is very hoarse never cries so he did not scream himself that way what can i do or should he se dr again he went yesterday n she secrease breathin treatments [/INST] Hello,By what you say, I feel that your kid might be having increasing respiratory distress. The kid might need medical attention.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani </s>

<s>[INST] I m a dance and aerobics trainer. I am now pregnant 2nd time after a gap of 6 years. How healthy will my pregnancy be? What are the precautions i should take? i have already low back tensions and aches. Should i b worried? [/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.Please do not worry.I would like to know your pregnancy duration, in terms of months or weeks.1] Even if there is a gap of 6 years , you need not be worried about present pregnancy. 2] About the precautions to be taken in this pregnancy- Indulge in routine exercise and healthy diet regimen.Avoid fried foods, Salty foods, refined sugars Include more portions of fruits, vegetables and salads in diet.Drink plenty of water. Please start on B 12, folic acid till 14 weeks of pregnancy and later on ass Iron, Calcium and Protein supplements.3] for low back ache, adopt right posture , avoid bending and lifting weights. Apply local analgesic ointments. 4] Once again, do not worry; all things will be fine.May God bless you with a Bundle of Joy.     I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam Neurgaonkar </s>

<s>[INST] Hello doctor, My last period date was 21st last month. I had unprotected sex on 20th last month and had taken an I-pill within two hours. Since the 6th of this month, I am having irregular bleeding which has been increasing. Is it a side effect of the pill? Is it implantation bleeding? I also have a history of ectopic pregnancy which had happened two and a half years back. [/INST] Hello. Emergency contraceptive pills are hormonal pills that can disturb cycles. Post pills, there could be withdrawal bleed and you can have unscheduled spotting, erratic bleeding, and irregular periods as well. For your satisfaction, I suggest having serum beta hCG (blood pregnancy test) and then to regulate cycles, you can have combined oral contraceptive pills cyclically for three months. In case of irregular periods for many months with abnormal hairs growth and sudden weight gain, it is better to have a transvaginal scan and blood sex hormonal tests on day-2 of periods. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] Hi doctor, My daughter is 20 months old and weighs 15 kg. She is a very active child. She was suffering from severe itching and rashes. The doctor diagnosed her with scabies. He prescribed HH mite cream for three days, and Atarax syrup 2.5 ml thrice a day. On the rash, he asked us to apply Flutivate cream at night time. It has been 15 days since the treatment was started. The itching and rashes have gone down, but she is still itching once in a while. Now, she started itching her motion area too. Can you please tell me if there are further tests to be done, or medicines to be changed? [/INST] Hello. Please continue the Atarax syrup (Hydroxyzine) only if there is itching. You can repeat HH mite cream (Permethrin) if itching is significant. It has to be applied to the whole body below the neck. Avoid the head, face, neck, anal and vaginal areas. Also, avoid regions where the skin is scratched. Over the scratched regions, you can apply Flutivate (Topical Fluticasone). Clip the nails of the baby, before the application, as the eggs of the scabies mites are generally present in the nails, which might cause a reinfection. Apply at night, and wash properly the next morning. All the family members should undergo the same treatment, even if they do not have symptoms. All the bed sheets and pillow covers and clothes of the family members should be washed separately. Fresh bedsheets or pillow covers should be used the next morning. I suggest you use HH mite soap (Permethrin topical), till complete recovery after this application. Itching may continue even for a week or two after HH mite application. So, if you have already followed the above procedure during your previous application, you can just use soap for now and wait for recovery. If you have not followed the above procedure, you can repeat the application of cream. For more information consult a paediatrician online --> </s>

<s>[INST] i had breathing problem (but not so frequent) from childhood.It was once in 6 month. Doctors called it is a kind of alergic brochitis. Now it has become so frequent from last 1 month. I consulted a doctor he also said it's kind of allergy.He prescribed me Montek LC PECEF duo to take.. He also prescribed me Asthalin(inhaler) to take when required. Now i am taking Montek LC everyday but i can't see any improvement . I have to use inhaler everyday atleast twice.. Feels like lotz of cough is inside. Do i need to stop Montek? What are the other solution to cure my disease. [/INST] u can use montelucast plain as long as you likebut according to my experience food protein is causig you problem milk and wheat get allery specialist consultation to get blood serum tests for specific anti bodies for milk wheat potato and other food you eat withdraw the food according to resul and you will have good results </s>

<s>[INST] Hi During my first pdelivery 3 years back I was diagonised with cholestesis (heavy itching in the 9th month) and hence had an C section..I remember my doc saying then that I need to take care when I take any birth control tablet. I would like to take an ipill today as I do not want to be pregnant..Is it safe for me to take it ? I am 31 years old 5 feet 2 inches and weighing around 65 kgs [/INST] HiCholestasis effect is due to the hormone estrogen. That is why your doctor rightly advised against using birth control tablets. When she said this she was talking with reference to birth control pills containing both estrogen and progesterone.The I PILL contains progesterone only. So you can use I PILL without worrying about cholestasis. Moreover the progesterone is washed off from your body in few days.If you wish to postpone pregnancy I advise you to discuss with your doctor and use regular contraception.I hope I have answered to your satisfaction. </s>

<s>[INST] Hello , I have 2 questions too ask you . I'm 15 years old and a male I have a straight spine , but my lower and upper back is hurting along my spine for no reason . I sometimes think it's because my body fat on my back , the 2nd question is when I breathe my back pops . Please I need a respond. [/INST] Hello, Back pain in young guy like you can be due to back muscle spasm. It occurs due to sudden movement of back either due to heavy weight lifting or sudden bending. You need to take muscle relaxant like Myospaz or Myoril. It will help you in pain relief. Also apply diclofenec ointment and warm water saline at your back. I would also assure you that any sound during back movement is normal if it is not associated with pain. It is mostly due to tendon movement or bone cracking. No need to be panic about this. </s>

<s>[INST] Hi doc im 26 years old and my legs are so bony compared to my upper body im so embarrassed with my legs at an angle in the mirror my hips go in as if the outline of my pelvic bone there s very little fat and when laying on my side when I lift up my leg I see no hamstring muscle my I can t leave my room because of my insecurities. Its so hard to go to work each day because I know every bodies looking at me and my upper body is so normal and full not fat average build with muscle and my legs are sticks with no butt at all im confused because I haven t. Always been like this when I was younger I was very normal and now I hate being me please help [/INST] HelloWelcome to HCMI have read your query and I want to bring some points for your understanding.Body weight and fat distribution in the body are genetically determined factors as one moves from one phase of life to other so does our body shape. Being genetically determined doesn't mean one cannot do anything about it.So my recommendation is to start an exercise programme and meticulously follow it. It's a slow step in developing the body to desired shape and the most fruitful one. For exercising different group of lower limb muscle either start at home work out or join a gym.Exercise will not only help your lower torso but also help in shaping upper body and will redistribute fat.Healthy foods- Dietary intake is of utmost importance since fast foods can lead to central or abdominal fat deposition which may further hamper your state. Intake of proteins is desired by the body during strengthening to build up new tissues.Be confident of yourself and carry yourself with attitude. It's something that matters most and above all. don't judge yourself by the eyes of others.Try out these above tips and forget what the world thinks about you. You are always welcomed by our team at HCM for any issueFor any further query/second opinion follow me at HCMRegardsDr.Sumit Chawla </s>

<s>[INST] Hi my name is Wanda ,Im trying to find a doctor who except medicated and help with very bad pain due to fibromalga and joint pain please someone help me please plus muscle locking and pain. I,m from Albany, Ga. even the surround areas in ga. a doctor I can trust plus be comforted [/INST] HiYou may take lyrica 75 mg twice a day for a week gradually increasing over following week to 200mg per day if tolerated well.Also take tramadol 100 mg twice a day and Amitriptyline at bed timeConsult in a fibromyalgia clinic or go to a rheumatologist for few tests for confirmation of diagnosis.fibromyalgia mostly affects soft tissues,rarely joints, so joint disease may be additional diagnosis which should be tested by blood arthritis profile </s>

<s>[INST] I had a wisdom tooth removed about a year ago and its been fine but recently I feel like the hole opened up. Its sore and feels like hamburger. I don't know what I did but chewing back there on accident makes it worse. I started swishing with salt water last night. Any advice? [/INST] Hello, Thank you for consulting with HCM.As you are mentioning that you got your wisdom tooth removed about 1 year ago, in that case the hole should not open again as the tooth is missing. But it can be possible that the tooth adjacent to the wisdom tooth might have become carious and now because of the infection of the root area , there is pus collection in gums which is now discharging from the gums.Or it can also be possible that there is a traumatic ulcer in the gums.For confirmation of diagnosis you have to visit a dentist and get an x-ray done of that area which will show the infection. And treatment will done accordingly.Hope it will help you. </s>